Attitudes of Hearing Impaired Children
 and their Parents
to the use of Colourful Hearing Aids

 

 

RESULTS

 

As this study dealt with nominal data, the only typical score that could be used was the mode or most common score. There was no useful way to measure spread and no logical reason to note a "mean" age. Bar charts were used to represent the distribution of responses, as the categories did not form a sequence or progression. Statistical analysis was carried out on some of the replies from both the children’s and the parents’ questionnaires and examples of the comments provided were included to add a qualitative element to the study.

 

The Children

 

The children, 25 boys and 19 girls, who took part in this study ranged in age from 4 years 9 months to 13 years 4 months. Over 86% of the children had been identified as hearing impaired before school age and, of these, 27 had had their hearing loss confirmed before the age of 3. 28 (63.7%) were of primary school age and 16 (36.4%) were in secondary education. Over 78% of the primary age children liked their hearing aids and nearly 69% of the secondary children liked theirs. (fig 1) Unsurprisingly perhaps, it was those who did not like them who were most vehement in their observations.

"They think they are ugly and they make fun of me"
(9 year old girl)

"Some children pick on me if I wear coloured aids or not."
(13 year old boy)

 

A higher percentage of boys than girls, of both age groups, said that they liked to wear their hearing aids at home, although, when this was broken down further into whether they liked to wear their aids while taking part in leisure activities, the percentages were almost equal (68% boys, 68.5% girls).

 

There was no significant difference in the percentage of children wearing coloured aids or traditional beige ones. Between 62% and 65% of each group liked to wear their aids all the time. Between 22% and 24% were not happy to wear their aids at home though they wore them at school and only one member of each group did not like wearing hearing aids at all.

 

 

77% of parents reported that their children wore their aids all the time. The number of children with coloured aids who did so was almost exactly the same as those with beige aids. It was interesting to note that most parents seemed to be fully aware of their children’s views on the wearing of hearing aids. 60% of boys and 80% of girls thought coloured aids would be "better" at school and an even higher percentage (88% boys and 70% girls) felt they would be "better" at home. (fig 2)

 

 

The following quotations sum up quite clearly the overall view of the children who responded to the questionnaire.

"I would like to have coloured aids as I think they would look cool on me. I think my friends would think that I was really cool wearing them and forget that I have a problem."
(10 year old boy)

"They are much cooler than boring brown aids."
(12 year old girl)

"They would make me look cool. They are groovy."
(8 year old girl)

 

Their Schools

 

30 replies (68.2%) came from children in mainstream schools, 12 (27.3%) were from hearing impaired units attached to mainstream schools and the remaining 2 (4.5%) were from hearing impaired children attending schools for children with additional learning difficulties.

 

A sizeable majority of children in each educational setting thought coloured aids would be preferable at school. (fig 3)

 

Attitudes of children in different educational settings to coloured aids.  figure 3.

 

Their Families

 

18% of the replies came from only children, a further 27% from the eldest child in the family and 50% were from the youngest child. Only 2 of the singletons did not want coloured aids, only 1 of the eldest children in the family and 2 of the youngest.

 

Of the children who were the eldest in the family, 4 had coloured aids and 8 did not. Of the youngest children, however, 13 had coloured aids while 9 did not. Among the only children, 4 did and 4 did not have coloured aids.

 

The parents of most of the eldest children who did not already have coloured aids either did not want them or were undecided, while only one of the children themselves opted for the traditional beige aid.

 

Where the youngest children were concerned, over 60% of those who had beige aids wanted coloured ones and their parents agreed with them.

 

The views of the only children and their parents were evenly split between wanting beige or coloured aids.

Among the parents who replied (44), only 7 did not want their children to have coloured aids and a further 5 were undecided.

 

Their Aids

 

Although bright coloured hearing aids have been available in the UK for over 10 years, the longest any respondent had been wearing such aids was 5 years. Almost 50% of the children with coloured aids had had them for a year or less. (fig 4)

 

 

This apparent recent increase in interest is borne out by figures from one manufacturer, (Phonak UK Ltd.), who announced that 54% of all their Pico-Forte hearing aids sold in the UK between January and March 1999 were bright coloured. All other models averaged between 10% and 20% coloured aids.

