FROM US TO YOU :THE PROCESS OF GETTING THE RIGHT HEARING INSTRUMENTS The process of getting the right hearing instruments is important and ongoing. It requires strong motivation and active participation from you as a parent. Even the most advanced instruments will not help if your child does not wear them, or if they are not properly maintained.Your child's willingness to wear hearing instruments will most likely depend on how much you can teach and motivate them. The more knowledge they have, and the more involved they feel, the easier things will be. The earlier the child learns to handle their hearing loss and hearing instruments, the more ownership they will take and the more confident they will feel. One way to achieve this is to make sure that their first experiences with hearing instruments are positive. For instance, make sure that the first sounds your child hears with the new hearing instruments are gentle, comfortable sounds such as music or friendly talk.Also, be aware of the importance of being motivated as a parent. If you are unmotivated and cannot accept what is going on, your child will immediately react and reject the hearing instruments. Remember to be happy and positive when they first start wearing them.However, no matter how well your child seems to be adapting to the hearing instruments, there will always be times when he or she takes them off - sometimes much to your frustration. Be aware that there can be many reasons for this, not all of which are related to the hearing instruments or the hearing loss.We asked parents what message they would like to send to parents whose baby had recently been diagnosed with hearing loss. And this is their message for you: 1. Your baby is the sameprecious little person they were before you foundout about their hearing loss.2. It is fine to be sad.3. Some days will be hard but most days will be wonderful.4. Soon you really will be able to say,"It's only hearing loss"and realize that it is nowhere near as bad as you imagined it might be.5. Over the years you will experience joy,surprise, laughter and pride asyou see what your child achieves.6. Don't be scared - you are not alone.7. Reach out to other parents in the same position and ask them lots ofquestions.8. Have coffee with a deaf mum or dad - they can be a great resource.9. Take time out to enjoy your family and friends - and ask for help whenyou need it. Kiss your beautiful baby and hang on for the ride of yourlife. It is going to be different to what you imagined but it will surprise anddelight you over and over again. Hearing aids arevital in developing your baby’s ability to listen and speak. Ideally, your babyshould wear hearing aids all the time when they are awake. Unfortunately,that’s not always possible during the early months of life.For practicalreasons, your baby might only use the hearing aids for certain times of the daywhen they are very small. It’s important to increase the use of hearing aids asyour baby develops.The aim is for yourbaby to wear the hearing aids for all their waking hours, as soon as possible.In these very earlystages,it may be difficult to tell whether your baby is hearing with the aids.Don’t be discouraged. Young babies can’t do much to show you they are hearing.Find out more about how to tell if your baby is hearing in ‘Signs of hearing inbabies.'It’s important tocheck your baby’s hearing aids daily. Your baby can’t tell or show you muchabout what they hear, so you can only know if the hearing aids are working bychecking them. This is a routine you need to continue until your child is oldenough to tell you if something is wrong with the aids.Your audiologistwill show you how to check the hearing aids. Most people need to be shown a fewtimes before they feel confident. Your audiologist will be happy to review theprocedure with you as often you like.The hearing aid mayproduce a whistling sound when your baby is lying down or leaning. This iscalled acoustic feedback and is a common problem for newborns. It happensbecause the ears are small and soft and your baby spends a lot of time withtheir ear pressed against a surface, such as when sleeping or feeding.You can reducefeedback by using a lubricant. Your audiologist can recommend a lubricantsuitable for hearing aids. Young babies may need new ear moulds every few weeksto reduce the feedback.Try to use thehearing aids as much as you can, in ways that still allow you to enjoy spendingtime with your baby. It helps if you can make wearing the hearing aids part ofyour baby’s routine.If you can only usethe hearing aids for certain times of the day:A bouncinette canbe helpful. Your baby’s head and neck are supported and you can