2026 Early Hearing Detection & Intervention Conference
March 15-17, 2026 • Jacksonville, FL
| When “Mild” Isn’t Minor: Case-Based Applications of SII in Pediatric Audiology
When “Mild” Isn’t Minor: Case-Based Applications of SII in Pediatric Audiology
Mild hearing loss is too often underestimated as inconsequential, yet both research and clinical practice demonstrate meaningful and lasting impacts. As described by Clark (1981) and utilized in clinical practice, mild hearing loss is classified by pure-tone thresholds between 26-40 dB HL. Far from benign, this degree of hearing loss can undermine the foundations of speech and language development while also diminishing access to the subtleties of communication, which include soft speech, speech at a distance, and speech in noise (WHO, 2019). Despite these conclusions, guidance has historically been inconsistent and amplification decisions variable, leaving clinicians without a clear framework for intervention. McCreery et al. (2020) advanced the field by leveraging the Speech Intelligibility Index (SII) to quantify unaided access to speech, linking scores of 80 or less with increased risk to language outcomes. Their recommendation reframed mild hearing loss not as “minimal,” but as a condition deserving proactive intervention. Building on this, Wiseman et al. (2025) broadened the role of SII beyond candidacy determination, showing its clinical utility across the continuum of care, from diagnosis to hearing aid verification to family counseling. This expansion has underscored the SII as a powerful tool for both science and practice. This presentation draws on three pediatric case studies from a large medical center to illustrate how adopting these guidelines has fundamentally reshaped our approach to managing “mild” hearing loss. Through these cases, we will move beyond thresholds and audiograms to highlight how SII provides families with a clear, evidence-based rationale for timely amplification. Attendees will leave with practical strategies to apply unaided and aided SII in their own settings in an effort to explain hearing results in accessible terms, set realistic expectations, and advocate effectively for early and appropriate care.
- Define the classification of mild hearing loss and summarize its documented impacts on speech, language, and communication in children.
- Apply unaided and aided Speech Intelligibility Index (SII) values to determine candidacy for amplification and guide counseling strategies.
- Integrate case-based evidence to support timely intervention and advocate for appropriate management of children with mild hearing loss.
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Presenters/Authors
Madison Muccino
(Primary Presenter,Co-Author), University of Miami Department of Otolaryngology, mxm194883@miami.edu;
Madison (Maddie) Muccino, AuD is currently a pediatric audiologist in the Children’s Hearing Program in the Division of Audiology in the Department of Otolaryngology at the University of Miami. She previously worked as an audiologist at the University of Maryland Medical Center. Dr. Muccino graduated with her Doctor of Audiology degree from Rush University in 2023 and a Bachelor of Science in Communication Sciences and Disorders from Springfield College in 2019. This is Dr. Muccino’s first time attending and presenting at EHDI! Dr. Muccino is passionate about advocating for early diagnosis and intervention of hearing loss in pediatric patients and is dedicated to counseling and supporting caregivers throughout the process.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exists.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
No relevant financial relationship exists.
Nonfinancial -
No relevant nonfinancial relationship exists.
Chrisanda Sanchez
(Co-Author), University of Miami Department of Otolaryngology, cmsanchez@med.miami.edu;
Dr. Chrisanda Sanchez is a bilingual pediatric audiologist at the University of Miami. She is an Associate Professor in the Department of Otolaryngology and the Director of the Children’s Hearing Program at the University of Miami. Dr. Sanchez’s clinical career has centered around pediatrics, specializing in pediatric cochlear implants, hearing aids, and other implantable devices. Her research focuses on improving access to hearing healthcare for Spanish speaking patients and implantable devices, specifically targeting pediatric device implantation and outcomes.
ASHA DISCLOSURE:
Financial -
• Receives Salary for Employment from University of Miami.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
Financial relationship with University of Miami.
Nature: Employed by UM.
Nonfinancial -
No relevant nonfinancial relationship exists.