Introduction

A child in your class may recently have been diagnosed with tinnitus, or a child may report to you hearing noises in their head or ears. This informatino will tell you a little more about what tinnitus is, how it may affect children in the classroom, and how you can help them.

What is tinnitus?

Tinnitus is the sensation of hearing a sound when there is no external source for that sound. In a minority of cases the sound may have a physical source within the body, like the sound of a person’s pulse, but in most cases the sound is generated spontaneously by the brain.

Is tinnitus common in children?

It’s a commonly believed myth that tinnitus only affects older adults, and that it doesn’t occur in children. However, tinnitus is very common in children - reported figures suggest that between 12% and 36% of children experience it. Tinnitus appears to be twice as common children with hearing loss compared to children with normal hearing. There is some evidence to suggest that it may be common in children with otitis media (glue ear).

The majority of children are not troubled by their tinnitus and it does not affect their performance in class. However, a small number of children can be distressed by it. Working with the child’s parents/carers, this leaflet will help you provide reassurance and support to a child with troublesome tinnitus.

What does tinnitus sound like?

Everyone’s tinnitus is different. Many people hear a ringing sound, but others hear whistling, buzzing or crackling.

The noise may be heard in one ear, in both ears, in the middle of the head or it may be difficult to pinpoint its exact location. The noise may be low, medium or high pitched. There may be a single noise, or two or more components. The noise may be continuous or it may come and go. It can be quiet or very loud, or the volume may fluctuate.

How does tinnitus affect children?

Whilst the experience of tinnitus is common, most children are not bothered by it, and a simple explanation and reassurance are all that are required. However, a small number of children will require support to help with distress or the impact it has on their lives.

Children with tinnitus may report difficulties with listening and concentration. These may include:

  • unexplained listening difficulties, not usually generalised across the school day, and possibly having a specific association
  • the child being worried or anxious about not being able to hear the teacher’s voice easily, and concern about being told off for not paying attention
  • having problems hearing speech when there is background noise, in acoustically poor rooms, or in quiet situations

Tinnitus is sometimes a difficult condition to learn to live with and often causes anxiety. Anxiety, in turn, often makes the experience of tinnitus worse.

Many children with tinnitus feel isolated because they don’t know who to talk to about the presence of sounds that they can’t control or explain.

Several authors have noted that children tend not to tell adults spontaneously about their tinnitus, but when directly asked, they are generally able to describe their symptoms, quite often in a descriptive or emotive way.

Very young children may not know why they hear sounds in their head or ears, or may believe that there is actually something there, for example, buzzing bees, monsters, or rice crispies.

Older children can share similar worries that there is something in their head, but they may also be worried that they are losing their hearing, “going mad”, or that they will be unable to go to university or get a job when they are older. If a child shares these concerns with you, share them with their parents/carers.

How can I help?

If you have noticed a child displaying some of the “soft” signs of tinnitus outlined above, ask the child why they think they are having problems hearing. If tinnitus is described as a cause, a discussion with the child’s parents/carers may be required. Talking to children about the noises they hear in their ears or their head, and whether it bothers or annoys them, needs to be done sensitively and in a non-leading manner.

If a child attempts to tell an adult about tinnitus and feels dismissed, they may worry about why the adult won’t discuss it. The child may then become scared of tinnitus and what it might mean, or fear being ridiculed if they know it is not a “real” sound.

Children with tinnitus will benefit from your patience and understanding as they adjust. Just letting them know that you are aware that what they are going through may be causing them problems will be a huge help.

There are a number of ways to reduce the impact of tinnitus in a school environment. A management plan can be developed with the child after assessing their experience of tinnitus. This may be included in the child’s Educational Health and Care Plan.

Management techniques

A child may have recently been diagnosed with tinnitus or mentioned that they are experiencing tinnitus. Most children with tinnitus manage well, and it does not affect their performance in class.

If a child is troubled by their tinnitus, then they, their parents/carers and health professionals will work with you to devise some simple strategies to help the child cope better in the classroom. These could include:

  • consider moving the child away from noisy groups/people if they are showing signs of distress or difficulty hearing
  • agree with the child a way of alerting you if tinnitus is triggered in a lesson - this could be a laminated card with a message or some other agreed signal
  • during group work, sympathetically consider requests for the group to move somewhere quieter to work
  • some children benefit from low level noise (eg a computer or heating fan) and may prefer to sit close to this sound
  • working in a quiet place for a long time (eg during library time or exams) may be distressing for the child or make concentration difficult. Background sound (eg a fan, or sitting near an open window) or the use of low level music on an MP3 player may help
  • having the child make a “support card” which is to hand - perhaps reminding them about how to relax and breathe to help take their mind away from their tinnitus. This could be decorated with favourite pictures, for example.

Further information

We can provide further information and support. Many resources can be found on this website

You may find it helpful to call the our confidential freephone helpline on 0800 018 0527.

The material in this leaflet borrows heavily from the document Tinnitus in Children: Practice Guidance produced by the Paediatric Tinnitus Working Group of the British Society of Audiology, and particularly the work of Caroline Munro. We are very grateful for their support and co-operation in the production of this leaflet. The practice guidance can be downloaded free of charge from http://www.thebsa.org.uk/resources/ or a printed and bound version is available to buy from our shop.

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