Expert: Harriet B Jacobster, Au.D. - 6/12/2009

Question
QUESTION: My daughter is 6.5 years old and has hearing problem in the left Ear and I am giving below the details of her case:
1. I had noticed that my daughter would sometimes ask to repeat statements and many times would turn the right year forward if she was was unable to hear. This I started noticing about 1 year back.
2. We thought that there was lot of wax in the year so we took her to an ENT-the doctor did a test of the ear which I think is the Typanometry test in which the daughter was made to listen to sounds and results were automatically generated. The doctor had diagnosed that she had flued in her ear eustachian tube. The Doctor then had recommended some excercises
3. My daughter frequently suffers from cold and running nose and therefore it may have happened that her eustachian tube was blocked.The doctor advised some excercises.
4. However there was no improvement in the hearing and infact in last 2 months we have seen it deteritorate.
5. My daughter otherwise has an OK speech but does have socialising problems in a new invironment and gets lonely in a party if people are not directly talking to her.
6.We have recently got her Audimetry Ear test and nose X-Ray done with following results:
- She has serious to profound hearing loss in the Left ear and so it is almost 80% hearing loss. As per the doctor his loss is of a permanent nature and can be addressed only by a hearing aid.
- The right ear was found to be OK.
- The X-Ray of the nose indicates moderate adenoides blocking the air passage
5. The doctor has recommended an MRI of the brain for futher evaluation

Request your advise on a) She is a sensitive child and we would assume that putting her on a hearing aid would make her very conscious and restrict her developement.Is it better to avoid it and let her think that every thing is normal till she reaches an age of 14-15 when she can handle it better. b) Is it better to use a hearing aid than BAHA or other hearing solutions which involve surgery. I ask this because with developements in technology happening every year in hearing aids I feel waiting for a good technology in case we need an AID like BAHA will be a better idea.

ANSWER: Hi Nitin,

It is never a good idea to delay aiding an ear with hearing loss.  This can lead to a condition known as auditory deprivation in which the unaided ear and nerves fail to develop. If that happens, the ear may become essentially unaidable in the future.  Especially in a young child who is still in the language and cognitive learning stages, normal, or near normal, hearing from both ears is crucial. So, no - do not delay giving her a hearing aid. You would be doing irreversible harm by avoiding the issue.

Now, the key is to make this hearing aid fun for her rather than an imposition.  There are beautiful decorative beads, etc, that can be placed on the hearing aid to make it look more attractive and almost like a pretty piece of jewelry. Hearing aids also come in a variety of colors for more fun appeal.  You should be able to consult with a pediatric audiologist who can give you great ideas.  

Do not assume that because she is sensitive, putting the hearing aid on her would make her self-conscious.  On the contrary, because the aid will help her hear better, it may actually boost her self-confidence.  

As for the options of Hearing aid versus BAHA - I would suggests that you try the hearing aid first.  It is less invasive and with an 80% loss may still be able to give her sufficient amplification.  You can always choose the BAHA option further down the road if traditional amplification does not work.

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology

---------- FOLLOW-UP ----------

QUESTION: Thanks for the advise which I think really addresses my concern very well.
Please also help me with- Which kind of Hearing aid should be preferred- In the Ear , Cochlear Implant or behind the ear based on the type which has the maximum technology advancement and would be most helpful.

Answer
Hi Nitin,
At this point, most, if not all, hearing aids have essentially comparable technology.  In the case of a pediatric fitting, we usually opt for a behind-the-ear (BTE) aid over an in-the-ear (ITE) for several reasons: Your child's ear is still growing and it is not unusual for children to "outgrow" their hearing aids in just a few months.  It is far more efficient to replace an earmold for a BTE than an entire hearing aid as would be the case for an ITE. Next, BTE hearing aids come equipped with a special Direct Audio Input connector so that they can be coupled to an external audio sources, such as an FM system.  

Cochlear Implantation is not standard treatment for unilateral hearing loss. But that aside, a CI is not considered until is has been shown that a hearing aid no longer provides benefit to overall auditory function.  

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology