Just before the appointment ends, Santiago’s audiologist asks if the tool they just used could have helped him explain his hearing loss to his classmates when he first got hearing aids.
“Definitely,” he says with a smile.
Santiago is talking about My Hearing Explained for Children (MHEC), an Ida Institute pediatric counseling tool. Through icons, emojis, and simple questions, the one-page PDF helps clinicians engage young clients and their families in a conversation about the child’s hearing loss, including test results, their perceived ability to hear sounds and understand speech, their level of fatigue at the end of a day, and helpful technology or communication strategies.
Santiago, 11, is one of many young people who have benefitted from this tool since his audiologist, Melissa Harrison, and her colleagues at the Children and Young People’s Audiology Centre (CYPAC), Evelina London Children’s Hospital, started using it.
Forced to move most of their appointments online in the spring of 2020 due to COVID-19, the NHS team selected a set of counseling tools that could easily be used in virtual appointments. They chose MHEC to use with their pediatric clients aged 7-13+.
The initial pilot project showed that the tool was useful in the majority of cases to help children explain various aspects of their hearing loss and to give them the opportunity to think about where they would like to hear better and the steps to make that happen. Based on this success, CYPAC decided to integrate the tool into their online service.
Helps children engage during appointments
In Harrison’s experience, it’s often challenging to get children, especially pre-teens, to engage during appointments. But she and her colleagues have found that the tool is an easy prompt and often results in children engaging in and even initiating conversation.
Santiago’s mother, Natalie, agrees: “I think it’s a very simple way for us to see how Santiago is hearing. And he’s very comfortable using it – it’s not difficult.”
The tool’s use of three simple emojis – a happy, a neutral, and an unhappy face – is the key to getting children to open up, according to Harrison. It’s relatable for any child, whatever their culture or language, and provides flexibility, allowing them to simply point to an emoji if they are reluctant to talk.
As a whole, the CYPAC audiologists have found that the tool allows the child to express themselves when they may not have the words to do so, which is particularly helpful in appointments where a parent tends to be outspoken and answer on behalf of their child.
A child- and family-centered tool
The initial pilot project showed that MHEC can improve the whole family’s understanding of the child’s hearing loss and even reveal discrepancies between the child and their parents in their perception of the hearing loss, prompting valuable conversations.
For example, while using the tool during a recent appointment, Harrison asked her young patient how much energy he had left for listening at the end of the day. He explained that he’s exhausted as he spends so much energy focusing and asking for repetition. This was new and surprising information for his mother, who had no idea her son was getting so tired. A spontaneous conversation between mother and child followed, allowing for a productive discussion on different ways the boy could wind down in the evening and recharge.
In this and other similar interactions, Harrison has seen first-hand how the tool enables both a person-centered and a family-centered approach by focusing attention on the child and their specific needs and experiences, as well as engaging the family in developing strategies together.
Quick, easy, and flexible
Not only can the tool enable the clinician (and family members) to learn valuable information about the child’s experiences and empower families to discuss and decide on communication strategies together, it’s also practical and flexible, according to Harrison.
In her experience, it doesn’t take long to go through the form; it’s easy to use both online and face to face; and it can be used in multiple scenarios, from discussing hearing test results to checking in with long-term patients, and with patients with and without hearing aids.
CYPAC audiologists have found MHEC particularly good to use for children who are non-compliant with their hearing aids or where the parents are not fully on board. By asking the child how well they hear with and without the devices and marking the two answers on the same scale, the tool can be used to clearly demonstrate the improved hearing and understanding and reduced listening fatigue that results from those devices.
The team were also positive about the experience of integrating the tool into their practice. Following the successful pilot project, the full team was trained in using the tool and it was made available to all audiologists in all types of appointment.
MHEC is now used frequently in both online and in-person appointments at CYPAC to explain hearing test results and demonstrate hearing aid benefits in a person- and family-centered way.