Children's Health: Hearing aids a waste of time in deaf children

A profoundly deaf child should skip trying a hearing aid and go straight to a more elaborate cochlear implant, according to U.S. hearing experts.

Hearing aids simply amplify sound, but a cochlear implant directly stimulates the nerves in the inner ear. Part of the device is surgically implanted and part is worn externally.

Dr. John Oghalai, clinical chief of the hearing centre at Texas Children's Hospital in Houston, says guidelines for adults state that prior to receiving a cochlear implant, recipients must demonstrate they do not benefit from a hearing aid. Pediatric guidelines are based on adult recommendations and require children to undergo hearing aid trials for three to six months.

Oghalai and his colleagues followed 58 children who were deemed deaf and tried a hearing aid. Fifty-two children did not benefit from the hearing aid and immediately received cochlear implants. The other six children were able to hear with the hearing aids, but did not develop normal speech and language. At the end of the hearing aid trials, these children also received cochlear implants. Following cochlear implantation, both sets of children showed significant improvements in hearing scores, and the six children who had benefited from a hearing aid went on to develop speech and language.

Oghalai says the results show hearing aids can help improve a child's hearing, but in those who have profound hearing loss, they are simply not enough. "It may not be worth the time to try a hearing aid on these kids for three to six months because basically they're all going to need a cochlear implant if the initial hearing test says that they're deaf," he says, adding the hearing aid trials could be wasting valuable time for speech and language development.

However, children must be at least one year old before they can receive a cochlear implant, and Oghalai says there is still some use in giving children hearing aids prior to that time. This helps acclimatize them to wearing a device in their ears and gets their parents used to keeping track of something that could get lost.