Caring for Kids with Hearing Difficulty

and Why Over-the-Counter (OTC) Hearing Aids Are Not Recommended for Children


by Thomas A. Powers, PhD

February 22, 2023


Detection of hearing loss in children should occur as early in life as possible. Ideally, infants born with hearing loss should be identified by three months of age so that rehabilitation programs — including the fitting of hearing instruments — can be initiated. The first three years of life are critical to speech and language development.


A child with suspected hearing loss is evaluated cooperatively by the audiologist, the physician (otologist/otolaryngologist), and other appropriate specialists when required. The extent of the work-up varies greatly depending on the complexity of the problem. After all the evaluations are completed, a treatment plan is formulated that depends upon the degree and configuration of the hearing loss and whether the loss is expected to progress. Long-term follow-up of children with hearing loss is usually required and other members of the health care team (family physician, pediatrician, hearing healthcare professional, speech-language pathologist, and social worker) are frequently involved. For more information about hearing health and hearing loss intervention for children, visit the For Kids page.


In October 2022, FDA regulations went into effect that allowed the sale of over-the-counter (OTC) hearing aids. The guidelines have extensive technical and labeling requirements including that these devices are not intended to be sold to anyone under 18 years of age. Children with hearing loss require special intervention from audiologists and the medical community. Untreated or inappropriate treatment for hearing loss can result in significant delays in the development of speech and language skills, educational success and social interactions with family and peers.


The hearing devices usually fit on children are referred to as “prescription” devices. These are devices that can only be sold through licensed hearing professionals and, in the case of children, should be sold and fit by a licensed audiologist. Prescription hearing aids can be programmed to the specific audiogram of the child and have features that are age appropriate. These features include:


  • Tamper-proof battery door to reduce the risk of accidental swallowing of a button cell battery.
  • Child appropriate device size – children’s ears and ear canals change over time and the hearing aids, as well as the earmold, should be evaluated and replaced as the child grows.
  • Volume safe design – advanced signal processing feature allows the hearing aid to adjust to the background environment to allow the child to communicate in both quiet and noisy environments.
  • Connection to school equipment – some classrooms have FM equipment that allows the teacher microphone to sync with the child’s hearing aids.  In many noisy environments like classrooms, hearing aid may not be adequate when the teacher is speaking at a distance from the child.  OTC devices typically are not designed to connect to these devices.    


An audiologist, or more specifically a pediatric audiologist, can provide support to the family in terms of referral to agencies that may be able to assist with coverage of the cost of hearing aids and with the child’s school educational team to ensure developmental milestones are achieved.  They are also available to help give guidance and support to your family through the challenges and triumphs that come along with raising a child with hearing loss.


The success of hearing aid fittings on children and their continued use is heavily dependent on the post-care, counseling, and guidance that is received from professionals such as audiologists.  


If you suspect that your child may have a hearing loss, consult a licensed audiologist to have a complete hearing evaluation. The earlier the loss is detected, and hearing aids, implants or other intervention is initiated, the quicker the pathway to meeting important speech and language milestones and acquiring vital academic, social, emotional, and cognitive skills can begin.

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