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Even the best-fitted hearing aids or cochlear implant fall prey to external factors. Noise, distance, and reverberation may affect the sound quality.

When the devices are unavailable or not working effectively, your child’s use of visual cues means they may struggle. Luckily, most, if not all of these issues can be easily addressed with a little awareness and action from you.

Practice makes perfect

Hearing aids are like a muscle: the more you use them, the better they work. Encourage your child to wear them for as many of their waking hours as possible. Skills such as listening and understanding language improve with practice. The more your child hears with hearing aids, the greater their vocabulary and language experience, and the better they will understand, even in more difficult situations.

Reduce noise

We all struggle to hear well in noisy environments, but with a hearing loss it’s even more challenging. You may be surprised to learn that children generally won’t hear as well as adults in noisy places, either. Not only is their auditory system not fully mature, but they don’t have our vocabulary and language experience, so are less able to “fill-in-the-gaps”. Combine all these factors, and it’s clear that children with hearing loss will be particularly disadvantaged in noisy environments.

When conversation and understanding is important, try to get rid of unnecessary noise. For example, when reading to your child or helping with homework, turn off the TV or radio.

When you are out and about, try to move away from noise sources such as traffic, air conditioners, loudspeakers and loud groups of people.

Large rooms without carpets, curtains or other soft furnishings can be very ‘echoey’ because any sound in the room bounces around off the hard surfaces. This is called reverberation and it interferes when your child is trying to hear. Opt for rooms with carpets and soft furnishings for stories and important conversations if you can.

Classrooms are also often very noisy. This poses real problems for children with hearing loss who are trying to learn. A remote microphone system is often crucial for a child with a hearing loss.

As your child gets older, help them to become aware of noise issues and look for solutions. They can identify sources of troublesome noise, reduce the noise themselves or ask for the noise (or music) to be turned down. If not, they can learn to identify the best available position away from the noise.

Get in close

Distance is a real problem for anyone with a hearing loss. Speech coming from a distance is softer, and it often gets mixed up or lost in other noise in the environment.

Your child hears best when the speaker is no further away than one to two metres.

Teach your child to move towards whoever is listening or speaking to. This includes encouraging them to sit towards the front of group situations or not starting conversations from another room.

If your child needs to listen to someone speaking from a distance for long periods, use a wireless microphone system if possible.

Ensure your child can see you

Even if your child is taught to understand speech through listening, they, like most people, will use visual cues for information in noisy environments:

Position yourself so your child can see your face. Try not to eat or cover your mouth while you are talking to your child.

A well-lit (but not glaring) environment will help your child see the speaker better.

Speak clearly but naturally. Exaggerating or shouting can make it more difficult for your child to understand speech.

Try to remain in one spot while talking. It’s difficult to understand someone who is moving about while they speak. If your child needs to make use of visual cues, this also becomes harder if you are moving.

When reading aloud, make sure the book is not covering your face.

In difficult listening conditions, encourage your child to watch the speaker’s face for visual cues.

Get their attention

Children possess the marvellous ability to tune out adults, especially their parents, even if that person is standing and talking right in front of them. This means you are contending with general inattentiveness as well as hearing loss. The first step is to make sure your child knows you want to say something to them.

Start with their name to establish that you are addressing them.

Before giving instructions or asking questions, allow time to shift focus from what they are doing to you.

Make good use of available technology

Your child’s hearing loss increases how hard they work to listen. As a result, their attention may wander or they may find school more tiring. With good listening conditions and technological support, you can reduce this strain and free them to concentrate on processing what’s being said.

Your child’s hearing aids or cochlear implant needs daily checking.

Listening checks such as the Ling seven-sound test (ah, ee, or, oo, mm, s, sh) let you simultaneously check the device and detect changes in your child’s hearing.

Use remote microphone technology (e.g. FM systems) at home as well as at school.

From an early age, encourage your child to flag problems with their devices as soon as possible.

Equip them to ask for help

Nobody catches everything that’s said to them, but there are a few techniques that help your child clarify uncertainty

Develop age-appropriate ways for your child to ask the speaker to repeat something. People may think “what?” or “huh?” is impolite, so “pardon?” is a safer bet

Discourage pretending that they heard, as it may backfire.

Get them to unobtrusively check important details such as times, dates, phone numbers or addresses by repeating them back to the speaker.