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Why OTC Hearing Aids Aren’t Right for Kids—But Other Options Are

For the first time, certain hearing aids are now being sold in drug stores and online without any involvement of a medical professional. These over-the-counter (OTC) hearing aids have created a lot of excitement as a more affordable option to help people with hearing loss.

While OTC hearing aids can benefit some people, it's important to know that they are not meant for children. In fact, for kids, they can actually be harmful. Read on to learn why, and how to find better options to treat your child's hearing loss.

How common is hearing loss in children?

In the United States, roughly 1 to 3 of every 1,000 babies are born with hearing loss. That makes it the most common congenital health condition that can be screened at birth. By the time children reach school age (6–19 years), almost 15% have some degree of hearing loss. There are many different reasons why a child may be born with or acquire a hearing loss later in life.

Options to help kids with hearing loss

Families have options for helping their child with hearing loss communicate effectively. For example, there is technology that can improve a child's ability to access sound, including prescription hearing aids, cochlear implants and personal FM systems.

The U.S. Food and Drug Administration (FDA) is clear that OTC hearing aids are only for adults ages 18 and older. But this may not be obvious when you see them on store shelves or in advertisements. And the FDA does not require that retailers verify the age of the buyer or user to be sure they are 18 years or older.

Families may be tempted to purchase these products for their child, especially if their insurance doesn't cover hearing aids. However, this should never be considered an option for children—even if families have difficulty paying for a prescription hearing aid. There are other sources of help (see "What can I do if hearing aids aren't covered by my insurance?" below).

How can OTC hearing aids be harmful to children?

OTC hearing aids are designed for people ages 18 years or older. Because of this, certain essential components of pediatric hearing aids that protect children will not be included in these products.

Necessary features for children's hearing aids include:

  • Tamper-proof battery doors: Children are naturally curious and will want to explore their hearing aids. Pediatric prescription hearing aids come with a tamper-proof battery door to prevent younger children from gaining access to the battery. Without this feature, kids can swallow the battery. Recent studies have shown that hospitalizations of kids who have ingested lithium coin batteries and button batteries are rising. This can result serious injuries, damage to vital organs, and even death.

  • Child-appropriate size: A prescription pediatric hearing aid is designed for a child's small ear, which is still growing. Placing an adult-sized OTC hearing aid into a child's ear may result in more hearing loss due to over-amplification. Consistent over-amplification, which means a hearing aid is making sound louder than a child's hearing loss requires, can have other physical effects such as headaches. This can influence a child's ability to concentrate and function in their daily lives.

  • Specialized testing: An audiologist (healthcare professional who specializes in the assessment and management of hearing loss) who provides a prescription hearing aid to a child uses multiple tools to make sure that the hearing aid is a good fit for them. This includes use of specialized equipment and testing in a sound booth. These measures ensure that the child is getting the best access to the full range of speech.

    A child's hearing levels, and anatomy of each ear are unique. That's why age-appropriate testing is important. An audiologist confirms that the hearing aid is giving out just the right amount of sound needed for the pitches that are important for understanding speech and learning spoken languages. A poorly fit OTC hearing aid might actually make it harder for a child to learn language. This increases the achievement gap compared to their hearing classmates over time.

  • Volume-safe design: Prescription hearing aids have sophisticated sound processing capabilities that automatically adjust to a child's hearing needs in the moment. These needs can change throughout the day based on factors such as background noise in a room or the activity they are participating in (for example, sitting in class versus watching television).

    Audiologists often disable the volume adjustment buttons on hearing aids to keep children from manually changing the volume. OTC hearing aids are required to have a volume-control feature and there may be no way to disable this feature on many products. Children may turn the up the volume too loud. This puts them at risk for noise exposure and additional hearing loss. There is also a risk a child might turn the volume all the way down, further reducing their access to sounds.

  • Connection to school equipment: A hearing aid is only one tool that a child uses to connect to their world. In the school setting, many children sync their hearing aid to equipment in the classroom, such as an FM system. This helps them hear the teacher better and keep up with the curriculum. Hearing aids alone are not enough in a noisy classroom or when the teacher is talking at a distance from the child. OTC hearing aids will not be designed to connect to these types of equipment, putting the child at a disadvantage educationally.

Why is addressing a child's hearing loss so important?

Untreated hearing loss can have a big impact on a child's speech and spoken language development. Children with hearing loss who use hearing aids in early childhood show faster growth in spoken language skills compared to children who do not use hearing aids. Early language delays can have a cascading impact on literacy and school success.

Even a "mild" hearing loss may result in a child missing daily language and learning opportunities from birth throughout their school years. This can affect achievement in all subjects if left unaddressed. Children with untreated hearing loss can also experience social and behavioral challenges. They may miss parts of conversations or social cues—making it difficult to make or keep friends. This can lead to feelings of loneliness or isolation. Difficulty hearing and communicating may also lead a child to feel frustrated, causing them to act out in school and other settings.

The academic, social and behavioral consequences of untreated hearing loss can impact a child's future career options and success.

What are the signs of hearing loss—and what should I do if I am concerned about my child?

Signs and symptoms of hearing loss can be different for every child. Even if your child passed a hearing screening, they still may develop hearing problems later in childhood. Signs to watch for include, but are not limited to, the following:

  • Not startling to loud noises (birth to 3 months)

  • Trouble locating where sound is coming from (7 months to 1 year)

  • Delay in speech/language development (7 months to 1 year)

  • Difficulty following directions (school age)

  • Sudden change in academic performance (school age)

  • Unexplained behavioral problems or "tuning out" (school age)

  • Listening to the entertainment devices at loud volumes (school age)

  • Any reports of strange sounds in the child's ear, e.g., bees buzzing (school age)

If you are concerned about your child's hearing, ask your pediatrician for a referral to an audiologist in your area. Audiologists have special tests to evaluate hearing at any age (from newborns to adolescents). Depending on the child's age, the method and equipment for evaluating their hearing may be different. This is why it's important to see these specialists if you have concerns. You can also find audiologists through online searchable databases including EHDI-PALS and ASHA ProFind.

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What can I do if hearing aids aren't covered by my insurance?

Unfortunately, not all insurance plans cover children's hearing aids. If your family is in this situation, consider the following:

More information

Last Updated
American Academy of Pediatrics and American Speech-Language-Hearing Association (Copyright © 2023)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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