Albion Barker

Bridges and Tunnels getting LOUD

When listening takes extra effort: understanding listening fatigue in school-aged children

At school and daycare, children spend a large part of the day listening: to their teacher, to classmates, during group work, in the playground and at assemblies. For a child with hearing loss, keeping up with all of that can take extra effort.

Hearing aids and other listening technology make a huge difference, but they don’t make every sound clear or make listening effortless. Background noise, distance from the person speaking and several people talking at once can all make it harder to follow what’s being said.

That ongoing effort can lead to listening fatigue. A child may be concentrating hard just to catch the words, leaving less energy for understanding, remembering and joining in. By the end of the day, they may be worn out from the work of listening.

It can be difficult to recognise. A child who is tired or overwhelmed might become quiet, lose focus, ask for things to be repeated, seem irritable or find it harder to take part. These signs can have many causes, and every child is different. But they can be a reason to check whether listening has become difficult.

As Albion gets ready to start school, we’re thinking about how much listening a busy classroom asks of a child, and how important it is for the adults around them to understand that effort. A child can be bright, capable and keen to learn, and still need support to make listening easier.

Small changes can help. Getting a child’s attention before speaking, facing them, moving closer and reducing background noise can make words easier to follow. In a classroom, good acoustics and a remote microphone system may help the teacher’s voice stand out. Regular communication between families, teachers and hearing professionals helps everyone work out what’s useful for that child.

Listening fatigue isn’t a lack of effort or interest. Sometimes a child is already using a lot of energy just to listen. Understanding that can help us respond with patience, make practical changes and give children the chance to rest and recharge.

That’s one reason we’re taking part in Loud Shirt Day. We’re raising awareness of the everyday experiences of children with hearing loss and supporting the work that helps children and families build the skills and confidence to communicate. Please support our fundraiser and help more children get the understanding and support they need to hear, learn and take part.

Navigating daycare with hearing loss

Blog post #2: Daycare with hearing loss

Starting daycare is a huge milestone for all families. Were we special? No. But we certainly felt added pressure and guilt. Despite negotiating a three-day-a-week return to work, I hated leaving our little boy. Then, just a few months after the emotional process of settling him in, his educator retired.

Albion started daycare just before his first birthday. With guidance from The Shepherd Centre (TSC), we chose family daycare: a smaller environment with only four children and one educator. It felt like it might be quieter and more attentive. But as we were coming out of COVID, family daycare was very popular. People thought fewer children meant fewer germs, and our first daycare experience wasn’t ideal.

It wasn’t our preferred location, and the daycare was in a separate space behind the main property. Albion was the youngest by a couple of years. While the other children ran around, he often just sat there. My heart ached when I dropped him off and picked him up.

The Shepherd Centre prepared us well for the transition. They gave us the tools, resources and explanations to help set Albion up for success. They also visited the daycare to check that the environment was suitable.

The early intervention TSC provided was as much about educating us to advocate for our child as it was about supporting his development and progress towards key milestones. They helped us find the language to explain our situation.

“Albion has mild-to-moderate bilateral sensorineural hearing loss” isn’t exactly a phrase that rolls off the tongue ;-)—let alone one you can confidently explain. TSC helped us understand the cause and impact of his hearing loss and, most importantly, how to support him. They even helped us create a booklet explaining his needs, along with practical ways to improve his access to sound.

Very early on, we were asked to consider how best to support Albion’s communication, including access to sound and sign language. His hearing loss sat on the cusp of benefiting from both approaches, so it felt like a significant decision.

TSC also visited Albion’s daycares to make recommendations and support the educators. Noisy air conditioning, nearby roads, hard surfaces and background music can all make listening more challenging. The team explained how to communicate with him: get close, make sure he’s facing you, and wait for acknowledgement that he’s heard and understood.

We couldn’t believe the support we were receiving. We still can’t.

