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A challenging age to have a hearing loss

Being an adolescent is a time of contradictions. No longer a child and not yet an adult, adolescence is the time when children want to establish their independence, find their own sense of style that sets them apart from the crowd while at the same time they do not want to be identified by their peer group for being ‘different’. Adolescents that have hearing loss typically have concerns that wearing hearing aids will make them seem different or that their peers may think that they are stupid because they need to wear hearing aids. Indeed, other children in school, their neighbourhood or people they do not know in the community may make these assumptions. For a teenager to be willing to wear hearing aids he needs to understand the critical importance to his future, and to be armed with the attitude and confidence to be among his peers while wearing hearing aids and not be affected by the casual flippant remark.

Understanding the realities of listening and learning with hearing loss

All parents want their children to excel academically, socially, and other ways that will build them a wonderfully successful future. Teenagers with hearing loss have just as much potential for success as those who do not have hearing loss. The difference is the barrier that hearing loss creates to accessing the sound in the world around them. It is very possible to take steps so that your teenager can indeed fulfill his or her potential in the world – but it takes action, understanding, consistency, and much support.

Always putting the puzzle together without all of the pieces
Although your teenager may seem to hear you pretty well at home (with and sometimes without their hearing aids), the world is far from always being quiet and communication usually does not happen face-to-face, especially in school where the foundation of your teenager’s future is formed. If you were able to see only 4 out of every 5 words on a page it is obvious that it would take you longer to figure out the content of what was written and that you may not be able to understand it all. Similarly, your teenager with a hearing loss is unable to hear all of the words or parts of words that the teacher is saying. Although it seems obvious, the teenager with hearing loss probably does not realise how much he does not hear or misses out of everyday conversations or classroom instruction. Your child’s audiologist can ask your teenager to repeat words in quiet and in low background noise, like what is typical in a classroom. This is one way to illustrate to him just how much the hearing loss is effecting everyday listening. It is natural for your teenager to struggle more than many of his classmates – he has to work harder to figure out what was said, before he can begin to understand the information. His brain is actually receiving less information and is not able to process the information as well. Hearing aids (and an FM system) will allow your teenager to hear more and process the information more completely with his brain, so learning will be easier and less tiring and grades will be better.

More hearing helps, but pieces are still missing
Children with mild hearing loss may be able to ‘fake it’ pretty well at home because they can hear most of the speech sounds in quiet and from a close distance, but school listening is still a sizable challenge. The greater the degree of hearing loss the less speech will be perceived and the harder it will be to ‘get by’ without amplification. Your teenager has his own hearing challenges and innate ability to cope. Regardless of how smart or resourceful, your child will be able to perform his best in school if he can clearly hear as much of the teacher instruction as possible – and to do that consistent use of hearing aids is necessary.

Hearing loss can show up when speaking
How clearly we hear speech sounds is something that we constantly monitor and adjust. If your teenager doesn’t hear all of the speech sounds then he cannot hear when he is not saying them right. This often leads to speech that sounds imprecise, or mushy.

Listening across distance is challenging
Because of difficulty listening across distance, your teenager may not hear a teacher’s question correctly and give the wrong answer. This is embarrassing! Your teenager’s hearing loss is obvious even without wearing hearing aids, only people will tend to think that he is not smart instead of that he may not be able to hear. Your teenager may think that the answer is to not talk in class or to people other than a few close friends but that still won’t keep people from wondering about him when he ‘slips’ or is required to talk. Wearing hearing technology is more honest and will be better understood and accepted by peers and teachers than the consequences of not wearing hearing aids.

Socialisation can be affected
When people talk about high school the part that is the most fun is the time spent with friends. Teenagers who hide their hearing loss tend to isolate themselves from others. They don’t join clubs or groups as often, go to sporting events or dances less frequently, or are so busy expending energy and worry about faking what they didn’t hear and covering up communication slips that they end up not fitting in. Sometimes when people with hearing loss hear only bits and parts of conversations they begin to worry that other people are talking about them. This causes even more reason to feel isolated.To be the fun person your teenager is, he needs to hear his best!

