Audiology Intervention for Children with Down Syndrome

By: Karyn Voels Malesevic, AuD, CCC-A, Manager of Audiology and Family Services

Children who have Down Syndrome can often have hearing loss, so a therapy center that also has an Audiology Department onsite can make coordinating care easier. Their hearing loss may range from permanent and needing hearing aids to having frequent middle ear infections and require consistent hearing tests.

According to the research article Understanding Hearing and Hearing Loss in Children with Down Syndrome, “Children with Down Syndrome are at a greater risk for permanent and transient hearing loss as compared with their typically developing peers. Long-term consequences of late or failed diagnosis, particularly in this population, can significantly affect quality of life, including school performance, speech and language, behavioral challenges, community engagement, and safety. Therefore, ongoing audiologic monitoring and otologic management is highly recommended for this group into adulthood.”
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Easterseals DuPage & Fox Valley has Audiologists in our Elgin and Villa Park centers who are experts at working with children that may have been considered “difficult to test” by other clinics.

We are able to fit hearing aids and make repairs and earmolds on children and adults through state programs such as Early lntervention, Medicaid, DSCC, ORS, and via private insurance or private pay options with very competitive pricing.

At Easterseals we work with the local educational Audiologists, who serve children with hearing loss that are in school. That work allows for cohesive coordination between school testing and any hearing aid or other specialized services that may be needed at an outside clinic.

We are also proud that we can continue to see the children in our care as they grow up into adulthood via our audiology clinics.

For more information on our hearing services, visit eastersealsdfvr.org/hearing.

 

5 Tips for Keeping Hearing Aids on Babies/Toddlers

By: Beth Rosales, Au.D, CCC-A.

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As both an audiologist and a mother of 2 young children who wear hearing aids, I definitely understand that keeping hearing aids on your child can be a very difficult task. Young children and babies seem to love to get their hands on those hearing aids and pull them right out of their ears! I often hear from parents of babies and toddlers that they have tried to keep the hearing aids on their child, but it seems impossible. As a result the child doesn’t wear the hearing aids regularly, which means he or she is not hearing very well most of the time, and this will likely delay oral speech and language development.

When 2 of my boys ended up needing hearing aids, I knew I had to do everything I could to keep their hearing aids on their ears when they were awake. Well, I can say from personal experience that the struggle is very real when it comes to keeping hearing aids on young babies and children, but utilizing some helpful tools and tips can make it a lot easier.

Tip #1 – Pilot hats

Baby nico on swingThis is best for babies up to 18 months old or so. I fell in love with pilot hats and here’s why you should too. Not only are they cute, but they will make your life so much easier!! For my boys, pilot hats worked better than anything else when they were very young. The pilot hats should be lightweight and ideally have mesh sides or very thin material that will not block the sound from entering the microphones of the hearing aids. It’s important to get a pilot hat that fits well. If it is too loose, then it will be too easy for your little one to get his hands under the hat.

Here are some great places to get pilot hats that work well with hearing aids:

  • LilNells: https://www.etsy.com/shop/LilNells  My personal favorite shop! The hats fit my sons very well, and she makes them with snap closures, as well as ties. I love the snap closure because they are harder for toddlers to undo (tie up closures can work too, but tie closures are easier for kids to play with and untie). The shop owner also has options with mesh sides available and unlined (thin) hats, both of which are good for hearing aids. She is great at making custom orders, so if you see a hat you like that doesn’t have mesh sides, send her a message to see if she can make it with mesh sides, or if you have an idea or color you’d like, just send her a message to see if it is possible. Hats cost about $15 – $18.
  • Anchor Your Hearing shop: etsy.com/shop/AnchorYourHearing. These hats come with mesh sides which are very breathable so there won’t be too much material covering the microphones of the hearing aids. You can email the owner of the shop through etsy with any questions about orders, sizes, etc. Hats cost about $15-$18.
  • Emmifaye shop: etsy.com/shop/emmifaye. Another etsy shop that sells pilot hats for hearing aids with mesh sides. Cost per hat is about $12.
  • Hanna Anderson hannaandersson.com. These hats are also an option ($14 for the Pilot Cap – not the “winter” pilot caps which are lined, but rather the regular pilot caps which are thinner, not lined, and less expensive than the winter hats).
  • Silkawear silkawear.com. Cost is about $28 per hat.

