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AMPLIFICATION OPTIONS

TYPES OF HEARING AIDS
All hearing aids consist of four basic parts:

  1. Microphone - picks up the sound and sends it to the amplifier
  2. Amplifier - makes the sound louder
  3. Receiver - sends the amplified sound into the ear canal
  4. Battery - supplies the power to the hearing aid

Behind-the-Ear Aids
The behind-the-ear (BTE) hearing aid is the device most used by children. The components are all contained in a plastic case which sits behind the ear. The case is connected to an earmold (not shown here) by a piece of clear plastic tubing. The earmold is specially designed to fit inside of the user's ear. A BTE hearing aid may be used with any degree of hearing loss and can be very flexible for use with a telephone or assistive listening device. (Photo courtesy of Siemens, 1997)

In-the-Ear Aids
The in-the-ear (ITE) hearing aid is smaller than the BTE hearing aid. All of the components fit inside of the plastic case which is made to fit the user's ear. The ITE hearing aid is not always the most appropriate choice for pediatric amplification because the aid must be replaced as the child grows. (Photo courtesy of Siemens, 1997)

In-the-Canal Aids
The in-the-canal (ITC) hearing aid is even smaller than the ITE hearing aid, fitting entirely inside of the ear canal. The ITC is used primarily with mild-to-moderate hearing losses. It is not recommended for pediatric use because of its size, and because it must also be replaced as the child grows. (Photo courtesy of Siemens, 1997)

Body Aids
A body aid consists of a rectangular case and an earmold. The rectangular case contains the microphone, amplifier, and batteries and may fit into a pocket or "fanny pack". There is a cord which connects the case to the button receiver. The button receiver is snapped into an earmold which is placed in the ear. The body aid is often used by people who have a severe-to-profound hearing loss.

Bone Vibrator Aid
The bone vibrator hearing aid is primarily used by patients with conductive losses, or those who cannot wear traditional hearing aids, such as patients with atretic or microtic ears. The vibrator sits on the mastoid bone and is held in place by a headband.

Cochlear Implants
The cochlear implant is a relatively new device. It consists of internal parts, which go under the skin behind the ear and in the cochlea, and external parts worn behind the ear and on the body. The internal component, which is inserted during a surgical procedure, is made up of an electrode array, a receiver, and a magnet. The electrodes are inserted into the cochlea and the receiver and magnet are set into the bone behind the ear. The external component is made up of a transmitter coil, a microphone, and a speech processor. Both the transmitter coil and microphone are worn behind the ear, while the speech processor may be fit into a pocket or fanny pack. There are several criteria which a child must meet in order to be considered an implant candidate. The child must have a severe-to-profound bilateral loss, and receive little or no benefit from hearing aids. Medical, psychological, and educational status are also taken into consideration prior to implantation. (Picture courtesy of Cochlear Corporation, 1997)

Click HERE for more information regarding cochlear implants.

FM Systems
FM systems, or auditory trainers, are primarily used in the school setting; however, they may be useful in a variety of listening situations. The system consists of two parts: a transmitter and a receiver. The speaker wears the transmitter and speaks into a microphone attached to it. The listener wears the receiver which picks up the signal from the microphone and delivers it to the ear through an earpiece on the child's hearing aid. The size and shape of the two components may vary, but the purpose remains constant: to raise the level of the speaker's voice above the background noise (increase the signal-to-noise ratio). (Photo courtesy of Phonic Ear Inc. 1997 Phonic Ear Inc.)

HEARING AID MAINTENANCE

About the Hearing Aid
The hearing aid is a delicate instrument. Ideally, the aid should be checked for repairs needed and cleaned by an audiologist at least once a year. Careful handling and proper maintenance will help prolong the life of the child's hearing aid to a typical useage of about 5 - 7 years.

