We actually hear with our brains, not our ears. Think of your ears as a doorway for sound to get to your brain, which turns what you hear into meaning. Auditory brain development is also connected to how we learn to talk. By listening to others, your brain learns the meaning for words. In fact, your brain starts receiving auditory information before you’re born and continues to grow auditory connections after birth. Newborn babies identified with hearing loss have already missed some hearing opportunities, which means it’s extremely important to find the right hearing device as soon as possible so their brains can start catching up. Think about hearing loss as a doorway problem and technology as the means of breaking through the doorway to feed auditory information to the brain.
TYPES OF TECHNOLOGY
For the best outcomes, work closely with your pediatric audiologist to understand your baby's degree of hearing loss, and if you don't understand, don't be afraid to ask questions.
Thankfully, babies with hearing loss have many options today. For most babies diagnosed with hearing loss, even a profound hearing loss, there’s a hearing device that can offer their brain access to all the sounds of speech. The device recommended for your baby depends on the nature of your baby’s doorway problem at any point in time. You are your baby’s first teacher and it’s important to find the right device for your baby to gain the best brain access to all the sounds of speech.
Ears are the Door to the Brain
Dr. Carol Flexer, a notable audiology thought leader, explains how we hear with our brains and why hearing technology is so important.
FIRST HEARING DEVICES
Hearing aids are typically the first hearing devices recommended to activate the auditory centers of your baby’s brain as soon as possible. The quality of today’s hearing aids for infants and young children can provide excellent brain access to all of the sounds of speech, leading to the development of listening and spoken language, reading, and academic success.
Behind-the-Ear Hearing Aids
Behind-the-Ear Hearing Aids are typically recommended for sensorineural hearing losses and for some conductive hearing losses in order to deliver auditory information through the doorway to your baby’s brain.
- These are hearing aids that can be customized for your baby’s hearing loss, and they use earmolds to fit your baby’s unique ear shape.
- Making earmolds for your baby is a painless, easy process. The audiologist uses a soft substance to make an impression of your baby’s ear. This impression is sent to a special lab to be made into an earmold. Some audiologists may be able to make the earmold right in the office.
- After attaching the new earmold to the device, the audiologist will create settings (programs) on the hearing aids that are specific to your baby’s hearing loss.
Your baby grows rapidly in the first year of life; this means that your baby’s ears will also be growing. Earmolds will have to be remade many times during the first year – especially the first six months of life. The quality and fit of the earmolds will be critical for your baby’s brain to access the best sound through the hearing aids.
CHECKLIST: HEARING AIDS FOR LITTLE EARS - Keeping hearing aids on little ears during all waking hours is important for learning to listen and talk. Learn what you can do to help your baby keep their hearing aids on and get the most listening possible.
Bone Conduction Hearing Aids
Bone Conduction Hearing Aids may be recommended if your baby’s doorway has a conductive problem/hearing loss.
- These devices are placed on the bone (mastoid) located just behind the ear and are held in place with a headband. The sound travels through the mastoid bone to the auditory nerve and then to the brain, so that your baby can hear – or receive auditory information.
- When your baby gets bigger, there are bone-anchored hearing aids (BAHA) that may be recommended. These consist of two parts, one that’s surgically anchored to the bone behind the ear and another removable part that is the actual hearing aid. At that point, a headband is no longer needed, as the hearing aid is always right where it’s supposed to be.
Your baby’s brain, with even severe to profound hearing loss, can access some speech by wearing hearing aids. In fact, many children continue to develop good speech and language with hearing aids. However, children whose brains are not able to access all the sounds of speech at a soft level (35 dB HL) through their hearing aids, due to the degree of their doorway problem, may miss out on the higher frequency speech sounds, such as /s/ and /f/. This reduced auditory brain access may affect speech development and the ability to learn higher level language skills required for reading and academic success.
When you and your baby attend regular appointments with the pediatric audiologist to manage their hearing devices and are enrolled in early intervention, you’ll have a team of LSL professionals supporting you. They can guide you in the decision to make a change in hearing technology if hearing aids are not getting enough auditory information to your baby’s brain to meet your LSL goals.
When Hearing Aids Are Not Enough
Cochlear implants are hearing devices that provide brain access to sound through a surgical procedure. They are typically recommended if your baby’s brain cannot access all the sounds of speech to develop listening and spoken language by using hearing aids. In the United States, cochlear implants are not typically inserted before one year of age, although they may be recommended much younger. There are specific audiological and medical guidelines that your audiologist and physician will share with you if a cochlear implant is recommended.
A cochlear implant consists of two main parts:
- One part is surgically implanted under the skin and in the inner ear (cochlea).
- The second part, called the speech processor, is worn on the ear like a hearing aid and has a magnetic piece that attaches to the side of the head.
A cochlear implant actually replaces the part of the inner ear, the cochlea, that’s not working properly, and it works by sending electric signals to stimulate the auditory nerve which carries information to the brain.
Getting Cochlear Implants
If cochlear implants are recommended for your baby, you’ll go to a series of appointments at a cochlear implant center to determine if they qualify. You’ll consult with a cochlear implant surgeon, audiologist, and other professionals, like a speech-language pathologist or educator of the deaf and your early interventionist. There are several cochlear implant manufacturers available in the U.S. Your medical team will provide you with the information you need to make the best choice for your baby. Choosing the cochlear device that best fits your baby’s needs is an important one because your baby will wear the cochlear implant (as their doorway, brain access device) throughout their life.
Companies with FDA-approved Cochlear Implants in the U.S.
Assistive Listening Devices
In some cases, whether your baby uses hearing aids, cochlear implants, or bone-anchored technology, additional devices may be recommended to help your baby hear their best in any listening environment.
A personal FM system is a device that connects to your baby’s hearing aid or cochlear implant and then to a microphone worn by you, which sends the sounds of your voice directly into your baby’s hearing device and then to your baby’s brain.
- The FM device helps your baby hear even in noisy environments, which includes most of the places your baby will live and play.
- Many families use the FM device for car travel, grocery shopping, restaurants, daycare and school settings, or anywhere that background noise makes listening more difficult for a new listener and keeps your baby’s brain from hearing the full range of speech and language surrounding them.
A sound field system is a device with a set of speakers and a microphone. This device is also used to help your child access spoken language in noisy environments.
- The sound field system is typically used in a classroom setting. The microphone is worn by the teacher and the sound is presented from speakers anchored to a wall or a shelf.
- The teacher’s voice is amplified throughout the room so that everyone hears clearly. There is often a microphone that the teacher can pass from student to student so that your child has access to the classroom communication of their friends.
Many other devices and accessories are available to connect to computers, smart phones, and TVs. There are also permanent systems, like inductive loop systems and infrared systems, that can be installed in commonly used environments. You’ll need to talk with your audiologist or LSL professional to see what the manufacturer of your child’s hearing device offers and/or recommends.
CARE AND TIPS
Every hearing device needs routine care and maintenance. You’ll need to understand how to use batteries, cables, and other parts of your baby’s hearing devices. Your LSL professional team will help teach you about the care and maintenance of your baby’s hearing devices.
For device-specific care, hearing technology manufacturers often have many informational resources, like customer service departments that can answer questions about equipment, manuals for troubleshooting, and websites with instructional videos.
After familiarizing yourself with device care, find a secure place in your home to keep all your equipment and spare parts. Many people like to use well-trafficked, enclosed places, like medicine cabinets and kitchen drawers, so they don’t lose track of them.