Hearing Loss in Your Child: Communication and Assistive Listening Devices

Hearing Loss in Your Child: Communication and Assistive Listening Devices

Communication Decision

One of the most difficult decisions that you might have to make for your child would be the method of communication that he/she would use. The choices vary from the Aural-oral which relies totally on normal spoken language to Sign language that is a language that uses visual hand signs only. Other communication methods that are in between these two choices would include Total Communication and Cued Speech.

No single approach would work with all children. Thus, a thorough discussion with your audiologist and speech language pathologist would help you decide the primary communication method your child would use.

Visits to centers where these particular methods are taught before deciding would also help. A good audiologist would never presume to suggest the best option for your child. Instead, he would provide you with all the information you require to decide the best option for your child and your family.

sign-language

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Communication method chosen would also bear an important impact on your child’s school placement when he is older. A child with hearing impairment with good amplification and acquisition of speech and language can be considered to be placed in normal schools. Others might be placed in integrated schools while those who use signing as their primary communication mode have the choice of attending special school for hearing impaired children.

 

Assistive Listening Devices (ALD)

assistive-listening-device

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As your child’s needs changes, hearing aids alone might be insufficient for all situations. Devices that are designed for specific needs of a hearing impaired person are often termed as assistive listening devices.

The most popular ALD would be the FM system. This system which usually couples to your child’s hearing aids is important in situations that are noisy and there is a significant distance between the speaker and the hearing impaired person. Examples would be classrooms, meetings and lecture halls.

Although a hearing aid amplifies speech and modern digital hearing aids are capable to reduce some background noise, the challenges of a noisy classroom is more difficult. Imagine a teacher that is standing at the front of the classroom at a distance that is more than the optimum amplification region for the hearing aids.

 

fm-system

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In addition, background noise that is highly speech noise. When the speech signal from the teacher reaches your child’s hearing aids, the loudness is greatly reduced; it is then further degraded by competing background noise. It would be very hard and tiring for your child to continuously pay attention to understand the teacher.

An FM system which consists of a microphone worn by the teacher and a receiver worn by the hearing impaired child ensures that the speech signal is transmitted directly to the child’s hearing aid, thus ensuring no degradation of signal due to noise. FM systems are routinely recommended to school going children to aid their studies.

Other ALD devices would include vibrator alarms that wake up the child in time for school as he would not hear the normal alarms because he does not wear his hearing aids to sleep. More examples would be blinking lights for fire alarms, teletext phones and many others.

 

hearing-aid-child

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Hearing loss is a condition that could be managed by you. The important thing to remember is that your child is just as normal as the next child with the only problem being he does not hear sounds as clearly. In every other aspect he has the same potential to be whatever he wants. It is up to parents and professionals to ensure that the impairment does not become a handicap.

As parents, you face the heavy burden of being your child’s teacher, mentor, friend, therapist, advocate and support system. However, you have the assistance from a whole range of professionals, ever improving technologies for amplification and other communication needs as well as the growing knowledge on hearing impairment and ways of managing it.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

 

Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

Hearing Loss in Your Child, What to Do Next?

Hearing Loss in Your Child, What to Do Next?

First series of hearing loss in your child: When parents are told that their child has hearing loss, many a times they are lost about what they should do next. What are the management steps that parents should take to help their child?

 

Knowledge is power

There is nothing more important than finding out every detail of the problem that your child has. Feel free to ask your audiologist or doctor, how they test your child and what is the purpose of each test done. Confirm how reliable were the tests done. Next ask the exact nature of the hearing loss as it would be crucial on deciding what the next step would be.

If it is a conductive hearing loss, whereby the problem is either on the outer ear or the middle ear, the problem might be cured by a medical doctor. If it is a sensorineural hearing loss, determine whether it is a permanent hearing loss or is there a chance of a cure.

The audiologist should be able to advice you on this. Remember, you have the right to have a second opinion. You can ask the audiologist to provide you a copy of all the results, a report for records and also reference if a second opinion is sought.

baby-child

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You should also find out the sounds that your child could still hear. Contrary to common perception, it is rare for us to find an individual who does not have any hearing at all. In fact, most children with hearing loss have a degree of residual hearing. Knowing the types of sounds your child can hear as well as the level of loudness is important to help him communicate. Even for temporary hearing loss, it is important to know the communication strategies that you would need in order to help your child through this trying period.

