Teaching Advocacy

This week I attended the Pediatric Audiology Conference run by the Children’s Hearing Institute. It was a wonderful meeting. Joan Hewitt and I did a 3 hour course on the LMH test. It was the first time we got to really discuss it with an audience and it was great.

I also got to listen to a number of other wonderful talks.

Cheryl DeConde Johnson did a very good talk on things to consider besides the audiogram when looking for success for children with hearing loss. One of the things she discussed was what factors needed to be considered about the child and school. It was an excellent reminder of things we sometimes forget.


Listening skills


What is the child’s language ability? Are expressive and receptive language at or close to grade level? Will they be able to understand what is being taught in the classroom and communicate well with peers? Do they have good pragmatic language? How well are they able to understand speech and how much do they rely on speechreading? If they rely on visual cues where are they sitting in the classroom? Can the easily see the teacher and other students? What are their speech perception skills? Do they hear well enough to follow conversation auditorily? Do they have any auditory processing difficulties that interfere with learning? Are they cognitively at grade level, or close? If a child is cognitively at the kindergarten level but chronologically at 2nd grade how will they manage in the classroom?


Linguistic concerns


Is the child’s language at the level where they can follow conversation in the classroom? Is the child familiar with the vocabulary of the classroom? Will they be able to follow a science lesson? Can they follow conversation at the length and depth that conversation is in this grade?

If they have difficulty with the language, vocabulary, length of sentences, complexity of language we can expect that there will be difficulties in the classroom as well as in social situations. Until about the middle of 2nd grade lots of the games children play do not require much language. After the middle of 2nd grade language is a very big part of games and if children do not have the necessary language, socialization will be limited.

Many children with hearing loss have auditory memory delays. It is critical that every child be evaluated for auditory memory and if it is delayed some part of a child’s therapy should be directed to building auditory memory skills.




Children with hearing loss often experience more fatigue than their peers. Listening is a difficult task. It is important that school staff understand this and plan for it. Children need to be scheduled so that there are break times during the day in which they do not have to listen and concentrate.

At the end of the school day they need a short time in which to unwind and not have to concentrate. Once they have taken a break they can return to homework and other activities.


Teaching self-advocacy


Every IEP includes teaching advocacy skills. We need to consider what that really means. First, what are the advocacy skills that we would like to teach?

We want children to advocate for themselves we need to be sure they understand what they need to advocate for.

  • Children need to recognize when they are hearing and when they are hearing and when they are having difficulty. If they are having difficulty hearing they need to try and try and figure out
    • Is the problem hearing due to problem with technology? If they think their technology is not working children need to learn about how to troubleshoot the equipment, change batteries etc. If it is not working, children should know who to turn to in school to get assistance and how to reach parents for help.
  • Children need to recognize when they are missing information in school.
    • Is the teacher using the FM?
    • Is there a pass around mic? Is it being used appropriately? If there is no pass mic is the teacher repeating comments by the class?
    • Can changing seats help? If yes, the child needs to be helped to learn to ask permission to move.
    • If the child doesn’t understand what is being said, can the child learn to ask for clarification? If the child does not know the vocabulary that is being used they need to understand that they should ask for definitions. If it happens only occasionally the child can as the teacher for clarification. If it is a frequent occurrence then it will be necessary to have a teacher of the deaf or other teacher preview vocabulary and concepts and prior to them being taught and review them after to be sure that the child has learned the necessary information.


Before children can be asked to advocate for themselves, we need to recognize what the needs to be advocated for and help the children recognize it and build the skills to advocate.


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. Hi Jane. Was just talking about you and your Ebbets Field stadium seats. Hope all is well. I’m retired now;however you like the energizer bunny never stop. Kudos to you my friend and to Cheryl all of us who have been in the trenches supporting optimal outcomes for all of our hearing impaired and deaf students. Stay well.

    Dr Judy Masone
    Do the right thing, because it is the right thing to do….

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