Tip #2 – Crochet type of Headbands

baby headbandIf pilot hats don’t work, but your child tolerates wearing headbands well, then consider trying crochet type of headbands (worn over the ear, somewhat like the mesh pilot hats). Some patients have found that tight fitting, crochet type of headbands are useful to hold the hearing aids on and these can sometimes be found at stores like Target or Walmart. They can also be found online at stores or on etsy.com.

Tip #3 – Toupee Tape

toupee tape.jpgHooray for toupee tape! Some children benefit from using toupee tape on the behind-the-ear part of the hearing aid. I use this on my 4-year-old son’s hearing aids when he has gymnastics class! It helps stop his hearing aids from flopping off his ears. This is basically like 2-sided tape that you can use on skin. You can cut the tape into a small square or rectangle to fit onto the hearing aid. Place the tape on the behind-the-ear hearing aid, and then tape it to the child’s head since it is meant for skin contact. Some people have found this helpful to use along with the hats or headbands. My 4-year-old no longer needs a pilot hat, so this is a nice solution for when he is doing sports activities. You likely need to replace the toupee tape daily or whenever you take the hearing aids off your child and then put them back on him. Toupee tape can be purchased at places like Sally’s Beauty Supply (local stores carry this). www.sallybeauty.com.

Tip #4 – Otoclips

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I love otoclips! Otoclips are helpful in preventing the loss of hearing aids when a child pulls them off. An otoclip is attached to the hearing aid and it has a cord and clip that is attached the child’s clothing so that if the child pulls the hearing aid off, it will be hanging from the cord attached to the clothing.

Here are some websites that sell otoclips:

  • Westone: www.westone.com. Search for “otoclip” and if your child wears one hearing aid, he will need “monaural” and if your child has 2 hearing aids, he will need “binaural”.
  • ADCO Hearing: http://www.adcohearing.com/. Website offers a very large variety of tools for hearing aids and hearing loss, including otoclips (under “hearing aid supplies”, “clips and loss protection”).
  • The Bebop Shop (etsy.com): https://www.etsy.com/shop/thebebopshop. Very cute otoclip options, as well as some matching hair clips.

For additional tips and resources, visit Hearinglikeme.com. 

Tip #5 – Positive attitude

Have a positive attitude about your child’s hearing aids! Young children pick up on how their parents feel about things. Remember, hearing aids are a very good thing. Hearing aids will help your child hear speech and other sounds that they otherwise would not detect. This will help your child develop oral speech and language skills. So if oral communication is what you want for your child, then hearing aids will help them move toward reaching this goal. Hearing aids are wonderful things!

For more information on hearing services for children or adults, visit eastersealsdfvr.org/hearing.

Understanding Hearing Loss

By: Cindy Erdos, Au.D., CCC-A

Hearing loss can have serious consequences for individuals who experience it, as well as their loved ones.  We know that hearing loss has a negative impact on social, psychological, cognitive, and physical health.  Hearing is crucial to developing meaningful relationships and fully enjoying life.  People who cannot hear well are often cut off from their family, friends, and community.

seniors talkingAccording to the Hearing Loss Association of America (HLAA) approximately 48 million American have hearing loss; 30% of adults 70 or older have hearing loss; and 16% of adult 20-60 have hearing loss.  It is estimated that 1 in 5 America teens have some degree of hearing loss.

Based on this information, you should not be surprised to find yourself in a conversation with an individual with some degree of hearing loss.   Many people believe if you have a hearing loss, getting a hearing aid will fix the problem.  But not everyone with hearing loss is a candidate for hearing aids, and not everyone with a hearing loss is ready for hearing aids.  It may be a surprise to learn that hearing aids are not the only solution for individuals with hearing loss.

As an audiologist, I hear these types of comments from patients and family members almost daily:

  • “I don’t need a hearing aid, everybody mumbles”
  •  “I hear better with my glasses”
  • “Everyone yells at me so I can’t understand”

Let’s look at each statement to try understand what might be happening.

“I Don’t Need a Hearing Aid- Everybody Mumbles”

Understanding hearing loss can help us understand this comment.  There are two main types of hearing loss, conductive hearing loss and sensorineural hearing loss.  Conductive hearing loss is often hearing loss caused by a medical problem such as fluid in the ears or even wax in the ear.  Conductive hearing loss mostly affects how loud sounds are heard.  Conductive hearing loss typically can be medically corrected.

