“I Won’t Need Hearing Aids When I Grow Up” and Other Misconceptions: Informed Choice for Students
Many years ago, a student told me “I won’t need hearing aids when I grow up.” When I asked why she thought this, she told me that she’d figured it out because she had never seen an adult wearing hearing aids. She assumed that probably some adults had had hearing aids when they were children, but that their hearing losses disappeared when they grew up and they didn’t need hearing aids anymore. Not having any information to help her, and not having anyone that she felt comfortable asking, she had formed her own (not illogical) conclusion about her future. From my own experience, encountering students who know little or nothing about their own hearing loss is the rule, not the exception. It is rare that I find a student who is able to understand his/her own audiogram and explain it to me. As professionals, we are always cognizant of ensuring that the adults in the child’s life understand the implications of hearing loss. Do the parents understand the implications of only wearing hearing aids 2 hours per day? Does the classroom teacher understand that just because the student turns when his name is called, that does not imply comprehension? Do all of the high school teachers understand the importance of putting on the FM system transmitter? Will someone be doing a presentation to the student’s classmates to nip potential bullying in the bud? However, in all of our plans to in-service the adults, we don’t always remember the need to in-service the student.
It is not really very surprising that many students don’t know much about their own hearing losses when we consider where students have opportunities to obtain this kind of information. Clinical audiologists, who do have the technical knowledge to explain hearing loss and audiograms to their pediatric patients, understandably have a great deal on their “to do” list at an appointment to ensure that audiograms and hearing aid settings are updated, and that parent concerns and questions are addressed. Some students might feel comfortable asking their clinical audiologist a question, but many do not. Parents, who spend the most time with their children and the best opportunities to field questions, often do not have the knowledge to be able to explain technical information. Very often, teachers of the deaf and hard of hearing are the ones to include this type of education in their educational programs, but again, they are also concerned with language and literacy goals, checking equipment and ensuring that school staff are well-informed and implementing classroom recommendations.
Clearly, this educational work with students needs to be specifically included in our plans, and there can be a place for both professionals and parents in doing this. Ultimately, we cannot expect students to be able to be good self-advocates and to be on board with what we want them to do (such as wearing their hearing aids and using their FM systems), if they do not have a clear understanding of their own hearing. When students do not understand the impact of hearing loss on communication in their day to day activities, it is not uncommon for them to blame themselves, to feel stupid or incompetent or have poor self-esteem. If a classroom teacher gives a homework assignment while the students are packing up their books to go home at 3:30 and the student with the hearing loss is the only one to miss the information (and then be the only one who didn’t do the homework when the teacher checks the next day), it is not very likely that he/she will say “well, no wonder I didn’t hear the homework, it was too noisy because everyone was slamming their books and scraping their chairs and that’s a difficult situation for me because of the kind of hearing loss I have.” What is much more likely is that the student’s self-talk will be “I wasn’t concentrating hard enough, I wasn’t listening hard enough, I’m not as smart as everyone else, I can’t remember things, why can’t I do what everyone else can do?” We would like students to have a better answer to “why do you need to wear hearing aids?” than “my parents said I have to”. One of the resources that I often use to demonstrate the impact of hearing loss on social interactions is the video “The Lost Joke” from the National Deaf Children’s Society (NDCS) in the UK. The look on the student’s face at the end of the video demonstrates both the implications of not being able to participate in a conversation and how alone she is in coping with the effects of her hearing loss, better than any handout. As much as we try to support our students with hearing loss, ultimately, they will need to find their own way in life, and being armed with a toolkit of accurate information about their own hearing loss is foundational.
What can we do as professionals to help students learn about their own hearing losses? Finding resources for teaching deaf and hard of hearing children about their own hearing losses is surprisingly difficult. There are some resources for teens and young adults – for example, the section “Deaf-Friendly Information for Teens and Young People” on the NDCS website, but age-appropriate information for younger students is more difficult to find. The website successforkidswithhearingloss.com has great resources in the Self Advocacy section, as does the Ida Institute, which offers the My World counselling program which can be used in a variety of settings, including during an audiological appointment. Clinical audiologists are limited by the amount of time they have available with a child, but if we can not only educate parents about their child’s hearing loss but also direct them towards resources that they can use with their children, parents can become the local experts for the child. Why not include some children’s books about hearing loss in your waiting room reading materials, or provide a list of books that parents might be interested in buying to read with their children? For example, “Lucy” is a book about a rabbit with a unilateral hearing loss; “Let’s Hear It for Almigal” is the story of a little girl with bilateral cochlear implants; both available on Amazon at reasonable prices. Point parents towards resources such as the National Deaf Children’s Society YouTube channel, Hands and Voices, the Ida Institute, or local parent organizations such as Voice for Deaf and Hard of Hearing Children.
Students need information about their own hearing losses, but they also need the language to talk about it. For example, a student explained to me that he knew he had a moderate hearing loss, but that he didn’t need to wear his hearing aids because when he put them on, things didn’t really sound any louder than when he wasn’t wearing them. In fact, this student had typical hearing in the low and mid frequencies, and a moderate hearing loss in the high frequencies - as audiologists, we know why his hearing aids don’t sound loud but why he needs them anyway, but he didn’t. As professionals, our focus is always on informed choice for parents based on appropriate information. This student is making a choice about wearing his hearing aids, but it isn’t an informed choice. While knowing how to read his own audiogram may not suddenly inspire him to start wearing his hearing aids, he now understands why he is being asked to do so. Knowledge, as they say, is power.