Parent guidance

Parent guidance

We hope that by now you feel more informed and prepared to address your child’s hearing concerns. If you have any doubts about his or her hearing, we strongly recommend that you have his or her hearing tested as soon as possible to avoid complications with language abilities. Finding a solution quickly also increases your child’s success with hearing instruments, and helps prevent the emotional and social difficulties related to hearing loss.To help you and your child through this journey, the following pages include a detailed plan that will guide you through every step of the way. You will also find a list of suggested questions to ask your child’s Hearing Care Professional that will help you find the best solution for your child.

Adjusting to his or her hearing impairment and instruments may at first take your child some patience and practice. In case you need some support, we’ve also included helpful tips on how to communicate with and encourage your child. For parents of school-aged children, there is an important section on education, as well as a guide for your child’s teachers.


Planning your child’s treatment

Below is a detailed guide for the treatment of your child’s hearing impairment.

Find a licensed, reputable Pediatric Hearing Care Professional

This could be an audiologist, hearing instrument practitioner, otolaryngologist or an otologist, who is specialised in treating children. Most offer the hearing test at no cost, so check beforehand. If you need help finding one close to you, please click here .

Make an appointment for your child’s hearing test

The Hearing Care Professional will examine your child’s ears for possible physical causes of hearing loss like excessive wax build-up or an infection. A hearing test will also be performed to measure his or her ability to detect sounds at various frequencies or pitches. The entire process usually takes about an hour. It doesn’t hurt and will help the Hearing Care Professional find a solution to suit your child’s particular needs. Don’t hesitate to ask questions and encourage your child to be as open and relaxed as possible. The more the Hearing Care Specialist knows about your child, the more successful the outcome.

Choose your child’s hearing instrument

Depending on the test results, the Hearing Care Professional will give you a recommendation of hearing solutions best suited to your child’s hearing and personal needs. Feel free to do your own research as well on the solutions available and perhaps compare prices at other Hearing Instrument Specialist stores. You may also want to check with your health insurance to find out how much of the costs will be covered. The Hearing Care Professional knows what your child needs best, but you will make the ultimate decision together with your child. It is important and beneficial to involve your child in this process.

Have your child’s ear impression made

If your child will be receiving a hearing instrument, then he or she will be scheduled for an ear impression, which is an exact duplicate of the contours of the ears. The ear impression is sent to hearing instrument manufacturers to make custom earmolds for coupling the hearing instruments to the ear. Usually, this only takes a few days.

Schedule your child’s fitting

The next appointment will be for the Hearing Care Professional to optimally adjust your child’s hearing instrument. The adjustments are normally done with a computer, based on an audiogram, and on your child’s reactions or comments, depending on age and speech development. The audiologist will teach you and your child how to operate the hearing instrument, and how to hear best in different environments. If your child is young, then you will practice inserting and removing his or her hearing instruments and learn how to clean and care for them. Older children will be taught to take responsibility of these steps themselves.

Follow up visit(s)

Your child will be asked to wear the new hearing instruments for a few days in his or her regular surroundings. You (or your child, if older) may want to keep a diary to record your child’s impressions of the sounds she or he hears. Based upon how well your child can hear in everyday surroundings, the Hearing Health Care Professional may make additional adjustments to the hearing instruments if necessary.

Help your child learn to enjoy sound again

Learning to listen with hearing instruments takes time and a degree of patience in the beginning. It‘s also important to be realistic and not to expect 100-percent hearing in every situation. If your child is older, starting from about 12 years of age, he or she has the additional support of eARena , an interactive auditory training DVD, which will help your child adapt to and enjoy the hearing system in the least possible time.

Questions to ask your Hearing Care Professional

The following is a list of questions for parents and carers to ask the Hearing Care Professional to ensure an optimal fitting process for the child.

Are the hearing instruments BTE devices, and are they specially recommended for the child’s age?

There are different types of hearing instruments on the market, for different types of hearing loss as well as for different age groups. The hearing instruments you select should meet the child-specific requirements regarding safety, cosmetics and required audiological features. Not all instruments are intended for pediatric use.

Do(es) the hearing instrument(s) possess a direct audio input (DAI)?

A DAI is necessary for linking the hearing instrument/s to an FM systems, a wireless transmission system that is mostly used in schools and especially in difficult, noisy listening environments to improve speech intelligibility.

What about the costs for the hearing instruments and the fitting?

Does the health insurance pay the costs, and how much do you have to pay for the hearing instruments and the accessories yourself? Are hearing instrument batteries included or do you have to buy them separately?

Is it possible to have an early interventionist see the child?