 

Many of the families whose children were wearing traditional beige aids had not been aware of the existence of bright coloured aids. As the hearing aid companies make a small charge to change the colour of the casing, perhaps there is a reluctance among cash strapped District Health Authorities to advertise them.

 

NHS aids are not yet available in bright colours so children who have been prescribed any of the NHS range of aids will not necessarily have been aware of the coloured aids. Once again, economics may play a part in the lack of advertising of the commercial alternatives.

 

Some parents expressed concern that the obvious colours might lead to teasing or bullying by other children and that their children might be embarrassed by wearing them. Others were confused as they were also aware that it could be useful at times to draw attention to the hearing loss. In only 4 cases did both the parents and the child actively dislike them. For instance, this comment was from the parent of a 12 year old girl who prefers her beige aids as they match the colour of her ears.

"Unobtrusive is best.......discretion is the key to acceptance.

No-one wants to stick out like an oddment."

 

 Other comments included:

"I would prefer an inner ear aid as this would be less obvious."
(9 year old boy)

"(coloured aids) may lead to bullying"
(his parents)

 

 The parents whose children wore coloured aids were overwhelmingly pleased with them even after some initial fears. The following quote is from the parents of a boy with purple aids:

"Initially we were apprehensive about our son wearing them in case he was teased.....we think they are, in fact, less noticeable."

 

23 of the replies came from children who already wear coloured aids but over 77% of the total actively preferred the bright colours, while half the remainder liked the translucent aids with visible workings.

 

The most popular colours were blue (20%) and red (18%). Purple (13%) was the next most popular solid colour although over 18% liked the translucent aids which are made in various shades of tinted plastic which enables the insides to be clearly seen. These had been classed as "clear" for the purpose of analysis as, although some children had expressed a preference for a specific tint, others had ticked the "clear" option on the questionnaire. Pink featured quite strongly in the girls’ list of favourite colours (11%) but, perhaps not surprisingly, not at all in the boys’ list. 8% of the boys liked yellow although it was not chosen by any of the girls.

 

11 children did not give any reason why they chose a specific colour and 9 gave no information as to how their hearing aids were regarded by other children. 

 

A full breakdown of the colour preferences can be seen in figure 5.

 

 

The Parents

 

While the first two parts of the parental questionnaire were seeking mainly factual information about the children such as age of diagnosis, place in the family and the type of school attended, the final section of their questionnaire asked the parents to indicate how strongly they agreed or disagreed with certain statements.

 

These statements aimed to reflect some of the attitudes to the use of coloured aids by hearing impaired children currently expressed by their families, peer groups and the wider community.

 

Mann Whitney tests of significance were carried out on these results in order to accept or reject the null hypothesis that there is no difference between the opinions of parents whose children have, or do not have, coloured hearing aids.

 

The Mann Whitney test was used as a non-directional test which avoids the possibility of outliers distorting the results and because there was no way of ensuring similar variabilities between the groups of parents. The Mann Whitney statistic (U) was initially calculated and, as the numbers were large, a standard score (z) was then found and used to determine the significance of the results.

 

Just under 82% of parents whose children already wore coloured aids felt they were good for the child’s self esteem. (fig.6) "T", whose mother wrote that he had never been as confident until he got his coloured aid, attends mainstream secondary school. He said, of his school friends’ reaction to his aid:

"They say it cool and imazeing (sic) and they say they wish to have one."

 

57% of parents whose children wore traditional beige aids agreed. Over three times as many parents of children with beige aids as those with coloured aids felt unable to give an opinion either way.

 

 

A Mann Whitney test of significance was carried out. As the numbers were large a standard score (z-score) was calculated. In this case z = 2.59 and was significant at the 1% level. We can therefore reject the null hypothesis that there is no difference between the views of parents whose children have, or do not have, coloured hearing aids regarding their effect on the children’s self esteem. From the data it can be seen that parents whose children already have coloured aids tended to feel the aids were better for the children’s self esteem than those parents whose children have traditional beige aids. The following comments were typical of this group.

"It was a confidence booster for T….he thought it was cool."
(parents of an 11 year old boy)

"He has never been as confident with his hearing aid until he got his green one."
(parent of a 12 year old boy)

 

The majority of parents in both cases agreed that brightly coloured aids help others to be aware of the child’s hearing loss. (fig.7) 

 

 

A Mann Whitney test showed there to be no significant difference between the views of the two groups of parents in this case.

