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Hearing Aids & Cochlear Implant Options

  1. Hearing Aids
  2. Types & Sizes of Hearing Aids
  3. Batteries
  4. Colors of Hearing Aids
  5. Processing in Hearing Aids
  6. Questions to Consider Asking the Audiologist when Getting a Hearing Aid
  7. Useful tips for caring for your hearing instruments
  8. How to Care for Your Hearing Aids
  9. Troubleshooting Hearing Aids
  10. Cochlear Implants

Hearing Aids

A hearing aid is an electronic device that amplifies sound at different levels for different pitches. Hearing aids consist of a microphone, amplifier and receiver:

Diagram of a hearing aid showing microphone (picks up sound waves from the air and transforms them into electrical signals), receiver (sends the amplified sound into your ear), earhook (connects the hearing aid to the earmold), on/off switch/program switch, battery door, and volume control.

  • Microphone - an electronic device that picks up sound (an acoustical signal) and changes it to an electrical signal in the hearing aid. There are several types of microphones which can be used in hearing aids. Some microphones can assist with listening in background noise. Ask an audiologist for more information.
  • Amplifier - an electrical device that makes the sound which was changed into an electrical signal larger (creating a louder signal)
  • Receiver - an electronic device that changes the electrical signal back to sound (an acoustical signal)

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Types & Sizes of Hearing Aids

  • Behind-the-Ear (BTE) - a hearing aid that sits behind the pinna and is coupled to the child's ear by an earmold. The hearing aid can come in a skin tone or a bright color. Consult your audiologist regarding important safety options such as a volume control cover which prevents the child from turning the volume too loud or too soft; battery lock - keeps the child from opening the battery door and taking out the battery (used to prevent battery ingestion) BTE aids are chosen for children due to safety concerns, flexibility, durability and ease of changing the earmold when the child grows
  • In-the-Ear (ITE) - a custom-fit hearing aid (made for a specific person) that fits in the bowl of the ear
  • In-the-Canal (ITC) - a custom-fit hearing aid (made for a specific person) that fits in the ear canal and entrance to the ear canal
  • Completely-in-the-Canal (CIC) - a custom-fit hearing aid (made for a specific person) that fits in the canal of the ear;
  • Earmold - a custom mold of the child's ear that takes amplified sound from the behind-the-ear hearing aid to the ear. Each earmold is made specifically for one child and cannot be used by another person. In the first two years of life, earmolds may need to be changed frequently due to the child's rapid growth. At over three years of age, a child may keep the same earmold for as long as one year. As the child grows, an earmold may become loose and cause feedback/whistling. Earmolds come in clear tones to match the skin or a variety of colors.


A battery provides electrical power to the hearing aid. The estimated battery life for a button battery varies with each device and its power needs. Estimated battery life is available from your audiologist. Batteries are made by several manufacturers. The hearing aid will require the same size battery every time, however the manufacturer of the battery does not have to be the same every time. An easy way to remember the battery size is by the color of the sticker on the back of the battery:

  • Size 10 - yellow
  • Size 312 - brown
  • Size 13 - orange
  • Size 675 - blue

Battery Care

  • Store and discard batteries in places that cannot be reached by infants, children, or pets
  • After you remove the battery tab, air enters the battery activating the battery. Therefore do not remove a sticker until the battery is to be used. Replacing the tab when the battery is not in use will not extend the battery life.
  • Batteries should be stored in a cool dry place at room temperature. Exposure to extreme heat or cold will shorten the life span of the battery (this may be important when carrying hearing aid supplies in the car.) Avoid cold places like the refrigerator where condensation can cause corrosion. Batteries should not be carried loose in your pocket or purse since metal objects such as coins or keys can short out a battery.
  • BATTERIES ARE TOXIC! - if swallowed, contact the Battery Ingestion Hotline: (202) 625-3333. Call collect.

Colors of Hearing Aids

Hearing aids in all the colors of the rainbow.

