What Should I Do if My Child Complains of Ringing in the Ears?
By Becca Kane, AuD, ATA Tinnitus Program Advisor
Question: My daughter began complaining about hearing noise in her ears, which she describes as high-pitched ringing that’s constant. How do I get her evaluated?
Becca Kane, AuD: Tinnitus can be a symptom of congenital hearing loss, hearing loss due to noise exposure, chronic ear infections, neurological disorders, head trauma or traumatic brain injury (TBI), and other diagnoses accompanied by balance problems. As such, it’s important to have your child’s tinnitus evaluated. An appointment with your pediatrician is a good starting point. It’s also recommended that your child see an audiologist and otolaryngologist (ENT) to have an audiogram to determine whether there is hearing loss that could be present along with tinnitus. The physician may also recommend a workup to see if there’s an underlying cause of the tinnitus and possible hearing loss.
Q: How do I talk to my child about her tinnitus?
BK: If you have ever had tinnitus, it may be helpful to tell your child that you’ve also experienced this phenomenon. Hearing that someone else close to them has encountered tinnitus may help children feel less scared about their own tinnitus. It may also be constructive to help children describe their tinnitus by likening it to more familiar sounds they can identify in their environment, such as “Does your tinnitus sound like a note on a piano?” or “Does your tinnitus sound like crickets?” This unexpected and unwanted “visitor” may become less scary to them the more they’re able to comfortably talk about it. Family support is key. Children often want to be validated, especially with a symptom such as tinnitus that is invisible to the outside world.
Q: How can I help my middle-school-age son deal with tinnitus? I’m worried because he’s withdrawing from his friends and social activities, including sports. I don’t know what to do.
BK: Management of tinnitus for children is similar to that for adults, with the overall goal to retrain the brain to perceive tinnitus as an insignificant sound. The following steps can be useful in aiding that process and reducing the intrusiveness of tinnitus:
- Use sound enrichment to reduce tinnitus awareness in bothersome scenarios. It may be helpful as the parent or caregiver to anticipate when your child will be in a quiet and therefore potentially difficult scenario to manage. For instance, during homework time, the tinnitus may be distracting for your child, making it hard for him to concentrate. Having background sound that diminishes the tinnitus but that’s not engaging — such as music without lyrics — can be helpful.
- Work together with your child to identify sounds that he perceives as helpful at reducing his awareness of tinnitus in various situations.
- Set your child’s bedroom up for sleep success by finding the right background noise conducive to good sleep. For instance, use a fan to produce low-level background noise and experiment with a sound machine or tinnitus app to find soothing or relaxing sounds to facilitate sleep. Environmental sounds such as ocean waves are a popular choice. Ultimately, the sound should be something your child finds relaxing.
You should encourage your child to return to normal extracurricular activities. It may be that he must slowly work on increasing how long he feels comfortable in different environments, but a gradual reentry into a normal and familiar routine can lessen the impact of tinnitus on his quality of life.
It’s helpful to ask yourself as the parent or caregiver what is preventing your child from viewing the tinnitus as an insignificant sound. Is there underlying anxiety or depression? Is he experiencing a heightened stress response to the new and unwanted noise? If yes, an evaluation with a pediatric psychologist would be an important component of lessening the negative emotional reaction to tinnitus.
Learning to separate the symptom — tinnitus — from the emotional reaction is an acquired skill. Working with a professional who utilizes cognitive behavioral therapy (CBT) or mindfulness-based stress reduction (MBSR) techniques, for example, would provide an opportunity for him to learn and practice a variety of coping strategies.
Some families note that their child begins to wear earplugs in social situations out of fear that outside sound will make their tinnitus worse. It’s recommended to protect hearing in loud situations such as at concerts, fireworks, and while mowing the lawn. And it’s also important to monitor the volume and length of use when listening to music or podcasts with headphones. But, otherwise, use of earplugs for normal everyday activities isn’t recommended.
You can connect with local providers who specialize in tinnitus to take an effective multidisciplinary approach to lessen the impact of tinnitus distress on you and your family. The ATA’s healthcare database on www.ATA.org can serve as a resource for finding these connections to facilitate appropriate care.
Rebecca Kane received her AuD from James Madison University, Virginia, in 2007. She was the lead in establishing the Duke Tinnitus Clinic, connected with the Duke Medical Center in Durham, North Carolina, where she worked for 13 years. She has presented on electrophysiology, tinnitus, and hyperacusis at various local and national conferences. Her publications have focused on utilization of an integrative medicine approach for tinnitus management. She currently provides remote support for tinnitus patients in her role as a Tinnitus Advisor for the American Tinnitus Association.