Sensorineural hearing loss is often caused by damaged nerve cells in the inner ear most commonly due to age, noise exposure or hereditary hearing loss.  Sensorineural hearing loss typically cannot be medically corrected and is most likely permanent. For many individuals starting to develop a sensorineural hearing loss, the low frequency sounds are heard at normal or nearly normal level (or volume), but they gradually start losing higher frequency sounds.  For understanding speech, high frequency sounds, or consonants provide a lot of meaning.

Besides the Listener’s hearing loss, another key factor that contributes to the “Everybody Mumbles” comment is caused by the speaker.  Many of us speak very quickly during conversations which causes us to blur our speech.  For an individual who is missing key sounds, conversational speech often compounds the difficulty understanding and can make it nearly impossible to follow the conversation.  Here are two examples of how conversational speech is delivered and received.

“The shiplef ona twowecruise.”   (The ship left on a two week cruise)

“We’re lookin for a whitruck tabuy.” (We are looking for a white truck to buy)

One of the most important things we can do when speaking to someone with hearing loss is to slow down a little bit, speak clearly, and pause between phrases or key words. 

“I Hear Better With My Glasses”

pexels-photo-432722.jpegAlthough only 30-40% of the English language is visible on the lips, most people, whether they realize it or not, speech read to some extent.  Relying on lipreading alone can be extremely difficult, but speech reading can be a nice supplement to hearing and understanding a conversation.  And fortunately, a lot of the consonant sounds that are difficult for many hearing impaired individuals to hear can be “seen.”  For example, “death” and “deaf”.  The sounds “th” and “f” look very different on the face.  Speech reading is more than simply lip reading, or using what you see on the speaker’s lips, it involves watching facial expressions and gestures to understand conversation.

When speaking with someone with a hearing impairment, remember they may benefit tremendously by being able to watch your lips as you speak. To assist them make sure you are within 3-6 feet; face them ensuring the visible features of speech are available; do not cover your mouth with your hands other objects; and make sure there is good lighting.  Remember, “I hear better with my glasses on” because I can see your face better.

“Everyone Yells at Me so I Can’t Understand”

Having hearing loss does not mean someone can tolerate sounds louder than someone with normal hearing.  There are a few reasons louder is not always better for someone with a hearing loss.  The first is due to something called “recruitment.”  Related to the damage to the nerve cells, all individuals with sensorineural hearing loss have recruitment.  Very simply, recruitment is when we perceive sounds as getting too loud too fast.   Just as loud sounds can be uncomfortable for someone with normal hearing, loud sounds can be very uncomfortable for someone with hearing loss.

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Typically, we yell or speak loudly to someone when we are upset or frustrated.  Speaking very loudly to someone with hearing loss can give the impression that you are angry with them.  No one enjoys being yelled at and it can make the person feel embarrassed about their hearing loss.

If you find yourself in a conversation with someone with a hearing loss, remember it “Takes Two to Tango.”  Your part is to deliver your message in a way to maximize your communication partner’s ability to understand.   Some key points to remember:

  1. Make sure you are within three to six feet from the listener
  2. Get the listener’s attention before speaking
  3. Make your face is visible and look at the listener
  4. Speak slowly and clearly, but do not exaggerate
  5. Louder is not always better

If you are concerned that you or a loved one may have hearing loss, contact an audiologist at Easter Seals DuPage & Fox Valley for a complete hearing evaluation and more information on communication strategies. For more information, visit: http://www.easterseals.com/dfv/our-programs/adult-services/.

 

What is Tinnitus?

By: Cynthia Erdos, Au.D., CCC-A , Audiologist

When I was about 7 years old, I remember lying on my bed listening to my brain work. I cannot remember a time when I didn’t hear a little humming, or buzzing in my ears.  Not until I was in graduate school did I realize the sounds I heard was considered a “symptom” of a possible problem in the ear or within the entire hearing system.  When the professor starting discussing something called “tinnitus”, I turned to my fellow grad student and said, “Do you mean when it is quiet, you don’t hear anything?”  She just gave me a funny look and nodded.

For me, the humming or sounds of crickets is just something I have always heard. If the sounds were suddenly gone, I might be worried and wonder what was happening.  I can only imagine if your ears have been quiet since you can remember, and suddenly you heard a buzzing, humming, ringing or any new sound in your ears, it could be disturbing.  The American Tinnitus Association reports over 45 million Americans struggle with tinnitus, making it one of the most common health conditions in the United States.

