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Promoting Connectivity for Children with Hearing Loss

McCreery, Ryan PhD

doi: 10.1097/01.HJ.0000457008.01932.dd
Building Blocks

Dr. McCreery is associate director of audiology and staff scientist at Boys Town National Research Hospital in Omaha, NE.



With all the advances in hearing aid signal processing that have occurred in the last 15 years, professionals working with children who are hard of hearing can easily lose sight of the limitations hearing aids have in a wide range of everyday listening situations. Children live in the same noisy world as adults but often experience greater difficulty listening in background noise, with reverberation, or when multiple people are talking.



Hearing aids alone are unlikely to be sufficient for helping children function in these challenging environments. Fortunately, a wide range of available options can aid children in staying connected with their friends, families, and communities.

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Too often, frequency-modulation (FM) or remote-microphone (RM) hearing assistance technology (HAT) is one of the only options we consider for children who wear hearing aids. When we think of remote-microphone HAT for children, we often assume that these systems are primarily for educational use, to help children understand their teachers.

While there's no doubt that RM-HAT systems are important in classrooms, professionals and funding agencies recently have become aware of the potential benefits of these systems for infants and younger children in other environments.

Parents often report that remote-microphone HAT is useful for children of all ages in listening situations where hearing aids alone are insufficient to promote communication, such as listening in the car, during sports, or in crowded public places with lots of background noise or reverberation.

Although RM-HAT systems are incredibly important, there are a lot of other tools that also can help keep children connected.

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Advances in technology mean that we have more ways to communicate with each other now than ever before. Text and video messaging using computers and smartphones have replaced traditional modes of communication for some families, while others may not have access to this technology or prefer to use traditional phone communication.

Regardless of how the families we serve choose to communicate, our job is to provide children with the connectivity needed to accommodate those choices.

Even infants and toddlers may have the opportunity to connect with friends and relatives from long distances, so we shouldn't wait until the child asks us to figure out how to deliver the audio signal from a tablet or smartphone to the hearing aid. Make parents aware of the options that are available given their communication preferences.

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When fitting an infant with amplification for the first time, it's easy to forget that, with a little luck and a good orientation to care and maintenance for the parents, the child might be wearing those same hearing aids on the first day of kindergarten. As a result, we should anticipate not only the child's immediate connectivity requirements, but also the needs that will arise in the future.

While it's not possible to predict all the child's future needs, a questionnaire like the Developmental Index of Audition and Listening (DIAL) can be useful for surveying families about the listening situations in which their child may require additional connectivity.

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Connectivity should help promote the development of self-advocacy and independence for older children who wear hearing aids. As part of that goal, the hearing healthcare professional should make sure that adolescents have access to acoustic warning signals from home fire and carbon monoxide alarms if they will be home without their parents.

Solutions can be as simple as devices that provide visual warning signals or more advanced like computers, tablets, or smartphones set up to receive text warnings about severe weather or other emergencies.

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In public settings such as houses of worship, theaters, and museums, the availability and functioning of hearing assistance technologies can vary widely. Children who wear hearing aids will want to be able to hear and communicate in these situations.

The hearing healthcare professional should discuss the available options with children and their families and demonstrate the connectivity capabilities of the hearing aids. Problem solving may become necessary if there are particular venues or environments where auditory access is a significant challenge.

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As children get older, they may choose to play video games or communicate with friends online. While some of this communication may occur via text, audio communication is becoming increasingly available and important for children engaging with peers online.

Discussing options with children and their parents can help identify creative solutions that support online communication with computers or gaming systems. For example, earphones and headsets may need to be modified to function with hearing aids. One patient at our clinic rewired his own headset so that he could audio chat with friends online.

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Technology allows for a wider range of communication options, but these options in turn require an equally large number of potential solutions. Many technologies and listening environments were not designed with people who use amplification in mind.

Fortunately, professionals serving children who are hard of hearing and their families can help promote auditory access in a variety of environments and situations by providing information and acting as problem solvers and advocates.

With the technology and knowledge that we have at our disposal, children who wear hearing aids should be able to communicate with their friends and families in the same situations that their peers with normal hearing do.

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