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Tiredness in deaf children

Photo: Deaf children can feel very tired from concentrating.

Tiredness and fatigue are common issues for deaf children. They often have to concentrate harder to follow conversation, whether in speech or signed. Understanding that the fatigue is related to deafness is an important first step. There are lots of things that can be done to support your child with their tiredness.

Michelle is mum to Isla (7) who is deaf.
“Isla would come home from school very cross. She wouldn’t play with her sister and would push or hit her – so unlike her. At weekends Isla was her lovely self again, but on Mondays it started.”

Concentration fatigue

Most people have times when they find concentrating hard work, such as when following someone who's speaking softly or when there’s lots of competing noise around.

Deaf children have to pay much more attention than hearing children. They use lots of different ways of listening and understanding, like lip-reading or following signed conversations, and may find they have less energy for other things.

If your child uses speech and listening, remember that children aren’t able to ignore another talker in the same way that adults can. When there are multiple talkers in a room, this means the child will not be able to pick out the one voice they should be listening to.

Listening takes effort and if deaf children may seem more tired than their siblings at the end of the day, it’s because it’s more of an effort for them to listen and interact for longer periods. Feeling more tired may have an impact on their learning at school, on how they feel about doing homework and also on their learning, development and behaviour within the home.

Michelle is mum to Isla (7) who is deaf.
“She enjoyed school at first, but as time went on she was getting more and more tired. She’d come out of school and not talk to me.”

How does concentration fatigue affect deaf children?

  • Sleepiness in the morning or falling asleep on the way home from school.
  • Inattentiveness or difficulty concentrating on work or conversations.
  • Giving up easily as tasks seem more difficult.
  • Getting easily frustrated.
  • Mood changes.
  • Changes in play activity, like having less stamina or not enjoying some activities as much as usual, especially in noisy environments.
  • Wanting to remove their hearing technology when they feel tired, so they can ‘switch off’ for a while and recharge.

Lucy is mum to Emily (9) who has a moderate to severe hearing loss.
“Emily is always tired, especially on school days, so we limit after-school activities. Days out are planned in advance and quiet time is factored in. Sometimes she wants to take her hearing aids off and not do anything.”

Can lip-reading reduce listening effort?

Possibly, but lip-reading requires cognitive resources too. Lip-reading skills take time to develop and are limited by the vocabulary the child already knows. Also, many lip patterns are identical for different speech sounds. Research suggests that children with sufficient cognitive resources (like working memory) can make use of lip-reading to reduce listening effort.

Samantha is mum to Harvey (12) who is profoundly deaf.
“Harvey’s teachers at primary school noticed he would make clicking noises and other sounds in afternoon lessons. Sometimes he’d engage in silly behaviour and be easily distracted. His Teacher of the Deaf thought it was due to listening fatigue, with the effort of listening and lip-reading becoming too much for him towards the end of the school day. These actions were simply Harvey’s way of staying alert while his brain was frantically trying to fill in the gaps of what he couldn’t hear.”

Tips for dealing with concentration fatigue

  • Make sure listening is made as easy as possible, including the consistent use of hearing aids or cochlear implants, the use of an FM system (radio aid or soundfield system), and by making simple adaptations to the environment to ensure background noise is kept as low as possible.
  • Have quiet times in the day when your child can rest.
  • Help your child to manage their own tiredness by not overloading their schedule.
  • Encourage your child to understand their own needs around their deafness, and to talk to teachers, family and friends about what those needs are. Take a look at our information on starting primary school and starting secondary school for more details.
  • Help your child to understand that being tired is OK, and help them find ways to relax.
  • Encourage your child to explain to their friends that if they aren’t talking much it’s not because they don't want to, but because they’re too tired to concentrate all the time.
  • Help your child gain the confidence to ask about moving seats in school if they can’t hear or see the teacher.
  • Make communication as easy as possible for your child by facing them, having good listening and lighting conditions and keeping background noise to a minimum.
  • At family gatherings and round the dinner table try and make sure one person speaks at a time so your child can focus on the conversation.
  • Help others who know your child to develop good deaf awareness skills.
  • Recognise that sometimes it’s OK for your child to remove their hearing technology so they can switch-off and take a break from the hearing world.
  • Help your child get a good night’s sleep with good sleeping routines.
  • Always remember, if they ignore you they’re children and children sometimes ignore us!

Other causes of fatigue

While fatigue in deaf children is often recognised as related to listening or lip-reading effort, there are many other causes of tiredness in children. If you are concerned you should also speak to your GP or Health Visitor.

Top tips from other parents

Use sign language as well as speech

“We chose to use sign language to support speech with Isabelle as soon as she was diagnosed. This is really helpful for hearing fatigue as we find comprehension doesn’t take quite as much effort compared with listening alone.”
Nicky is mum to Isabelle (3). Both are profoundly deaf.

Take time out in school and at home

“There’s a boy in Harry’s class who often prefers to eat lunch in a quiet classroom and if Harry’s having a bad day, he sometimes enjoys eating lunch with him. It gives him a little time out. After school most days he tells me he’s going to his bedroom for 10–20 minutes to, as he calls it, ‘chill out’. Sometimes he’ll take his hearing aids off, sometimes not.”
Jenni is mum to Harry (5) who has moderate to severe hearing loss.

Find a way to allow them to take their frustration out

“Tell them it’s okay to be tired and if they become frustrated stop whatever you were doing, hug them and ask what makes them feel that way. Let them take out their frustration on bubble wrap or rip up paper with them and soon the frustration may turn into laughter.”
Lucy is mum to Emily (9) who has a moderate to severe hearing loss.

Include strategies for dealing with concentration fatigue in a child’s Education, Health and Care (EHC) plan (or equivalent)

“Harvey’s EHC plan include strategies to bring Harvey’s attention to noises he makes and his behaviours so he can take control and stop them. This usually works, but if he continues the Learning Support Assistant can allow him to read for 5–10 minutes or have a short break. They can also take him out of the classroom and continue the lesson somewhere quieter.”
Samantha is mum to Harvey (12) who is profoundly deaf.

Make a manageable study plan

“I help Jack break up his homework and studying into manageable chunks and timetable it with lots of breaks in between. I sit with him while he’s working to help him stay on task but I let him lead the timetabling process so it’s manageable for him. I encourage alone downtime, but I always make sure he knows I’m here for him if he needs to shout, scream, cry or vent his frustrations.”
Melanie is mum to Jack (17) who has a fluctuating hearing loss.

Make activities as relaxing as possible

“TV is a relaxing activity for most people. From an early age I’ve always had subtitles, without them it’s such an effort to understand and I won’t bother watching it. Isabelle is too young to read subtitles so we tend to only choose programmes that we have the book for. We’ll spend time reading it through a few times before introducing the programme. She sits with it on her lap and follows the plot, turning the pages as the action progresses.”
Nicky is mum to Isabelle (3). Both are profoundly deaf.