childhood hearing loss success

What Does It Take For A Child With Hearing Loss to Succeed

I had the honor of presenting several presentations at the first AGBell International Conference in Madrid. Carol Flexer and I were asked to present the final Keynote (What Jane and Carol Know).

It was a wonderful honor and our colleagues in the audience were terrific. We talked about how critical audition is to build the auditory brain. And how we go about building the brain. We reported on research that supports what we have believed from our clinical experience which, it turns out, to be true. Yeah research. We discussed technology, and therapy, and the role of families.  


What a Child with Hearing Loss Needs to Succeed


Here’s a summary of what children with hearing loss need to be successful:

            1) Early identification – newborn hearing screening. Babies who have newborn hearing screening receive technology by 3 ½ month. Those who do not receive newborn screening do not receive hearing aids until about 16 months.

            2) Early appropriately fit technology – not just getting it on the child, but being certain that the child is hearing soft speech. 90% of what young children learn they learn by overhearing. To overhear you need to hear soft speech. The better you hear, the better you learn. With technology, children need to hear in the String Bean, and need to have good (80-89%0 to excellent (90-100%) speech perception at normal and soft conversational levels in quiet and in competing noise. Monitoring on a frequent basis will show if a child is receiving good benefit from technology. If a child is not hearing well enough with hearing aids, and if settings are not providing good benefit, consider moving to cochlear implants. Remote microphone systems should be used from infancy. Even babies need to hear.

            3) Technology must be worn all day. Research shows that children who wear technology 10-12 hours/day do better than children who wear technology less.

            4) Auditory based therapy involving the family. Research by Geers and others has shown that children who use spoken language only, do better in speech perception, speech production, and literacy,  than children who use sign language ever for a short time.

            5) Family support is critical. Children are with families more than they are in school. Families can provide excellent language stimulation and modeling. As clinicians, we need to assist families in learning what they need to know to be their children’s best language models

            6) Children need a rich language environment. They need more than the ability to name items. They need extensive discussion about things around them. Look at this shoe. Who’s shoe is this? What shall we do with this shoe? Where is its mate? What is this shoe made of? Where are your shoes? Does everyone where shoes? Does the dog where shoes? I like this shoe. I want top wear it etc.

            7) Opportunities to learn – Children need lots of opportunities to learn. They need to go places: the park, the library, museums, the zoo. The more places they go the more opportunities there are to talk about different things. Children need books. We need to read to them at least 15 minutes/day. My routine baby gift is books, with a note to baby to be sure parents read lots of books to baby. Babies also need music. Sing sing sing to baby. Don’t worry if you do not have a good voice. Baby doesn’t care. Make up a song about what you are doing. “I’m washing the dishes, the dishes, the dishes. I’m washing a glass and it is full of soap.”

            8) Children need to be in educational programs that are willing to make adaptions that will help children succeed. First and foremost, use of a remote microphone in all academic subjects and maybe even in social situations like lunch and recess. Children need to be seated in a seat which will allow them to hear well and they need to be allowed to move around to enable them to hear well. Teachers of the Deaf need to be available to assist in developing academic skills. Preview and review of classroom vocabulary as needed. Speech-language-auditory therapy to assist in building skills.


Obviously we talked about a lot more, but this is the summary. Thank you Carol Flexer and AGBell International.  

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.


  1. I appreciate the concept of just audiology and technology. Hearing loss is much more than just than a cure through technology. This is a myth that continues to marginalized people with hearing loss.

    I hope to see data that proves the statement that made here.

    It’s important to look at the whole child. I have worked with so many young adults with cochlear implants and hearing aids who felt isolated and alone in mainstream. Poor social skills.

  2. You made a good point that with a newborn hearing loss exam you can get the technology they need at 3 1/2 months old. We just delivered my daughter about a month ago and I’ve been so worried about anything that might be wrong with her. I would love to get her hearing tested to see if there is anything I need to do to help her succeed.

  3. Thanks for the different ideas on how to help kids with hearing loss, such as auditory based therapy with the family. When choosing what to do, it might be a good idea to research local therapy clinics. This way, you can find one that offers the type of auditory therapy or any other services you want that will help your child.

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