What is Tinnitus?

Tinnitus is the clinical term used for a sound heard in the head or ear when no external source is present.  It can be constant or intermittent and can be heard in one ear or both ears.  Tinnitus is usually not a sign of something serious.  Tinnitus is a symptom of a dysfunction with the auditory (hearing) system and is usually associated with some degree of hearing loss.

For some individuals, tinnitus can be a debilitating condition.  It can negatively affect a person’s overall health and social well-being.  Tinnitus has been associated with distress, depression, anxiety, sleep disturbances or even poor concentration.

What causes tinnitus?

There are many causes for tinnitus.  Almost any condition that can cause hearing loss can cause tinnitus.

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The most common cause of tinnitus is exposure to loud noise-it is very important to protect your ears from noise.  Some other causes include:

  • Meniere’s disease
  • TMJ disorders
  • Head injuries or neck injuries
  • Obstructions in the middle ear
  • Ear wax
  • Middle ear fluid
  • Tumors of the head or neck
  • Blood vessel disorders
  • High blood pressure
  • Atherosclerosis
  • Medications, including over the counter
    • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
    • Certain antibiotics
    • Certain cancer medications
    • Water pills and diuretics
    • Quinine-based medications

Treating the cause of tinnitus often eliminates tinnitus.  Unfortunately, often the cause of tinnitus is related to permanent damage to the hearing system, such a noise exposure, or the cause is unknown.

Is there a cure for tinnitus?

It is important to understand that tinnitus is a symptom, not a disease or condition.  The most effective way to treat tinnitus is to treat the underlying cause of the tinnitus.  For many people, however, it is impossible to know the exact cause of tinnitus.  If you have tinnitus, you should be evaluated to determine if there is a treatable medical condition.  A thorough tinnitus evaluation often includes a medical examination by an otolaryngologist and a hearing evaluation by an audiologist.   Currently, there is no safe and consistent way to cure tinnitus.  There are evidence-based practices to help patients improve quality of life by learning to manage tinnitus, or manage their reactions to the tinnitus.

There are many ways to learn to manage tinnitus.  Research studies show the best ways to manage tinnitus include education, sound therapies and counseling. For example, be aware of the toys your child plays with, as some can be very loud for little ears. The Sight & Hearing Association releases an annual list of the loudest toys that you can check before making holiday or birthday gift lists.

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If you or a loved one is suffering from tinnitus, the first step is a complete hearing evaluation.  To find out more information about Easter Seals DuPage & Fox Valley’s audiology services and scheduling an evaluation visit our website: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/audiology.html .

How Loud is Too Loud?

May is Better Hearing and Speech Month!

By: Cindy Erdos, Au.D., CCC-A

The Stanley Cup playoffs are underway, and the finals start next week.  I love watching hockey and I am an audiologist, so when I came across an article titled “Can hockey playoffs harm your hearing?”  I had to read it.  The research says,  “YES,”  the level of “leisure” noise present during a hockey game is loud enough to damage your ears and hearing.  If you are lucky enough to get tickets to the Stanley Cup, or any hockey game, you should consider getting some ear plugs or earmuffs for your children.

Most people tend to think that hearing loss caused by noise only happens to adults who work in noisy environments or those who attend lots of rock concerts or elderly adults who have had a life-time of noise exposure.  Exposure to loud noise without proper protection can cause hearing damage to anyone, at any age.  There is a growing concern about noise-induced hearing loss in our children.  We need to protect our children’s ears from noise-induced hearing loss and we need to teach them to continue protecting their hearing throughout their lives.

Our Noisy World

Do you remember that last time you “heard” silence?  We live in a very noisy world.  We encounter sounds every day, all day long.  Traffic, sirens, machinery, lawn equipment, concerts, movie theaters, sporting events are just some of the sounds we encounter on a daily basis. Sound Sense points out that a lot of our children’s activities involve some degree of noise: school lunchrooms, sports and sporting arenas, movies, and electronic media.  As you look around you are likely to see children, and adults, listening to some type of personal listening devices.

Even some children’s toys produce high levels of sound.  The Sight and Hearing Association publishes the Noisy Toys List annually and recommends downloading a sound meter app on your smartphone to help measure noise.  Their rule of thumb is, “if a toy sounds too loud to you, it is too loud for the child.”

