Few common Question About Hearing Impairment.
Can medicines cure the hearing loss?This depends on the cause of the hearing loss. In general, problems in the outer and middle ear can be treated by medicine or surgery. Most of the defects of the inner ear or nerve cannot be treated. In such cases, hearing aids are the best solution.
Will my child ever hear with the hearing aids?
The hearing aid will help him hear sounds, which he/she cannot hear otherwise. Children take time to learn to respond to sounds. Young children with profound hearing loss may require 6 to 8 months before they show an understanding of how they must react to sound. How much a child will hear depends on the severity of the hearing loss and the benefit he/she gets from a hearing aid. Experience has shown that if children are fitted with hearing aid before the age of 6 months, their listening skills and verbal language skills develop almost normally.
How will the hearing aids help?The hearing aids amplify sounds and feed them to the ear so as to enable the child to make use of his/her residual hearing. Hearing aids do not cure a hearing loss nor do they restore normal hearing. That is why, even after wearing a hearing aid the child may participate poorly in conversation or even respond poorly to sounds in the environment. However the child improves with intensive auditory training. The aim of the audiologist is to fit a hearing aid which provides maximum benefit with respect to hearing all sounds and especially speech. However this is not practically achieved in every case. Some children may not get the desired benefit with any hearing aid so as to depend fully on hearing for all the ordinary purposes of life. Then the hearing has to be supplemented with speech reading. If the benefit is very inadequate, decisions about cochlear implant can be made at a later point of time.
It is important to ensure that the child receives a guided auditory training as even children who benefit from the hearing aid may continue to ignore sounds if they are not taught how to ‘listen’.
Training is an ongoing process. The Child’s progress depends on many factors including the child himself, the type of hearing loss, benefit from the hearing aid, usage of the hearing aid, how early the intervention began, regularity in the training program & above all, the extent of parent involvement. A child requires training until his speech, language and academic skills attain an age appropriate level. Often it is desirable to prepare children with hearing impairment to a level of language reading, writing and listening skills either equal or better than that of the hearing peers. It is possible, if a concerted effort is taken.
How many days does the child have to wear the hearing aid?
The child will have to wear the hearing aid all his life. Hearing aid does not cure hearing loss; therefore a child with hearing impairment will always need to wear it much like we wear our spectacles.
After fitting the hearing aid, how many children are able to speak fluently in a normal manner?Children who have hearing loss may not speak clearly in the initial stages but can improve speech with speech therapy. A lot depends on whether the child wears the hearing aid regularly and whether or not he/she receives regular training in his early childhood. It is important for the child to learn, to make the best use of his residual hearing, as hearing is the best channel to acquire speech. It is also important to see that bad speech habits do not develop.
My child refuses to wear the hearing aid; he/she wears it for a very short time. Why?
A child needs time to get used to wearing a hearing aid. Children are often curious and want to touch & handle the hearing aid, which makes the parent nervous that the aid might be spoiled. Instead of scolding the child, make sure he/she is kept busy with toys etc when he/she is wearing the hearing aid. Play with him & bring his attention to sounds. If after wearing it for some time he/she gets irritable, take it off for sometime. Put it back later & praise him if he/she wears the aids without a fuss.
Sometimes there may be other reasons why he/she does not wear the hearing aids.
(a)The moulds may be fitting poorly, the ear mould tubes may be too long or short or he/she may have pain in the ears. Check for these possibilities. If you see redness, swelling or ear discharge consult your doctor, preferably an ENT specialist.
(b)The hearing aid may be uncomfortably loud. Check if he/she shows irritability for loud sounds with the hearing aid. If you feel that the child is uncomfortable for any sounds, consult the audiologist.
(c)The harness may not be fitting well (body level aids), the volume control may be too high
(d)The child may be scared of the hearing aid or may feel shy. Parent should play a supportive & encouraging role and try to slowly increase the duration of hearing aid usage. You can even try putting on only the ear moulds without the hearing aid so as to get him habituated. You should be quick & gentle when putting moulds. If you hurt the child he/she will naturally be fearful.
Will my child speak and hear well once he/she uses the hearing aid?Children with hearing impairment, if given appropriate inputs and regular training, will begin to speak. A child with normal hearing begins to speak at 1 or 1 ½ yrs of age, though he/she has been hearing sounds since the day he/she was born (in fact even in the womb!). A child with profound hearing impairment begins hearing after he begins using the hearing aid. At this stage his ‘hearing age’ is ‘0’ although he/she may be older. From then on he/she begins the process of learning speech & language. As he/she hears differently from us, the process is slower at least initially and complicated by problems such as non- acceptance of hearing aid. Therefore it should come as no surprise that such a child will take 1-½ years or so to begin speaking. During this time the speed of progress in speaking depends on many factors such as:
Age at which hearing aids were fitted (earlier the better)
Maximum usage of hearing aids, proper maintenance of aids.
