Selecting a Musical Instrument for a Child With Hearing Loss

In an earlier post I wrote about the value of having a child with hearing loss learn a musical instrument. Lots of research has demonstrated that music helps develop the auditory brain. But, is every musical instrument appropriate for every child?

A Parent’s Question

A few days ago when I was doing a school visit for a third grader, her mom asked me if it was okay for her to play the French horn, which was the instrument she chose to learn. My first reaction was mixed – if a child has an interest in an instrument we should encourage it, but the French horn is a pretty loud instrument. Mom had the same concern.


As it turned out, today I came across an article in Science Daily which reported that professional French horn players run the risk of developing noise-induced hearing loss. In fact, French horn players are one of the most at risk groups of professional musicians for developing noise-induced hearing loss. Of 144 musicians surveyed, only 18% said they used any kind of ear protection. To be fair, lots of musicians are uncomfortable using ear protection because they feel that it interferes with accurately hearing the music which makes it difficult to perform at the top of their abilities. How does that stand up to developing a hearing loss? We know that hearing loss also interferes with the ability to perform well. I personally know of two professional violinists who had to give up work in a symphony orchestra because of tinnitus caused by noise exposure.

Implications for kids with hearing loss

If a person starts off with normal hearing and later develops a mild hearing loss from playing a musical instrument that is one thing. But what about a child (or an adult, for that matter) who already has a hearing loss? Does playing a musical instrument increase the risk? We do not really know, but we do know with absolute certainty that anyone who has a hearing loss needs to be careful about additional noise exposure. So what do we do?

First, if a child is going to be studying a musical instrument, it is important to have a pre-music audiogram so we know what her hearing was like before she started to play. Hearing needs to be re-tested on a regular basis to monitor it and to be sure it is not getting worse.

Second, an audiologist should check the loudness of the instrument at the child’s ear using a sound level meter. If the child is playing in an orchestra, testing should be repeated when the child is in orchestra.

Third, if the sound is loud, use ear protection. And that does not mean over-the-counter foam plugs. It means using personal musicians plugs, which should allow the student to be able to hear the music but also to protect hearing.

Are some instruments better than others?

Some instruments are quieter (guitar), some are farther away from the ear (piano), but almost all instruments have the potential to be too loud. Help the child find an instrument she likes, but help her understand that noise is a potential problem.

Helping kids accept ear protection

It is not easy to get kids to accept the need for ear protection. They all feel invincible and just do not want to use it. It is important that we educate kids starting when they are very little to understand that they need to take care of themselves. I got my granddaughter ear muffs (bright pink) when she was an infant because her parents who were in the music business wanted to take her with them to concerts. My son had learned as a young child that if he wanted to play the drums he had to use ear protection and he knew he had to do it for his daughter. His friends also learned it while they were growing up and having to deal with me. It helps to consider noise protection in the same was as we consider other safety issues. Kids are not allowed to ride bikes without helmets, they need to wash their hands before eating, brush teeth after eating and use ear protection when they are in a noisy place. If we are clear about it, they will understand.

About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 7 books, and written numerous books chapters and journal articles, and is a well known international lecturer.