Audacity Dec13_Layout 1 05/12/2013 13:26 Page 29
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29 Our body alarm clock helps us to see and hear better, so we can look and listen out for danger. But this means that we can hear our ear noises even more! Our brain also tells us to listen really carefully to the ear noises, because it thinks they are dangerous.
Summary The Child Friendly Tinnitus Model provides a useful clinical framework for tinnitus assessment, counselling and intervention in children and young people. Individualising the model, using developmentally appropriate language, and tailoring information giving to address the specific questions about tinnitus raised by the child and family is important for effective tinnitus counselling with children.
Box 6. My worry box All children have things that they worry about. Having an argument with a friend, having to do tests or exams at school, or changing school can all make children feel worried or stressed. When there is a lot of worry or stress around, children can feel more worried about their ear noises. Children tell us that their ear noises also start or get louder sometimes when they are thinking about or doing something that worries them.
Acknowledgement Special acknowledgement and thanks to Adrian Williams, Medical Illustrations, Royal National Throat, Nose & Ear Hospital (UCLH) for providing the images for The Child Friendly Tinnitus Model.
It is important to find out what kind of things are in child’s worry box that might be contributing to their stress levels and tinnitus. Asking about what is happening when the tinnitus is and is not around can help to identify things that make the tinnitus worse and better. The Tinnitus and Worry Cycle If we put all of the boxes and arrows together, we can see that it makes two circles:
References 1.
Edwards, M., & Titman, P. (2010). Promoting Psychological Well-being in Children with Acute and Chronic Illness. Jessica Kingsley Publishers, London.
2.
Emond, A & Kentish, R (in preparation). The Child Friendly Tinnitus Model.
3.
Holgers, K.M., & Juul, J. (2006). The Suffering of tinnitus in childhood and adolescence. International Journal of Audiology, 45, 267-271.
4.
Jastreboff, P.J. (1990). Phantom auditory perception (tinnitus): mechanisms of generation and perception. Journal of Neuroscience Research, 8, 221-54.
5.
Kentish, R., Crocker, S., & McKenna, L. (2000). Children’s experience of tinnitus: a preliminary survey of children presenting to a psychology department. British Journal of Audiology, 34, 335-340.
6.
Kentish, R., Kennedy, V., Benton, C., Rogers, C., Rosenberg, J., Salvage, S., Munro, C., & Phillips, J. (Currently under development). Tinnitus in Children and Teenagers. A Good Practice Guide. Paediatric Tinnitus Working Group.
7.
McKenna, L., Baguley, D., McFerran, D. (2010). Living with Tinnitus and Hyperacusis. London, Sheldon Press.
8.
Sheyte, A., & Kennedy, V (2010). Tinnitus in Children; an uncommon symptom? Archives of Disease in Childhood, 95, 645-8.
Circle 1: The more we listen to our ear noises and the more we dislike the noises, our body alarm keeps ringing and the more we notice the noises! Circle 2: The more we listen to our ear noises, our brain thinks that these are important noises for us to listen to. It keeps the traffic lights on green, which means we hear more ear noises and dislike these noises more. These circles can go round and round, making the ear noises a bigger and bigger problem as we listen to them more and worry about them. But the good news about circles is that you can break them in different places. Talking through the tinnitus and worry cycle with a child and their family invites ideas about how they can work together to break the circles to help the noise traffic light stay red for ear noises. For more information on how to use The Child Friendly Tinnitus Model in tinnitus therapy with children, please contact Dr Alice Emond, Clinical Psychologist (details above).
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