face your babydirectly with a clear view of your face. If you use a bouncinette, a nettingfabric cover is a good idea because the netting reduces the risk of whistlingfrom the hearing aids.Alternatively, youcould sit upright on a chair or the floor with your baby lying in your lap.Place your baby’s head on your knees and legs on your chest. You can get goodeye contact and it is a good position for playing ‘Peek-a-boo’ or ‘This littlepiggy went to market’!Hearing aids areusually removed for sleeping, mainly for comfort. It will not harm your baby towear the hearing aids while sleeping, although it might be a bit uncomfortable.The bedding behindyour baby’s head may cause the hearing aid to whistle. This may be annoying foryou. Your baby may or may not hear the whistle, depending on the degree ofhearing loss. In any case, the sounds heard will be affected by the feedback.Feeding is aspecial time with your baby. Most babies are cuddled close while they feed sowhistling from one or both hearing aids can be a problem.Cuddling isimportant, both for you and your baby. You may be able to find a way to cuddle your baby that does not cause the aids to whistle. Otherwise, turn off one orboth hearing aids at this time. If you can only leave one hearing aid turnedon, this is still helpful.Remember to turn the aids back on after feeding if your baby is still awake.The hearing aidsshould not get wet so you need to take them out when your baby has a bath.At times, it’simpractical for your baby to wear hearing aids. Your baby may not want to wearthem when tired, for example. There are a few ways you can help make it easierfor your baby to hear.At about six monthsof age,babies start gaining more control of their hands and begin to explorethe world around them. Just as many babies find it interesting to pull offtheir shoes and socks, some babies love to pull off their hearing aids. Somebabies also put them in their mouths.Replace the hearingaid if your baby pulls it off. Try to stay calm. If your baby keeps pulling theaid off, or if replacing it develops into a struggle, put the hearing aid awayfor15 minutes and try again later. This will help avoid a situation where yourbaby gets your attention by pulling the hearing aids off.Here are a fewideas for preventing your baby from pulling the hearing aids off. Aviator caps:Some parents use little cotton‘aviator caps’ which come down over the baby’s ears and tie under the chin.Providing the cap is made of thin fabric (like at-shirt) the single layer ofcotton over the hearing aid microphones makes very little difference to thesound reaching the hearing aid microphones. Soft baby headbands are analternative, but be careful not to cover the hearing aid microphone with thickfabric.Huggies: Some parents use ‘Huggies’ whichare available with us. A ‘Huggy’ is a clear rubber ring with two bands to holdthe hearing aid. The ring is fitted over your baby’s ear to hold the hearingaid behind the ear.Double-sided tape: You can get tape made for use onskin that will hold the hearing aid firmly against your baby’s head.Clips: We can give you a clip with cordsthat attach to the hearing aids. This stop the hearing aids from being lost andcan make it harder for your baby to get the hearing aids into their mouth.Your baby’s aidshave (or can be fitted) with a tamper resistant battery compartment so yourbaby cannot accidentally swallow a battery. Make sure you use this featurewhile your baby is young.Try to avoid yourbaby chewing on the ear mould, in case it is accidentally swallowed.Feel freeto discuss any questions or concerns you have with our audiologists.They willbe happy to help you. Hearing aids arevital in developing your baby’s ability to listen and speak. It takes a whilefor some babies to get used to their hearing aids, but with encouragement andperseverance they will become a normal part of your baby’s life.The aim is foryour baby to wear the hearing aids for all their waking hours,as soon aspossible.Signs of hearingbecome more obvious as your baby get older. At about six months of age, babiesusually have some head control and will be learning to sit up. At this age, youmight notice your baby’s head turn towards some sounds. Over the next fewmonths your baby will start to show increased interest in a wider range ofsounds than when they were younger.The types of soundsyour baby can hear with the hearing aids.Your baby can’ttell you if the hearing aids are working so you will need to check them everyday. This is a routine you need to continue until your child is old enough totell you immediately if something is wrong with the aids.We will show you howto do a daily check of the hearing aids. Most people need