Harsh truth about future earning
People with hearing loss who try to ‘get by’ without hearing aids on average end up earning 50% less than people with hearing loss who wear hearing aids*. The choices made in middle and high school set the stage for success in the future. If your teenager does not wear hearing technology his or her grades will not be as good, opportunities for training after high school will be limited, ability to perform in a job may be affected if hearing, speech, and willingness to talk with others are less than what they could be if hearing aids were worn. Why should your teenager’s future be limited? Wouldn’t any technology that could boost future success by 50% be seen as an advantage?

Arming your teenager with confidence and attitude

The teenage years include turbulent pressures that adults may not always recognise. How children cope with these pressures and peer influence has much to do with their self-image and feelings that they are a well loved person with many qualities that make them worth acceptance by others.

Attitude is learned at home
Parents’ attitudes towards the hearing aids are critical. Parents who try to hide the hearing loss by insisting on the tiniest hearing technology as possible or by suggesting that the child not wear their hearing aids in all settings are communicating that they do not accept the hearing loss as part of their child’s life and future. No friend, teacher, or family member can undo a negative attitude about wearing hearing aids if that is what the teenager has learned at home. This sense of rejection of the hearing loss and hearing aids is usually internalised by the child as a rejection or dissatisfaction with themselves. A belief can grow within the child that they are less worthy of love or are a bad person because they have a hearing loss and in order to be more acceptable to family and others they need to hide their hearing loss and try to ‘pass’ as normal hearing or deny difficulties caused by the hearing loss. Parent attitudes that do not support the recognition of the hearing loss and the need for hearing aids almost always result in the child refusing to wear the hearing aids, thereby potentially having a negative lifelong effect.

An opportunity for individuality
Discovering individual style is part of what teenagers do. Eyebrow piercings, blue Mohawk hairdos, flashy clothes, jewelry, makeup, technology are all ways in which teenagers assert themselves as individuals. You and your teenager may not like the fact that he needs to use hearing aids but you have a choice in your attitude about the hearing aids. He can be fit with the smallest hearing aids or choose hearing aid cases the same colour as his hair hoping that the hearing aids and hearing loss will be invisible. It won’t be invisible. Or your teenager can pick bright coloured cases, neon swirled earmoulds, and even hearing aid decals or jewelry. Even the students with multiple ear piercings, distinctive clothes or jewelry will notice this technology and your teenager can impress them that he chooses to show them off and it gives him an ‘edge’ to learning.

Technology is cool
New communication devices and music technology is becoming available all the time. Today’s hearing aids are like a high end stereo system crossed with a sophisticated computer. Hearing aids can automatically focus in on sound from the front, have noise cancellation capability, or can switch so that the sound is heard better in the car, for music, or other programs tailored to the individual person’s listening situations. Having an FM system paired with the hearing aids is like a personal listening assistant – your teenager doesn’t have to hear through all the noise his classmates do to pick up the teacher’s voice from across the room. He can hear her as though she is talking right next to him.Hearing aids and FM are technologies that give your teenager an edge.

A shield of humour
Humour is necessary in all stages of life but especially when you are a teenager. Adolescents constantly make fun of one another, usually to pay special attention through teasing, but sometimes to degrade a person into feeling that they are less worthwhile than others. We all have control over our own feelings. We have control over our own reactions. How a person reacts in situations lets people know about their level of confidence and vulnerabilities. Everyone respects someone who will stand up for themselves and make others laugh. When asked “What are those things?” your teenager could say something like “I’m a spy and can’t tell you.” Use humour as a shield and a way to earn respect.

Encouraging consistent hearing aid use

Below are some ideas on how you can support your teenager’s compliance toward consistent use of hearing technology.