Hearing Aid Care

  • Avoid High Temperatures - Don't leave the hearing aid in the direct sunlight, in a hot car, on a heater, or on any other piece of equipment that generates heat. Heat can damage the hearing aid amplifier and can cause batteries to deteriorate.
  • Avoid Moisture - Keep the hearing aid dry. Even perspiration can cause damage to the hearing aid.
  • Protect the Aid from Hard Knocks - Avoid dropping the hearing aid or bumping it against hard objects.
  • Removing the Aid - Get into the habit of turning the switch to the "OFF" position before you take off the aid. When the switch is in the "ON" position, the battery is discharging whether the child is wearing the hearing aid or not. If the aid doesn't have an "OFF" switch, open the battery compartment so that the battery is not touching the battery contacts.
  • Repairs - Do not attempt to repair the hearing aid. If the aid is not functioning properly, ask the audiologist or hearing aid dealer for assistance. Many times a loaner aid can be supplied by a hearing aid dispenser while the aid is being repaired.
  • Tubing and Cords - If the child has a behind-the-ear or eyeglass type of hearing aid, the tubing should be replaced when it becomes dry, brittle, and yellow. If the child has a body aid, the cord will eventually wear out or develop a short and need to be replaced. Avoid twisting the cord, and do not use safety pins to position the cord since the pin could inadvertently pierce the cord.

Earmold Care

  • Keep the earmold clean. If the opening becomes clogged with wax, clean it gently with a pipe cleaner.
  • At frequent intervals, the mold should be detached from the hearing aid and washed with soap and water. Do not wipe the child's earmold with alcohol since it will cause the earmold to deteriorate.
  • Before connecting the cleansed earmold to the hearing aid, make sure that the earmold is completely dry since a drop of liquid may block the passage of sound, as well as damage the aid.

Battery Care

  • Keep several spare batteries handy, but be sure to buy several batteries at a time since they lose their strength as they age. If the battery comes with a sticker on the back of it, it will not begin to drain until the sticker is removed.
  • Store the batteries in a cool, dry place.
  • Wrap the batteries in plastic to avoid accidental contact with metal objects, if you'll be carrying the batteries in your pocket or handbag.
  • Remove batteries from the aid at night to prolong battery life. Occasionally, a defective cell may leak and removing the battery daily will permit you to examine it and dispose of it before it damages the aid.
  • If the battery contacts in the aid become corroded, they should be cleaned by the hearing aid dealer or dispenser. Poor contacts can contribute to a loss of power and may result in a "frying" sound in the hearing aid.
  • If you notice a sudden decrease in battery life (determined by the frequency with which you replace batteries for the child), have the aid checked by the hearing aid dealer or dispenser. Excessive battery drain generally means a defective aid.
  • Remove dead batteries from the aid immediately, otherwise they may leak and cause damage to the hearing aid.
  • When you replace a battery, be sure the contacts of the battery match the markings on the battery compartment of the aid.

DAILY HEARING AID CHECK
This should be done every day before you put the hearing aid on your child. Twice a day is optimal.

Insert a Good Battery

  • Be sure the negative and positive terminals of the battery are inserted properly.
  • Notice the battery connections; they should be free from dirt and corrosion.
  • If you notice something that looks like corrosion, take a Q-tip and dip it in vinegar, ammonia or baking soda and water. Squeeze the Q-tip to get rid of excess moisture and rub the contact gently. You can also use a pencil eraser or a nail file to rid the battery connections of build-up.

Inspect the Earmold

  • Make sure that the earmold is free of wax and dirt.
  • Blow on the earmold and you should be able to feel a strong stream of air on your finger.
  • If the earmold is dirty, use a warm, soapy water solution to clean it. Wash the earmold only if it feels or looks dirty or has wax in it.
  • Wash only the earmold. Unhook it from the receiver on body aids and from the ear-hook on ear-level aids.

Inspect the Receiver of Body Aids

  • Inspect the cord for any cracks or damage.
  • Be sure that the receiver does not have a crack in it. Be sure that the nub fits snugly against the earmold.

Inspect the Tubing of Ear-level Aids
This is the tubing that runs from the earmold to the nozzle (ear-hook) of the aid.

