So Your Child Has a Hearing Loss: Next Steps for Parents
Types of Hearing Aids
There are three main types of hearing aids. Behind-the-ear hearing aids are used most frequently in infants and children.
- Behind the ear (BTE) hearing aids,
not surprisingly, fit behind your child's ear. They are frequently used
with pediatric patients as they tend to be most compatible with the
physical characteristics of infants and young children. Additionally, a
mini-FM system can be used in combination with BTEs to improve a
child's ability to hear speech. BTEs are connected to earmolds, which
are pieces of soft plastic custom-made to fit your child's ear.
Earmolds help keep the hearing aid in place and provide the channel
through which sound is delivered into the ear canals. As with clothing
and shoes, children do outgrow their earmolds and will need to have
them replaced once or twice per year. Infants' earmolds, however, will
need to be replaced about once every two months due to your child's
rapid growth across his or her first year. One symptom of children
outgrowing their earmolds is the presence of "acoustic feedback". When
the earmold isn't fitting well, sound will be able to escape the ear
canal and will be re-amplified by the hearing aid microphone, producing
feedback in the form of a high-pitched squealing sound.
- In the ear (ITE) hearing aids fit
completely in the outer ear. The case, which holds the components, is
made of plastic and must be replaced as the ear grows. For this reason,
ITE aids are not used frequently with young children. This style of
hearing aid is used most frequently for those with mild to severe
hearing losses.
- In the canal (ITC) hearing aids fit
into the ear canal and are customized to fit the size and shape of the
user's ear canal. Like ITE aids, ITC aids must be replaced as the ear
grows and, as a result, are not often selected for pediatric use. Like
ITE aids, ITC aids are employed most frequently for mild to moderately
severe hearing loss. The small size of both ITE and ITC aids make them
difficult to adjust and/or to remove for young children.
- On the horizon: Implantable hearing aids
(IHAs) comprise both bone-anchored hearing aids (BAHAs) and middle ear
implants (MEIs). A BAHA is useful for those with either congenital
atresia of the ear canal or chronic middle ear dysfunction (typically
chronic otitis media) that prevents the optimal use of conventional
hearing aids. Many of the candidates for a BAHA are those who have used
bone conductors worn on the scalp with a spring-loaded device that
exerts pressure on the skin. The BAHA offers a level of sensitive
hearing not achievable with these conventional bone conductors. The FDA
has approved the use of BAHAs for all age groups, including children as
young as 2 years. The long-term experience with use of the BAHA in
Sweden and England suggests that the device may be a preferred
alternative to surgery to open the ear canal or repair the middle ear
mechanism, particularly in children with the Treacher-Collins or
Goldenhaar syndrome. MEIs are used for persons with purely
sensorineural hearing losses.
Parents' Hearing Aid Survival Kit
- Hearing aid battery tester-to check the battery level each day
- Hearing aid stethoscope-to perform a daily listening check
- Forced-air stethoscope-to remove moisture and ear wax from the sound channel of the earmold
- Hearing aid dehumidifier-to store hearing aids overnight
- Earmold lubricant-to facilitate earmold insertion and reduce the likelihood of acoustic feedback
- Earmold disinfectant-to keep your child's ears healthy and happy!
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Patient Education