When talking about pediatric audiology, a common topic you might hear discussed is the concept of device use. What we mean by device use is the amount of time per day a child is using their hearing technology to access speech. Hearing technology can include any type of hearing aid or cochlear implant. A lot of research has emerged in the past few years that has helped to highlight more precisely the correlation between the amount of time children use their hearing technology and their spoken language development when compared to their hearing peers. This has driven a push from pediatric audiologists to parents to increase device use to a minimum of 8-10 hours per day (if the goal of the family is for the child to learn and communicate using primarily spoken language). While this push can be valid in many ways, there is one big issue that can sometimes be overlooked by audiologists:
Getting your child to keep their hearing technology on can be really #@$%*%@ hard.
I, myself, can only empathize when parents come in and say their child has only been wearing their hearing aids for one, maybe two hours per day. Maybe even not at all on the weekends. And the primary reason? Well, say the parents, keeping the technology on is nothing short of a war.
There’s screaming.
There are tantrums.
There’s throwing.
There’s biting.
Theirs breaking.
Tugging.
Ripping.
Flushing.
Crying.
If any of you follow My Battle Call by Valli Gideons, you even know that some children throw their technology to the gorillas. Literally.
When I say empathize, I simply mean that . . . while I’m a parent, I don’t have any children with hearing loss. So, I simply cannot identify with the struggle you are facing. I can only believe that it’s real, and I may cry with you. It’s just hard.
And sometimes, it may feel like these struggles are being dismissed. It’s an unfortunate practice in audiology to bypass the reality of raising a child who is Deaf or hard-of-hearing and stick to only talking about the technology. Wear it, they say. Keep it on, they say. Use a bonnet, they say. At least 8 hours per day, they say.
Your response? Well, doc – easier said than done.
And you’re right.
However, so is the pediatric audiologist. And, while they could be more sensitive to how you’re feeling, their hearts are in the right place. In our heads, you’ve expressed that you want your child to learn spoken language, and the first way to do that is to ensure your child has access the sounds of spoken language. Our primary goal for all our patients is for them have access to language and communication because this is a basic human right. When we see limited device use and there is no other targeted communication modality in the home, it’s something we worry about. Language deprivation is a big deal, and we want to help avoid that at all costs.
So, what can be done? Hopefully, if you have a good pediatric audiologist, you make a plan of action that best meets your needs. This includes relying on your ideas for how to best motivate your child to use their technology. For all behaviors, there is an antecedent that can trigger said behavior. And, if you’re human, following that behavior there is a consequence. These are known as the ABCs of behavior (antecedent, behavior, consequence). Talk with your audiologist and try to pin-point where the break-down (antecedent) occurs. Is it when you simply approach the child with the technology? Is it when they first take them off after only wearing them for a few minutes? Maybe it’s when they get too close to the wall and the hearing aid squeals.
Whatever that antecedent, you’ve got a behavior on your hands that makes it hard to persist with device use. How you choose to respond can lend towards the child’s perception of consequence. (If I do _______, then _______.) Work with your pediatric audiologist to understand what you can do to help the child understand that (a) it’s okay to be upset at the technology and (b) despite that upset, the child will still wear their technology.
There are a lot of tips and techniques out there from other parents of children with hearing technology. The most common is a reward system. Children respond to gifts and treats. And they don’t even need to be fancy, expensive gifts! Star charts can work wonders! Give a child a sticker for every hour they keep their technology on and make a sticker book. Connect the idea of wearing technology to something positive. While the quantity of time wearing technology is important, the quality of time wearing them is important, too.
Most importantly – don’t beat yourself up. If you have a bad day, that’s JUST FINE! Parenting is hard. Self-care is important. Sometimes you do just need to pick your battles, and maybe hearing technology isn’t one of them. You’re not failing your child. You are a good parent, and your child loves you limitlessly. Choose consistency. Pick yourself back up and try again the next day!
A lot of resources exist! Please check out our favorite – Hear to Learn. And don’t forget to reach out if you need support from us! Little Heroes Pediatric Hearing Clinic is here for you.
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