Wear Time and Family Support: Frequently Asked Questions for Professionals

Consistent hearing device use is critical for children with hearing loss to achieve positive listening and spoken language outcomes. For children who are deaf or hard of hearing, it’s important they wear their hearing devices all waking hours, so they don’t miss a moment of listening, learning, and brain building.

Even with this goal in mind, many families face real challenges when it comes to keeping devices on their child’s ears.

Professionals working with families often ask—how can they best support increased wear time for children and give parents tools to make their wear time goals a reality?

How can professionals support families who are struggling to keep devices on their child?

A helpful first step is to identify the barriers that limit device wear time and make it a hard goal to reach. Understanding these barriers allows professionals to offer more targeted, meaningful support.

Device Retention Difficulties

For some families, challenges may be practical. Devices may fall off easily, or a child may pull them off throughout the day. In these cases, work together to problem-solve and explore individualized solutions.

Complex Barriers

For other families, barriers may be more nuanced. Parents may be navigating significant life challenges such as housing instability, food insecurity, mental health concerns, or domestic violence, which make it difficult to prioritize device use. When basic needs are unmet, consistent wear time may not be an immediate goal.

In these situations, professionals can play an important role by partnering with an interdisciplinary hearing healthcare team. By working together and connecting families with appropriate support, professionals can help address foundational needs while continuing to encourage progress toward device use over time.

You may be able to understand a parent’s challenges with hearing technology through questionnaires like the Parent Hearing Aid Management Inventory, developed by Karen Munoz and colleagues and the Early Device Use Questionnaire and Scale of Parental Involvement and Self-Efficacy (Revised) Questionnaire, developed by Sophie Ambrose and colleagues.

What role does collaborative, multi-disciplinary care play in supporting full-time device use and literacy?

Families are best supported when audiologists, Listening and Spoken Language (LSL) providers, and other specialists, work together to ensure children are properly fit with hearing technology and supported in using it consistently.

When professionals on a child’s team work together, they create consistent messaging, can identify and address concerns, share tools, and collaborate on data, such as wear time information, parent-friendly tracking apps, and measures like the Speech Intelligibility Index (SII) to help align strategies and support families more effectively.

How can professionals address concerns about “listening fatigue” that may lead to inconsistent device use?

Consistent access to spoken language gives a child’s brain the input it needs to build neural pathways for listening, spoken language, and literacy. When devices are removed, access is interrupted.

If parents feel their child appears tired or overwhelmed, it can be helpful to reframe this as a need for a break from the environment and not from listening itself. Rather than removing devices, professionals can guide families to reduce background noise, move to a quieter space, or simplify the listening demands.

Offering a different activity like a favorite toy, book, or game, can also help re-engage the child in a positive, low-pressure way while keeping devices on.

How can professionals support families who are processing emotions of their child’s hearing loss while also helping them understand the importance of early auditory access?

Many families benefit from support that addresses both their child’s needs and their own emotional well-being. Professionals such as infant mental health specialists and social workers can be valuable members of a child’s hearing healthcare team. Integrating this type of care can strengthen a family’s ability to move forward and support their child’s development.

Additionally, there are several resources that could be helpful to share with families navigating the emotions of this new journey.

• This video focused on Encouragement for Parenting a Child with Hearing Loss features Dr. Teresa Caraway, Speech-Language-Pathologist for over 40 years, offering encouragement and direction for any parent navigating early emotions and tough moments.
• Hearing First’s private family Facebook Group helps families connect with other parents and caregivers of a child with hearing loss. Families share it’s invaluable to connect with other families, share experiences, ask questions, and talk about tips.

What do families of a child with single-sided hearing loss need to know about the data and wear time?

While research on outcomes and device wear time for children with single-sided deafness (SSD) is still emerging, early evidence suggests that consistent device use matters. For example, work by Lisa Park, AuD, CCC-A and colleagues found that increased cochlear implant wear time was associated with better auditory development.

When counseling families, it’s helpful to emphasize how the brain uses input from both ears to support listening. Without consistent auditory input to both ears – especially during critical periods of development – the brain may have more difficulty building these skills over time

Experiential learning can also be powerful for families to better understand. Simulating the unilateral hearing loss by having a parent listen to speech with both ears and then with one ear covered can make the listening challenges more tangible and reinforce the importance of consistent device use.

How can professionals help parents of a child with mild hearing loss understand the importance of wear time?

Many professionals find that parents of children with mild hearing loss may not immediately see the need for full-time device use. Similar to approaches used with single-sided hearing loss, hearing loss simulations can be a very effective way to help families understand the reality and impact of even a mild loss. Also, reviewing unaided versus aided Speech Intelligibility Index (SII) scores can be a motivating way to illustrate the difference hearing technology makes in access to spoken language.

How can professionals discuss the connection between device wear time and positive behavior?

For most children who are deaf or hard of hearing, the language of the home is spoken language, making consistent access to sound through hearing technology especially important for everyday learning and interaction.

When children have reliable access to spoken language throughout the day, they have more opportunities for meaningful communication and turn-taking – experiences that support not only language growth, but also self-regulation, cognitive skills, and social-emotional development. Over time, these foundational skills can contribute to more positive behavior and engagement.

Where can I find information to support audibility counseling?

Dr. Elizabeth Walker was the co-author of a paper that discusses audibility-based counseling. There is also a free Hearing First learning experience in which Caitlin Sapp, AuD, PhD, and Lisa Park, AuD, CCC-A will share helpful information on this topic. in which Caitlin Sapp, AuD, PhD, and Lisa Park, AuD, CCC-A will share helpful information on this topic.

How can I find more information about the research and resources on wear time and listening and spoken language outcomes?

In the latest installment in the Oberkotter Foundation’s Showcase Series, Dr. Elizabeth Walker explores the research linking hearing device wear time to listening and spoken language outcomes, and how current evidence can be applied to support families in increasing device use.

Learn More