Top 3 Noisiest Toys via Sight & Hearing Associations Noisy Toy List 2016

WWE

 

WWE 3-Count Crushers: Roman Reigns
Ages 6+
104.4 dB(A)

 

roadripper

 

Road Rippers Rush & Rescue
Ages 3+
103.9 dB(A)

 

tonak.jpg

 

My First Tonka Wobble Wheels
Ages 1+
103.2 dB(A)

 

The Center for Disease Control (CDC) recently published an article titled, “Too Loud!  For Too Long!” The article reports that hearing loss is the third most common chronic health condition and a major cause of hearing damage is noise exposure.  The World Health Organization (WHO) estimates that a billion-young people worldwide could be at risk of hearing loss due to unsafe listening practices.

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How Loud is Too Loud?

First thing to keep in mind is noise does not need to be unpleasant, or even physically uncomfortable to cause damage to your ears or hearing.   The intensity (loudness) of the sound and the time spent (duration) listening to the sound are critical. Intensity of sound is measured in decibels (dB).  Conversational speech is around 60 dB; a soft whisper is around 30 dB and a shouting directly into someone’s ear can be as high as 110 dB.  Your dishwasher probably runs about 70 dB and the sound of your hair dryer is around 90 dB.  City traffic (inside your car) is around 80-85 dB, but when riding a motorcycle, you are listening to around 95 dB of noise.  Watching your favorite sports team live may expose you to as much as 100 to 120 dB – depending on if your team is winning.

So how much is too much and how long is too long?  85 dB is the “magical” number. Occupational Safety and Health Administration (OSHA) recommends any employee who is exposed to 85 dB of noise be included in a noise conservation program to ensure their hearing is monitored and they are instructed on hearing protection practices.  The American Academy of Audiology recommends any time you are exposed to 85 dB or louder you should use hearing protection.   In addition to how loud the sound, you need to be concerned about the length of time you spend listening to the sound.

The chart below gives more examples of typical sounds and the maximum recommended duration:

Leaf blower:                                       90 dB (2 hours can cause damage)

Sporting event:                                 100 dB (14 minutes can cause damage)

Rock concert:                                     110 dB (2 minutes can cause damage)

Siren:                                                    120 dB (1 minute can cause damage)

SOURCE: CDC Vital Signs, February 2017

Unless you have a sound level meter app on your phone, you may not know if a sound is 85 dB, 70 dB, or 110 dB.  Here are some signs that a noise may be too loud:

  • You need to raise your voice to be understood by someone standing nearby
  • The noise hurts your ears
  • You have a buzzing or ringing in your ears, even temporarily
  • You don’t hear as well as you normally do until several hours after you get away from the noise
  • When listening to music through your headphones you cannot carry on a conversation without shouting

Prevention & Protection

Most of us rely on hearing to communicate and stay connected to others.  As we know hearing is critical to speech and language development, speech and language are critical for learning and academic progress.  Even mild hearing loss can affect a child’s academic success.  The damage from noise not only causes hearing loss, but it can cause tinnitus (buzzing or ringing in the ears) and/or hyperacusis (increased sensitivity to sounds).

The good news is ear damage due to noise exposure is almost completely preventable.  With a little knowledge, you can protect your child’s ears, as well as your own.  You can also teach your child to recognize when sounds are dangerously loud and how to protect their ears and hearing for a lifetime.  It’s a Noisy Planet has activities and suggestions for encouraging children to protect their ears.

More tips for safer listening are:

1) Turn the noise down

2) Walk away or avoid the noise

3) Take breaks from the noise

4) Block the noise or use hearing protection

5) Use the 60:60 Rule:  listen to music at 60% maximum volume for no more than 60 minutes a day.

Putting cotton or tissue in your ears may make you feel like you are protecting your ears, but most likely you are not providing appropriate protection against sound and possibly causing more damage as you may feel like you can stay longer in the noise because you have “protected” them.  You should use products that are made specifically for protecting your ears from noise.  You can purchase disposable earplugs from a pharmacy.  You can order earmuffs for you or your children.  You can even have customized earplugs made which are often more comfortable as they fit your individual ears.
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Damage due to noise is completely preventable.  First you need to recognize when a noise could potentially be dangerous, and then take step to prevent the sound from damaging the delicate structures or your ear.


 

If you are concerned that you or a loved one may have noise induced hearing damage, contact an audiologist at Easter Seals DuPage & Fox Valley for a complete hearing evaluation and more information on how you can keep the hearing that you have. Visit our website here.

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