 

One parent pointed out that:

"Having them in this style would make people more aware as well as showing people ‘Yes I’m deaf or hearing impaired – so what!’"

 

 An equal number of parents felt that bright coloured aids would or would not encourage other children to pick on the hearing impaired child. Those whose children wore beige aids tended to agree with the statement.

"They (the aids) are skin coloured and don’t show up too much, making him more socially acceptable."
(parent of a 6 year old boy)

"(Coloured aids) may lead to teasing / bullying."
(parent of an 8 year old boy)

Those with coloured aids did not.

"We have had only positive reactions from the coloured aids."
(parents of an 11 year old girl)

 

Some parents expressed their confusion and fears, feeling instinctively that the coloured aids would highlight their children’s difficulties, but, at the same time, being aware that this may not always be what they or the child wanted. One parent put it very clearly:

"Other’s opinions are vastly different. We have been accused of flaunting our children’s deafness and making a show of them. Other people say it’s great, it (coloured aids) makes people aware of the girls’ deafness."
(parent of 10 year old and 6 year old girls)

 

Only 3 parents indicated no opinion either way. (fig.8) 

 

 

The Mann Whitney statistic (U) was calculated as 150.5. From this a standard score (z-score) of 1.96 was obtained and was significant at the 0.05 level.

 

The null hypothesis was rejected and, from the data, it was apparent that parents whose children already have coloured aids are significantly less likely to think that the aids will cause others to pick on them than the parents of the other group.

 

72% of parents regarded bright coloured aids as being less easy to mislay (fig.9) 

 

 

The Mann Whitney (U) statistic was calculated as 182.5. This resulted in a z-score of 1.18 which was not significant therefore the null hypothesis could not be rejected for this question.

 

Almost 66% thought young children would be more likely to wear coloured hearing aids. (fig.10)

 

"We would be happy if he chose to wear them as we’d see that as positive affirmation of his hearing loss….I do think they would be useful at times in drawing attention to the hearing loss and raising awareness in general. But there are times when this is not appropriate and his feelings may change as he grows older and wants to be the same as everyone else."
(parent of a 9 year old) 

 

 

The Mann Whitney statistic (U) was calculated as 203.5. This resulted in a z-score of 0.89 which was not significant. We can therefore not reject the null hypothesis that there is no difference in the opinions of the two groups of parents concerning the age of children more likely to wear coloured hearing aids.

 

Over 50% agreed that teenagers see bright coloured aids as a fashion statement. (fig.11) 

 

 

The Mann Whitney statistic (U) was calculated as 134.5 which translated into a z-score of 2.34. This was significant at the 0.05 level. We can therefore reject the null hypothesis in this case and, from the data, can see that parents whose children have coloured aids are more likely to feel that teenagers see the aids as a fashion statement.

 

In contrast to the majority who felt that coloured aids are seen as a fashion statement, 44% of parents felt that teenagers did not like to be noticed (fig.12) and that their attitude to their hearing aids might alter when they changed to secondary school.

 

"So far….we have had only positive reactions to the coloured hearing aids….however I do appreciate that C. has yet to start secondary school and that may be different altogether."
(parent of a 10 year old girl)

This attitude was mirrored by one 13 year old boy who said:

"I am happy with the colour I have got because if I had another colour it would draw attention to them."

 

 

The Mann Whitney calculations in this case resulted in a z-score of 0.10 which was not significant so the null hypothesis could not be rejected. There was no significant difference in the opinions of the two groups in this case.

 

Almost three quarters of all the parents did not know whether spares and /or repairs took longer for bright coloured aids, while the percentage unaware among the parents of those children who were already wearing them was 54%.

Just over 25% of all the parents who replied regarded brightly coloured aids as too obvious. (fig.13)

 

 

The Mann Whitney statistic (U) was calculated as 143.5. This resulted in a z-score of 2.13 which was significant at the 0.05 level. We can reject the null hypothesis and, from the data, can see that parents whose children wear traditional beige hearing aids are more likely to feel that coloured aids are too obvious.

 

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