Auditory training to make full use of residual hearing as hearing is the best-input channel to learn speech & language.
The child’s intelligence.
Family’s attitudes towards the hearing aids & child.
Regularity at intervention programs.
Inputs provided by parents to ensure that his training is carried over at home.
The child having other associated problems such as visual impairment, mental retardation etc. in addition to hearing impairment.
In general when your child begins to speak, he/she should be encouraged. Do not be judgmental about his speech. The clarity will improve slowly over the years and he/she will benefit from speech therapy during this process.
Can my child stop wearing the hearing aid after he starts speaking?No, He/She cannot stop wearing it after he/she learn to speak. Does a normally hearing child shut down his/her ears after he/she learns to speak? Don’t we all enjoy the sense of hearing ? So why should a child with hearing impairment lose a chance to enjoy sounds?
My child is so young. Should we wait until he/she grows a little older before we put the hearing aid on him?
‘NO’ NOT AT ALL. In fact the younger the better, because he/she will begin hearing sounds at a younger age and lose less of his/her critical time. He/She will grow up with the hearing aids and accept them easily and most importantly, he/she will learn to make use of his/her residual hearing and acquire speech and language faster than he/she would if he/she started wearing the hearing aids at an older age. However, with young children, hearing aids may be requiring adjustment. This can be done through periodic evaluations of his/her performance.
A young child should have his/her hearing and hearing aid evaluation done at least once in 6 months.
As a parent you must make sure that you encourage him to make maximum use of the hearing aids. Be vigilant as babies often put things in the mouth or bang things. Attend an intervention program. That will help you handle any problems related to hearing aid acceptance and show you what you can do with even young babies.
My child does not pay attention to any sounds? Is he/she actually
Hearing with the hearing aid?
This is a common problem. Lets look at an example: “Suppose you are doing some important work, You concentrate so much that, often you don’t attend to what someone says or if some one calls out to you. But suppose you were expecting someone, you would anticipate and respond when the time came. That is because the sound in question was in some way important to you”.
For a child with hearing impairment who has just began using hearing aids, ‘sounds’ or ‘listening’ has not become important yet, so he/she often does not respond appropriately. Some times he/she may be responding (by facial expressions, by becoming very quiet, by making sounds devocalizing) but you may fail to notice it because you expect that he/she should turn around when you make a sound.
In either case it indicates that step by step auditory training is needed to improve listening skills. It is a long process which you will understand more easily if you attend intervention programs regularly.
In short, you must encourage maximum hearing aid usage and make listening an interesting experience. Incorporate it in games (bring his/her attention to sounds as they occur. Cue him to attend to people speaking) Praise generously when he/she responds correctly. Encourage curiosity in sounds. Building a ‘Positive Listening Attitude’ is very important.
Why should we speak in one language?A Child learns a language by hearing it being spoken around him. Language acquisition is a relatively slow process for a child with hearing impairment due to his/her difficulty in hearing. If we use more than one language at the beginning the child will get confused with the vocabulary and grammar and his/her progress may be hampered. Since it is important that we speak a lot to the child, the first language should be one that all adults at home speak fluently. Once the child has picked up the first language sufficiently well, a second language can be introduced.
Should my child wear the hearing aid when we go out?YES, HE/SHE MUST! Ideally the hearing aids should be worn all through waking hours except when having a bath. Your child should be exposed to all types of environmental sounds. The outside world holds many learning opportunities which he/she will miss if he/she does not wear his/her hearing aids.
Why are you not providing me with a hearing aid? I find it difficult to
hear what people say.
There are situations in which a hearing aid is not needed or cannot provide the benefit needed. It can also happen that wearing a hearing aid may cause more difficulty in communicative situations. In such cases the audiologist may decide not to prescribe a hearing aid.
How many times do we have to go to the centre?
You must regularly follow up for assessment and intervention until they are complete.
Why does he/she not turn around if I call his/her name?He/She will take time to realize even that he/she must respond to sounds. He/She must also associate the sound of his/her name to himself & understand that he/she is being called. This takes time as it involves the ability to discriminate between different sounds & identify a particular sound (his/her name). This is the reason why he/she does not turn around if you call him by name.
What is a cochlear implant?
A cochlear implant is a prosthetic device, which is meant for people with severe to profound sensor neural hearing loss who do not get adequate benefit from hearing aids. An implant directly stimulates the nerve cells in the cochlea via an electrical current whereas a hearing aid provides amplified sound to the ear. An implant needs to be fixed through surgery. Detailed assessments are necessary before deciding whether a child is a suitable candidate for a cochlear implant. An implant does not cure the hearing loss. The child has to wear an instrument, which is visible externally. He/She will also have to under go intervention to improve speech & language abilities.
