Below are descriptions of the different styles of hearing aids.

Behind-the-ear (BTE) - BTE's are worn behind the ear and attach to a custom ear mold that fits in the ear. BTE's are the most common type recommended for children.

In-the-ear (ITE) - this type of hearing aid comes in many sizes but are not recommended for children under age 14.

Bone conduction hearing aids - these are placed on the bone just behind the ear and held in place by a headband. Typically recommended for conductive hearing loss.

Bone-anchored hearing device - one part is surgically anchored to the bone behind the ear and a removable part is the hearing aid. A headband is no longer needed to keep it in place. When the child is older, the anchor for the hearing aid may be surgically implanted on the bone permanently so a headband will not be needed. BAHA is the trademark name of a particular manufacturer.

• Hearing aid fittings should be done by an audiologist, who is qualified or licensed to fit and dispense hearing aids for children.
• Hearing aids for children should not be purchased online or "over the counter". This is specialized equipment that requires fine tuning by a professional trained in pediatric hearing aid fittings.

• The pediatric audiologist should have the results of previous testing. However, it might be a good idea to bring copies of all hearing screening or previous test results.
• Some babies are at a higher risk for hearing loss than others. It is helpful to provide information about pregnancy, major illness, or childbirth problems and any family history of childhood hearing loss.
• Write down your list of questions ahead of time and bring them along.
• Be sure to ask the clinic for any paperwork you may need to complete prior to the visit.

Several factors could play a part in how long it will take to get an appointment. When a hearing loss is diagnosed, the goal is to fit hearing aids as soon as possible or before 1 month from diagnosis so language development can begin. You are encouraged to follow-up quickly to schedule an appointment.

• Contact the pediatric audiologist to find out what is needed to prepare for the appointment. Typically they will want the child to be sleepy/tired and/or hungry. Some tests may require the child to be alert.
• Preparation depends on how the test is done and the age of your child.
• For newborns and very young infants, the testing is done while your baby is sleeping. For older babies sedation might be recommended.
• Children who are old enough to cooperate for testing should be well-rested, relaxed, and ready to play.

The hearing aid test and fitting is normally a multiple step process that can take a series of appointments. Your child's pediatric audiologist will guide you in knowing what steps are needed to ensure your child gets fitted with the right hearing aids.

• Financial assistance works differently in different states/jurisdictions. Some have laws that require insurance companies pay for hearing aids for children. Some insurance companies offer hearing aid benefits. Some states have programs to provide donated hearing aids.
• Some state early intervention (EI) programs may pay for hearing aids (as the last resort), earmolds, and hearing aid supplies, such as batteries.
• Some programs are based on financial need. These programs can assist with costs related to audiology services, hearing aids, assistive devices, and speech-language pathology services.
• Talk with your pediatric audiologist if you have concerns about paying for your child's hearing aids.

• Experience does matter, but smaller facilities with fewer patients often provide excellent services.
• Top quality facilities can be found in both urban and rural areas.
• If you have concerns about the test results, you may want to seek another opinion from an additional facility.
• Talk to other parents about their experiences with different facilities.
• You can compare facility services and details using the EHDI-PALS search tool.

What if I need an interpreter for my appointment? Be sure to notify the office that you require this service when making the appointment. It might also be a good idea when you confirm your appointment date/time that you also confirm an interpreter will be there.

Can I bring a friend/family member with me to the appointment to help me better understand test results and next steps? Sometimes it feels like there is a lot of information being shared. It's okay to ask about bringing someone to assist and take notes.

Are there other fees/costs that I need to be prepared for at the time of the appointment? Parking charges vary according to the clinic location and policy. Parking may be located in a different building. So remember to ask for the parking location, how to get to the clinic from the parking lot, the cost of the parking and if their office validates parking for a reduced rate.

Consider asking the clinic or your medical insurance plan if there will be a copay for the service. Amount of copay, if any, depends on the type of insurance plan and whether the medical professionals are in or out of your plan network.

Is there any paperwork I need to complete prior to the appointment? This is specific to the provider and may be indicated by your insurance coverage. It is a good idea to ask when making the appointment as there may be new patient forms that can be completed in advance online.

It depends on the range of hearing the child has and any amplification being used. This is a great question to talk about with your pediatric audiologist. For example, you could ask about whether or not they hear specific sounds like emergency sounds and soft sounds like rain or leaves, etc.

It's important to check your child's hearing aid every morning when you first put them on, and throughout the day if you suspect your child is not hearing well. You can check your child’s hearing aids by listening to them using a special tool and doing a daily sound check using the "Ling 6" sounds.

