Frequently Asked Questions About Device Use

In the next section, we focus on questions many parents have asked about device use with young children.  Note that most of this content (with a few exceptions) applies whether your child is using hearing aids or cochlear implants or both.

How can I get my child to use the hearing devices on a regular basis?

Some babies accept hearing devices easily.  Other babies may not like having something in their ears, similar to when babies do not want to wear hats or shoes. A baby may accept hearing devices at first but start to pull them out when he or she gets older and more active. The goal for every child is to work up to wearing the hearing aid during all hours the child is awake and make hearing device use a part of their regular daily routine. Yet starting or maintaining a regular schedule for hearing aid use can be hard. It is best to keep trying every day and focus on times of the day when hearing is important, and your child is well rested and happy.

Here are some strategies to help your child wear their hearing devices more often:​

• Put the hearing aids on during times when you are close to your baby and talking/signing, singing, or playing with them. Another good time is during visits with his early intervention specialist. This might only be for short amounts of time at first. 
  
• Put the hearing aids in when your child is distracted with a toy or food item they enjoy so your child is pre-occupied and less likely to notice the hearing devices. 
• Some parents use a lightweight cap or headband that covers their baby's ears (see examples here​) to stop their child from pulling devices off. This may be needed for a short time to stop the habit of pulling or playing with the devices. It is important to check that the cap does not change how the hearing aid works or cause the hearing aids to whistle. Your baby's audiologist can help you check this.
• When your child reaches toddlerhood, you may find a reward to provide for wearing their hearing devices (ex: receiving a sticker for wearing the hearing aid for a certain amount of time).
  
• Having a routine time to put in hearing aids, like when getting dressed in the morning, can help your child get in the habit of putting on and wearing hearing devices.​     

• It is important that you are in charge of hearing aid use. You, as the parent or caregiver, are in charge of when the hearing aids go on and come off.  It is not up to the young child to decide that.
• If your child is pulling her hearing devices out frequently, you can put the hearing aids back in and set a time limit before you take them out again (see more examples in the next question).
  

Your Family/Infant Specialist or audiologist can give you more ideas to help with your child, so do not be afraid to share your concerns or questions with them.

My baby keeps pulling his devices out of his ears. What can I do?

You may find that your toddler will not leave the devices alone.  Perhaps your little one constantly pulls them out or takes them off. Maybe she has discovered how to get everyone's attention by pulling them out and running away!  These behaviors can be challenging and frustrating for parents. It may make you wonder if your child will ever adjust!  You may feel guilty because you know the importance of keeping devices on as much as possible. You are trying to keep the devices on for all the child's waking hours and that seems like an impossible dream! You may also worry about the safety hazards if your baby puts the devices or its parts in the mouth. Know that you are not alone. Many young children go through phases like this. In the sections below, we offer some tips for the many parents in this situation. 

It is important to find out if there are any problems with the hearing aids that might cause your baby to pull them out - including an earmold that does not fit well or hearing aid volume that is too loud or too soft. Your baby's audiologist can teach you how to listen to your baby's hearing aids to check the sound. If needed, your baby's audiologist can change the ear mold or adjust the hearing aids.

​ I get frustrated when my child pulls the devices off every time I look away! I am trying to keep my cool, but it is stressful! What can I do?"

Babies spend a lot of their time exploring. That means they will explore their ears and their hearing aids or cochlear implants. Here are some tips for staying calm when your baby repeatedly removes his or her devices:

