In the olden days, when I started to work in this field, we used to think that parents where having trouble using hearing aids with their children because they were not comfortable with technology. That might have been true 50 years ago, but it is not true today. They all have smart phones, smart TVs etc.
So now, when parents are having trouble with technology now, we have to talk about why.
Acceptance of Hearing Loss
It is very difficult to learn that your child has a hearing loss. The grief and fear can be overwhelming. Parents react in different ways. Some families will plunge right in and ask what is needed for their child to develop listening and spoken language. Others just can’t cope.
When I deal with a family that is having trouble coping, I spend a lot of time hand holding. Sometimes it is really handholding. Lots of talking. If a family is resisting getting earmolds and hearing aids I still make appointments for the to come in every week or two so we can talk. I am always hoping that this will be the week they decide to move ahead. Most families are able to move ahead within a couple of weeks. A few families take longer.
So, what should we do?
I think it is important to talk about the brain. How does the brain develop? Why is it important to develop the brain early? How do we develop the brain for a child with hearing loss. What happens if we do not develop the brain early? How does this effect language learning and literacy? If we don’t develop the brain early can we develop it later? (In case anyone has any doubt, the answer is NO – you cannot develop the brain later.) That is why we are doing newborn hearing screening!
This is a conversation that takes a while. You cannot expect to have this conversation quickly standing in the hall. It us truly an education. We are educating parents about a topic they likely have not thought about.
Once parents have the information, we should ask, “what is stopping you from moving ahead?” Here we really need to listen. And we cannot be judgmental and families need to believe that we are not being judgmental. Different things affect these considerations. Some are cultural.
I can think of a family who came from a culture in which marriages were arranged. They were concerned about putting technology on their baby because the grandparents worried that unmarried siblings of the parents would not be considered marriageable. Some other families cannot move ahead because of grief. In another family, the mom just couldn’t bring herself to put hearing aids on her baby. She would not allow me to take earmold impressions. It was too overwhelming. We met every week and she came in with her baby. We sat in the hall and talked. She didn’t want to come into the test booth or my office. After about 6 weeks of this I started to worry that we might not reach the point where mom would accept technology. Just at the point when I was becoming concerned if this was child neglect mom came through. She was ready and we moved ahead. She continued to be very sad in the beginning, but as her daughter showed that she was hearing and started to babble, mom realized that there was light at the end of the tunnel. When her daughter entered kindergarten, mom sent me an email thanking me, her daughter was a star.
In both of these cases it was only by providing information to families and providing them support, were they able to move ahead. In both cases I suggested that grandparents come in so we could talk about why technology was critical. Just getting that information really helps families understand the issues. Parents cannot be expected to educate the grandparents, at least not in the beginning. If we offer to educate the extended family the parents will have more support
Behavior?
Most of the time, if a child is not accepting technology, it is because the parents are not accepting the technology. Children take their direction from their parents. If parents are hesitant in putting technology on, children get the message that there is something wrong with it.
I always ask parents to put the technology on. I want to see how they do it and how comfortable they are with it. If they are not comfortable I will see that and we can then practice so that they become more comfortable.
I had a family who came in without the technology on their two year old. I asked mom to please put the hearing aids on. Mom tried to get them on and the child strongly resisted, kicking and biting. Mom said, wait, ran out and got a the biggest chocolate donut I have every seen and tried to bargain with her child by offering the donut if he would accept the hearing aids. I said – NO. We do not give children a reward for doing something they need to do. I just put the child on my lap, lets between my legs, one of my arms across his chest holding his arms down and got the hearing aids on.
I talked to mom, again about why her child needed to have hearing aids on all the waking hours. We talked for a long time about why this was difficult. We talked about the fact that it was difficult, that having her son do something that he didn’t want to do was difficult. We both cried but mom got the message and she understood that he needed to just wear the hearing aids because he needs to – not to get a treat.
So what’s the plan?
- Talk to parents about developing the auditory brain and about critical periods
- If behavior is an issue (likely only a small number) help parents understand that they need to take responsibility
As they say – JUST DO IT
