Breaking the Stigma: 5 Tips For Treating Hearing Loss In Children
Hearing loss is a significant public health issue affecting approximately 20% of Americans. Despite its prevalence, there remains a certain stigma around this condition that leads to denial and misinformation. As an "invisible condition," hearing loss is easy to ignore, deny, or dismiss, yet the consequences of untreated adult-onset hearing loss are significant.
Understanding the Stigma Surrounding Hearing Loss
Hearing loss can have many causes, including genetics, noise exposure, and some medications. For many people, the first sign of hearing loss is difficulty detecting high-pitched sounds, which can impact their ability to hear on the phone, engage in conversations in busy settings like restaurants, or hear children's voices. Despite this, many people choose not to address the issue, assuming that their hearing loss is not severe enough to warrant a visit to a specialist.
However, this assumption is far from the truth. In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D. found that mild hearing loss doubled the risk of dementia.
Hearing loss can also contribute to social isolation, which can lead to a lack of contact with others, limit the number of fulfilling relationships, and increase the risk of addictions, depression, dementia, and even heart disease. As hearing loss worsens, it is not uncommon for individuals to avoid conversation, knowing that it will result in frustration or embarrassment.
It is staggering to consider that approximately 48 million Americans suffer from some level of hearing loss, with 60% of them either in the workforce or in educational settings. This means that they are likely struggling in their day-to-day activities. Despite this, only 1 in 7 wear hearing aids, and even fewer seek out alternative solutions such as assistive devices.
It is crucial for diagnostic and rehabilitative audiologists to understand the intricacies of treating hearing loss in children. By focusing on the five tips outlined in this article, audiologists can provide optimal care for babies, children, and their families.
Author: Jodi Little, Au.D.
Dr. Jodi Little is a native of Colorado and has over 20 years of experience in audiology. She has provided audiological services to both pediatric and adult patients in clinical and educational settings.
With the implementation of universal newborn hearing screening, childhood hearing loss is now being identified earlier than ever before. It is estimated that 1-6 out of 1000 newborns tested have some degree of hearing loss in one or both ears. While some hearing loss in children may not be evident at birth, it can be acquired later in childhood. Childhood hearing loss can be congenital, with or without a known genetic cause, or it can be secondary to an anatomical malformation, or conductive in nature, which is due to middle ear infections or other middle ear involvement.
Due to the increased difficulty in acquiring language that children with hearing loss may experience, audiologists have a professional obligation to ensure that hearing loss is treated quickly and appropriately. The following tips will help to ensure that children with hearing loss are properly diagnosed and professionally managed:
Early identification of childhood hearing loss is imperative as it can lead to language and learning delays if left untreated or undertreated. Research shows that infants who begin treatment by 6 months of age will reach language milestones on par with same-age peers. On the other hand, delayed identification and treatment can lead to significant language deficits and learning delays.
Initial hearing screening for infants should be performed using Evoked Potentials (ABR, AABR, BAER, ABAER), Evoked Otoacoustic Emissions (EOAE, OAE, TEOAE, DPOAE), or a combination of both test measures, as per specific state guidelines. Regardless of test methods performed, Audiologists need to act quickly with accurate diagnosis and treatment options.
To ensure a quiet and still baby during diagnostic appointments, Audiologists should attempt to schedule appointments during an infant's regular naptime. If working with a toddler or preschool child, a "bag of tricks" and unique, eye-catching toys can be used to keep the child's interest and attention focused in the sound booth.
Behavioral Response and Visual Response Audiometry should be used age-appropriately to obtain a child's first behavioral responses, always working to obtain ear-specific behavioral responses as soon as possible. Conditioned play audiometry can eventually be used to gain ear-specific responses.
The audiologist's job is to make the proper diagnosis and to present all treatment options to the family. Collaboration with an ENT/Otologist for medical clearance of amplification fitting and any medically based intervention is necessary. Treatment options are always based on parent communication preferences, which are selected based on the degree of hearing loss and communication preferences.
Depending on the type of hearing loss, several treatment options may be available, and parents must be counseled through the determination process, including the consideration of the mode of communication and treatment selected. Language input is critical, and language acquisition, whether oral or signed, is the primary goal for early intervention services. Introduction to sign language and/or aural stimulation must occur immediately upon diagnosis.
If oral/aural methods are chosen, it is important for the audiologist to have a good understanding of the pediatric fitting algorithms used by manufacturers and how to properly work through the programming settings to reach optimal prescriptive targets. It is recommended to order hearing aids with battery locks initially to ensure that the infant/child cannot remove a battery as it presents a significant health risk if a battery were to be swallowed. Most manufacturers offer a pediatric fitting kit for parents, which includes basic tools such as a listening tube, battery tester, and earmold dryer. The pediatric kits usually come with family-friendly literature, including instruction manuals and books designed specifically for young children.
It's essential to remember that a sleeping baby is an audiologist's best friend. Most testing, as well as earmold impressions, can be taken while the child sleeps. Specific test protocols are in place for cochlear implant candidacy and should be diligently followed.
