child hearing loss school

Receiving Support in Schools

When I started working in this field (in the age of the dinosaurs) there were no services in schools for children with hearing loss. Families had to find services for children outside of school. As my career progressed things improved and services started to be available in the schools. Now things are turning around and it is again difficult to get necessary services in schools.

I hear from parents all the time looking for help in getting services for children. So let’s talk about what children need in school and what we have to do to get there.


Who is providing services?


Unfortunately, most schools in the US now do not have Educational Audiology services and many do not have teachers of the deaf. That means that there is often no one in the school who really understands hearing loss.

Some school districts share educational audiologists and teachers of the deaf and some use others in the schools to provide services.  Some of the necessary services are provided by speech-language pathologists who may have had no courses in providing services to children with hearing loss.  What does not mean for our children?


Advocacy first


We really need to help children develop advocacy skills. Children need to recognize when they cannot hear well, and they need to be able to tell teachers and school staff when they cannot hear. Children need to be able to tell when their personal technology or FM system was not working or was working inconsistently.

Who is responsible for helping children develop advocacy skills? It should be an Educational Audiologist, Teacher of the Deaf, and/or a listening and spoken language specialist who may or may not be a speech-language pathologist.

If there are none of these professionals in the school, a special educator may be assigned to provide these services. Again, many special educators do not have a lot of information about hearing loss.


Services needed


Technology: We need to be sure that technology is working well. If children cannot hear optimally, they will have a very difficult time learning. Someone at school needs to be assigned to check equipment daily. In lower grades, the classroom teacher can check by doing the Ling sounds and sentences daily when the child’s back is turned. As children get into middle school others will have to be assigned this task since children are moving around. But by middle school children really start to be disturbed by having to carry around the FM microphone and giving it to each teacher. All teachers need to be educated about the FM and there needs to be someone at school who really understands technology and can help.

There should be a pass around microphone that all the children in the classroom can use so that the child with hearing loss hears classroom discussion. If there is no pass-around microphone, the teacher needs to repeat all student comments so that the child with hearing loss can participate in discussion.

Families need to understand the importance of using technology full time. It is not okay to take personal technology off after school. Lots of learning takes place after school. We know that children may be tired at the end of the day so  short break is okay, but it really needs to be short.


Academic assistance: Children with hearing loss are very likely to need assistance in school. While they may start school with language at age level, they are at a disadvantage relatively quickly because they are being asked to learn in a noisy environment. That means that learning will be significantly more difficult than for their peers. Children with hearing loss will benefit from Preview and Review of vocabulary and concepts. If a child doesn’t understand the terminology used in a classroom discussion, they will miss the entire discussion. I have a difficult time getting schools to understand that we should not be waiting for a child to be failing before they start to provide this kind of service. This should best be provided by teachers of the deaf but there are some speech-language pathologists who can provide this service. They should have no difficult teaching vocabulary but they may have more difficulty teaching concepts.

Extended test time should be available. And exams which have oral sections should be provided in a quiet room with the person giving directions standing in front of the child.


Classroom seating: Seating needs to be arranged so that children can both see and hearing what is being said. Best seating should be towards the front of the room but not the front row, and in center or towards the side but not at the far side. If the teacher moves about the room the child needs to be able to move with her so that he can hear. It is important to remember that children need to also hear peers. So if there is no pass mic in the classroom the teacher needs to repeat everything that is said. As I have said previously, it is essential that students hear comments of other students. Classroom discussion is critical.


Speech-language service: Like all other services, schools do not provide services until a child is failing. If a child has some areas of weakness (just what we would expect for a child with hearing loss) those areas need to be addressed. Most of the time services are only provided when a child has significant low scores in most areas. We need to help schools understand that by working on areas of weakness (the common areas are auditory memory, vocabulary, and complex language) we can prevent failure.


Auditory fatigue: Listening all day is difficult for children with hearing loss. No matter how great the technology is it is not perfect. They are still going to be struggling and trying to fill in what they are missing or not hearing clearly. Children need listening breaks during the day. Difficult academic subjects should not be right after each other. There need to be some breaks where they can relax a little. It is important to remember that by the end of the day listening will be difficult so difficult subjects or exams should not be scheduled for the end of the day.


Providing support: Children with hearing loss in mainstream schools are often the only child with hearing loss in the school. It is important that children have peers. Monthly, or at least several times a year, all the children with hearing loss in the district should meet together. Just knowing you are not alone is critical. Peers can help children accept hearing loss in a way that is not available in other ways. Peers can help convince children who are having difficulty using and FM or even hearing aids, accept the need for technology. Peers can talk to each other about problems hearing in school or outside of school and how they can solve the problem.

Families also need support. Support groups for parents should be scheduled several times per year to discuss their concerns and to provide support for them.


Providing services and information to families in their native language


Not all families use English as their first language. Even if they do use some English, they may not be completely fluent. It is important that all families have all school information in their native language. In addition to interpreter services, they need to have all written materials that anyone in the school receives in their native language.


We need to push for our kids


Students with hearing loss have the ability to be whatever and whomever they want to be. We, families and professions, have the responsibility to be sure that children with hearing loss are getting everything that they need.

As they say in sports, Just Do It!!!!!



About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 7 books, and written numerous books chapters and journal articles, and is a well known international lecturer.