An early interventionist is a specialist who visits the child on a regular basis, playing and exercising with him or her. He or she also trains parents to support listening development and gives hints and tips for everyday life.

Are there any child-specific accessories available?

Child-specific accessories might for example be a clip to attach the instruments to the child’s clothes to avoid getting lost, or a maintenance kit with accessories to help keep the instruments clean and working.

How about colors?

Children enjoy lively, playful colors. A hearing instrument in the child’s favorite color is easier to accept. Colorful stickers help to personalize the hearing instruments and support psychological ownership.

Troubleshooting

You should contact your Hearing Care Professional for answers to any other questions. Your Hearing Care Professional can provide counseling for your child and family whenever the need arises.

The hearing instrument does NOT whistle when you hold it in your hand (only applicable if hearing instrument does not have an automatic feedback reduction system)
Check:

  • Is the hearing instrument switched on?
  • Is the volume control in the right position?
  • Is the battery’s power sufficient?
  • Is the earmold blocked with dirt or earwax?
  • Have you selected the right listening program? (For example, programs designed specifically for telephone use will not allow you to hear any whistling when the instrument is held in the hand.)
  • Is the hearing instrument damaged?

The hearing instrument whistles while your child is wearing it.
Check:

  • Is the earmold inserted correctly?
  • Is the volume control in the right position?
  • Is there any crack in the earmold tubing or ear hook?
  • Is there too much earwax in your child’s ear canal?
  • Is the earmold too small, because of physical changes in the ear canal?
  • Is the earmold tubing connected well to the earmold and the hook?
  • Is the hook or tube damaged?
  • Is the child leaning against a flat surface, blocking the microphone? (E.g. infant in car seat)

The hearing instrument is dead.
Check:

  • Is the battery flat?
  • Is the battery inserted correctly?
  • Is the hearing instrument turned on?
  • Is there any corrosion on the battery or the battery contact area?
  • Is the earmold blocked with earwax?
  • Is the earmold tubing blocked?
  • Are there water droplets in the ear hook?

Your child says the hearing instrument isn’t working properly.
Check:

  • Is the volume control in the right position?
  • Is the opening to the microphone blocked with dirt or dust?
  • Is the battery flat?
  • Is the earmold blocked with earwax or dirt?
  • Is there too much earwax in your child’s ear canal?
  • Is the hearing instrument damaged?
  • Are both the hook and the tube dry?
  • Connect the stethoset and check if the hearing instrument still works, and/or if you can hear unusual sounds.

The hearing instrument generates distortion and/or unusual sounds (like crackling).
Check:

  • Is there corrosion or rust on the battery or inside the battery compartment?
  • Is the battery inserted properly in its compartment?
  • Is the on-off switch at the correct position?
  • Is the volume control in the right position?
  • Is the earmold blocked?
  • Are there water droplets in the ear hook or earmold tube?
  • Is the earmold fitted correctly?

Communication tips

What you can do to help your child listen better

  • Gain your child’s attention before speaking. Call your child’s name or signal to your child. Make sure that you have your child’s attention (e.g. eye contact) before speaking.
  • Stand close and keep still when speaking. Standing near and keeping still at the child’s eye level helps him or her hear better and be less distracted by movements.
  • Face your child. Stand close and face your child when speaking. Looking at your facial expressions and lip movements can help your child understand better.
  • Speak in a clear and audible tone of voice. Speak slowly and use simple words and sentences to your child. Gesturing may be helpful.
  • Give clear, unambiguous instructions. Use simple sentences and make all instructions clear and concise.
  • Check for understanding. Make sure that your child understands what is being said. Observe his or her facial expression. Alternatively, ask your child to rephrase or repeat given instructions.
  • Allow your child some time before responding to your questions. Be patient and positive: an anxious and self-conscious child will experience even more difficulties thinking of replies to questions.
  • Be positive and encouraging. Be sensitive to your child’s feelings and give praise generously. Be positive about your child’s learning and celebrate all progress made, no matter how small.

Compensatory strategies

  • For an older child, you can teach your child to self-monitor and regulate his or her own listening. Your child should recognize firstly that he/she can make a difference in his/her own listening.
  • Face the speaker. Encourage your child to face the speaker, maintain eye contact and keep attention on the speaker.
  • Problem solving. Encourage your child to identify situations where he/she has difficulties listening (e.g. in the canteen) and think of possible solutions to improve his/her listening (e.g. move to a quieter corner).

Encouragement

Introducing hearing instruments to a young child for the first time can be challenging. While some children accept their hearing instruments easily, others may not. Here are some suggestions that will help your child accept his or her hearing instruments.

