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Advances in hearing aid and FM technology have allowed audiologists to provide children with improved access to sound, speech and language, which has translated into more students being mainstreamed into the typical school classroom. Therefore, when audiologists offer the appropriate technology, considerations and interventions to a school-aged child, they literally are opening the door to significant learning opportunities. However, some important questions need to be asked and answered before that child is sent back into the classroom.

For example: Recently, a local school called me to consult on an FM system recommendation. A student had come to school with a note for the teacher saying the child was just fit with two hearing aids. Attached to the note was a copy of a report from a local audiologist recommending an FM system.

Consequently, I found myself in the middle of a classroom facing a 7-year-old boy with new hearing aids that required connection to an audio shoe through a specific battery door. I found the correct battery door and made what I thought were the necessary connections, only to discover that the hearing aid was not accepting the FM signal. Why? Well, it seems that this particular hearing aid needed to be told to accept the FM somewhere in the programming software.

When working with kids between the ages of 3 and 21, there are some basic things to remember and processes to follow. First and foremost, make sure the hearing aid is child-friendly and child-safe. During the typical school day, children are exposed to several hours of conversations and sounds. They are asked to participate in class discussions and expected to interact with other students in less than acoustically friendly environments. Consider the child that does not have easy auditory access to these environments. They may miss pieces of classroom instruction, peer conversations, incidental communication interactions, and much more. These children are at risk for reading and learning disorders consequent to their auditory impairments.

But kids' hearing aids also need to be teacher- and therapist-friendly. In the course of a school day, a child will move in and out of classrooms, out onto the playground, into the gymnasium, and into a cafeteria. Most children do not think about changing "programs" depending upon their environments, much less pressing a button to get to an FM program. So, it also is important to determine who will be monitoring the child's hearing aid in the classroom. Most general education teachers, as well as special education teachers, are not formally trained to manage hearing aids, yet these are often the professionals that are asked to be responsible for the daily management of these children.

Further questions: When a manufacturer tells us that a hearing aid is FM-compatible, we have to ask, "How?" Is it as simple as clipping on an audio shoe, or do I have to do something else to modify the hearing aid? How does the hearing aid have to be programmed to accept an FM signal?

Then there is the question of which FM system to purchase. Many schools are told by the clinical audiologist exactly what systems to purchase; however, after the school receives the equipment there is too often no follow-up support to set up the equipment and explain it. You may need to offer support services or, in some cases, it may be beneficial to instruct schools to purchase equipment and then send it to you for programming.

In many parts of the country, there are educational audiologists employed or contracted by school districts to help with this equipment. Contacting the school prior to specifying an FM system and working closely with the school personnel will further ensure comprehensive management of school-aged patients. Open communication between the clinical audiologist, the parents and the school or educational audiologist will help determine if equipment is readily available at the school or if new equipment needs to be purchased specifically for the child.

If an educational audiologist is not working with the school district in your area, there are several resources available to help guide clinical audiologists. The Educational Audiology Association, American Academy of Audiology and American Speech-Language-Hearing Association all offer information pertaining to intervention for children with hearing loss.

Donna M. Goione-Merchant, AuD, ABA, is an audiologist in private practice in Brick, NJ. Contact her at 732-458-5050, donna-m@att.net.