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Once hearing assessment have been completed and we have a definitive understanding of your child’s hearing thresholds, our team will work as quickly as possible to obtain hearing device(s) for your child.

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The primary goal of hearing devices is to ensure speech is audible to your child. During the hearing aid evaluation, (known as a Hearing Aid Consult), we discuss the amplification options available for your child. During the fitting of the hearing device(s), we will program the device(s) according to your child’s needs and hearing thresholds, and we will teach you (and your child) how to use and care for the hearing device(s). At the follow-up visit, we will test your child’s hearing with their hearing devices on (if appropriate).

Drop-In Hearing Aid/Cochlear Implant Hours

If you need to have your hearing device examined, earmold re-tubed, or have someone examine a broken cochlear implant, please feel free come in without an appointment during our drop off or our “walk-in” hours. Please call the clinic (San Diego, Oceanside, or Murrieta) to ask for the drop-off and/or walk-in hours.

Styles of Hearing Aids

For most hearing differences, hearing devices are recommended to help maximize the amount of auditory information a patient receives. Hearing devices come in a variety of sizes and colors, as well as with differing degrees of technology. When selecting different types of amplification the audiologist will keep several variables in mind:

  • Your child’s age and needs
  • Your child’s hearing thresholds
  • The durability of the hearing aid
  • The service from the manufacturer
  • The hearing aid’s ability to connect to other devices that are used in school

The audiologist will recommend which type of hearing device is best for you or your child’s type of hearing thresholds. They will then work with your family to make sure that your child is getting the most out of their hearing device.

Behind-the-Ear (BTE)/Receiver-in-the-Canal (RIC)


This style of hearing aid fits behind the ear and is anchored in the ear canal with a variety of types of earpieces. These styles of instruments are particularly suitable for children as they can often allow for connection to other devices in the classroom.

In-the-Ear (ITE)/In-the-Canal (ITC)/Completely-in-the-Canal (CIC)

These styles of hearing aids all have in common that the hard plastic, custom shell is designed to fit completely in the ear canal. They vary in size with an ITE filling the entire ear and a CIC fitting further into the ear canal. These styles are not recommended for young children due to the growth which renders the hearing aid loose in the ear, requiring remaking of the hearing aid, as well as the small size of the aid being a choke hazard.

Bone Conduction Hearing Aids/Bone Anchored Hearing Aids

These styles of hearing devices are used for children that have a hearing difference in the outer or middle ear which cannot be medically treated and/or surgically corrected at the current time. These can also be used with children who have limited usable hearing unilaterally/single-sided deafness. Bone conduction devices provide sound through a small vibrator that is attached to the head via a wearable headband or surgically implanted attachment.

Cochlear Implants

Some children, due to the severe or profound nature of their hearing levels, may be candidates for cochlear implants. This is a device that is surgically implanted into the inner ear, and with the help of an external speech processor, sends sound information directly to the auditory nerve.

It is important to realize that none of these devices are cures for hearing differences. They cannot return hearing to the typical hearing range. This is because they are not a ‘fix’ but instead an assistive device. It is very important that other strategies are used along with amplification.

Prior to obtaining a hearing aid, two things are required:

  • A medical clearance from an ear, nose, and throat (ENT) physician obtained within the last six months of the fitting of the hearing device(s)
  • A hearing test performed within the last six months of the fitting of the hearing device(s)

Once devices have been selected, your child will be scheduled for a hearing aid fitting and follow-up appointments. Your audiologist might use one of several methods for fitting and evaluating the hearing devices.

The fitting and verification methods could include:

  • Probe Microphone Assessment
    For probe microphone testing, a small, soft tube is placed in the child’s ear next to the earmold or earbud. The probe microphone measures the amount of sound coming out of the hearing aid while it is on the ear. Adjustments can be made to the hearing aid while it is in place in the ear. This is particularly important as children have much smaller ears than adults. We know that ear size impacts the functioning of a hearing aid, so it important to take measures on each child’s ear to make sure hearing aids are set correctly.
  • Real-Ear-Coupler-Difference Measures (RECD)
    It can be difficult to test babies and young children using regular probe microphone tests as babies may not keep the probe tube in their ear or sit quietly enough for the time needed to perform the required measures. In these cases, a RECD can be obtained instead. The audiologist makes a quick measure in the child’s ears, and then does all of the subsequent adjustments with the hearing aid inside a test box. The hearing aid can be adjusted for the child, and the child does not have to keep anything in their ear for more than a few seconds.
  • Aided Diagnostic Assessment
    The appropriateness of the hearing aid fitting is monitored and assessed over time. This is done via standardized questionnaires, assessment of speech sounds-called Ling Sounds-in the soundbooth, via real-ear measurement, and even via an aided cortical evoked potential (CEP) test. Much like other electrophysiological testing, such as the brainstem auditory evoked response test or the auditory steady state response test, electrodes are placed on the child’s head and sound is directed into the ear. Performed when the child is awake, the CEP test makes use of wireless transfer of information from a computer to the child’s hearing aid. We are able to use speech sounds such as ma or ga and play them at a conversational level. Our goal is to ensure that each speech sound is audible via the hearing aid.  