Getting your child to wear hearing aids

  • Establish the wearing of hearing instruments as part of the dressing routine. To help children get used to wearing their hearing instruments, integrate it into their daily dressing routine. Put on the hearing instruments when your child is awake and take them off at bedtime.
  • Be in control. With a young child, establish the understanding that you will be the one putting on and taking off the hearing instruments.
  • Make it fun for the child. Make the wearing of the hearing instruments fun and interesting for your child. Your Hearing Care Professional may be able to provide you with a dummy hearing instrument. Put the dummy hearing instrument on your ears and show your child how it looks. Praise your child when he or she puts it on. Wear the dummy hearing instrument with your child so that your child does not feel alone.
  • Make it a special day. When your child puts on the hearing instruments for the first time, declare that day a special one. Do something special with your child (e.g. go to the park to play).
  • Distract your child with toys. Allow your child to play with their favorite toy when you are putting on the hearing instrument.
  • Special time. Make the wearing of hearing instruments a special time for your child. Allow them to have a cookie or do something special (e.g. color a star).
  • Personalize the hearing instrument. Establish a sense of ownership. Allow your child to select his or her preferred color of hearing instruments and choose stickers to decorate it.
  • Use a lubricant. Soft earmolds are usually recommended for young children. A lubricant can help with the inserting of soft earmolds into your child’s small ears. Consult your Hearing Care Professional for a suitable lubricant.
  • Explain to the child the need for it. Read ‘Annie hears her world’ to explain to your child the need for wearing the hearing instruments.
  • Slowly increase the length of wearing time. Your child might need a period of adjustment to the hearing instruments. He or she needs to learn to hear with the hearing instruments. If required, slowly increase the length of wearing time over a week. And if your child is wearing the hearing instruments only for a certain period of time each day, have the hearing instruments on when you are spending time interacting with your child.

When your child says I do not want them

  • Stay calm, be gentle but firm. If your child keeps pulling out the hearing instruments, stay calm and gently but firmly put it back on. If your child immediately pulls it off again, wait for a while before putting it back.
  • Reward chart. Children love rewards and praise. Use a reward chart to encourage your child to wear the hearing instruments. Negotiate the reward. Record on the chart when your child wears the hearing instruments for a desired length of time each day. At the end of a week, the child may have his or her reward.
  • Look for other reasons. If your child persists in pulling out the hearing instruments, he or she may be telling you ‘Mummy, the sound is too loud’ or ‘The earmolds hurt’. Check the volume control and look at the child’s ear for signs of discomfort. Do the ears look red? Are there sore spots? Is the earmold too tight for your child? If so, please consult your child’s Hearing Care Professional.

Preparing for your child’s education

When your child reaches school age, you will be faced with decisions about their education. Look to your Hearing Care Professional for support and advice. You may also contact your local Education Department for information concerning suitable schools.

Contact suitable schools and take time to talk to the teachers. Here are some questions that you may ask:

  • Does the school have experience supporting children with hearing loss?
  • Does the school have special support teachers for children with hearing loss?
  • How many children with hearing loss are there in the school?

Tips for teachers

What you can do to help your student listen better

  • Provide preferential seating. Have the child seated away from adverse noise conditions. Provide the child with better visual and auditory access to the teacher.
  • Improve acoustic quality in classroom. Reduce echo and unwanted background noises such as chair shuffling in the classroom, by having wall to wall carpeting, acoustic ceiling tiles, thick curtains and foam baffles to absorb these background noises.
  • Provide lecture notes prior to lessons. Provide lecture notes in advance. The child can become familiar with new topics before a lesson. This allows the child to focus on his/her listening.
  • Provide a personal FM amplification system. Personal FM systems deliver the teachers’ voice to the child’s ears above the noise level and unaffected by distance.
  • Complement verbal explanations with visual cues. Pictures, graphs and illustrations can be helpful in reinforcing auditory information.
  • Gain your student’s attention before speaking. Call the child’s name or signal to the child. Make sure that you have the child’s attention (e.g. eye contact) before speaking.
  • Stand close and keep still when speaking. Standing near and keeping still at the child’s eye level helps him/her hear better and be less distracted by movements.
  • Speak in a clear and audible tone of voice. Speak slowly and use simple words and sentences to the child. Gesturing may be helpful.
  • Give clear, unambiguous instructions. Use simple sentences and make all instructions clear and concise.
  • Check for understanding. Make sure that the child understands what is being said. Observe his/her facial expression. Alternatively, ask the child to rephrase or repeat given instructions.
  • Allow the child some time before responding to your questions. Be patient and positive: an anxious and self-conscious child will experience even more difficulties thinking of replies to questions.