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Unilateral Hearing Loss The high rate of late hearing aid fitting and loss to follow-up among infants with unilateral hearing loss is not surprising given the lack of clear guidelines for management of these infants. On the one hand, JCIH recommends early intervention for all infants with hearing loss, including those with unilateral hearing loss. Guidelines for pediatric hearing aid fitting put forth by the American Academy of Audiology, however, are somewhat equivocal. The guidelines state that amplification is indicated for some children with unilateral hearing but goes on to say that the decision should be made on an individual basis and in consideration of the preferences of the family (ref AAA). Prevention of auditory deprivation and academic difficulties associated with unilateral hearing loss and providing the advantages of binaural hearing and are strong theoretical arguments in favor of amplification for the hearing impaired ear (McKay et al, 2008). However, there is a lack of research evidence that definitively demonstrates the benefits of amplification for these children. As a result, audiologists may be ambivalent about recommending a hearing aid for a unilaterally hearing impaired infant and may be less assertive in their recommendations than for infants with bilateral hearing loss. In a study involving interviews of parents of hearing impaired infants, McCracken et al. 2008 found that parents were uncomfortable when audiologists did not give clear and definitive recommendations regarding amplification. When audiologists give weak or inconclusive directives, parents may not perceive unilateral hearing loss as significantly affecting their child’s development and may not be convinced of the importance of follow-up and intervention.