Hearing Assistive Technology: FM Systems

Being able to understand in the classroom is a critical component for learning. In a typical spoken language-based classroom, the degree of background noise and reverberation are high enough to affect speech understanding, attention, and academic achievement. In addition, most teachers will turn to the board or move around a classroom, causing the loudness of the voice to vary.

For children with typical hearing, these everyday classroom noises and events do not create a problem. For hard of hearing children, even with appropriately fit amplification, the speech signal is not loud enough or clear enough to allow for maximum understanding. Even children with minimal hearing levels, fluctuating hearing, or unilateral hearing differences struggle with background noise interference and variations in the loudness of the teacher’s voice. A hearing assistive technology is often used to help increase a child’s access to sound, particularly in a noisy and reverberant setting such as a classroom environment or a restaurant. There are several types of hearing assistive devices. The two most commonly used are the personal and classroom Remote Microphone Systems (RMS) which are described below.

Personal FM

or a PERSONAL Remote Microphone Systems (RMS), the person speaking wears or holds a transmitter microphone, or the transmitter is placed in the middle of a group (picking up speech from all around). Using harmless radio waves, the Remote Microphone Systems (RMS) sends the speech signal to the listener, who wears a tiny receiver behind the ear or a neckloop with the transmitter attached to it (the transmitter communicates with the hearing device wirelessly via the neckloop).

Classroom Sound Field System

Another Remote Microphone Systems (RMS) option is a CLASSROOM SOUND FIELD SYSTEM. With this system, the speaker still wears or holds a transmitter microphone, or the transmitter is placed in the middle of a group. Speakers in the classroom amplify the speech to a level louder than the background noise, and all children in the room enjoy the benefit.

Studies have shown that Remote Microphone Systems (RMS) have the best results when implementation is made early in the amplification-fitting or cochlear implant process. Consideration for connectivity of a hearing assistive technology is included in the selection process for hearing devices or cochlear implants. These devices can help facilitate improved spoken language development.

Other Assistive Technology

Noise Protection/Musician’s Molds

Studies have shown that for 12.5 percent of 6-19 year-olds and 16.8 percent of 12-19 year-olds in the United States, their hearing thresholds have become worse due to noise exposure (exposure to loud sounds). We often overlook the dangers of noise and music in school-aged children and teenagers. Noise protection and musician’s earplugs are created using a custom impression of the ear. The molds are then fit to the child/teenager’s ear three weeks later. These types of molds allow the child to enjoy noisy activities (concerts, sports events, etc.) without permanently impacting their hearing.

Swim Molds

When children have a hole in their eardrum or open tympanostomy tubes, they often are instructed by their physician to not allow water to get into the ear. A custom swim mold requires an impression to be taken of the ear, mailed to a manufacturer of swim molds, and then fit to the child’s ear approximately three weeks later.

Telephone Solutions

Most hearing devices now have telephone solutions to allow for better connection to the phone. Many options exist for louder ring tones or volume controls.

Television Solutions

Television solutions to be used both with and without hearing devices are readily available using infrared, Bluetooth, and FM technology. These devices direct sound right to the ear, allowing for a reliable transition of information and eliminating bothersome background noise. These systems allow a child to listen to the TV at a comfortable listening level without disturbing others in the room.

Alerting Devices

Depending on the severity of the hearing levels, some children may not be able to hear important warning signals, even when appropriately amplified. Alerting systems help a hard-of-hearing child be aware of important events such as doorbells ringing, knocks at the door, telephone ringing, smoke/fire alarms, and alarm clocks. Alerting devices can supplement the use of hearing devices by providing visual/vibrotactile stimulation to sound.

Induction Loop System

An audio frequency induction loop is a wire that circles a room and is connected to a sound system that transmits the audio signal to hearing devices via a T-coil. It can be found in many public buildings including banks, post offices, churches, and theaters. For more information, click here.