HEARING AIDS
Hearing aids make sounds in the environment, including speech sounds, louder. Not all hearing aids are the same. Some hearing aids are worn behind the person's ear. These are called Behind The Ear hearing aids. Some hearing aids are worn inside the ear (In The Ear Aids) or inside the ear canal (In The Canal Aids). In The Ear and In The Canal hearing aids are often not suitable for youngsters as they outgrow them very quickly. For children, the most practical hearing aid is the Behind The Ear hearing aid. There are many different models of Behind The Ear hearing aids. The advantages and disadvantages of various hearing aid models should be discussed with your Audiologist.

How Does a Hearing Aid Work?
The main parts of a conventional hearing aid are the battery, the microphone, the amplifier, the receiver, the volume control, and the on/off switch. Look at the diagram below and compare it with your child's hearing aid.

The microphone is usually found on the top of the hearing aid. The microphone picks up environmental sounds including speech in the form of sound waves. The sound waves are then changed into electrical signals and sent to the amplifier.
The amplifier is inside the hearing aid. Its job is to make the electrical signal louder and then send the signal to the receiver.
The receiver is also inside the hearing aid. Its job is to change the amplified electrical signal back into sound waves for us to hear. The amplified sound waves are then sent through the tubing and earmold into the ear.
The volume control allows you to adjust the loudness level of the hearing aid. Your audiologist will tell you which volume number your child should maintain.
The O-M or O-T-M switch is your on/off switch. '0' means Off, 'T' means telecoil which is used when talking on the telephone or when using the hearing aid with another assistive listening device such as an FM system, and 'M' means microphone or the 'on' position. Not all hearing aids have a 'T' setting. Hearing Aid technology is changing rapidly.  Many hearing aids now have built in FM capabilities and elaborate programming that may be adjusted for different listening environments.  When purchasing a new hearing aid, be sure that you are aware of the advantages and disadvantages of the model you have chosen and how the programming capabilities compare with other makes and models within a variety of price ranges.

Limitations of Hearing Aids
A hearing aid can make sounds in the environment, including speech sounds, louder. However, a hearing aid cannot:

• fix or cure a child's hearing loss
• make only speech sounds louder -all sounds in the environment will be amplified to some extent
• help the child hear sounds at frequencies where he or she has no residual hearing

Why wear a Hearing Aid?
The main goal of hearing aid use is to amplify sound to enable a person to gain meaning from that sound. In order to gain meaning from sound a child must be able to detect a sound, discriminate or tell the difference between sounds, and recognize sounds. This will not be automatic for a deaf child who is used to hearing and listening to sounds in the environment. Parents will have to 'teach' their child to hear and listen to sounds. For example, one approach involves:

• stopping and acknowledging that a sound has occurred
• focusing your child's attention to a sound by using gestures and words
• showing your child what made the sound
• telling your child what the sound means

By modeling this process for your child, you will teach them how to attend to sounds, recognize sounds, and thus comprehend sounds.

When a child is wearing a hearing aid, the aid will not only pick up speech sounds and amplify them, it will also pick up other environmental sounds that are around, such as traffic, other people talking, the radio or television, or rustling of papers, and amplify those sounds as well. These background 'noises' will interfere with the child's ability to hear and discriminate the speech of a speaker. As well, the voice of the speaker will lose its loudness the further away the speaker is from the deaf child. The speech that the microphone on the child's hearing aid is able to pick up will have lost loudness and clarity. This is especially important to attempt to regulate in the classroom.

FM Systems are wireless systems that aid in the transmission of sound from the speaker to the listener. The speaker wears a microphone and transmitter. The speaker's voice is sent to the receiver on a small pack that is worn by the child. The receiver is connected to the child's hearing aids. The speaker's voice is then received by the child directly, and competing noise in the environment is minimized. This can be particularly beneficial to children attending preschool or daycare centers.

Listening can be quite a task for a child with any degree of hearing loss. The speaker's voice is in constant competition with background noise. In a preschool environment, for example, this background noise may consist of 'busy noise' such as books opening and closing, pencils sharpening, feet shuffling, chairs and desks moving, paper rustling, general movement in the class, and children interacting. Other background noise that may affect a child's ability to attend to the teacher or other adult may include background noise from overhead fans, heating systems, traffic' outside, children in the hallway, and even the rain outside! With this in mind, the use of an FM system may help a child 'listen'. The following is a list of benefits and limitations to using an FM system. It should be noted that FM systems are not suitable for all children. You should discuss the use of an FM system with your audiologist and educator knowledgeable in the area of deafness and hearing loss.

• Speaker's voice will be amplified and background noise will not
• Creates a more favourable situation for the child to hear and listen
• Decreases the required listening effort
• Increases the likelihood of learning and acquiring information
• Decreases the effects of speaker movement (e.g., if the speaker turns around so that his/her back is to the child and continues talking, the signal will still reach the child
• Decreases the effects of distance from the speaker
• Transmission of the signal up to (approximately) 45 meters
• Decreases effects of reverberation (echo effect of sound)

• System must be monitored daily for effective use-this may discourage some adults from using it
• Limits communication with those not wearing the FM transmitter
• Social interaction with larger groups of people requires different equipment
• Users of the FM system must be instructed on the appropriate use and wearing of the equipment
• In a classroom environment, teachers may find the FM apparatus uncomfortable and undesirable to wear
• Child may not be able hear/monitor his or her own voice

A solution to many of these limitations is to have your child fitted with a hearing aid that allows the child to pick up and amplify sounds from both the FM System and the hearing aid at the same time.  For more information on these systems.