to be shown a fewtimes before they feel confident. Your audiologist will be happy to review theprocedure with you as often as you need.As your baby spendsmore of the day awake, try to increase use of the hearing aids until they areworn for all waking hours.You may need tospend five minutes playing games with your baby after you first put on thehearing aids. There will be less need for this distraction as your baby becomesfamiliar with the aids. The hearing aids will become a normal part of life justlike clothes,shoes, hats and all the other things that babies get used to.When babies gainmore control of their head and neck, the problem of acoustic feedback(whistling)usually lessens. But, your baby’s ears will still be soft and growquickly, so you may need to continue getting new ear moulds frequently. Using alubricant can help reduce feedback. Your audiologist will be able to recommenda lubricant that is suitable for use with hearing aids.You will have moreopportunities to help your baby learn about speech and other sounds as thehearing aids are worn more often. Here are some tips for helping thedevelopment of your baby’s listening skills.Talk and sing: Spend time every day verballyinteracting. Position yourself about one metre from your baby’s hearing aids.Describe your actions: As you go aboutyour daily activities, talk to your baby about what you are doing.Exaggerate your voice: Try to overstress the normal variations of pitch as you speak. Many people do thisnaturally when they talk to babies.Use music: If you are listening to music, letyour baby see you sing along. You might like to pick your baby up and dancetogether every now and then.Play games: Try to play games that involvesound.Pair sounds withactions: Join interestingsounds with fun activities. For example, make aeroplane sounds while you flyyour baby around the room or say ‘hop-hop-hop’ as you step your fingers up yourbaby’s leg and tickle their tummy. And, don’t forget the traditional baby gameslike ‘peek-a-boo’Copy your baby: Repeat any sound your baby makes.See if you can have a conversation, making sounds to each other in turnUse rewards: When your baby responds to a sound,give a reward such as a smile, clap or cuddle. At this age, babies can learnvery quickly how to get your attention.If your baby finds your reaction fun,they are more likely to respond to the sounds againDon’t rely on external stimulation: Noisy toys can belots of fun, but babies are generally more interested in human voices. Don’trely on toys, TV or radio to provide lots of stimulation for your baby. SomeTV, radio and music is fine, but interaction with you is much more interesting.Reduce background noise: When you spendspecial time with your baby (talking, singing or playing games), try to reducebackground noise so your baby can hear you as clearly as possible. Turn off theTV or radio.Let your baby explore your mouth: Many babies atthis age start to put their hands into your mouth as they explore your face.This can be a good chance for your baby to feel your mouth and tongue moving asyou speak.Hearing aids areusually removed for sleeping, mainly for comfort. It will not harm your baby towear them while asleep, but it might be uncomfortable.Bedding behind yourbaby’s head will probably cause the hearing aids to feed back.This may beannoying for you. Depending on the degree of hearing loss, your baby may or maynot hear the whistle, but the sound heard will be affected by the feedback.Feeding is aspecial time between you and your baby. At this age, many babies sit in highchairs for meals. Feeding your baby is an ideal opportunity to talk about whatyou’re doing and introduce your baby to important phrases and words. Describeyour baby’s food. Ask your baby if they want ‘More?’ and of course, talk toyour baby about the food being ‘All gone!’The hearing aidsshould not get wet. Take them off before bathing your baby.At times, it’simpractical for your baby to wear hearing aids. Your baby may not want to wearthem when tired, for example. There are a few ways you can help make it easierfor your baby to hear.Amplify your voice: Speak in a raisedvoice, but don’t shout. Shouting makes your speech less clear. Instead, speakup as though you are talking to someone on the other side of the room.Keep your baby nearby: Your voice willbe louder and it will be easier to hear and see you if you are close. Even ifyour baby cannot hear you, being able to see you will make your baby feelsecure.Cuddle your baby: This is a good time to hold andcuddle your baby as you talk, because feedback won’t be a problem. Some peoplesuggest holding your baby snuggled up under your chin or cheek, enabling thevibrations