Enticements
Peer groups have more influence over a teenager’s sense of well being than parents. If a teenager’s circle of friends know about the hearing loss and realise that the hearing aids are necessary they can be a powerful support group and help to deflect negative remarks. A group of peers could be hosted for a special meal or event during which the teen, with the support of the parents, could show off the hearing technology. If your teen is a new hearing aid user, the first week of wearing the hearing technology (or teeth braces, an arm cast, or any other new and different ‘must do’) is the most difficult. A special reward at the end of the week to congratulate the teenager on making it through and something that also rewards the circle of friends for their ongoing support can be ideal.

Rewards
As with recognition of good grades, a long term recognition of use of the hearing aids is very helpful to reinforce continued daily wear and is good for the teen’s self esteem. For example, for each grading period that goes by without hesitation in wearing the hearing aids can be rewarded with an extra incentive (i.e., choice of music, movie). Your teenager is doing something above and beyond what his classmates have to deal with and his courage, perseverance, and commitment to his own future success is worthy of applause. Also, it is customary for a hearing evaluation to occur annually during which hearing aids can be recased with different colours and earmoulds can be remade. This could be at an added expense to the parent, but if possible would allow the teenager to change his or her ‘look’ as tastes change with maturation.

Discipline
It is not unreasonable for parents to pay for replacement or repair of hearing technology that appears to have been purposely lost or damaged – but only once. Just as with rewards, ways to encourage teens to follow through on what is best for them needs to be tailored to what an individual holds most dear and meaningful. Since the hearing technology is extremely expensive, perhaps it is reasonable to allow the teenager to enjoy favorite activities but make their continued enjoyment contingent on good amplification wear habits. Make it clear from the start just how much you as parents value the teenager wearing the hearing aids and keeping the hearing aids in good repair, and the consequence for willful neglect or damage. 

Hearing aids and choice

Every person must do some things that they would rather not do. Outside of building character, it is a fact of life. Consider the situation of a child who did not like to ride the school bus and deliberately was late for the bus pick up, then missed school because the parent had already left for their work. It is obviously unacceptable for the child to choose to miss school. Missing school affects grades, socialisation, and ultimately the child’s future. A child is NOT given a choice about whether they will attend school or not attend school. For a teenager with hearing loss, not wearing hearing aids means that they will miss part of each lecture, each assignment, each class, each social interaction, and overall each school day. Hearing loss has a substantial enough impact on the child’s school and future success - it is NOT appropriate that the teenager be able to choose whether to wear the hearing aids or not.

For almost all teenagers with hearing loss, wearing hearing technology is a prerequisite to performing their best in school. That said, your teenager gains more independence daily and you may find yourself at a point where, despite your insistence and attempts of behavioural control, your son or daughter will absolutely not wear the amplification. As a parent this is difficult as you are aware of the potential high cost of not hearing on your child’s future. Making the child’s teenage years miserable for the child and the harmony of the family comes at its own price. If you find that you have tried your best to influence your child’s hearing aid use without result, recognise that you are not alone. It is not uncommon for young people to reject their hearing aids for a while during secondary school due to turbulent teen pressures that adults may not recognise. Many return to wearing hearing technology after a while as they come to realise the importance of good grades on their future. Others choose a future path that can be accomplished without optimal hearing. Parents love, nurture, and provide as much guidance as possible, realising that children do not always make the choices they would prefer.

The parent’s role in helping their teenager navigate learning the skills to building a successful future takes patience, love, rules, and understanding. The teenager’s role as they move from late childhood into adulthood is to establish their sense of individual identity and develop the foundation skills and abilities that will allow them to be the best and most successful adult in the future. Hearing loss is a challenge to potential success that can be overcome by consistent use of hearing technology and extra attention on school progress and skill attainment. The end product – a wonderfully independent and self-sufficient adult – is worth it!


About Karen Anderson
Karen Anderson has worked in paediatric and educational audiology settings with families, early interventionists, teachers and children with hearing loss for over 25 years. She resides in Florida, USA with her family.


Information provided by Oticon. Reproduced with permission.
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15-Nov-2015 7:52 PM (AEST)