Hearing Aids Guide
What is a hearing aid?
Hearing aids are small electronic, battery-operated devices that collect sounds with a microphone and direct the louder signal into the user’s ear.
Hearing aids work by boosting the intensity (loudness) level of sounds at different frequencies (pitches). Higher-frequency sounds, such as “t,” “p” and “s,” have less energy and need a greater loudness boost to be heard than low frequency sounds, such as “a,” “oh” and “ah.”
Hearing aids are programmed to fit the needs of a person’s hearing patterns, such as boosting intensity level for high frequency sounds that he or she may not hear at all and less for low frequency sounds that he or she may hear better.
What type of hearing aid should I choose?
There are several types of hearing aids – behind the ear, in the ear, in the canal and implantable hearing aids.
An audiologist can help determine which hearing aid is best for you or your child.
Depending on the amount of hearing loss, hearing aids may be worn in one ear (monaural) or both ears (binaural). For children who are learning to listen and talk, using hearing aids in both ears is generally recommended.
Behind-the-Ear (BTE) Hearing Aids
BTE hearing aids are slim and fit on top of and tucked behind the ear. Typically, an ear mold is used to anchor the hearing aid to the ear and to direct amplified sound into the ear canal, so a tight fit is required for them to do the job properly.
BTE hearing aids are suitable for almost all types and degrees of hearing loss, and for all ages. Mini BTE hearing aids are the most appropriate for infants and young children. As babies grow, ear molds are replaced frequently and attached to the existing hearing aid (the entire aid is not replaced).
BTE hearing aids and ear molds come in different colors and older children may enjoy selecting colors or stickers to express their individual styles and personalities.
Because they are visible, BTE hearing aids are easy for parents to “check on” and can also be “fixed” to stay in the ear or, at least on the child, and prevent loss. This can be done by using toupee tape, a thin cap or using other attachments that secure the hearing aid to the child’s ear or clothing.
Ask your audiologist for suggestions as to what methods are best for your child’s hearing aids.
In-the-Ear (ITE) Hearing Aids
ITE hearing aids are built into a custom-made shell obtained from an impression of the outer ear and ear canal. They are appropriate for adults with mild to moderately severe hearing loss.
Their small size and hard outer shell make them unsafe for babies and young children.
It is not unusual for older children to ask their parents for an ITE aid as they approach middle or high school. ITE aids can be a viable option for the child who has worn a BTE-style aid previously; however, it is recommended that the child’s outer ear has slowed in growth and that parents be certain that this type of hearing aid is a good fit for the child’s degree and type of hearing loss.
In-the-Canal (ITC) Hearing Aids
ITC aids fit into the ear canal and are customized to fit the size and shape of the user’s ear canal. ITC aids are smaller than ITEs and must be replaced as the ear grows and, as a result, are not typically selected for pediatric use.
Like the in-the-ear aid, this style is recommended most frequently for mild to moderately-severe hearing loss. ITC aids are the most popular style with adults. ITC aids, like the in-the-ear aids, may be a viable option for a child after ear growth has slowed provided that the child’s type and degree of hearing loss can be accommodated by a hearing aid this size.
Completely-in-the-Canal (CIC) Hearing Aids
These are built into a custom-made shell obtained from an impression of the ear canal. The CIC, however, fits a bit farther into the ear canal and extends deeper toward the eardrum than the in-the-canal hearing aid. Although generally not “invisible,” this hearing aid style is often the least conspicuous or noticeable.
These hearing aids are usually appropriate for mild to moderate losses, and for sloping high-frequency hearing losses. Like in-the-ear and in-the-canal hearing aids, they are not appropriate for infants or young children.
Implantable Hearing Aids (IHAs)
IHAs are comprised of both bone-anchored hearing aids (BAHA) and middle ear implants (MEIs). A bone anchored device is useful for people with either congenital atresia of the ear canal or chronic middle ear dysfunction. Many candidates for bone anchored hearing aids have successfully used bone conductors, which gently oscillate, or vibrate, the skull and reproduce sound waves that activate the users’ hearing mechanisms.
The U.S. Food and Drug Administration (FDA) has approved the use of BAHAs for all age groups, including children as young as two years old. The long-term experience with use of the BAHA in Sweden and England and its increasing popularity in North America suggests that the device may be a preferred alternative to surgery to open the ear canal or repair the middle ear mechanism, particularly in children with the Treacher-Collins or Goldenhar syndrome.