from your voice to be felt.At this age, babiesstart gaining more control of their hands and begin to explore the world aroundthem. Just as many babies find it interesting to pull off their shoes andsocks, some babies love to pull off their hearing aids. Some babies also putthem in their mouths.Replace the hearingaid if your baby pulls it off. Try to stay calm. If your baby keeps pulling theaid off, or if replacing it develops into a struggle, put the hearing aid awayfor15 minutes and try again later. This will help avoid a situation where yourbaby gets your attention by pulling the hearing aids off. It can be difficultto tell whether hearing aids are working in a young baby with a hearing loss.In the first six months, the signs that your baby can hear are subtle.Asa parent, you nodoubt feel concerned about your baby's development. This information will helpyou recognise your baby's responses to sound.A baby's responseto sound is affected by their age, stage of development and degree of hearingloss.Alack of responsedoesn't necessarily mean your baby cannot hear.Babies with normalhearing don't respond to the softest sounds that they can hear in the first twomonths of life. At this stage the baby's responses to sound are hard to detect- babies might widen their eyes when they hear a sound, or stiring their sleepDifferent levels ofsound arouse various responses in babies, depending on how active they are.Babies react to softer sounds when they are just dozing off to sleep as opposedto when awake and active.Some sounds will bemore interesting to your baby than others. In early life, babies are intriguedby voices, so they will respond to voice at softer levels than they wouldrespond to other noises around the home.Babies are alsomore interested in complex sounds like rattles or music than in simple soundslike beeps or simple whistles. If a sound is repeated too often, young babieslose interest and may stop responding altogether. This is called habituation.Babies withsignificant hearing impairments may be unfamiliar with many sounds around them.It might take some time after the hearing aid has been fitted to see clearsigns of hearing.The vocalisationsof babies give clues about what they can hear. Some babies quieten down andconcentrate when their hearing aids are first turned on each day; others becomenoisier as they test their aids. Older children may make a wider variety ofsounds when wearing their hearing aids.Although it'schallenge trying to tell how much your baby can hear, you can get a lot ofinformation when you know what to look for.1. Talk to us aboutthe ways your baby might respond to sound.Your baby's ability to respond tosound will depend on the degree of the hearing loss and the effectiveness ofthe hearing aids. Ask us to explain the types of sounds they think your babymight hear.We assess yourbaby's hearing with a Behavioural Observation Audiometry, which uses a range ofdifferent noisemakers. You will be able to observe some of the ways that yourbaby responds.This guide willhelp you identify the behaviours that show your baby is hearing sounds.2. Take note of what your baby does at homeDon't try to doyour own hearing tests. If your baby is overly active or tired they may notrespond to the sounds you expect. This can be disheartening. If you've made thesame sound several times your baby might have habituated and won't respond atall. It's better to just keep alert so that you are ready to observe thoseresponses to sound that your baby naturally displays.You will see thebest hearing responses when it's quiet and your baby is not fast asleep orupset. You will probably see more obvious responses when your baby is very calmor drifting off to sleep, or when there are sudden loud noises. If the house isnoisy it may be more difficult to see responses to certain sounds.It's important towatch whether your baby's response may have been to visual cues as rather thanauditory ones. If you clap your hands in front of your baby's face causing ablinking response, you can't really tell whether the blink is due to the loudsound or the motion of your hands. Some babies may also be tuned in to thesmell of a parent's perfume or aftershave and use that as a clue to whenMum orDad is close by.The followingquestions are a guide to help you with your observations:Also considerkeeping a "listening diary" to record your observations.This willshow you your baby's progress and can be useful in discussions with youraudiologist and your child's early intervention teacher.3. Discuss your observations with us, including anyconcerns and questions. Your observations are invaluable inhelping us make decisions about fine-tuning your baby's hearing aid.