Even with that support, we had a really sad experience at the second family daycare Albion attended. The educator was in her first year of running her business and was friendly at first. Then she became annoyed that we were “disrupting” the other children by taking Albion to speech therapy during the day. Eventually, she began raising “behavioural” concerns. We were heartbroken. We wondered if there was more to his diagnosis than we understood.

Once again, the professionals around us supported us. During an observation at the daycare, Michelle, Albion’s wonderful speech therapist, quickly noticed that he wasn’t hearing the first social cues many people take for granted. He would often miss the first request to stop or miss a “no” in response to a question. His inability to hear was being mistaken for belligerence.

Despite this professional explanation, the educator stood by her view that we were disrupting her “business”. We left immediately and pursued formal complaints.

The three-day work week didn’t last long. I felt pressure to increase to four days quite soon, despite still managing a high volume of appointment (many of them in Macquarie Park, a fair trek from the Northern Beaches with a little one). Soon after, I was offered a promotion on the condition that I return full-time.

I share this as an example of the reality of working while caring for a child with additional needs. The appointments and the mental real estate it occupies will can feel overwhelming.

Eventually, we found a long daycare that was great, as well as a new family daycare for two days a week. This one was amazing. Perfect.

Like many difficult periods with children, this was a phase. It shaped us and ultimately helped us find better outcomes.

It taught us to be fierce advocates. For the first time in our lives, we were facing discrimination. Although Albion’s hearing loss was classed as mild to moderate, we were already seeing how others could misunderstand it. It has made us fiercer advocates and Albion has become more resilient and confident.

It took a team of people to help us learn this. 

We’re now approaching starting school with a similar sense of trepidation mixed with the newfound trust we have in our support network which today also includes the itinerant team - Hearing  

The early days (and diagnosis)

Albion’s hearing loss was picked up very early through the SWISH test; the newborn hearing screen many parents will remember.

In NSW, the SWISH program aims to identify significant hearing loss by three months of age and help babies access early intervention by six months. The screen is done while a baby is asleep or resting quietly. Soft clicking sounds are played near their ears and sensors record their responses.

Albion’s first screen didn’t pass in one ear. The second didn’t pass in the other. We weren’t too concerned at first. We assumed it might be fluid that would clear before the next test. But the third screen, back at the hospital, didn’t pass either. That was when the appointments and investigations began.

What followed felt like an avalanche of information. There were swabs, blood tests, CT and MRI scans, genetic testing across the family, eye tests and audiograms for Neil and me. The doctors talked us through a range of possible outcomes. It was overwhelming, all-consuming and frightening. We put extra pressure on ourselves with an insatiable need to understand everything and find answers.

All of this was unfolding during COVID, already an unsettling time with a newborn.

In the middle of the chaos, we were introduced to The Shepherd Centre. They soon became our constant; our go-to for support, information and clarity as we anxiously navigated our way through the process.

Eventually, we got an answer. Albion’s hearing loss was genetic. Neil and I both carriers of the same rare gene variant, despite there being no family history. Emotions ran high throughout. The fear and sense of blame and responsibility weighed heavily on us both.

Despite the uncertainty of that time, getting Albion’s hearing aids happened quickly. Hearing Australia were wonderful. We were told Albion was among the youngest children they had fitted with hearing aids. He wore the same red hearing aids for the next four years and never seemed self-conscious of them.

We also learned that his hearing loss wasn’t associated with a syndrome or other disabilities, and was expected to remain stable. Thankfully, that has been the case so far.

The Shepherd Centre adapted quickly to COVID. Because they supported many children with compromised immune systems, they were able to offer a small number of face-to-face support groups while also moving sessions to Zoom. I’ll never forget learning the second verse of Twinkle, Twinkle, Little Star in my lounge room, singing into my laptop.

It certainly wasn’t the new-mum group experience we might have imagined. But it became something we needed more than we knew.

We feel lucky for many reasons, but especially for the support network that helped us through the whirlwind of those first six months.

More about the NSW SWISH program: https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/Pages/hearing-check.aspx