What do Children Need to Hear in the Classroom?

The majority of what children learn, they learn using audition. We learn by overhearing conversation around us. Children need to hear the teacher, but they also have to hear other children’s comments and questions. They need to be able to hear classroom discussion in order to participate. They need to hear their own voices so they can monitor how they sound and self correct. They need to be able to hear in the auditorium, on the playground, and around the lunch table. They also need to hear movies shown in class and to hear from their computers.

 

The importance of assessing auditory function

Hearing is a complex function. Hearing is more than knowing sound is present. It is important to be able to understand what is being said. We cannot assume that a child has normal hearing because they hear some things or turn to their names. School personnel need to know that a child may hear some sounds but not hear speech normally. A child may hear speech in quiet but may not hear when there is competing noise. Without a complete audiological evaluation which includes testing functional performance, it will not be possible to know what a child hears and to plan for management.

Children learn what they hear. Children can develop language and academic delays if they do not hear normally, if they hear a distorted signal, if they have inconsistent exposure to clear speech, and if they are in an environment in which their auditory brains are not exposed to auditory language/auditory information.

 

What happens if a child cannot hear well?

Hearing loss will affect language development and language skills, all academic areas, literacy, and social skills. Everything we learn in school has a language base. If a child’s language is not at grade level, the child will have difficultly learning in every subject.

 

Hearing for academic learning

Classrooms are noisy environments. Academic learning relies on hearing. If auditory access is not adequate language learning will be limited, and classroom learning will be limited.

 

Hearing for socialization

School staff may not recognize that social skills are directly related to language. Young children do not use complex language in play but as children get older, language becomes basic to socialization. When children are having problems with socialization, look to language. Children need to be able to pick up on tone of voice to get jokes, sarcasm and annoyance. They need to understand slang and idioms. Language is critical.

 

What factors affect auditory learning

Hearing is first. We need normal hearing (with or without technology) to enable children to access auditory information. Children who have hearing loss or middle ear disease will have problems accessing auditory information. Children also need good and constant language modeling. It is critical to control the auditory environment. Children will hear best when they are close to the person talking and when there is little or no competing noise. School personnel needs to understand need to control classroom noise. They also need to understand that the need for remote microphone systems.

 

Factors that impact access in the integrated classroom

The rate and pace of classroom instruction can be an important factor. Teachers who talk quickly will be more difficult to understand. The ability to learn using incidental listening will be a factor in learning. If language of the classroom is more complex than the child can understand, learning will be affected.

 

Auditory problems associated with learning

Children will have problems learning if they have

  • Inconsistent responses to sound
  • Difficulty understand speech information
  • Difficulty with auditory processing
  • Difficulties in response timing (it takes them a while to understand what is said – a listening delay.)
  • Short attention spans for auditory stimuli
  • Easily distracted by auditory stimuli
  • Have frequent requests for repetition
  • Have difficulty with phonics
  • Have difficulty remembering information learned through spoken communication
  • Difficulty with localization

 

What is needed for classroom success?

For a child to succeed in the classroom she needs to have language and literacy at age level, the ability to hear and understand the teacher, the ability to hear and understand peers, and good socialization skills.

 

What does school staff need to know?

In order to help children with hearing loss maximize their performance, teachers need to know the students level of competence in listening and conversational skills, the student’s ability in communication repair, suggestions for reinforcing in different environments and skills for supporting self advocacy.

 

Technology

School staff needs to know what kind of technology a child needs. They need to know how to check hearing aids or cochlear implants. They need to know when and how to use remote microphones. Staff needs to know how to confirm that technology is working and what to do if it is not. They need to know how to check listening EVERY morning to enable them to recognize if there are any problems with the technology. They need to understand that without fully functional technology, a child cannot learn in the classroom.

 

Final words

There is a lot involved in helping children with hearing loss succeed in a classroom. First, school staff needs to understand the effect of hearing loss and what children with hearing loss need. An educational audiologist and teacher of the deaf will be significant in accomplishing this. Then families need to be vigilant to be sure that children are getting what they hear. It is a team effort.

 

 

More than 80% of kids with hearing loss are educated in mainstream settings. For them to succeed, they need to be able to participate in every aspect of school activities. THEY NEED TO HEAR!!!!

Newborn hearing screening has resulted in really early identification. Kids with hearing loss are identified within weeks of birth. But we all know that early identification is not enough. Infants and babies need to be fit with technology IMMEDIATELY so that they do not miss a single moment of hearing. Audiologists are responsible for being certain infants and babies hear. Obviously that’s not all that needs to happen but if audiologists have not insured that babies and children hear, nothing else can happen. Once babies hear parents, teachers, therapists can take over and work towards developing the auditory brain and teaching children to listen, talk and read.

