Audiologic Rehabilitation

All of our senses are important, but hearing plays a major role in many areas of life. For babies and children especially, hearing is key to healthy development in many skills: language and speech, as well as emotional, social, and intellectual development. When hearing loss is diagnosed and treated early, it has minimal impact on a child’s development and abilities. It is important to know that hearing rehabilitation for babies can and should begin as soon as the hearing evaluation process is complete — there is no need to wait.

Has your child been diagnosed with hearing loss? Hearing rehabilitation is tailored to each child’s needs and may include:

Hearing Aids

Hearing aids are the most common hearing rehabilitation devices for all ages. These are small electronic devices worn on or inside the ear that amplify sounds from the surrounding environment.

How Hearing Aids Work

The devices pick up sound waves (sounds) from the environment using a built-in microphone and pass them through a tiny amplifier. The amplified sounds then return to the outer ear, where the normal hearing process takes place.

Fitting the Hearing Aid

After your child receives a diagnosis and the level of hearing loss is determined, you should see an ear, nose, and throat (ENT) doctor to determine whether the hearing loss requires medical treatment or hearing rehabilitation. You will then be referred to a speech-language pathologist for consultation and hearing aid fitting.

Hearing aid fitting is provided at one of the hearing rehabilitation centers for children. The process includes fitting the devices on the ears, adjusting each device separately for each ear, hands-on practice, instructions for daily use, and a trial and adjustment period of at least 4 weeks in exchange for a deposit.

You can and should seek support from the professionals at the hearing center where the fitting process was completed. You can also contact organizations and nonprofits that support parents of babies and children with hearing loss by providing information, support, and professional guidance: MICHA Israel, Beit MICHA – Tel Aviv and Central District, Shmaya, Shma Kolenu, AV Israel, and others.

Funding Options for Hearing Aids

• HMO coverage: HMOs help cover the cost of hearing aids for babies and children up to age 18.
• Ministry of Welfare and Social Affairs assistance: Financial assistance for hearing aids may also be available through the Ministry of Welfare’s individual assistance committee by applying for a grant for essential needs for people in need.

Implants

Implants are hearing devices intended for cases of severe hearing loss in which hearing aids cannot provide sufficient hearing access. Implants replace the function of the inner ear and send stimulation directly to the nerve endings. Most implants have two parts — an internal component and an external component. The internal part is surgically implanted in the inner ear, while the external part is usually worn behind the ear.

How does it work? The microphone in the external part (the processor) picks up sounds from the environment, converts them into electrical signals, and sends them to the internal implanted component, then to the electrodes and finally to the auditory nerve fibers.

Today, there are implants designed to meet a wide range of hearing needs and types of hearing loss.

Types of Implants

• Inner ear implants include several types:

  • Cochlear implant: A cochlear implant includes internal and external components. The external part includes a speech processor, which converts incoming sounds into electrical signals; a transmitter, which sends the signals to the internal receiver; and a magnet, which attaches the external transmitter to an internal magnet located under the skin. The internal part includes a magnet, receiver, and an electrode array implanted in the nonfunctioning cochlea of the inner ear. The implant bypasses the damaged cochlea and sends signals directly to the part of the brain responsible for hearing.
  • Combined implant (EAS): This implant is intended for sensorineural hearing loss characterized by severe hearing loss at high frequencies and milder hearing loss at low frequencies. It is suitable for cases where additional hearing deterioration is not expected.

• Middle ear implants include several types:

  • VSB implants: These implants are intended for moderate to severe conductive hearing loss, meaning cases where there is a mechanical problem with sound conduction. The implant operates using mechanical energy and directly stimulates the structures of the middle ear.
    BAHI - Bone Anchored Hearing Implants: These implants are anchored in the skull bone and are intended for conductive hearing loss that makes standard hearing aids difficult to use. They are also suitable for cases of profound hearing loss in one ear, helping transfer sound to the hearing ear.
• Auditory Brainstem Implant (ABI): This implant is intended for cases where there is no auditory nerve or when the cochlea did not develop. The implant directly stimulates the auditory nerve fibers located in the brainstem.

Auditory Learning

Fitting a hearing aid or implant for a child is only the beginning of the hearing rehabilitation process. From that moment on, the hearing system receives a huge amount of auditory information, so the child must adjust both to the hearing device and to the way the brain interprets sound.

To get the most benefit from hearing devices, auditory learning or hearing training is very important. HMOs help cover hearing training sessions for children with cochlear implants, according to each HMO’s coverage policy.

The hearing rehabilitation process includes training the brain. Through gradual exposure, the brain learns to distinguish between different frequencies, sound levels, and sound durations. This helps the child respond to and interpret sounds such as speech and understand messages. The process is guided by speech-language pathologists in quiet, comfortable settings as well as in more challenging and noisy environments (such as group conversations), allowing children to practice and improve speech understanding in different listening situations.

Speech and Language Therapy

After hearing aids or an implant are fitted, it is especially important to teach speech and language skills, particularly for babies and young children who have not yet developed these abilities. Developing speech and language skills takes time, even for hearing babies. During the first year of life, babies are exposed to sounds and speech in their environment and gradually begin developing language. Hearing loss may create challenges for a child’s development in other areas as well.

During the first period after hearing devices are fitted, your child will begin an adjustment period. Before using hearing devices, your child may have heard certain speech sounds differently, which may have affected the development of some speech sounds and speech patterns. For example, certain consonants (“consonants” are speech sounds produced by partially or fully blocking airflow in the mouth, such as “p,” “m,” or “g”) and speech intonation may not yet have fully developed.

Returning to Daily Life and Community Settings

Returning to daily routines and integrating into community and educational settings after cochlear implant surgery or hearing aid fitting is a personal process that depends on many factors, including the needs of the child and family, the rehabilitation approach chosen, and the child’s individual abilities and potential. Because there is no single path that fits every child, each child receives a personalized plan tailored to their specific needs and abilities.

It is recommended to contact a rehabilitation center that specializes in children with hearing loss. The staff can evaluate your child’s needs and guide you toward the most appropriate educational and rehabilitation support options.

For more information about your rights and available benefits, read the article: Rights for Children with Hearing Loss.