If hearing aids are recommended for your child, you will most likely have many questions about their appearance, function, and cost. Selecting the right hearing instrument requires the assistance of an experienced pediatric audiologist. The audiologist will be able to recommend the device that best suits your child’s needs and preferences. And while selecting the right hearing aid for your child is a serious process that requires active participation from you as a parent, it can also be a fun and exciting time for you and your child.
Hearing aid consultations at the Center are free of charge. You will need to bring past hearing tests and records, and your child’s attendance is usually required. We encourage parents to allow older children to be active participants in the consult, as this is an empowering part of the process that gives your child ownership over their hearing loss.
We also understand that cost is of great concern, as hearing aids are very expensive. Most insurance companies do not cover the cost of hearing aids, although some plans do offer benefits for children. We will help you figure out options for payment and even refer you for state coverage or other programs when appropriate.
How Hearing Aids Work
Hearing aids consist of three major components: a microphone (picks up sound waves and transforms them into electrical signals) an amplifier (modifies and amplifies those electrical signals) and a receiver (changes the modified electrical signals back into acoustic signals, which the wearer hears). Today’s hearing aids are completely digital and programmable. The audiologist uses a computer to set a prescription for the hearing aids based off of your child’s hearing test results and unique needs. The Center audiologists provide fitting and programming of these major hearing aid manufacturers’ instruments: Oticon, Phonak, ReSound, Starky, Unitron, and Widex.
Styles of Hearing Instruments
There are two basic styles of hearing instruments; those that sit “behind-the-ear” (BTE), and those that sit “inside-the-ear” (ITE). BTE hearing aids are suitable for every kind of hearing loss, from mild to profound. The amplified sounds pass through a clear plastic tube into an ear mold, which is custom-made to fit the child’s ear, so that it looks and feels just right. BTE instruments are slim and fit neatly behind the ear. They are available in several colors to closely match the color of hair or skin, as well as bright, fun colors, which are very popular with children.
BTE hearing aids are most often recommended for children because they are sturdy, not limited to the size of the child’s ear canal, and can connect with additional technologies, like a personal FM system (more on this below).
ITE hearing aids are custom-made to be worn inside the ear, and are usually recommended for mild to moderate hearing losses. ITE devices come in several sizes, but they are not usually recommended for young children, because their ear canals are too small and are still growing. However, if they are suitable for the degree of your child’s hearing loss, he or she can typically wear them from age 10 years onwards.
There are also hearing aids for children who are unable to use either BTE or ITE hearing aids because of conditions known as atresia (absence of the ear canal) or microtia (very small or absent outer ear).
Because these children most often have normal inner ears, their hearing loss is considered conductive, and they require a hearing instrument that can bypass the middle and outer ears. These devices are known as bone conduction hearing aids and are worn either on the forehead or the area behind the ear called the mastoid. They are held in place by a soft band with considerations for surgical implantation in later childhood.
The Center audiologists are experienced in fitting and programming the major pediatric bone conduction devices, the BAHA and the Ponto.
Hearing Aid Verification
Hearing aids usually require much more follow up and adjustment than, say, eyeglasses do. The audiologist will work to ensure that the hearing aids are programmed so that speech is audible and comfortable over a range of input levels (i.e., soft speech to very loud speech). This is done by placing a microphone in the child’s ear canal to actually measure the hearing aid’s response to such signals.
The audiologist might also repeat a hearing test in the sound booth while the child is wearing the hearing aid. Additionally, parents and teachers might be asked to complete questionnaires comparing the child’s listening behaviors pre- and post-hearing aid fitting in order to assess hearing aid benefit.
All of these procedures are an important part of ensuring that the the hearing aids are doing what they are intended to do – either make speech audible and comfortable for your child, or give your child sound awareness for safety purposes!
What Are Cochlear Implants?
Some children with severe to profound hearing loss or auditory neuropathy/dys-synchrony will receive little speech understanding benefit from hearing aids. In these cases, children may be referred to a cochlear implant team for assessment. A cochlear implant is an advanced, surgically placed device which picks up sound waves and transforms them into electrical pulses that are delivered directly to the auditory nerve. While cochlear implants do not restore hearing, when combined with specialized communication training, they may help your child develop spoken language.
Before they can even be considered, a whole range of medical criteria must be fulfilled. Through a partnership with UCSF, the Hearing and Speech Center offers a program called Cochlear Implant Interconnect to help families through the process. The the American Speech-Language Association Cochlear Implants page offers detailed information on what cochlear implants are and how they work. Cochlear implants are not appropriate for all children and there are bioethical questions surrounding their use. The Laurent Clerc National Deaf Education Center at Gallaudet University provides an excellent clearinghouse of information through their Cochlear Implant Education Center site.
Please note that while the Center provides comprehensive hearing aid services, we are not a cochlear implant assessment or service clinic. Our pediatric audiologists can talk to you about cochlear implants, but for assessment you will be referred to another facility in the Bay Area, such as UCSF or Stanford.
Your child’s hearing instruments are the first step to better hearing. But in noisy environments, particularly the classroom, a personal FM (Frequency Modulated) system can greatly improve your child’s listening and learning experience. Classrooms are difficult listening environments even for children with normal hearing. This is partly because the teacher’s voice has to carry a long way, but is mostly due to background noise – feet shuffling, chairs moving around, students talking, papers rustling.
Additionally, many classrooms have poor acoustics because of the lack of sound-absorbing materials on the floor, walls, and ceilings. A personal FM system is composed of a microphone and transmitting device, worn by the teacher, and a receiver, worn by your child and coupled to their hearing aids. Your child still hears everything as usual through their hearing aids, but the teacher’s voice (and therefore lesson) is heard at a level louder and clearer than all of the background noise.
Public schools are responsible for ensuring your child has access to an FM system in the classroom, but many families also opt to purchase one for home and personal use. There are many variations and possible set-ups when it comes to FM, which your child’s audiologist can discuss with you.
Hearing Aid Accessories
Today’s hearing aids are capable of connecting to cell phones, personal music players, gaming devices, computers, televisions, and so forth. This means that children with hearing loss can turn their hearing aids into their personal headsets! These interfacing “streaming” devices use cables or Bluetooth technology to grant children with hearing aids access to any audio signal. Your child’s audiologist can tell you more about these devices, which range in price and function.
Other hearing aid accessories include items for care and cleaning, retention cords, sweatbands, decals and stickers, and charms and letters that connect to ear mold tubing. There are many options out there to make wearing hearing aids fun!