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By providing information about hearing aid retention strategies throughout early childhood, collecting accurate information about daily hearing aid wear challenges, and working as a team, it should be possible to find appropriate strategies to keep children “on the air,” facilitating listening, language, and learning.
Adjusting to hearing aid use can be very difficult for infants, children, and their families. In an effort to explore the problem of hearing aid retention, the Pediatric Hearing Aid Retention Project Survey was developed by the authors and sent to parents and audiologists to determine what retention devices they find most useful. Table 1 illustrates the combined responses provided by parents and audiologists for rating hearing aid retention accessories. A valid concern exists about the acoustic transparency of hearing aid retention accessories that cover the microphone of hearing devices. Based on the acoustic transparency evaluation results, Ear Gear is considered to be acoustically transparent, and the caps tested significantly affected the response only at 5000 Hz and that was only a 4 dB difference.
Audiologist working with early intervention providers to help establish hearing aid wear goals for the family and provide support. Help families understand their child’s hearing loss and what their child is missing by not having their hearing aids on. Thinking outside the box and understanding what is holding them up gets you on the right path. Work with a partner agency to provide a Mother’s Day Out situation so someone else will keep the hearing aids on to show the parents it can be done. A “to do” list with achievable measures and a date of completion usually prior to our next appointment (eg, complete Early Intervention evaluation, go to dispenser to pick up hearing aids, etc). Keeping in close communication and not closing the door simply because the family has barriers or is taking a longer time to make choices. Ear Gear, Hanna Andersson Caps, and SafeNSound received the best ratings by both parents and audiologists (see Table 4 for parent ratings). The difference in parent and audiologist ratings is significant and may indicate that audiologists and parents are not communicating well.
Also of significance is the number of parents who reported never having heard of a product. If parents are having a problem with hearing aid retention, it would seem to be critical to have information about all products available and their effectiveness. One outcome of the survey was the development of free brochures for families of young children ages 0-12 months, 12-24 months, and 2-5 years (an example is shown in Figures 3a-b).
By providing information about hearing aid retention strategies throughout early childhood, collecting accurate information about daily hearing aid wear challenges, and working as a team, it should be possible to find appropriate strategies to keep children “on the air” facilitating listening language and learning.

Putting hearing aids on a child requires accepting the fact that the child has a hearing loss. Data from the Jones and Launer study1 showed that 40% of children wear their hearing aids only 4 hours or less each day and only 10% achieve full-time hearing aid wear. The results of the survey clearly illustrated that the families who use retention devices typically have a significantly different view of the effectiveness and safety of the devices as compared to how audiologists rate these features. Parent and Audiologist Ratings of Hearing Retention Devices, based on 286 Parent and 101 Audiologist Responses.
The acoustic transparency of Ear Gear, Hanna Andersson pilot cap, Silkawear cap, and the Hearing Henry Headband was determined via electroacoustic evaluation with an AudioScan analyzer and Phonak Piconet2 hearing aid. The Hanna Andersson cap and Silkawear cap were placed so that the material of the cap that would typically be over the ear was wrapped tightly over the hearing aid case and microphone to simulate typical wear.
Gain and frequency range response for hearing aid (HA) only, hearing aid on false ear (with pinna effect), and four hearing aid retention products.
Ear Gear and Hanna Andersson and Silkawear caps had responses within 0-3 dB of the hearing aid worn on the false ear for most of the frequencies tested. The Hearing Henry Headband, and possibly all headbands, when worn inappropriately has the potential to significantly decrease gain and frequency response.
Clips (Critter Clips, Phonak Junior Kidz Clips, Otoclips) received high scores from audiologists—but not parents. Audiologists may not be aware of the problems parents experience with hearing aid retention devices and may therefore be making recommendations without real practical information to draw upon. Anderson, PhD, is an educational and pediatric audiologist, and is director of Supporting School Success for Children with Hearing Loss, Plymouth, Minn. Improving hearing and hearing aid retention for infants and young children. Hearing Review. Even when families accept the fact of the hearing loss, putting on hearing aids and taking a child out in public and to family gatherings can be difficult.
Using a pediatric ear hook and short earmold tubing, the hearing aid may fall off if not fit well. With the volume control taped in a position just below full on, the response 50, gain at 50 dB and 60 dB SPL, SSPL90, frequency range, and harmonic distortion were obtained for the hearing aid alone, the hearing aid on a false ear (to obtain the pinna effect), and the hearing aid with each accessory. The Hearing Henry Headband, if worn appropriately, will not cover a hearing aid microphone. Ear Gear minimally changed the frequency range (low and high) when compared to the response when the hearing aid alone was on the false ear. Ear Gear minimally changed the frequency range, while the caps reduced reception of low frequency sounds only.

Parents should be told initially and at subsequent visits to the audiologist that there are devices available to assist in retention and given specific information to assist in selecting the appropriate product for a particular child. She is also the author of many test instruments and materials, such as the SIFTERs, CHILD, LIFE, and ELF. Jane R.
Suddenly hearing when a child has been in a quiet world can be a surprise, causing a child to remove the hearing aid. Both infants and older children encounter problems keeping hearing aids on the head when they are active.
The Hearing Henry Headband worn inappropriately over the hearing aid microphone significantly impacted the high frequency response. Of 101 audiology respondents, 23 had not heard of Hanna Andersson Caps and 54 had not heard of SafeNSound. The audiologist needs to question the parents about problems with hearing aid retention at each visit as an important part of management of the young child with hearing loss.
Madell, PhD, has a consulting practice in pediatric audiology, and is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist. When hearing aids flop around or fall off, parents may feel that it is easier to remove them while the child is active.
Therefore, the Hearing Henry Headband was placed over the hearing aid microphone to simulate acoustic response if the headband placement was inappropriate. The Hearing Henry Headband increased the low frequency range when the microphone was covered.
With 40+ years of professional experience, she has published four books and written numerous book chapters and journal articles. Whenever the hearing aid is off—even for a few minutes—the child is missing language and listening input, which should be avoided. The gain with Ear Gear and both caps was within 1-2 dB of that found with the hearing aid on the false ear. Toddlers may remove hearing aids exploring their environment and may attempt to take them apart. Preschoolers may remove them as part of a power struggle with parents, especially when having a temper tantrum.
Only the Hearing Henry Headband, when positioned across the microphone, reduced gain (8-9 dB gain reduction).

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