KidsAudiologist

Tinnitus in childhood – management

Posted on: September 22, 2011

Updated 19th June 2015 to include new links to useful websites and interesting articles.

In my last post I talked about the importance of acknowledging tinnitus when children mention it for the first time or are upset by it. Although there is rarely a cure for it, learning about and understanding their tinnitus can make managing it much easier.

Tinnitus is very subjective and impossible to measure so we have to rely on what the young person tells us. Tinnitus sometimes interferes with what you’re trying to listen to and often distracts when trying to listen in quiet environments. In noisy environments such as classrooms, the tinnitus isn’t normally noticed but once children start trying to study during quiet periods their tinnitus can be quite distracting.

For children with a hearing loss or auditory processing disorder (APD) the impact of tinnitus should be carefully considered. For many people stress makes their tinnitus worse. One of these stressors may be difficulties in hearing easily. This is cyclical – the harder things get, the worse the tinnitus gets, the more it annoys you and worse it all feels etc. Other stress might include exam periods for example. And tinnitus may cause sleep problems – usually in getting off to sleep – and this may have knock on effects during the day.

The best course of action for each child depends exactly on their circumstances and needs. For some children a simple explanation of tinnitus and knowing that they aren’t alone and lots of people experience it is enough to reassure them. For some children some simple masking or distraction techniques work well. For example, if the main problem is concentrating in the quiet then it can help to introduce some controlled, low-level background noise such as a fan or white noise. Occassionally quiet background music works so long as it’s a music style that you like (listening to classical when your taste is reggae isn’t going to be relaxing) and so long as it doesn’t distract you from what you want to be concentrating on! At bedtime I find it helps to listen to talking books and drop off to those. Some people prefer sounds of the seashore or other relaxing recordings, or plain old white noise. Various bits of equipment that might be of interest can be seen here.

Whenever there is a hearing loss present, even a slight one, then the most appropriate action is to have hearing aids fitted. The introduction of amplified everyday sounds that you should be hearing help to mask out the tinnitus. And making listening as easy as we can helps reduce stress levels so FM systems with hearing aids, or the iSense for children with APD are helpful in school.

For those childen who appear to be very affected by their tinnitus then they will be helped by specialist help from a paediatric audiology team with experience of childhood tinnitus. Following assessment they will use a combination of techniques including Tinnitus Retraining Therapy (TRT) and cognitive behavioural therapy combined with providing tools to help children self-manage their tinnitus giving them back some control and reducing the impact of their tinnitus on their day-to-day lives. In Tinnitus – it’s not just ringing in the ears! one mum describes how helpful a referral to a children’s tinnitus service was for her son in understanding and managing his tinnitus.

British Society of Audiology’s Audacity magazine (Issue 2 December 2013) includes two useful articles on childhood tinnitus:
pp26-29 Tinnitus Counselling in Children, Dr Alice Emond and Rosie Kentish
pp30-31 Tinnitus in children: Guidelines for Good Practice, Claire Benton

British Society of Audiology’s Tinnitus in Children; Practice Guidance (March 2015)

UCL run an annual Advanced Audiology Masterclass in Tinnitus and Hyperacusis. The 3 day Masterclass starts with a research update on the current understanding of the mechanisms of tinnitus and hyperacusis. It then addresses the different approaches for the assessment and management of these symptoms in adults, before focusing on paediatric patient management. In 2010 the lectures were recorded and can be watched free here.

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