By Dr. Robert Fanning

Q: My 4 year old wants to wear headphones when watching movies and listening to music just like his big brother. I’m concerned about both of them damaging their ears and having hearing loss later in life. Is it safe for a 4 year old to wear headphones and how safe is using headphones on a regular basis for my tween?

A: I generally start seeing children use headphones in my clinic at around the age of 4 or so, which I think is fine. When I see this, I take the opportunity to counsel the parents on safe use. Of course, not using the headphones in the first place is the safest option.

Also, let me address headphone use in very young children (age 4 and under): I cannot imagine that the ears of infants and young children can accommodate the headphones that come with iPhones and other devices. Because the ear canals of young children are so small, they add an additional boost to sound levels in the same way that placing your thumb over a running garden hose increases water pressure. It is just unnecessarily risky to have these little ones wear headphones.

When it comes to a time limit on headphone use, my colleague Brian Fligor has done much work in this area, and he developed an “80/90” rule – no more than 80% volume for 90 minutes – that I counsel my patients to use. Although no rule of thumb is perfect, this is a good one. It is easy to remember and apply, and it is sensible.

The most certain long-term effect of headphones on for too long and too loud is permanent hearing loss. We have learned in the last few years that more and more children, mostly teens, are developing hearing loss caused from exposure to loud sounds. The hearing losses we see in these children are usually mild but can increase with age, continued exposure, or both.
Parents should know that there is a relationship between exposure level and duration. It may be obvious that a very loud sound can be harmful for even a short duration. What parents may not know, though, is that even moderate levels of sound can be harmful too if they are accompanied by long exposure times.

When it comes to styles of headphones, the standard ear bud style seems to be potentially hazardous because the phone is placed at the opening of the ear canal but without a snug fit. Older children and teens push these phones deeper into their ears to block out background noise and to hear more bass in their music. As the phones slip around and out of their ears a bit, they just start increasing the volume. Over-the-ear phones or buds that can form a seal at the ear canal can help block out background noise and provide better sound quality so that users will be less inclined to increase the volume.

Parents should be mindful of all sources of potentially hazardous sound levels, not just earphones. For example, many of my teen patients attend loud concerts, which can put them at risk for hearing loss. In these cases, I counsel them and their parents on the importance of using hearing protection devices. One of the top resources I recommend to parents is www.dangerousdecibels.org.

Dr. Robert Fanning is an audiologist at Phoenix Children’s Hospital, www.phoenixchildrens.org.

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