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 hearing pathway and/or 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 - recent research suggests that one child in 30 has clinicially significant tinnitus. Tinnitus appears to be twice as common in 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.

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 do I tell if my child has tinnitus?

Ask! Children will answer reliably if asked whether they do have noises in their ears. However, they may not disclose this to you spontaneously. Children are usually capable of describing their noises; younger children may talk in terms they are familiar with, such as buzzing bees or a choo choo train.

Won’t asking about tinnitus make my child anxious?

Some parents (and health professionals) are concerned that asking a child about tinnitus may create awareness and anxiety, or that it may turn non-bothersome tinnitus into bothersome tinnitus.

Clinical experts have found that the opposite is the case. Asking about tinnitus gives an opportunity to reassure the child and address any concerns they may have.

Asking your child whether they hear noises in their ears or their head, and whether it bothers them needs to be done sensitively. Children - particularly very young ones - may want to answer in the way they think will please you, especially if they don’t fully understand the question. Older children may be reluctant to talk about tinnitus, as they may not want to be seen as different, or they may feel they won’t be believed. It is often helpful to bring up the topic as part of a gentle conversation, showing the child that you are interested in what they think about the tinnitus, and in how it makes them feel. If the tinnitus has always been present, your child may assume that everyone experiences the same, and will often be untroubled by it.

So when should I talk to my child about tinnitus?

Tinnitus may be impacting on different areas of your child’s life, and parents should be mindful of this. The signs below may be present in children with tinnitus.If your child has any of these, it may be helpful to ask them if they have noises in their ears when the problems are present. These signs can also occur for other reasons.

  • Sleep difficulties - particularly in a young child. They may want sound (eg music or TV) or may not want to fall asleep on their own or in a quiet bedroom
  • Noise avoidance - they might be distressed in a noisy environment, or they try to avoid noisy situations
  • Quiet avoidance - conversely, they may be unhappy in quiet places, or they try to avoid quiet environments
  • Difficulties in concentrating and listening - these may be generalised, or specific, such as hearing speech when there is background noise, or in quiet situations
  • Feelings of anger, frustration, fear or helplessness
  • Difficulty with hearing aid use - most children with hearing aids experience less tinnitus with their hearing aids in. If your child’s tinnitus is worse when wearing hearing aids, their hearing may need to be reassessed
  • Unusual feelings in the ear - particularly feelings of fullness

What should I do if my child says they hear noises?

Whilst the experience of tinnitus is common, most children with tinnitus are not bothered by it, and a simple explanation and reassurance are all that is required. We have information leaflets - targeted by age group - which you and your child may find helpful.

If your child is distressed by their tinnitus,and/or also complains of pain, feelings of fullness, vertigo, dizziness, hearing loss or if the tinnitus fluctuates in time with your child’s heartbeat, do consult your GP, who will then make referrals as appropriate.

If distressing tinnitus is left untreated, it can have a significant impact on your child’s physical and emotional wellbeing, and their educational progress.

Whilst tinnitus is rarely a sign that urgent care is required, the distress it can cause your child means that a prompt intervention is advised.

Referral routes vary, but children are generally referred to paediatric audiology and/or ENT services. There are currently few specialist tinnitus services for children in the UK, but the number is increasing steadily. Our helpline can advise where your nearest local service is.

How does tinnitus affect children?

A small number of children will require support to help with distress or the impact it has on their lives.
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.

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, or monsters.

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.

How can I help?

Take the time to listen to your child talk about their noises, their questions and their worries. If you have non-bothersome tinnitus, it might be reassuring for your child if you share your experience. If your child attempts to tell you about tinnitus and feels dismissed, they may worry about why you won’t discuss it. They then become scared of tinnitus and what it might mean, or fear being ridiculed if they know it’s a sound only they can hear.

You may find our information leaflets and activity books helpful to use in discussing tinnitus with your child.
Your child 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.

Management techniques

There are a number of ways to reduce the impact of tinnitus in home, social and school environments. A management plan can be developed with the child after assessing their experience of tinnitus. You should ensure that your child’s teacher and others are, with your child’s permission, aware of their tinnitus and the help that they may need.

You, your child and any health professionals involved will be able to devise some simple strategies to help the child cope better. These could include:

  • your child could learn some simple breathing exercises or relaxation techniques. These can be helpful if they tend to be distressed or anxious
  • some children benefit from low-level noise (eg a computer, heating fan) or low-level background music. They may prefer to sit close to this sound or fall asleep with the sound running (if safe to do so)
  • working in a quiet place for a long time (eg during library time or exams) may be distressing for your 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 or smartphone may help
  • having your 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.
  • protecting hearing when exposed to loud levels of sound eg music practice, loud events. Discourage prolonged exposure to sound, loud music, computer games etc. For more details, see www.plugem.co.uk

What next?

We have a range of resources available for both you and your child, that can help them learn to live well with tinnitus. These include free information booklets and activity booklets, as well as products such as sound generators and ear plugs. Teenagers may find it interesting to explore our interactive tinnitus e-learning programme www.takeontinnitus.co.uk.

Our helpline staff can answer your questions on any tinnitus-related topics on 0800 018 0527 (Monday-Friday, 9am-5pm). They can also be contacted via email on [email protected]


References

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. The authors 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/

Baguley D, Andersson A, McFerran D and McKenna L. Tinnitus: A multi disciplinary approach. 2013. John Wiley & Sons Ltd
Humphriss R, Hall A, and Baguley D. Prevalence and characteristics of spontaneous tinnitus in 11-year-old children. International Journal of Audiology. 2016. DOI:10.3109/14992027.2015.1120890

Download this information leaflet:

Tinnitus_A_Parents_Guide_Ver_1.3.pdf