Primary school

Your child has a mild hearing loss - What's the next step?

Source: Australian Hearing

Mild hearing loss is not always easily detected. A child may not show any symptoms until presented wit more difficult listening and communication situations such as a noisy classroom. Some children are initially referred due to parental or teacher concern. Others are detected via school screenings and parents may be surprised by the diagnosis.

When parents discover that their child has a hearing loss of any degree, they go through a range of emotions. People may react in different ways to the news and have different ways of coping. We know from experience that the diagnosis of a mild loss can be very upsetting for some families, whilst others are not affected so strongly. You are welcome to discuss any specific concerns you may have with your audiologist.

What do we know about the effects of a mild loss on children?

The impact of the hearing loss varies amongst individuals. Research has shown that some children experience little or no difficulties as a result of their hearing loss, while others may be affected in a number of ways. Some of these ways are:

Soft voices may be unclear
Voices may seem unclear, especially if the speaker has a soft voice or is some distance away.

Difficulty hearing in noisy environments
Hearing in noisy conditions can be more difficult with a mild hearing loss than with normal hearing. This may impact on how well a child hears in the classroom.

Delayed speech and language development
A hearing loss may result in a delay in development of speech and language.

Educational issues
According to research conducted in Nashville, USA in 1998, school-aged children with mild hearing loss have a higher risk for educational difficulties and academic delays¹.

Reduced self confidence
The same research shows children with mild hearing losses can have less self-confidence than children with normal hearing.

Increased listening effort
This may make children tired or irritable at the end of the school day.

Not all children have problems.A study undertaken on primary school – aged children in Australia in 2006 showed that children who had a slight or mild sensorineural hearing loss in both ears performed no differently from normally hearing children on a range of language, reading, behaviour and quality of life measures².

What can be done?

If your child has just been diagnosed with a mild hearing loss, there are many things to consider when deciding which course of action is best for your child and your family.

It is important to fit hearing aids very early in children with losses greater than 40 dB. Research has not yet shown the best approach to take for children with milder losses.

Talk to your audiologist about your personal concerns for your child’s hearing loss.

Communication strategies

All children can benefit from good communication strategies - you can start today.

Gain your child’s attention before speaking
Try to make sure that they are focused on listening before speaking to them.

Face your child when speaking
Ensure your child can see your face clearly. Speak normally. Don’t speak to your child from another room or at a distance. Keep your hands away from your face when speaking. Seeing your face will give your child extra clues if any speech sounds are missed. Encourage your child to look at you while you are speaking.

Limit excessive distracting noise where possible.
For example, turn the TV off or down or move to another room so it is not competing with your voice when you are speaking to your child.

Ensure you child’s teacher is aware of the hearing loss and implications in the classroom
This will allow the teacher to adopt appropriate strategies in the classroom to assist your child.

Amplification options

Some children may require more than just communication strategies. Amplification device options available include:

Hearing aids;
Personal FM system;
Soundfield amplification system.

The choice of rehabilitation option will depend on:

Effect of hearing loss at home and at school;
Child’s understanding of speech;
Child’s speech development;
Attitudes and concerns of parent, child and teacher; and
Support available.

Is your child experiencing problems at home as well as in the classroom? If so hearing aids may be the most appropriate option. If your child’s main concern is classroom performance, an FM or Soundfield amplification system may be a more appropriate option. Your audiologist will discuss your child’s test results and management options with you.

Will hearing aids help?

When children have a very mild hearing loss it is not easy to predict whether hearing aids will help. A hearing aid may help your child to hear quiet sounds and sounds coming from a distance. This could make it easier for your child to:

Learn from overhearing other people talking and interacting with each other.
Hear soft environmental sounds, to get more information about what’s happening around them.
Hear soft speech sounds (for example, f’, ‘s’, ‘th’) more easily. This should help them understand speech more easily and to learn to make these sounds in their own speech.
Listen to and understand conversations with less effort.

However, some children with a mild hearing loss find that a hearing aid does not overcome their biggest problem - hearing in background noise. Others find that the benefits of wearing a hearing aid are outweighed by the disadvantages such as having to wear something on their ear and look after the hearing aid.

Your audiologist may use parent, teacher or child questionnaires to help understand exactly how and when the hearing loss is affecting your child. You will be able to discuss the benefits and limitations of various device options.

Hearing aid acceptance

It is one thing for the audiologist to fit a personal hearing device and quite another matter for your child to wear it!

If you decide to proceed with amplification for your child then family support and support at school will be important factors in determining the success of the hearing aid or FM fitting.

What happens if we decide to use a hearing aid or personal FM system?

Children and young adults up to 21 years of age can obtain a high quality range of amplification options at no cost, through Australian Hearing’s program. There is also the option for families to purchase devices with non-standard features if they wish. Your audiologist will work through the options with you. A small annual maintenance fee is payable after your child has been fitted with the device.

What happens if we decide we don’t need an amplification device?

Your audiologist will discuss an appropriate management plan with you. For further information please see: Management of children who have a permanent unaided hearing Loss.

What happen if we want to get a Soundfield system?

Australian Hearing’s program does not provide Soundfield systems. However your audiologist can provide you with information about suppliers and about possible sources of funding support.

Can I change my mind?

Children’s needs and their attitudes to their hearing loss change over time, as do technological options, so it is a very good idea to review your situation periodically. You may choose to introduce or withdraw amplification in the future. There will be no cost involved if your child was fitted with a fully subsidised device. Your audiologist is always willing to help you with assessment, information and expert advice.

References:

Bess FH, Dodd-Murphy J, Parker RA (1998) Children with minimal sensorineural hearing loss: prevalence, educational performance and functional status. Ear & Hearing, 1998 October 19(5): 339 – 54
Wake M, Tobin S, Cone-Wesson B, Dahl HH M, Gillam L, McCormick L, Poulakis Z, Rickards F W, Saunders K, Ukoumunne O C, Williams J (2006), Slight/mild sensorineural hearing loss in children. Pediatrics 2006;118;1842-1851.