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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 3

Technological Supports for Hearing

The two primary assistive technology aids for infants and toddlers who are deaf or hard of hearing are hearing aids and cochlear implants.

Hearing Aids

Hearing aids are amplification instruments that make sounds louder. Hearing aids can be of analog programmable or digital technology. It is an Early Steps policy that infants and toddlers receive hearing aids within one month of diagnosis from an audiologist. Audiologists in Florida are required to refer to Early Steps upon confirmation of a hearing loss that meets Part C criteria. Part C, as payer of last resort, can assist in the coverage of hearing aids per the specifications set forth on page 8 of the SHINE Procedural Safeguards.

When working with a child who has hearing aids it is important to ensure that the child is wearing the aids during all waking hours and that the batteries are working. If the child covers his/her ears or pulls the aids out of the ears, it is important for the caregiver to check the function of the hearing aids to be sure they are working properly. It is also important to remember that the audiologist needs to provide continued follow-up to change the ear molds as the child grows, to adjust settings, and to monitor progress. Hearing aid follow up checks are appropriate every 1 – 3 months depending on the child's age.

Cochlear Implants

little boy with mullet haircutCochlear implants are electronic devices that are implanted inside the child's cochlea. There is an external device that is a speech processor that is attached to the head at ear level. The device allows electrical signals representing sound to be delivered directly to the auditory nerve. Infants are usually considered for the surgery around 7 - 9 months of age and are actually implanted shortly after their first birthday. The parents need to do the following on a daily basis.

  • Ensure that the cochlear implant is working properly by checking to see if the cords are plugged in properly.
  • Check to see that the appropriate setting is being used.
  • Make sure that batteries are charged and that all pieces appear intact.

Infants and toddlers who use cochlear implants must be followed closely by their audiologist, especially during the first few months, to ensure that the settings are correct and the child is responding as expected to sound input.

The ITDS should be aware of the effect that static electricity can have on a cochlear device and take the steps recommended in the FDOE Cochlear Implants Technical Assistance Paper such as encouraging the family to use anti-static spray on carpets and clothing. The ITDS can also work with the family to reduce background noises, and assist them with strategies for developing listening skills during intervention sessions.

It is important for the ITDS to know that Part C does not pay for cochlear implants. The FDOE Cochlear Implants Technical Assistance Paper provides a resource list and suggestions on cochlear implants.

Community Services for Hearing Impairment

The SHINE program is the earliest community support for a family. The SHINE service coordinator and SHINE provider have the information on available intervention methods and information on community resources. The SHINE Index provides information on hearing aids insurance, and the hearing aids bank. The Sertoma Clubs are also an excellent community resource for local funding. Their mission is service to the deaf and hard of hearing.


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