Locked in Listening: Why Personalized Hearing Aids and Microphone Control Matter for Kids with Peripheral Hearing Loss

Dear Parent or Professional Working With a Child Who Uses a Hearing Aid Microphone System,

I want to clarify a common issue I see in school-based hearing support. Children are often fitted with FM or DM microphone systems that allow the teacher’s voice to be sent directly to their hearing aids. While this can improve access to the teacher’s voice, it can also reduce the child’s autonomy and interfere with spatial hearing if it isn’t implemented thoughtfully.

The core issue is control. Many children are given microphone input from a teacher or support staff, but they have no ability to turn it off, adjust the volume, or blend it with environmental sounds. The microphone becomes dominant, and in many systems, raising the volume doesn’t just make things louder, it prioritizes the external microphone input and further suppresses the regular microphones on the hearing aids.

Those regular microphones—typically two on each device—are directional and designed to help children make sense of where sound is coming from. For children with mild hearing losses, these microphones often provide enough access on their own, and they may not need a remote microphone in many settings. But the greater the hearing loss, the more isolation is needed to make the teacher’s voice accessible. It becomes more like having the teacher on the phone, with their voice streamed directly to the child while the rest of the environment fades away.

This has a major impact on spatial hearing. When a child can’t hear where sounds are coming from, they lose orientation to their environment. They may hear the teacher, but not the classmate next to them. They may hear a voice in their head, but have no way to anchor that voice to a location in space.

It’s also important to talk about signal-to-noise ratio and why that matters so much in real classrooms. Classrooms are noisy places, often with poor acoustics, multiple talkers, background movement, and reverberation. The more hearing difficulty a child has, the harder it becomes to pick out speech from all that background noise. This is especially true when the speech is coming from a distance, or is soft, accented, or rapid.

In those situations, FM or DM microphones can be incredibly helpful. They bypass the classroom noise and deliver the speaker’s voice directly to the child’s ears. That clean signal is powerful and can make a huge difference in access. But it doesn’t mean the child should be tethered to the teacher or coach. That kind of one-way connection takes away too much of the child’s control. It may improve access to speech, but it comes at the cost of autonomy, spatial awareness, and sometimes, emotional safety.

This is especially problematic for group work, social interaction, and emotional regulation. Spatial hearing isn’t just academic—it’s personal. It’s how children know where they are and who they’re connected to.

I often compare this to a seesaw effect, which specifically applies to the way volume control works in Phonak hearing aids and their sister brand, Unitron. When a Roger microphone or PartnerMic is connected, turning up the volume on the hearing aid doesn’t just make all sounds louder. Instead, it increases the Roger mic input and decreases the environmental microphones, shifting the balance of what the child hears.

Imagine standing in a pool. Turning up the mic lifts you up, almost like being pushed out of the water on a pole. You become isolated and primarily hear what is coming through the microphone, such as the teacher’s voice, while everything else fades into the background.

There are times when that level of isolation is helpful—for example, during a lecture or when receiving instructions from a coach on the sidelines of a soccer field. But in many classroom or social settings, that isolation is far from ideal.

Kids need to be able to choose when they want to hear one specific person better and when they want to hear everything going on around them in its proper location.

Sometimes audiologists will adjust the ratio of how much the FM or DM microphone boosts the speaker’s voice compared to the environmental microphones. While that may be helpful in certain settings, not giving the child the ability to adjust it themselves takes away their control. When the microphone is not connected to the hearing aids, volume controls on Phonak or Unitron devices behave normally, allowing the child to adjust their own hearing aid volume across all inputs. But once a microphone is attached, the controls shift the balance in favor of the remote microphone, limiting the child’s access to the environment unless they are given access to those settings.

There are many stories out there of kids who couldn’t focus on group work because they were still hearing the teacher talking to a different group—or even to another adult in the hallway or the bathroom. This isn’t just a programming issue. It’s a design flaw in how we think about support.

Children should have the right to disconnect the microphone, adjust the sensitivity, and manage their input.

It’s also important to understand the difference between types of microphones. A remote microphone like the PartnerMic must be worn by the speaker and lacks internal noise reduction. It often picks up clothing rustle and environmental distractions because it cannot filter background noise. By contrast, a more sophisticated FM/DM microphone like a Roger system has greater flexibility. It can be worn, pointed at a speaker, or placed in the center of a table, and it can be set to omnidirectional or directional mode depending on the environment. However, neither of these microphone systems restores spatial hearing. They stream sound directly into the hearing aids, bypassing the natural listening cues the brain uses to locate where sounds are coming from.

That ability to localize sound—to know where a voice is coming from—is essential for classroom participation, safety, social awareness, and emotional security.

Autonomy isn’t optional. It’s essential.

The key is giving them the tools and the trust to do so. There are certainly children who may not yet be capable of full self-advocacy or independently managing their hearing devices. But if we don’t presume competence, if we don’t give them the chance to learn, how do we know what they can and cannot do?

I once fit a three-year-old nonverbal autistic child with hearing aids, and even at that age, she was completely capable of managing her own volume. She learned to adjust the settings herself so that she didn’t go into sensory overload or meltdowns. She even figured out how to switch into a second program that played calming pink noise when she needed it. That ability made a huge difference in her ability to stay regulated and access instruction.

By the way, she’s now eight years old, fully verbal and conversational, and she still loves her hearing aids. I’m not sure that would’ve been the case if I had forced her to stick with one fixed setting and never given her the chance to shape her own auditory environment. These kids are sensitive, especially the autistic ones. And when we give them the right tools, they often surprise us.

When I check data logs, I often find that kids use these features thoughtfully and effectively. And if they aren’t using them well, we can always change the programming. But they deserve the chance to try.

This is also why I do not fit microphone-only systems without independent volume and input control. I am not willing to tether a child to someone else’s voice with no way to opt out.

Children shouldn’t be locked into one-directional listening. They should be able to tune in and tune out as needed, just like we all do. I believe they should have better control than typical hearing students, as they have to make up for enduring distortion and hearing loss.

Hearing support should empower kids, not limit them. That’s the standard I hold in my work, and it’s what I believe every child deserves.