Ask the audiologist about providing you with a kit to check the hearing aids and to care for them.

The pediatric audiologist and your child’s speech-language pathologist and/or teacher can support you as you learn how to manage your child’s hearing aids.

Ling 6 sound test is an easy way to tell how well your child is hearing with their hearing aid(s) using simple sounds.

Hearing and hearing aids need to be tested often for young children because hearing aids can break down at any time. It is important for your child’s communication and language development to quickly identify changes in your child's hearing status or potential issues that may arise with the hearing aids.

Expect to have your child’s hearing and hearing aids checked approximately every 1-2 months during the first year, every 3 months from 12-36 months of age and every 6 months between 3 and 5 years of age and then annually.

• The pediatric audiologist uses special equipment to adjust the hearing aids to make sure speech sounds can be heard and that loud sounds are not too loud.
• To set up the hearing aids the pediatric audiologist will need: your child’s hearing test results to run a special test called the RECD (or real-ear-to-coupler-difference). This involves placing a small, thin tube into your child’s ear canal with the earmolds on. Knowing the RECD and your child’s hearing test results will help the audiologist set up the hearing aids correctly.
• The pediatric audiologist will recheck the RECD every time your child gets new earmolds. As your child grows, the hearing aid settings will need to be adjusted.
• Always ask for a copy of your child’s test results. This is helpful information for you and your child’s intervention team.

• It is important that your child wear his or her hearing aids during waking hours and that the hearing aids are in good working order. It is also okay to "take a break" from listening. Contact your pediatric audiologist any time with concerns about keeping the hearing devices on especially in the early days/weeks.
• To learn spoken language, your child will need to wear the hearing aids every waking hour so that he or she has consistent access to sound.
• Children with hearing loss require more exposure to a word than children with typical hearing in order to learn it.
• It is important that your child is aware of environmental sounds. Lack of awareness can impact his or her safety, for example, when crossing a busy street, or detecting emergency alarms.

As your child grows, the earmolds will need to be replaced. For young children, the ear molds need to be replaced frequently. As a rule of thumb, between birth to 12 months, your child’s ear molds may need to be replaced approximately every month, for ages 1 to 3 years every 2-3 months, and every 6 months for ages 3 to 5 years and then annually thereafter.

It is important that your child’s ear molds fit well. This affects the quality of the sound that your child hears.

Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve.

• A 3- to 6-month trial period with hearing aids is recommended before a child is considered for a cochlear implant.
• Cochlear implants are considered when the child has severe or profound hearing loss and receives little or no benefit from hearing aids.
• Cochlear implants are currently approved for children 9 months of age and older.
• Talk to your child’s ear, nose, and throat doctor and pediatric audiologist if you have more questions about cochlear implants.

Many decisions must be made prior to selecting the best device for your child. Your child's pediatric audiologist will help you understand the features and benefits based on your child's age and lifestyle.

All new hearing aids will have a loss/damage warranty. The length of the warranty ranges from 1-5 years depending on the manufacturer. Additional insurance beyond the first year may be helpful to insure against loss. Be aware that the extended warranty does not cover repairs from normal wear and tear, and policies cover only loss of the hearing aid or physical damage beyond repair. Discuss the pros/cons with your child's pediatric audiologist to help you determine when additional hearing device coverage is beneficial.

This is an important question to ask. Loaner hearing aids can be temporarily used while in the process of selecting the appropriate amplification.

Hearing aids can malfunction and need repair. Loaner aids can be used anytime hearing aids need to be sent to the manufacturer for repair or are accidentally lost or damaged. If the audiologist does not provide loaner hearing aids, they may be able to assist in finding loaner hearing aid resources.

There are many different accessories that can secure your child's devices; retention cords, pilot caps, "Hearing Henry" headbands, ear suspenders, and Etsy stores could be Googled on the internet.

Contact your pediatric audiologist as soon as possible to arrange for repair and/or use of loaner hearing aids.

There are other people who may need to receive your child's hearing aid fitting report. You may need to sign a release form so that your child's information can be shared.

• Your child’s doctor (to know about the management of your child’s hearing loss)
• The state newborn hearing screening program (to know that your child received services)
• Your child’s early intervention providers (to help develop an appropriate intervention plan)
• Your child's school if your child is school-age

There are two considerations when playing sports or doing other physical activities. How your child will communicate with the coach and other players and possible damage to your child's hearing aids. This is a good conversation to have with coaching staff, your child and your child's audiologist. There are options available such as headgear that can protect hearing devices.