 

Hearing Aids

hearing-aid-child

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The Malaysian Association of Speech-Language and Hearing (MASH), the professional association for audiologists and speech language pathologists in it’s guideline states that all children with hearing loss of 25dBHL or more should be considered for hearing aid fitting. Various researches worldwide also indicate that a child who receives optimum amplification and rehabilitation early has the potential of developing speech and language that are similar to children with normal hearing levels.

In most cases of permanent hearing loss, your audiologist would recommend that your child should be fitted with hearing aids to help him/her hear. The first thing that we should know about hearing aids are that they help your child to hear by making sounds louder however they will not cure hearing loss. Your child needs to be trained to hear with the hearing aids as amplification alone is not sufficient to help your child understand sounds and language.

Technology in amplification has been improving tremendously. It is important that you know the difference between the various technologies available before deciding on which hearing aids are the best for your child. Most audiologists would recommend digital hearing aids compared to analogue hearing aids for your child. A complete discussion on the differences and benefits of these technologies would require an entire article. Your audiologist would be more than happy to explain to you about them.

 

ear-diagnosis-child

Image Source: Very Well

Another question that you would be asking yourself would be whether one hearing aid is enough or should you get a pair. For children with hearing loss in both ears, the best benefit would be amplification in both ears. This is to maximize their learning potential as well as to ensure that sounds are as natural as they can be. Wearing a single hearing aid when both ears have hearing loss is similar to using a monocle instead of your spectacles. An adult who has acquired speech and language might be able to cope but a child who is learning would struggle with a single hearing aid.

If your child has severe to profound hearing loss and gets insufficient amplification even from the most powerful hearing aids, then a cochlear implant might be beneficial. Again, please remember that a cochlear implant is a device that helps your child to hear and a lot of rehabilitation needs to be carried out before they could listen and understand speech as well as proceed to speak. This is true with both hearing aids and cochlear implants.

Next up on Health Tips by Teleme, the second series on Hearing Loss in Your Child: Communication and Assistive Listening Devices.

 

Source: The Malaysian Association of Speech-Language and Hearing

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

 

Dr. Shailendra

Dr. Shailendra

Ear, Nose & Throat Surgeon

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

Hearing and Speech Development in Children

Hearing and Speech Development in Children

The first 3-4 years of life is when the child acquires speech and language skills.  These skills develop best when the child is exposed to world rich in sounds (hearing skills), sights and exposure to the speech and language of their parent and care givers.

What is the difference between voice, speech and language?

1) Voice

This is the sound made from vibration of the vocal folds when air is pushed from the lungs through the larynx (refer to Figure 1).

 

Figure 1: How voice is produced in human

How voice is produced in human

2) Speech

Speech is created by talking to express language and requires coordinated muscle actions of the vocal folds, tongue, lips and jaw.  Speech is controlled by the Broca’s and Wernicke’s area on left side of the brain (refer to Figure 2).

 

Figure 2: The Broca’s (area to express speech) and Wernicke’s (area to understand speech) areas at the left side of the brain control speech by sending signals to the motor cortex (which control the mouth and lips) to articulate the words out loud

speech

3) Language

Language is how people express themselves through speech.

Communication Disorder Red Flags

baby's response to touch and sound

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 Communication is a process of exchanging verbal or non-verbal information between individuals. It involves the receptive (ability to understand) language, expressive (production of words to convey messages) language, speech (sound of a spoken language) and pragmatic language (rules in a spoken language).

Baby respond to voice and playing with doll

Image source: Pixabay

 

Every child may not develop these communication skills at the same time or rate as compared to another child. Every child is unique in his/her development. However, when a child does not acquire certain skills at a certain developmental age, this could be a red flag of a communication disorder.

 

Here are some of the communication disorder red flags to look out for:

If you notice any of these signs, please do not wait to seek help. It is highly recommended that you get your child evaluated by a qualified Speech-Language Therapist or a related professional (ie. Developmental Paediatrician, Clinical Psychologist).

 

References:

American Speech-Language-Hearing AssociationThe Hanen Centre, Jeanne S. Chall, Stages of Reading Development , N.Y.: McGraw-Hill Book Company, 1983.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

 

Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

 

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

 

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