• Try distracting your child with things he or she enjoys (i.e. toys, a snack, a book, etc.) while putting the hearing aids in or the cochlear implants on. You can also give your child a toy to hold to keep their hands occupied so they are less likely to bother the devices.
• Calmly put devices back on.  A child will sense if you are frustrated; being calm is reassuring and usually effective.
• Be persistent and positive.  You probably need to be more persistent than your little one!  One parent said, “you just have to be more stubborn than your child." This mom succeeded eventually by staying positive and putting the devices back in consistently each time the child took them out.
• Some children are more persistent than others, repeatedly removing the devices. Trust that this is a phase.  Try not to let your feelings get the best of you. In these cases, it may help to begin with short periods where you have time to devote your full attention to your child (playing, communicating, using language). Then gradually you can extend the time and build up to full-time use.
• Try to have a sense of humor.  Seeing the humor can help adults lighten up. Being willing to laugh at ourselves can reduce the tension in the moment.
• Remember that these behaviors have a positive side.  Your child may be asserting her independence or being curious. Those are wonderful developmental achievements, even though they can create barriers. See just how capable and clever your child is!
• Give it a break if needed.  You know your child best. It may not work well to put devices back in if your child is quite upset or even having a tantrum.  Trust your judgment and wait for your child to calm before trying again. Once devices are back in, give your child positive attention (sing, share a book, hug). 
  

My baby is young and I'm not sure if he is hearing differently using the hearing aids. How can I tell if my baby's hearing aids are working?

Keep in mind that babies may not respond immediately to devices. You may not see clear indications that he is hearing with them.  You may not see changes in speech and language right away.  You might wonder if the devices are working correctly.  Your baby's audiologist uses special techniques to make sure the hearing aids are set to your baby's unique hearing test. It is rare, but like all other electronic devices, hearing aids can break or not work like they are supposed to.

You can check the sound of your child's hearing aids at home by doing a listening check on a regular, daily basis. Listening checks are important to make sure your baby's hearing aids are amplifying the sounds around them in an appropriate, safe way.

Indicator lights are sometimes used to tell parents if devices are working appropriately. These are little lights located on the hearing device that tell us when devices are on, but not necessarily if the sound is the way it should be. Check with the device manufacturer on what the specific patterns/colors of light mean.

Over time, you and your family-infant specialist will see many responses to device use in your child's behavior.  You will learn in early intervention how to monitor your baby's responses to sound while using their devices (e.g., turning to the sound of a toy; getting excited when hearing a familiar song;  clapping hands when hearing “patta-cake").  Some parents may notice that their baby responds to sounds without the hearing aids on.  They might wonder why the devices are needed. Although this can be confusing, some children hear enough without hearing aids to respond to some sounds in their environment.  This does not mean, however, that they are able to hear all the sounds in our environment that are so important for learning speech and language!  If you find yourself wondering whether your child is benefiting from hearing aids, revisit the movie that shows you what speech sounds like with and without hearing aids. Consider that the movie plays speech at a “normal" level (from about 1 meter away), and anyone speaking quieter or farther away would be much more difficult to hear!  Talk to your baby's audiologist if you have questions about why your baby wears (or does not wear) hearing aids.​

I am afraid that my child will lose her devices. How can I prevent this?

See our tips above for making sure your baby's devices stay on.

Hearing devices are expensive, and many parents worry about losing such small devices.

For Hearing Aids:

New hearing aids typically come with loss and damage and repair warranties offered by the company that makes the hearing aids. Beyond the original warranty provided by the hearing aid manufacturer, families can insure hearing aids in the following ways:

• Purchase extended warranties for loss or damage from the hearing aid manufacturer
• Hearing aid insurance companies offer yearly warranties for loss and damage after the manufacturer's warranty is expired
• Some homeowner's insurance policies will cover the cost of lost hearing aids - ask your insurance agent

Your baby's audiologist can provide you with more information about warranties and policies available to help you protect your baby's hearing aids.