Hearing Aid Info

www.phonicear.ca

www.phonak.com

A Cochlear Implant is an amplification device. It is composed of parts worn externally, as well as internal parts that are surgically implanted in the cochlea.

Cochlear Implants are relatively new technology. In Canada they are generally only available to children with a profound sensorineural hearing loss that receive little to no benefit from other amplification devices such as hearing aids. However, each year in Canada there are more and more deaf children being implanted with these devices.

Cochlear Implants do not turn a deaf child into a hearing child. There have been many successful implants of the cochlear device, which have benefited many children. Yet, they are not suitable for every deaf child and criteria exist to establish the suitability of a deaf child as a cochlear implant candidate. A child with a cochlear implant will not automatically be able to 'hear' and understand language. The child will require years of professional intervention to develop auditory listening skills. This intervention requires a long term commitment from the family.

The use of cochlear implant technology can be very controversial. If you are interested in a cochlear implant for your child, it is important that you become well informed of all of the advantages, disadvantages, and commitment involved in the process of getting and maintaining an implant, both for you and your child. For more information consult with your audiologist, family doctor, or other hearing professionals.

For more information on the use of Cochlear· Implant technology in BC or Alberta, please contact the Cochlear Implant Program at BC Children's Hospital (604) 875-2345 or at Alberta's Glenrose Rehabilitation Hospital at (780) 471-2262.

For information on the internet simply do a search under the subject "Cochlear Implant" or see the web sites listed below.

Cochlear Implants

www.sickkids.ca/cochlear implant

http://www.zak.co.il/deaf-info/old/ci-faq.html

www.advancedbionics.com

www.cochlearamericas.com

OTHER ASSISTIVE DEVICES

There are various assistive devices that are available to deaf and hard of hearing people. These assistive devices may help the individual be more independent by amplifying sounds or by providing the deaf person with means of accessing communication other than through sound.
There are various private companies which may sell assistive devices for the deaf and hard of hearing. The Western Institute for the Deaf and Hard of Hearing, located in Vancouver and Kelowna, offers a wide selection of assistive devices and can give you information on the most up to date technologies to suit your needs. Discuss these needs with your audiologist as well as other hearing professionals such as a Teacher of the Deaf.

Closed Captioning
Most television programs and home movie rentals can be accessible to the deaf through captioning.  This means that the spoken words, sounds, and music heard on the program are seen on the TV screen.  The written translation appears across the bottom of your television screen.  If your television was made after 1993 and it is larger than 13 inches, you may have 'Closed Captioning' built in to your television set.  Check your owner's manual on how to access captioning.  If your television does not offer closed captioning, you may borrow a Closed Caption Decoder from your local cable company.  They are free of charge to families that have a deaf / hard of hearing member, provided that you subscribe to your local cable company and have a hearing report from your doctor or audiologist.

The TTY
A TTY (teletypewriter) is a telephone for deaf persons.  The TTY has a keyboard similar to a computer or typewriter and a small screen across the top of the keyboard.  Instead of communicating on the telephone using one's voice and ears, the deaf person types what he or she wants to say.  Two people with TTYs can communicate directly back and forth through the typed message.  If a hearing person without a TTY wants to phone a deaf person, or if a deaf person wants to phone a hearing person that does not have a TTY, they can do so through the Message Relay Centre. An operator will assist the conversation by acting as a relay person.  The operator will type what the hearing person says to the deaf person, and voice what the deaf person types to the hearing person.  Hearing persons without a TTY can contact the Message Relay Centre at
1-800-855-0511.

Deaf persons with a TTY wishing to call a hearing person can contact the Message Relay Centre at 711 or 1-800-972-6509.

Deaf persons requiring assistance in placing a call to other TTY users may call the Message Relay Centre at 1-800-855-1155.

Persons using a TTY may be eligible for discounts on long-distance calling.  Contact your local long-distance provider for more information.

  For more information, look at the beginning of your telephone book under Accessible Communication Services: For Customers with Special Needs

Videophones

Eye-2-eye Videophones are a relatively new technology.  By connecting them to your phone and/or ethernet connections, users can speak to each other via video through your television.  Voice and/or sign language may be used to communicate and no long distance charges apply. If the person you are contacting does not have a videophone, you may use your videophone to contact the Video Relay Service.  They will act as the interpreter/operator between you and a person using the telephone.
Families in British Columbia that have a deaf/hard of hearing child in their family may qualify for a free videophone through the Family Network for Deaf Children.  To purchase a videophone, contact the Western Institute for the Deaf and Hard of Hearing for information on local suppliers in your area.
For more information on using the Video Relay Service, click on the link below.
http://www.fcc.gov/cgb/consumerfacts/videorelay.html

Safety and other Alerting Systems
Have you ever wondered how a deaf person knows that the phone is ringing, that there is someone at the door, if there is a fire, if the baby is crying, or how they hear the alarm clock in the morning?  Deaf people can lead independent lives in this regard just as a hearing person would.  Many devices are available to deaf people that will alert them to sounds via-light signals or vibrations.  For a complete list of assistive technology for the deaf, visit the  Western Institute for the Deaf and Hard of Hearing