1. Hearing Instrument
Orientation for Children
and Their Families
Chapter 29 by Tharpe & Ryan

2. Family Counseling and Education
Family Education
Sjoblad et al., 2001
Often 2 to 3 week
delay between Dx
and HA fitting but
may be delayed
greater than 4
weeks

3. Family Counseling and Education
During this delay, parental experiences may be
either positive or negative
Negative -- self-doubt, anxiety
Positive -- gaining knowledge
Robbins (2002) -- recommendations for
audiologists to give to parents (re: parent-child
interaction) for time period following Dx prior to
enrollment in intervention program

4. Family Counseling and Education
Phase I -- From time of diagnosis to hearing aid fitting
● Continue to talk to your child -- Play gesture games, sing songs, be animated
● Begin a journal of your experience
● Contact the John Tracy Clinic -- they provide correspondence for families in more
than 20 languages
Phase II-- Early weeks just following the hearing aid fitting
● Keep a weekly hearing aid calendar
● Refer to your child by name -- always have a purpose for calling your child
● Use a hand-to-ear response when a sound is heard
● Tell your interventionists of changes in vocalizations as well as auditory responses
Phase III -- After the initial adjustment to hearing aids until formal intervention
● Imitate your child's vocalizations, using intonation, patterns and sound
● Encourage an anticipatory response to sound--make clear to your child that you
expect a response and wait for that response
● Select three common sounds in your home for your child to learn

5. Family Counseling and Education
Hearing Aid Orientation
Many parents will not remember all the
information to you present to them (Eiser et al.,
1994; Reese et al., 2005)
What to do?
printed handouts
reiterate the same information at follow-up
invite client's extended family to orientation

6. Family Counseling and Education
Fundamental Points for Parents

7. Family Counseling and Education
Care and Maintenance
cleaning - no alcohol, mold in warm water
storage - case with desiccant or drying unit
listening check by parent

8. Family Counseling and Education
Safety Features and Issues
Overamplification - verification, deactivate VC
Battery Ingestion
Ear Placement - left vs right

9. Family Counseling and Education
Realistic Expectations
Effects of Background Noise
Acoustic Feedback
Communication Strategies
Environmental Awareness

10. The Physical Fit
Earmolds - retain aids in the ear and house the
acoustic pathway from receiver to sound outlet
Style
Material
Venting
Tubing

11. Retention
Behavioral Retention: Establishing the Routine
Physical Retention and Protection

12. Family Counseling and Education
Phase I -- From time of diagnosis to hearing aid fitting
● Continue to talk to your child -- Play gesture games, sing songs, be animated
● Begin a journal of your experience
● Contact the John Tracy Clinic -- they provide correspondence for families in more
than 20 languages
Phase II-- Early weeks just following the hearing aid fitting
● Keep a weekly hearing aid calendar
● Refer to your child by name -- always have a purpose for calling your child
● Use a hand-to-ear response when a sound is heard
● Tell your interventionists of changes in vocalizations as well as auditory responses
Phase III -- After the initial adjustment to hearing aids until formal intervention
● Imitate your child's vocalizations, using intonation, patterns and sound
● Encourage an anticipatory response to sound--make clear to your child that you
expect a response and wait for that response
● Select three common sounds in your home for your child to learn

13. Follow-Up and Monitoring
How Often for Follow-Up
Every 3 mos. for first through age 2 years
Every 4 to 6 mos. for children 3 years and older
Hearing aid check - listening check and
electroacoustic analysis

14. Follow-Up and Monitoring
New Molds
new molds ~ 2 to 4x
year depending on
acoustic fit
Real-ear verification
following the fitting of new molds
Hearing evaluations - annually

15. Child Education
As the child gets older, interaction with aids
increases
Insertion/removal of aids and batteries
Cleaning/storing aids
Use of volume control and/or program button
Increasing knowledge of hearing loss/ aids

16. References
Eiser, C., Parkyn, T., Havermans, T., and McNinch, A. (1994). “Parents’ recall on the diagnosis of
cancer in their child,” Psycho-Oncology 3, 197-203.
Ingrao, B. (1999). “MORE THAN MEETS THE EAR : UNDERSTANDING AND OPTIMIZING YOUR
CHILD’S EARMOLDS,” Volta Voices 26-29.
Reese, J. L., and Hnath-Chisolm, T. (2005). “Recognition of hearing aid orientation content by first-
time users,” American journal of audiology 14, 94-104.
Robbins, A. M. (2002). Empowering parents to help their newly diagnosed child gain communication
skills. The Hearing Journal, 55(11), 55-56, 59. Retrieved from http://journals.lww.
com/thehearingjournal/Abstract/2002/11000/Empowering_parents_to_help_their_newly_diagnose
d.10.aspx
Sjoblad, S., Harrison, M., Roush, J., and McWilliam, R. A. (2001). “Parents’ reactions and
recommendations after diagnosis and hearing aid fitting,” American journal of audiology 10, 24-31.