 

Then they go to school

Who determines what a child needs when she gets to school? Unfortunately, hearing loss is a hidden disability. Once kids are appropriately fit with technology (I admit not an easy feat) they can learn and when they are listening and talking then those who are not in the know, think they are fine. I cannot tell you how often I have heard from school personnel “he has hearing aids (or cochlear implant) now so his hearing loss is cured, right?” Of course that is not right. Once you have a hearing loss, you always have a hearing loss. Yes technology helps but it does not solve all problems.

ASHA reports that children with hearing loss are under identified as needing school support services. Only 1 in 100 children with IEP’s is found eligible for services due to hearing loss. They may receive speech-language services by a speech-language pathologist (who may have had only one course, or part of one course in grad school about working with kids with hearing loss) but those services are almost always provided in a separate office. Will that SLP see how the child with hearing loss is struggling in the classroom? If children have good language skills, they may not qualify for services in school. No matter how good language is, children with hearing loss are very likely to experience difficulty managing in a classroom. It is just too noisy.

No matter how good a child’s language is, s/he will likely benefit from classroom listening technology. In order to demonstrate the need for classroom listening systems, audiologists need to work with SLP’s to assess how a child is hearing and help convince the school to provide a remote microphone system.

Audiologists are the best people to educate school staff about the effects of hearing loss and how to help kids with hearing loss succeed. School staff needs to understand that hearing aids are not like eyeglasses. Hearing technology does provide normal hearing for children with hearing loss. Speech that is soft, (when the talker is more than 6 feet from the listener) or when there is competing noise (every school) will be difficult to understand. Children with hearing loss have to work a lot harder to manage in a classroom, making school but more difficult and results in more fatigue by the end of the day. Because of the extra effort to listen, children may be left with fewer cognitive resources to use for learning new material. Teachers need to understand that it is not a question of the child with hearing loss just “paying better attention”. They need more assistance to learn.

In November 2014, the Department of Education clarified that according to ADA, schools are required to ensure that communication for students with hearing loss is “as effective as communication for others” through the use of appropriate aids and services. How will this be accomplished?

 

Remote microphones

The use of a remote microphone system can make a very significant difference in how a child with hearing loss hears in the classroom. When a teacher is wearing a microphone that is placed within 6 inches of her mouth, the child with hearing loss is receiving a signal that is much more clear with reduced effects of distance and noise. Great, the child will receive the information shared by the teacher. But is that all that a child needs to hear?

 

Listening to peers

We learn a great deal for all the people around us. Children learn from their peers. It is not just the correct answer, but the wrong answers and classroom discussion that helps us learn. So, ideally, every child with be wearing a microphone so that children with hearing loss, and if fact every child in the classroom will be able to hear what everyone says. That is not likely to happen any time soon. So what’s the solution? There are two possibilities. The teacher can repeat ALL COMMENTS made by any student (something they are not likely to be nuts about) or there can be a pass-around microphone that children use so that the child with hearing loss will hear all comments directly.

 

What can an audiologist do?

If only all school districts had educational audiologists. The educational audiologist would know the district and, over time, would have had the opportunity to educate staff about the effects of hearing loss and the needs of children with hearing loss. But, alas, as money becomes tighter, few districts have educational audiologists on staff.

Clinical audiologists will need to expand their roles to help meet these needs. What do we need to do? First, is technology doing what it needs to do? Are kids hearing well enough to ear well in the classroom? That means that kids need to have aided thresholds between 20 and 25 dB throughout the frequency range – including (or especially) in the high frequencies. Research by Moeller has demonstrated that 40% of children with hearing loss are not receiving sufficient benefit from their hearing aids. Recording aided thresholds on an audiogram that has the speech banana with the speech string bean on it (http://hearinghealthmatters.org/hearingandkids/2015/the-speech-string-bean) is a good way to demonstrate to the school (and parents) what a child is hearing and what she is missing. Testing speech perception at normal and soft conversational levels in quiet and in competing noise will also demonstrate how much a child is missing.

If we can demonstrate to classroom teachers what a child hears and what the child does not hear, school staff is more likely to embrace the use of a remote microphone system, to work to recognize when a child with hearing loss is missing something in classroom discussion and in working to improve performance.

Audiologists in clinical settings absolutely must expand their skills to work with schools if we are going to help our children succeed. Is it difficult. Yes. It is expanding our job and will require more time. But it is our job. We just need to do it.