Over-the-Counter Hearing Aids – are they a choice for kids?

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What are Over-the-Counter (OTC) Hearing Aids

Have you heard reports on the news about availability of over-the-counter (OTC) hearing aids? In October 2022, the United States Food and Drug Administration (FDA) established guidelines for OTC hearing aids to be made available for adults (18 years of age and older) with mild to moderate hearing loss. A variety of OTC hearing aids are available for purchase, without a prescription or a formal hearing test, from a variety of retailers (online and in stores like CVS and BestBuy). These hearing aids are typically self-fitting (with an online app) or fit remotely by a hearing healthcare professional. Although OTC hearing aids may be a good option for some adults, they are not intended for children and could even be harmful to them.

Why aren’t OTC Hearing Aids Appropriate for Children?

While OTC Hearing Aids may seem like an attractive and affordable option for children with hearing loss, caregivers need to be cautious when seeking appropriate amplification for their children. The Centers for Disease Control (CDC) estimates that 1-3 per 1000 children have hearing loss at birth. This makes hearing loss the most common health condition that can be screened at birth. The number of children with hearing loss increases when looking at school-aged children. Diagnosing and treating hearing loss is essential for maximizing a child’s overall development. For children with hearing loss, hearing aids are critical for providing access to speech and environmental sounds for speech & language, social-emotional, and academic development as well as for safety factors. An audiologist, with training in pediatrics, is best qualified to accurately test a child’s hearing and appropriately fit amplification. The FDA has clearly labeled OTC hearing aids as appropriate only for adults and because of this, they do not need to include several essential features required to protect children.

What is Involved with Fitting Children with Hearing Aids?

An audiologist will first assess a child’s hearing. The type of hearing test will vary based on a child’s age. Babies who fail their newborn hearing screening should receive a diagnostic hearing test (called an auditory brainstem response (ABR) evaluation) within the first 3 months of age. This is a painless test that allows an audiologist to measure a baby’s hearing sensitivity while they sleep.  Children older than 6 months of age will participate in behavioral testing to determine their hearing sensitivity. A hearing loss can be accurately diagnosed at any age and appropriate hearing aids can be quickly fit by an audiologist.  The audiologist will use individualized information to make sure hearing aids are fit and programmed appropriately and safely. The audiologist will also consider pediatric features and accessories that are not available with OTC hearing aids. These features may include:

  • Tamper proof battery doors to prevent children from swallowing batteries
  • Pediatric earhooks and earmold options designed for small ears
  • Child-friendly colors
  • Programming options customized for children
  • Remote microphone technology to help give children direct access to their teachers, coaches, and parents in noisy environments like school, home, and extra-curricular activities
  • Bluetooth compatibility options for easy access to things like tablets, cell phones, and gaming systems.
  • Indicator lights for low battery, power on/off
  • Pediatric apps with caregiver controls
  • Reports for caregivers and audiologists to see the average number of hours worn/day
  • Extended warranties to allow for the wear and tear of childhood

What if a family cannot afford hearing aids?

There are many options for financial assistance and there are excellent hearing aids at different price points that are not OTC hearing aids. The Department of Audiology at CHOP has a loaner hearing aid program so that a child can be fit promptly while their family is seeking out financial assistance options.  Please talk to your audiologist for options that may be available to you and as always, the audiologists at CHOP are here to answer any of your questions about your child’s hearing.