For Cochlear Implants:

Cochlear implant processors, parts, and accessories are very expensive. While recipients and families worry about damaging or losing these devices, the manufacturer's warranties can help ease those concerns. Processors, headpieces, and cables typically come with a five-year repair warranty with the initial cochlear implant kit. This means when devices are no longer functioning appropriately, they can be repaired free of charge if the problem occurs within the first five years of you owning them. These devices also have a one-time loss-and-damage warranty during the first five years which means if these devices are lost or damaged beyond repair, they can be replaced once within the first five years. When processor upgrades are purchased, the processor, headpiece, and cable purchased with the upgrade typically come with a three-year repair warranty. When these manufacturer warranties are over, families can insure the devices by:

• Purchasing extended warranties for loss or damage from the device manufacturer
• Some homeowner's insurance policies will cover the cost of lost hearing devices - ask your insurance agent

It is important to note that rechargeable batteries typically come with a one-year warranty but can sometimes be covered under the initial loss-and-damage warranty if lost with the rest of the processor. This will depend on the manufacturer's policy. Accessories often have a shorter warranty (between 30 days and 1 year) and are not covered under a loss-and-damage warranty. While accessories may come in the initial activation kit purchased by insurance, most accessories are not covered by insurance if repairs or replacements are needed. It is important to talk to your audiologist to have a complete understanding of your warranties and what steps should be taken to ensure safe keeping and long-life of the equipment.

My baby's hearing aid whistles sometimes. What causes the whistling and what can I do to stop it?

That whistling is called feedback.  You may have heard (a much louder version) at concerts or other public events.  It happens when sound coming out of a speaker winds up at the microphone that is being amplified. Usually pointing the microphone away from the speaker will stop the whistling/feedback from happening. In a hearing aid, the speaker and microphone are close together making it easy for sound from the speaker to make its way back to the microphone. Unfortunately, there is no way to redirect the microphone, but there are other strategies to minimize feedback:

Your baby's audiologist can turn on feedback management in your baby's hearing aids. Feedback management is an automatic feature in hearing aids that detects when feedback is happening and then works to reduce or eliminate the whistling.

Old Earmolds

Earmolds for babies and young children need to be replaced often. Young children's ears grow quickly and new earmolds will be needed whenever feedback starts to be a problem or the earmolds do not fit securely. It is not unusual for babies to need new earmolds every 2-3 months.  Earmolds should be made of a soft material. The soft material fits better than hard plastic materials in children's ears and is safer and more comfortable.

Incomplete Insertion of Earmolds – If the earmold is not inserted completely it can allow sound to escape out around the earmold and go back into the hearing aid. Make sure your baby's hearing aids are fully inserted into their ears. If the earmolds are fully inserted, but still whistling, it may be time for new earmolds.

• If earmolds have been inserted correctly but there is still feedback, there are a couple of products that may be short-term solutions to stop the feedback until new earmolds can be made.  Your child's audiologist can tell you if these are good options for your child and how to use them.
• A special foam pad called a Comply Wrap can be wrapped around parts of the earmold by your audiologist. This can help keep the sound from escaping from around the earmold.Water-based lubricants such as Otoease and or silicone-based creams such as Otoferm can be used to help th​e earmolds fit more securely and reduce feedback for some babies and children. The silicone-based creams are best for creating a seal between the earmolds and ear canal to prevent sound from leaking out past the earmold.
• Cerumen (Ear wax) in the hearing device – If there is ear wax inside the earmold tubing that blocks the sound from getting out of the earmold it can feedback into the hearing aid. Your audiologist can help you get the tools and teach you how to safely clean the earmold tubing to remove build-up of ear wax.

• ​Broken Earmold – If there is a crack or hole in the earmold tubing or if the tubing is broken it will cause some feedback that may be constant or intermittent. Your audiologist can replace the tubing or may be able to provide you with supplies and teach you how to change the tubing at home.

• ​Cerumen (Ear Wax) In the Ear
  Some children may have a large amount of wax build-up in their ear canal. If there is enough wax to block the ear canal it can cause the hearing aid to feedback or whistle when it is in the child's ear. Contact your pediatrician or ENT physician to have the cerumen removed.
  

What are some ways I can take care of my child's devices?

Hearing device manufacturers typically provide a “care kit" when you purchase new devices. The kit may contain a listening scope, cleaning brush, battery checker, and an instruction booklet. There are oftentimes video tutorials on the manufacturer's websites that will walk you through the steps of caring for your child's specific type of devices.