Choosing Your Child's Hearing Aids - Hearing Aid Types
Working with your audiologist, you will most likely have at least a few choices to make in regards to your child's hearing aids. BTE vs ITE? Digital? Programmable? Analog? The decisions aren't easy, and often times are influenced by other factors such as the availability of funds.
Behind The Ear (BTE) or In The Ear (ITE)
The difference between these to types of hearing aids is pretty self explanatory. Behind the ear aids sit behind the ear and have an ear mold attached that fits into the child's ear. In the ear aids are fully self contained within the ear.
For the majority of kids, behind the ear models are what you will use, and for a very obvious reason - kids are constantly growing, as are their ears. In the ear models are made to fit the recipient's ear and replacing them every time your child goes through a growth spurt is not feasible.
The components are all contained in a plastic case which sits behind the ear. The case is connected to an earmold by a piece of clear plastic tubing. 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.
With BTE's, you do have the ongoing expensive of new ear molds. As we said above, kids are constantly growing and their molds must maintain a proper fit in order to work properly and avoid problems like feedback. How often you replace the molds largely depends on your child's growth - from the time our kids were born until they were two years old, they had to get new molds almost every two months! After that, their growth, and the need to purchase new molds slows down greatly.
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.
Digital vs Analog? Programmable?
In choosing your child's hearing aid, one of the more basic choices will be that of digital versus analog. The basic difference in the two is how the sound is processed. The analogy that is commonly used is to think of analog as a record player and digital as a CD player - the CD obviously is clearer and produces better sound.
In a nutshell, marketing literature from hearing aid manufacturers (and some audiologists) claim digital is vastly superior in the quality of the sound reproduction. Analog processing keeps the waveform throughout the process, much like a record album. Further, analog aids amplify everything across all frequencies. Digital processing allows the instrument to do more complex and detailed operations.
Hearing aids can be divided into three major technologies. Your audiologist will guide you through the numerous options available to determine which of the following general technologies would be most appropriate for your child.
Conventional with analog signal processing (analog). These are the most basic hearing aids. They typically provide "linear" signal processing where soft, average and loud sounds are amplified equally. With these hearing aids, patients often turn up the volume control for soft sounds and turn down the volume control for loud sounds. These devices aids usually require the audiologist to send the hearing aids to the manufacturer whenever changes are necessary. These instruments are a good choice for patients where finances are a major consideration.
Programmable with analog signal processing (analog, digitally programmable). These are analog instruments with digital programming that allow the audiologist to change the parameters of the hearing aids via a computer. This might be necessary to compensate for changes in hearing or sound quality. Most of these hearing aids provide "nonlinear" signal processing where they amplify softer sounds more, and loud sounds less. Because this signal processing automatically adjusts volume, many of these hearing aids do not have a volume control. Some of these hearing aids have several memories "stored" in the hearing aids that are available for improved understanding in different listening situations. A remote control may be necessary to access these memories or change the volume. Some of these hearing aids also include more than one microphone for enhanced understanding of speech in noise.
Programmable with digital signal processing (digital). This is the most current and level of technology available. Hearing aids with DSP are capable of providing millions of calculations per second on the signal(s) received at the microphone before they are amplified and sent to the listener. Some of these hearing aids allow the audiologist to "divide" the frequency response into numerous bands for significant flexibility in shaping the response of the hearing aids to more closely match the individual needs of the patient. Some of these hearing aids include more than one microphone to further enhance the understanding of speech in noise. One of the advantages of these hearing aids is the capability to reduce or eliminate feedback or "whistling."
In the past, the single biggest factor between analog and digital was price - in 2000 when we fitted Bobby with his aids, digital aids were $2,000 more than analog ones! However, in very recent history, this has changed drastically and digital aids are now approaching the cost that we paid three years ago for analog programmable aids.
It is best to consult with your audiologist to find out what will work best for your child. Obviously any decision will be based on financial considerations as well. You may wish to check out our funding section for more information on how to obtain help in purchasing your child's hearing aids.
Help Kids Hear is a site dedicated to helping parents of deaf and hard of hearing (DHH) children. We are parents of hard of hearing kids and simply want to "give back" to the community. We welcome your comments, questions & suggestions. Please drop us a note at firstname.lastname@example.org.