What are the symptoms? Tinnitus can be a very distressing condition. However, with the correct support it can be well managed. Tinnitus can be most disturbing in quiet situations, and as with adults, children may have difficulty getting to sleep at night. Noisy environments can also cause problems. Loud sounds such as school bells may trigger the onset of troublesome tinnitus, and so the school environment can be particularly challenging for children with tinnitus. In the classroom, tinnitus can make concentration difficult, competing against the teacher’s voice for the child’s attention. Those with hearing loss (see entry Deafness) may find it more difficult to understand speech when tinnitus is present, meaning that information is missed. What are the causes? Tinnitus has been found to be more common in children with hearing loss, both sensorineural and conductive (see entry Deafness). Those with a moderate/severe sensorineural hearing loss have a higher rate of tinnitus than those with a profound loss, and those with an acquired hearing loss are more likely to experience tinnitus than those with a congenital (present at birth) hearing impairment. How is it diagnosed? Any child or young person with tinnitus should be referred for a thorough otological (structure of the ear) and audiological (hearing) assessment in order to rule out any underlying problems. In some cases the tinnitus is associated with a reduction in sound tolerance (hyperacusis) and this may also be diagnosed. How is it treated? In the first instance, any associated hearing loss should be appropriately investigated and appropriately treated. Tinnitus is often a consequence of hearing loss. So treating the associated hearing loss will often reduce the intrusiveness of any associated tinnitus. Tinnitus counselling makes a difference to children and young people, but only when information is presented at a level the child can understand. Whilst children are going to sleep, the use of sound therapy may be helpful, using simple background sounds such as an inexpensive environmental sound generator, fans, or quiet background music to distract from tinnitus. Good liaison with school can make a big difference. Teachers also need information about tinnitus, what it is, and how it affects their particular pupil. Working under pressure and in a very quiet environment can make tinnitus particularly difficult to ignore. It is important to alert the class teacher and the school to the child’s tinnitus and request that special arrangements are made for exams. For example, exams can be sat in a separate room with a fan or some other environmental sound that the child finds helpful as a tinnitus masker. Inheritance patterns and prenatal diagnosis Inheritance patterns Current research does not indicate that the condition is inherited. However, there are some suggestions of a genetic predisposition (meaning that some people with a certain genetic make-up may be more likely to have the condition). Prenatal diagnosis None. Is there support? British Tinnitus Association Helpline: 0800 018 0527Email: firstname.lastname@example.orgWebsite: tinnitus.org.uk The Association is a Registered Charity in England and Wales No. 1011145, established in 1992. It offers information and advice about tinnitus and coping techniques together with support and contact with others through local groups. It publishes a quarterly magazine called Quiet and has medical information leaflets available. Group details last updated September 2020. RNID (formerly Action on Hearing Loss) Tinnitus Helpline: 0808 808 6666Email: email@example.comWebsite: rnid.org.uk The Organisation is a Registered Charity in England and Wales No. 207720, and Scotland No. SC038926. It provides information and support for people with hearing loss and tinnitus. The Organisation offers day-to-day care for people who are deaf and have additional needs; communication services and training; and practical advice to help people protect their hearing. It campaigns to change public policy and supports research into an eventual cure for hearing loss and tinnitus. Group details updated June 2021.