Processing in Hearing Aids

Conventional or Analog Hearing Aids The most basic of the three levels of hearing aid technology. The audiologist determines the specifications a patient needs in the hearing aid, and then a manufacturer builds the aid to meet those specifications. The audiologist has limited flexibility to make adjustments after the hearing aid is returned from the manufacturer. The user is involved in how the hearing aid performs. The user adjusts the volume to suit the environment. Most of the adjustments are based on the volume setting that is selected for a specific environment.
Programmable (Analog) The audiologist uses a computer to program more precisely the hearing aid. Adjustments can be easily done in the office. Your audiologist will set the appropriate amount of amplification suited for your hearing loss and hearing sensitivity to soft and loud sounds. Some programmable hearing aids offer the option of having multi-programs for situations that require different amplification needs.
100% Digital Hearing Aids The difference between analog and digital is similar to a tape deck (analog) and CD player (digital). With digital hearing aids sound is processed in 0's and 1's making it easier to analyze the incoming signal and make fine changes that closely match the needs of individuals' hearing loss. The audiologist programs the hearing aid with a computer and can adjust the sound quality and response time on an individual basis. Digital hearing aids also have numerous channels of amplification compared to one to three in conventional and programmable devices. It is like having an equalizer in your hearing aid. Digital circuitry provides the most flexibility for the audiologist to make adjustments for the hearing aid 100% digital hearing aids provide clearer sound quality than most analog hearing aids. Although no hearing aid can completely eliminate background noise, the digital hearing aids have the ability to suppress (make softer) the background noise and amplify direct speech.

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Questions to Consider Asking the Audiologist when Getting a Hearing Aid

  • How much hearing loss does my child have? How does that relate to him/her hearing speech
  • May I have a copy of the hearing test results?
  • Is the loss permanent?
  • Does my child need more testing? How often should my child's hearing be tested?
  • Do both ears have the same hearing loss?
  • Should he or she have a hearing aid in both ears?
  • How will the hearing loss affect my child's speech and language development?
  • What will my child hear with the hearing aids?
  • How much do hearing aids cost? Can I get help to pay for the hearing aids?
  • Is there a warranty on the hearing aids? How long?
  • How often will my child need new hearing aids or earmolds?
  • What should I do if my child does not want to wear the hearing aid?
  • What should I do if my child loses a hearing aid or earmold?

Adapted from CDC Questions You May Want to Ask Your Child's Audiologist

Useful tips for caring for your hearing instruments

Modern hearing instruments are durable, easy-to-use and reliable. A few simple precautions will ensure that your instruments continue to give you many years of trouble-free service.

  • Always make sure your fingers are dry and clean before handling your hearing instruments. The microphone inlet is only a few tenths of a millimeter wide and can become blocked easily.
  • Avoid sharp knocks and impact. Insert and remove your hearing instruments over a soft surface (a bed or sofa).
  • Protect your hearing instruments from heat. Never leave your hearing instruments where they may be affected by extreme heat. Protect them from direct sunlight (at home and in a parked car) and do not leave them near radiators.
  • Protect your instruments from dampness. Remove instruments from your ears before showering, bathing or swimming. Do not leave them in the bathroom where they could suffer water damage. Dry any perspiration inside and around the ears regularly. Dampness and condensation can damage the circuitry in your hearing instruments.
  • Keep your hearing instruments out of the reach of children and pets. Dogs are irritated by the feedback (whistling) sound and attracted by the owner's scent. Often the result is a chewed up hearing instrument.
  • Avoid contact with make-up or hair spray. The fine particles produced by make-up or hair spray can easily block a microphone inlet. Always remove hearing instruments before using such products.
  • Clean your instruments carefully. Clean your instruments using a soft, dry cloth. Alcohol, solvents and cleaning fluids can damage electronic circuitry.
  • Keep your instruments in a safe place. When your instruments are not in use, always keep them in the presentation case or in a special drying box. Remove the batteries if the instruments will not be used for some time.
  • Always have repairs carried out by a specialist.

Adapted from Phonak Care and Maintenance of Hearing Instruments

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How to Care for Your Hearing Aids

How to take care of BTE hearing aids

The first thing to remember is to never ever put your hearing aids in water!

  • Never wear your hearing aids when you go swimming
  • Remember to take off your hearing aids before taking a bath or a shower.
  • It's okay to wear your hearing aids when it's raining a little (but don't wear them when it's pouring so hard your head will get wet!).

Since you cannot use water to clean your hearing aids, just wipe them clean with a soft cloth.It is very important to keep the microphone clean. If it gets blocked up, it cannot let sound into your hearing aids. Because you use you hearing aids a lot, some of the buttons may also get dirty, so you should clean them with the cloth or brush as well. If dirt and dust gets into the movable parts of the hearing aids they can break.

When you remove your hearing aids - before going to sleep - you can take the batteries out or leave the battery drawer open. This helps the hearing aids to dry out if they have become warm and damp during the day. If you live in a place where the climate is very warm and damp, you can get a special drying box for your hearing aids. Ask your audiologist.

Dogs and cats are often very curious about hearing aids - especially if they are left on, whistling, on a table. And if they get too curious they might chew on or even eat the hearing aids. It is therefore very important that you keep your hearing aids away from pets!

How to take care of your earmolds

It is okay for the earmolds to get wet. You can wash them in warm water around once a week or whenever they get dirty.