An electroacoustic measurement system, such as Verifit, is critical for verifying any pediatric hearing aid fitting. Some insurance contracts may require proof of verification measurements for payment of claims. Verification measurements can also be used as a counseling tool to provide parents with confidence in their choice of audiology clinic and audiologists.
Verification requires RECD measurements for infants and young children. The key to verification is to work quickly and employ just the right distraction to help the child sit through the test measurements. The measurement can be completed in less than 5 minutes per ear, so it is important to prepare for the pediatric patient prior to the appointment time.
Pay particular attention to probe placement, as this ensures an accurate measurement. If the fitting curves look strange, check probe placement as well as for any obstruction with the probe microphone. Good toys and a parent willing to help keep the child occupied are all you need.
Consistent Follow-Up Care
Follow-up care is critical in the treatment of childhood hearing loss. Parental feedback is crucial for fine-tuning the initially fitted hearing instruments. Questionnaires such as the LittlEARS Auditory Questionnaire (Tsiakpini, et al., 2004) and the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) (Ching & Hill, 2005) have received excellent peer reviews and can provide audiologists with insight into the functional performance of babies/children with hearing loss in their natural home environment.
Through the use of parent-friendly questionnaires, audiologists can gain insight into their child's auditory behaviors. It is also important that children with hearing loss are connected to state and local agencies that can aid the family in accessing services instrumental to early intervention and/or monitoring of language and communication milestones.
Routine hearing aid checks are necessary to ensure proper fitting of both the devices and the earmolds, thereby ensuring that language milestones are met with age-expected outcomes.
Parent counseling and training are crucial aspects of treating children with hearing loss. Parents will have many questions when it comes to having their baby's hearing tested, and audiologists should carefully guide them through the diagnostic and rehabilitative phases to alleviate any fears.
When moving forward with amplification options, parents must fully understand the goals of the fitting and be committed to the implementation of the new devices. Online tools, such as hearing loss simulators and family-friendly activities that work through communication and amplification options, can be helpful for counseling.
Making the implementation of amplification usage as easy as possible for parents is key, as it can be initially overwhelming for some. Audiologists should take the time to work with families on how to manage hearing devices. Caregivers must learn how to check hearing aid or cochlear implant batteries, check for excess wax with proper instruction on cleaning and maintenance of the devices, and insert and remove earmolds.
Recommended home products for parents and caregivers include earmold lubricant for ease of insertion, a battery tester with training on how to use it, a listening stethoscope to perform regular listening checks, an earmold air blower to recognize condensation in earmolds, wax removal tools and how to use them, and a retention cord to prevent the device from getting lost. Clips are available in cute designs such as the Critter Clip. Other fun accessories, such as tube riders, colored tubing, casing, and ear hooks, have made a place for themselves in recent years. Home moisture solutions are also available and should be used to manage moisture.
Understanding and utilizing the 5 tips for treating hearing loss in children outlined in this article is crucial for successful treatment. Moving the treatment plan forward ensures optimal language and learning development for all children with hearing loss and shows that audiologists are doing the right thing for kids and their families.
Working with children presents many variables, but this article aims to be helpful in serving little ones and the families who come through the clinic doors. By providing comprehensive care, collaborating with other professionals, and communicating closely with parents, audiologists can make a significant difference in the lives of children with hearing loss.
How ADCO Can Help
ADCO's goal is to help individuals suffering from adult-onset hearing loss by overcoming the stigmas associated with it and finding solutions that work for their individual needs and financial situation. ADCO strives to help individuals with hearing loss to finally enjoy the sounds of life.
Every day, ADCO has the pleasure of speaking with new customers, finding solutions for their challenges, and better understanding the struggles that hearing loss can cause. While hearing aids are a great solution for many, they too carry a stigma of their own. To address this, ADCO encourages everyone to try out an assistive listening device, which can help you enjoy conversations, watch television, talk on the phone, or anything in between. Once you experience the difference this can make in your daily life, you may be more open to seeking out other solutions to help you overcome the burden of hearing loss.
If you are located in the Denver area and would like to better understand your hearing loss, ADCO offers a FREE basic hearing screening in our store. However, if you are located elsewhere, we encourage you to speak with one of our product experts. Regardless of your location, ADCO can help you find the right solution if you or a loved one are struggling with hearing loss.
Additional Audiology Resources
- 10 Must-Have Products For Your New Audiology Practice
- 5 Tips For Treating Hearing Loss in Children
- How to Develop a Deeper Understanding of Your Audiology Patient
- How to Create a Better Patient Experience At Your Audiology Practice
- 7 Questions Parents Ask About Hearing Aids
More About the Author
Dr. Little is a passionate audiologist who enjoys all phases of the diagnostic and rehabilitative process and finds unique solutions to communication challenges for her patients. She is also passionate about hearing conservation and is a sought-after speaker on the topic of hearing loss in the dental field.
Dr. Little earned a Master of Science from Portland State University in 1994 and a clinical doctorate in Audiology from the Arizona School of Health Sciences in 2002.In her free time, Dr. Little enjoys playing tennis and spending time with her husband, children, and extended family. Her dedication to her profession and her patients is evident in her work, and she is committed to making a difference in the lives of those with hearing loss.