Support Services Handout Series
Number 5005 Audiology Sheet
Hearing Aids: Strategies to Get Them Out of the Box and onto the Child

Initial Considerations:

Children can be fitted with a hearing aid as soon as hearing loss is diagnosed, as early as infancy. Each child should be evaluated and monitored to determine their benefit from a hearing, and their progress in using a hearing aid. Some children will accept use of the aid from the first day, while some will not accept the hearing aid without kicking, screaming and throwing a tantrum. Most children usually fall somewhere in between. Each child is different and will react and relate to a hearing aid in their own way. Finding the best way to encourage use of a hearing aid for a child will be different for each child and family.

A child's interest or lack of interest in using a hearing aid will depend on a variety of factors including a child's residual hearing level , degree of benefit from a hearing aid, developmental stage, disposition, and ability to adjust to new things in his/her environment (new shoes, new hat, etc..) Below are a few strategies that may be helpful in the journey of promoting a child's hearing aid acceptance and use.

If a Child Accepts a Hearing Aid:

• Encourage it's use as much as possible during the day. If a child willingly keeps on the aid, there is no reason to remove it except for comfort purposes at night or nap time, when the child is swimming or bathing, or perhaps when the child is in a situation where he/she can not be closely monitored for possible loss of the aid.
• When the child is ready to remove his/her hearing aid, have the child participate in the process of putting it away. Provide a clearly marked box for the aid to be placed for safekeeping. Place the box in an area where the child can learn to put it away independently.

If a Child Will Not Accept Putting on the Aid:

• Try to introduce the aid in a variety of situations. If the child will not accept it at one time or place, they may accept it at another time or place.
• If one family member is not successful in placing the aid on the child, have another family member try it.
• Play games with the child having him/her put the hearing aid on an adult, doll, or stuffed animal.
• Give the child an opportunity to look at and touch the aid. Place it on a table and let the child touch it and try to put it on himself/herself. (Then maybe he/she will let you help place it on them)
• Have a deaf adult with a hearing aid or other child in the class who wears a hearing aid act as a role model. Have them demonstrate how to put the aid on.

If a Child Willingly Accepts the Aid, But Only for a Short Time:

• Accept and praise the child for the amount of time they have kept the aid on. Slowly try to increase amount of time of aid use.
• Introduce the aid again at another time during the day.
• While the aid is on, try to introduce activities that involve listening (videos, cassette tapes/CDs, sound toys, pointing out sounds in the environment). Hopefully, as the child attaches meaning to sound, he/she will become less resistant to the hearing aid and keep it on for longer periods of time.
• Encourage aid use during times when the child is occupied with something else they enjoy or they are doing something that is keeping their hands busy. (eating, watching tv, playing a game)
• Set up a designated time ( length of tv show, meal time, etc..) for use of the aid where the child can see the beginning and end to the process. When appropriate for your child' s developmental level ,use a visual timer (egg timer, vibrating alarm, flash light)

If a Child Rejects Use of the Hearing Aid:

• It is up to the family to decide if, how, and when it is worth fighting the battle of getting the child to accept and keep the hearing aid on.
• Try to determine if there is a reason the child may be rejecting the aid using some of the strategies described below.
  • To determine if the child is having trouble adjusting to the earmold, introduce the earmold alone. Have child adjust to mold use alone. Having a mold in the ear for the first time is like having on shoes for the first time. It is a new experience and something a child may have to adjust to.
  • Once the child adjusts to the mold, put the hearing aid in place, but leave it in the off position. Have the child get used to the weight/placement of the aid/mold together, without sound.
  • When the child seems to accept the aid/mold with the aid in the off position, turn the aid on and to the specified volume. If a problem now emerges, you may suspect that the rejection is related to the sound.
  • If it appears that the child is bothered by the sound, adjust the aid's volume to a level where the child appears tolerant. Use it at this level until the child has an opportunity to adjust to sound. When the child appears to accept use of the aid at a low volume, attempt to turn the aid to the recommended volume and observe if similar discomfort returns.
  • If a child demonstrates discomfort directly related to sound, keep the aid at the accepted lower volume and contact the child's audiologist. This will provide helpful diagnostic information to the audiologist in the continuing process of determining your child's specific hearing levels and correctly fitting your child's hearing aid. The hearing aid may need further internal adjustments that can only be made by the audiologist.

If the Hearing Aid Will Not Stay on the Child's Ear:

• String style eyeglass holders can be attached to the hearing aid, and pinned to the child's shirt. If the aid falls off, it will stay with the child.
• Toupee tape (for hairpieces) or other double sided tape ( with mild adhesive) can be used to attach to the hearing aid and behind the child's ear.
• The hearing aid tone hook ( plastic ½ moon shaped piece that attaches to the earmold and the hearing aid) may need to be modified by the child's audiologist to a position that best hugs the child's ear.
• The tubing on the earmold may need to be cut to a length appropriate to best keep the aid in place. If the tube is too short or too long, it may cause an inappropriate fit and discomfort for the child.
• "Huggies" are a brand name device that help keep hearing aids in place on a child's ear. These circular plastic hearing aid attachments come in a variety of sizes and must be measured specific to a child's ear. Huggies can be ordered via most hearing aid dealers. Ask your child's audiologist about them, as they must be measured to fit each child.
• "Otoclip" is a lightweight plastic cord and clip that attaches easily to the child and the hearing aid so the aid will not be lost if it comes off of the child's ear. These clips can also be ordered as "critterclips" with animal clips that attach to the child's clothing. These clips can be ordered through most hearing aid dealers.

Things to Keep in Mind About Batteries:

• Hearing aid batteries can be harmful if they are swallowed or find their way to other places they do not belong ( in the nose, ears, etc...). Make sure you can account for your child's hearing aid batteries ( the batteries in the hearing aids as well as the batteries kept in storage or discarded) If your child swallows a battery, contact your physician immediately.
• For young children, battery compartment locks are available on most hearing aids. If your child's aid does not have a lock consider having one added.
• If you are using a hearing aid that does not have a lock, do not change hearing aid batteries in the presence of young children. If children see you changing a battery they may want to investigate it themselves.

Developed by: Debra Nussbaum, Audiologist, Kendall Demonstration Elementary School.

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