Once you have washed the earmolds it is very important to dry them. You can dry the outside part with a cloth. Any water left inside the tube can block sound from your hearing aids.

Dry the inside by blowing the water out of the tubing. You cannot use your mouth to blow it dry, because the air from your mouth is moist. Instead, you must use an earmold blower, which sends dry air into the tubing.

If your earmold has a vent, remember to blow the water out of there as well.

Adapted from Oticon Kids Korner

Troubleshooting Hearing Aids

Problem: The volume drops

Check to see:

  • Low battery - replace it.
  • The earmold is blocked with earwax - clean with a small brush.
  • Blocked microphone inlet - consult your audiologist.

Problem: The instrument hurts the child's ear

Check to see:

  • The instrument is not correctly positioned - remove and re-insert it. If the problem persists, consult your audiologist.

Problem: The instrument is difficult to insert

Check to see:

  • Place a small drop of non-irritating lubricant on your finger and smear onto the ear canal entrance before inserting your instrument. Ensure that no lubricant enters the sound outlet or microphone apertures.

Problem: The hearing aid whistles while your child is wearing it.

Check to see:

  • Is the volume control in the normal position or is it too high?
  • Is there a leak in the system, primarily in the tubing connecting the earmold to the hearing aid?
  • Is there too much ear wax in the ear canal?
  • Is the earmold inserted correctly?
  • Is the earmold too small, because the ear canal has been growing normally?
  • Is the tube still connected with the earmold and the hook?
  • Is the hearing aid damaged?
  • Is the hook or tube damaged?
  • Is the child's head tilted so that something is up against the microphone (i.e. infant in car seat)?

Problem: The hearing aid is dead.

Check to see:

  • Is the battery OK?
  • Is the battery inserted correctly?
  • The battery compartment is not closed - shut it.
  • The battery is dirty - clean the battery surface.
  • The battery is dead - replace it.
  • Is the hearing aid turned on?
  • Is there corrosion on the battery or the battery contact area?
  • Does the hearing aid work after a new battery is inserted?
  • Is the earmold blocked by earwax?
  • Is the tube OK?
  • Is the hook dry?

Problem: Your child says the hearing aid isn't working properly.

Check to see:

  • Is the volume control in the normal position?
  • Is the opening for the microphone accessible?
  • Is the battery OK?
  • Is the earmold blocked?
  • Is there too much ear wax in the ear canal?
  • Is the hearing aid damaged?
  • Are both the hook and the tube dry?

Problem: The hearing aid generates distortion and/or unusual sounds (like crackling).

Check to see:

  • Is there corrosion on the battery?
  • Is the battery properly inserted in its compartment?
  • Is the on-off switch at the correct position and not in the middle between two positions?
  • Is the volume control in the normal position?
  • Is the earmold blocked?
  • Are both the hook and tube dry?
  • Does the earmold fit correctly?

Problem: The hearing aid got wet.


  • Shake the water away quickly.
  • Remove the battery.
  • Have the hearing aid checked by your Hearing Care Professional. If this is not possible: use your dry aid kit.
  • Leave the hearing aid in a dry place.
  • Connect the stethoset and check whether the hearing aid still works.

Problem: The hearing aid does not whistle when you hold it in your hand (Only applicable if hearing aid does not have automatic feedback reduction system).

Check to see:

  • Is the hearing aid turned on?
  • Is the volume control in the normal position?
  • Is the battery still OK?
  • Is the earmold blocked?
  • Have you selected the right program (for example, programs designed specifically for telephone use will not allow you to hear any whistling when the aid is held in the hand)?
  • Is the hearing aid damaged?


If the suggestions above do not solve the problem, contact your audiologist. Rely on your audiologist and their staff to provide answers to any other questions as well as counseling for your child and family whenever the need arises.

Courtesy of Siemens and Phonak

Cochlear Implants

Cochlear implants are used in individual with a severe to profound hearing loss in both ears. A cochlear implant system has a receiver/stimulator that is surgically placed in the child's cochlea. It also includes an external sound processor, which is usually worn on a belt or behind the ear. The sound processor picks up speech and environmental sounds It then codes the information and send it to implanted part of the system through the use of radio waves and a magnet. The implanted part of the system transmits signals to the auditory nerve, which carries them to the brain.

A cochlear implant does not correct hearing loss. In fact, it bypasses the normal hearing pathway, in which sounds travel through the outer, middle, and inner ear to reach the auditory nerve. A cochlear implant stimulates the auditory nerve directly. The brain then learns to take this electrical code and interpret it as speech.

Research has shown that with a cochlear implant, many children with severe to profound hearing loss can develop speech and language similar to that of children with normal hearing.