Behind-the-ear hearing aids

This page explains how behind-the-ear hearing aids work and who can use them.

More about other types of hearing aids.

How BTE hearing aids work

BTE hearing aids sit over the top of the ear. They connect to one of the following:

• an earmould (which fits snugly inside the ear), which are most commonly used for children and young person
• a soft plastic dome (for an open fit)
• a receiver in the ear

Open fits and receiver-in-the-ear hearing aids are more suitable for older children due to the small parts. Open fits are suitable for those with mild or moderate deafness, and receiver-in-the-ear hearing aids may be suitable for those who would benefit from an open fit but who have more severe deafness. 

The microphone in the hearing aid picks up sound and processes it digitally to make it louder and clearer. It then sends the sound through tubing to the earmould, open-fit dome, or receiver-in-the-ear.

Programming BTE hearing aids

An audiologist will use the results of a child’s hearing test to programme their hearing aids to meet their deafness and needs. Hearing aids make quieter sounds louder without changing the volume of louder sounds to keep everything within a child’s comfortable hearing range.

Hearing aids often have different listening programmes for various situations (for example, in normal and noisy environments or when listening to music). For young children, it’s likely their hearing aid will only have one programme without any controls or buttons to manage. As they get older, they can use more advanced programmes.

Features of behind-the-ear hearing aids

Microphone

The hearing aid's microphone can be programmed to pick up sounds from all around (omnidirectional) or from directly in front (directional). Most hearing aids will switch automatically between these modes based on the environment.

Controls

• Volume control. Most digital hearing aids adjust the volume automatically, so there may be no physical volume control or only a very basic one.
• Programme button. Allows switching between different programmes. Your audiologist will explain the programmes available are and in which situations to use them.
• Multi-function switch. Some hearing aids will just have one switch that controls the volume, programmes and mute functions. Your audiologist can set this up based on needs.

Your audiologist can enable or disable any buttons based on your needs.

Battery compartment

Most hearing aids turn on and off by opening and closing the battery door. A child-safe battery lock is a safety feature which stops children from opening the compartment and swallowing the battery. The lock is usually secured with a small screwdriver.

More about battery safety.

Elbows

Elbows (also called tone hooks or earhooks) are removeable extensions that attach to the hearing aid and hook over the top of the ear. They help make sure the hearing aid fits snugly on the ear and stays in place when moving or playing.

LED visual indicator

Some hearing aids have an LED light to show the status, such as when the hearing aid is working, has a fault, or needs a battery change.

Who can use BTE hearing aids

BTE hearing aids can be useful for babies and children with most types and levels of deafness. They may not be as effective for children with severe to profound deafness or those with auditory neuropathy spectrum disorder.

They can also be used temporarily for children with glue ear, particularly if they get it often or cannot have grommet surgery.

How sound is perceived

While hearing aids help children hear more clearly, they don't restore typical hearing. For example, a child or young person with hearing aids will still have difficulty hearing if a speaker is not facing them, is too far away or if there’s background noise.

Watch a simulation of what it's like to listen through hearing aids with and without a radio aid (YouTube).

Models and brands

The NHS usually provides hearing aids from these paediatric ranges:

• Phonak Sky Lumity
• Oticon Opn Play
• Oticon Play PX

These brands offer a range of colours and styles. There may also be styles that are more suitable for children who wear glasses.

There may be other brands or ranges more suitable for young deaf people transitioning to adult services.

Availability of different brands on the NHS depends on where you live and your local department's arrangements. Your audiologist should recommend the best available option.

There's no evidence that one model is better than another. The most important thing is that the hearing aid is programmed to meet a child's or young person's specific needs.