Behavior issues can be complicated. All children have temper tantrums and all children refuse to follow parental rules at one time or another. Children with disabilities, including hearing loss, have similar behavior issues as children with typical hearing but families may not treat them the same way. Many families feel that they cannot discipline their children with hearing loss because they are already overwhelmed with the hearing loss. Some families feel that they cannot discipline their children because they think they will not understand. And others come from cultures where very young children are not disciplined strongly.
In my view, lack of discipline is not in the best interest of any child, certainly not a child who already has a lot that they have to learn. Let me be clear. I am not from the group that hits children and sends them to their room without dinner. (You can check with my kids!) However, I am a believer in the “firm but kind” management strategy.
Parents need to understand that some disruptive behavior is typical of a child of that age. Two year olds, no matter the culture or hearing status will try to see what they can get away with. It is part of learning limits. But we, as the adults, need to teach kids what is acceptable behavior.
Is bribing a good idea?
I have seen too many parents bribe their kids to do what they should just be doing. Is it okay to bribe a child to wear their technology? No. Children have to wear technology if they are going to develop the auditory brain and learn to use audition to learn to listen and talk. They just have to wear their technology all waking hours – NOT NEGOTIABLE. When a parent offers a child a donut to put on hearing aids or CI’s they are setting that child up for failure. The child will start to negotiate when to have technology on when they want something – donuts, a new toy, special dinner etc. When I fit technology on babies I tell families that the children have to wear the technology all the time. I give the firm but kind lecture, and I talk about setting limits. I say “ you don’t let your child run in traffic, you don’t let them throw down the lamp in the living room, and you don’t let them take off the technology.”
It is the clinicians job to help parents understand that the value of listening. In my experience, when they understand the value of listening they will be able to help their kids keep technology on.
Are behavior limits different for children with hearing loss than for kids with typical hearing?
No. I went into a home for a home visit a while ago and the two year old was running around the house in his diaper with no hearing aids on. While I was talking to the mom about why he needed to wear his hearing aids, he climbed up on a table and tried to throw down the lamp. I moved fast and saved it. Mom said she felt he needed time when he didn’t have to work and to listen. We talked about what her goal was for her child at age 5, 10, 15. She wanted him to learn to listen and talk. Then we talked about what getting to that goal required. I understand that families feel sorry that their child has a hearing loss, has to wear hearing aids and go to therapy etc. But that’s how it is. I have said numerous times to kids I worked with that I understand that they are upset that they have to come to the clinic when their friends are out playing ball or going for pizza. I let them know that I understand and agree that it is not fair but, that is how it is. We can try and reorganize schedules but they are still going to have to do what they have to do. In my experience, if we provide sympathy they understand and will grudgingly cooperate. But they do cooperate. I had a teenager with a mild to moderate hearing loss who decided that they didn’t need hearing aids or an FM any longer. Parents were concerned to say the least and brought the child in. I showed the child on an audiogram with the phonemes on it what he was hearing with and without hearing aids. I asked him if he wanted to go to college. He said that of course he did. So we talked about how well he was likely to do in classes if he only heard some of the information. We negotiated that he would wear his technology when he was in critical subjects and could take it off when he was in less critical subjects. After about a week of taking them on and off he decided to leave them on.
As clinicians, we need to provide support to families and children but we can’t accept not doing what needs to be done. We need to remind everyone why we are doing what we are doing. Then we need to help them figure out what is negotiable and what is not. Some families will manage to do that will a little bit of support. Others will need counseling. Either way it is fine. Just as long as we get to the end point.