Where will my child study? Can he/she study in a school for children with normal hearing?Every child with hearing impairment must have access to education and it is his/her right. The placement will depend on the individual child’s abilities, which are determined through assessment. A special educator can tell whether the child needs to go to a special school or whether he/she can attend a regular/normal school. This decision is important because the correct school placement determines how the child’s future progress will take place. Many children with hearing impairment, who have good language abilities go to regular schools & perform well. However if a child has difficulties coping up with the regular curriculum he/she would benefit from a special school where teachers are trained to handle such children or continue at a regular school with extra help from a special educator. Refer to ‘Educational Services’ for more details.
What is our (parent’s) role? How can we help?We consider parents as partners in our intervention program. Parents are after all the child’s first teachers. The emotional bonding between a parent and child is very strong and should be nurtured. In children with hearing impairment the parents do have a task of trying to understand the child’s needs when he/she can not speak comprehensibly. This bond helps in the learning situation as well. Children love to have parents spending time with them and they in turn make
efforts to please the parents. Parents can help the child immensely through the difficult phase of hearing aid acceptance, speech and language learning and auditory training. After all the young child spends maximum time at home even if he/she goes to a center for intervention. It is important that the parent tries to carry over the activities at home as advised by the teacher/therapist. Parents must watch the intervention sessions carefully and try to do similar activities at home.
Keep a diary of events and consult your therapist regularly about the activities you did and whether they were appropriate.
What is the use of talking to the child? He/She does not respond to my voice nor does he/she understand what I say.
This is a common question especially as professionals insist that the parents must speak a lot to the child. Unfortunately what happens is that the process of speaking less to the child begins soon after the parents realize that their child does not hear. It is natural but you must make an effort to change it.
It does seem difficult to keep talking to a child who does not understand. You feel you are running out of topics. But do remember that if you speak to him he/she will also learn to speak as time goes on. However he/she must first begin to understand the language before he/she makes progress in speaking the language. He/She will show interest if you speak to him from the front. He/She will understand a lot from your facial expressions. Talk about what he/she is doing or what you are doing as it is happening. This will cue him further. Use games, photos, pictures or any objects that interest your child. Children love imitating mothers, so your daily routine activities like rolling chapattis, sorting vegetables, washing and folding clothes, dusting and cleaning are excellent opportunities to communicate and help your child learn speech and language.
Often parents find such activities frustrating mainly because at the end of the activity/day they expect the child to show a significant progress or speak something. This is impractical. Each day like this is a drop in the ocean of learning. So patience is important. Remember that this is equally difficult for your child. At the end of the day he/she does not even understand why you are not happy with him. Therefore talk to the child.
Will my hearing impaired child lead a normal life?He/She can lead a normal life. He/She will have to use a hearing aid or assistive devices which will help him lead an independent life. He/She can also avail the Government facilities & concessions for disabled persons.
Will a hearing impaired person get a job/employment?A person with hearing impairment can be trained for any job provided he/she has the skill for it. Early training in childhood ensures good language ability. This in turn helps the person to go to higher educational levels. There are exclusive vocational training and placement centers across the country. Refer to topic on Employment and vocational training for details.
Can a hearing impaired person marry?Yes, a hearing impaired person can marry & lead a normal life. There are however some cases in which hearing loss is due to hereditary/genetic reasons. In such cases, genetic counseling is necessary when the hearing impaired adult wants marry.
Will hearing impaired person’s children be hearing impair too?
No, not unless his/her hearing impairment is due to genetic reasons. If there is a family history of hearing impairment or the person has a syndrome (eg: Warden burg’s syndrome), it is necessary to seek genetic counseling to evaluate the risk of hearing impairment in the progeny.
RehabilitationHow the hearing and speech impaired are rehabilitated?
Deafness may be caused by an illness, an injury or through genetic inheritance. Some people fall in the 'hard of hearing' category while others are deaf before they can learn a first language. Different levels of deafness require different procedures for rehabilitation.
When you walk into a deaf and dumb rehabilitation centre, a team that consists of audiologists, speech language pathologists, special educators, psychologists, social workers, ENT specialist, pediatrician and a neurologist will examine you. You may be recommended surgery or fitted with a hearing aid or ear mould depending on their diagnosis. Patients who are unable to speak will be given speech and language therapy that includes learning the sign language, lip reading and other behavior modification tips to lead a normal life. Some patients may be prescribed medications.
Counseling sessions that include the impaired and their family follow. Most rehabilitation centers have follow up and outreach services to check up on the condition of the patient regularly. The deaf are provided vocational training in computers, accounting, printing and beauty culture which enables them to get a job in local companies. Some institutes that can help you out are.
