Jane Madell
March 4, 2012

When a hearing loss is identified, we all spend lots of time talking to families. We help them understand basics of hearing loss, how to read an audiogram, management options etc. Babies obviously do not get much counseling. But as kids get older, we really need to revisit all these topics with them. This hit me many years ago (I won’t confess to how many) when a family of a 6 year old came in for a final evaluation before moving out of state. I spoke with the mom about all the equipment issues and gave her recommendations for the IEP etc. Almost as an after thought, I asked Josh if he had any questions. He asked “how old do I need to be before I won’t need hearing aids any more?” I felt like someone had hit me in the stomach. I realized I had not done a good job of helping Josh understand about hearing loss. He knew how to take care of his hearing aids, and how to change the batteries, but he did know a lot about hearing loss. It changed the way I do my job.

What do kids need to know about hearing loss?
Most kids with hearing loss are being educated in the mainstream. They may be the only kid in their class who has a hearing loss. If they are not comfortable about who they are as a person with a hearing loss, there are going to be significant social and emotional issues as kids get older. Kids need to understand what hearing loss is, all the basics including types and degrees, and something about etiology. They need to understand what hearing loss means. Because they have always had a hearing loss they may not recognize that the world is different for them. Do they understand that other kids do not struggle to get the message? That background noise is less of a problem for other kids? That some kids can hear in the dark? (Think of what that means for sleepovers!) That some kids can hear in the swimming pool? That not everyone is exhausted at the end of the day from working so hard to listen?

Finding peers
Every child needs peers. For children with hearing loss, they will have one group of peers – kids in their class, kids in the same sporting or dance class etc. But will those kids understand the issues around hearing loss? Not likely. The best adjusted children with hearing loss I know have friends who also have hearing loss. This may be a social group that meets monthly, or other kids in a therapy group. It may be a group like those that meet annually at the AGBell convention or Hands and Voices meetings, or groups set up by clinics or schools where kids can meet other kids like them – kids with hearing loss. They may not talk about hearing loss full time with these kids, but there is a sense of belonging, a sense of being comfortable with who they are. If they are comfortable with who they are, they are more likely to feel comfortable when they are the only child with hearing loss in a mainstream setting.

How to provide counseling
There are basically two kinds of counseling: informational counseling and emotional counseling. Most of us feel most comfortable giving information. We were trained for that. We can do it easily. We do not want to listen to kids anger, fears, or tears.

So let’s start off with informational counseling. We can explain what hearing loss is, and why kids with hearing loss need technology. We can demonstrate how much better speech perception skills are with technology when we test with and without hearing aids. That, of course, does not guarantee that we will convince kids to love their hearing aids but at least we are providing them with information. Materials used to teach about hearing loss can lead to conversations about reactions and concerns about living with hearing loss.

Emotional counseling is much more difficult for most of us. How often do audiologists ask kids “How do you feel about having a hearing loss?” Or “ How do you feel about needing to wear hearing aids?” I can almost hearing everyone say “ARE YOU NUTS? The answer is probably yes, I may be a bit nuts, but if we could start to ask these questions, we really could be helping kids get some stuff off their chests.

What topics can we cover during a hearing evaluation?
We can certainly show kids the results of the hearing evaluation and help them understand about hearing loss. We can show them what they hear with and without their hearing aids or cochlear implants. We can show them how much better they hear with FM’s. Comparing speech perception scores in all these conditions is a very good informational counseling tool to help kids understand why technology helps. We can also ask if they are okay with all this. We can ask directly how they feel about having to use hearing devices, about how they feel about being the only one in their class with hearing devices, about having trouble hearing when the lights are out. Or we can just say something like “I know it is hard to have to use hearing aids when you are the only one etc”. We can open the door and let them know that it is really okay to talk about these topics, that it is okay to feel badly about it, and that other kids with hearing loss feel the same way.

Meeting other kids
Introducing kids with hearing loss to other kids their age is always a good thing to do. The next issues of this blog with talk about running support groups for kids with hearing loss.

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