  • Check this for cracks or weak spots.
  • If it becomes hard and cannot be compressed, it should be replaced by the audiologist.

Attach the Stethoscope to the Hearing Aid

  • Turn the aid on and off several times to check the switch.
  • Turn the aid up to the volume where your child wears it and listen for distortion.
  • Check to see if the aid gets louder as the volume control indicates.
  • It will never be linear but you need to be familiar with the loudness gains of your child's aid.
  • For body aids, take the cord between your thumb and index finger and "run" your fingers down the cord.
  • Wiggle the cord at both ends and listen for "breaks" in the sound.

While Listening to the Aid, Do the "6 Sound Test"
Say the following sounds:

  • "a" as in father
  • "ee" as in feet
  • "oo" as in food
  • "sh" as in shoe
  • "s" as in sun
  • "m" as in man

Try to say these sounds at the same loudness and subjectively determine if any of these sounds sound strange to you. You will begin to learn how they should sound and will begin to notice distortion, should it occur.

HEARING AID TROUBLESHOOTING
The following information will help you to keep the child's hearing aid in the best working condition. Most problems with hearing aids can be remedied if you have two pieces of inexpensive equipment (a stethoscope and a battery tester) and faithfully check the child's hearing aid every day. Any problem with the hearing aid that you cannot solve should be referred to the child's audiologist or hearing aid dealer as soon as possible.

Squealing (Acoustic Feedback) at Normal Volume Level

  • To determine the cause of feedback first take the hearing aid off your child. Keep the hearing aid on the loudness setting it is already on. Put your finger over the end of the earmold hole. If the whistle goes away the mold may be too small. Have the audiologist make a new earmold impression if needed.
  • If the whistle does not go away, take off the mold and put your finger over the receiver hole (Body aids only). If the whistle goes away, get a plastic washer. This washer will help stop the sound from leaking out between the receiver and the mold. For ear-level hearing aids take the earmold off of the earhook and place your finger over the tip of the earhook. If the whistle goes away, the earmold tubing may need replacing.
  • If the whistle still does not stop, unscrew the earhook and place your finger over the opening to the aid. If the whistle stops then replace the earhook. If not, the hearing aid may have a problem called "internal feedback". This means that the whistling is coming from inside the case and needs to be returned to the audiologist or hearing aid dealer for repairs.
  • If the problem is not solved via the above procedures, check with your audiologist regarding the volume control setting to determine if it is too high.

Hearing Aid Does Not Work

  • Check the battery with the battery tester. Replace the battery if it is dead.
  • Make sure that the positive and negative terminals of the battery are in proper position in the battery compartment.
  • Check for corrosion on the battery contacts. If corrosion is present, it can be removed with a pencil eraser.
  • Check to see that wax is not covering the opening of the earmold. The earmold may be washed with warm, soapy water. Be sure it is completely dry before putting it back on the hearing aid.
  • Check to see that the external switch is not set to the "telephone" or "off" position.
  • While listening to the aid, wiggle the cord (Body aids only) where it inserts into the receiver and into the aid. If the sound is intermittent, the cord has a short.
  • Make sure the correct type of battery is being used.
  • Make sure the earmold tubing is not collapsed or clogged.

Intermittent, Scratchy Sound

  • Wiggle the cord (Body aids only) where it inserts into the receiver and into the aid. If there is intermittent sound or the quality changes, the cord needs replacing. Replace the cord and check again.
  • Make sure that the battery is correctly seated and snug in the battery compartment.
  • Make sure tubing does not collapse or bend when the child's head is turned.
  • Make sure plugs are firmly inserted in their receptacles.

Distorted Sound Quality, Motorboating ("putt-putt") Effect, or Weak Volume

  • Change the battery.
  • If another receiver is available, replace the old one (Body aids only).
  • Make sure the mic opening is not covered or clogged.
  • Check for corrosion on the battery contacts and terminals.
  • Clean with a nail file or pensil eraser while holding the aid upside down so particles fall out of the aid rather than into it.

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