In order for any child to succeed, it is vital that he or she has access to an appropriate learning environment that addresses their individual needs. Therefore, the type of educational setting appropriate for your child (Listening and Spoken Language classroom vs. American Sign Language classroom) will depend on the goals you have set with your hearing health team. With medical treatment, ninety percent of children with hearing loss are able to develop speech and require a specialized Listening and Spoken Language preschool environment to do so, but since learning objectives can vary dramatically from child to child, it is important for you to seek up-to-date medical advice from medical professionals to determine the best learning mode for your child.
When making decisions about your child’s education goals with your health care team, it is important for you to understand what an Individualized Education Program(IEP) is, and how to make sure it is being followed. It is also important for you to understand the right your child has to the most inclusive (normal) educational environment that is appropriate for them under the national Individuals with Disabilities Education Act (IDEA).
The Alexander Graham Bell Association for the Deaf and Hard of Hearing has a free online Parent Advocacy Training course which details the entire process you will go through to establish your child’s educational needs and goals. In 90 minutes you can learn to take control of your child’s IEP process.
Many terms you will encounter in taking care of your hearing impaired child are described below.
- What is the difference between deaf and hearing impaired?
- Medical advice for medical problems
- Your Doctor Will Tell You if You and Your Child Should Learn Sign Language
- It is possible that the experts coming to my home and counseling me about what to do with my child are wrong?
- What is mainstreaming?
- I was told my child was born Deaf and that I should not take that away from him. Is that true? My doctor says it is possible for him to learn to hear and speak like me.
- Will sign language hurt my child if I eventually want him to hear and speak?
- If I do not want my infant with hearing loss to hear and speak, do I need to learn to sign or will he learn in school?
- What is an individualized education plan (IEP), and who is in charge of it?
- What is Early Hearing Detection and Intervention (EHDI)?
- What is American Sign Language(ASL)?
- What is Bilingual-Bicultural education?
- What is the difference between deaf and Deaf?
- What is the Individuals with Disabilities Education Improvement Act (IDEA)?
- What is meant by the Least Restrictive Educational Environment?
- What are Listening and Spoken Language Specialists?
- What is Auditory-Verbal therapy?
- What is an itinerant teacher of the deaf?
- What is an FM System or an Infrared System for the classroom?
- What is an Individual Family Service Plan (IFSP)?
- What is an Independent Educational Evaluation (IEE)?
What is the difference between deaf and hearing impaired?
A hearing impairment is any level of hearing below normal. An impairment can be mild, moderate, severe or profound and may affect one or both ears. Hearing impairments are usually addressed with hearing aids. The word deaf is usually reserved for severe to profound hearing loss in Both ears. Deaf children are more likely to require cochlear implants for successful speech and language development.
Medical Advice for Medical Problems
In the 21st Century, advisors of early hearing loss detection and intervention must come from the medical community, not from the education community. Thirty years ago, education in a signing environment was all that could be done for children with severe to profound hearing loss. In the last 20 years it has become possible to detect newborn hearing loss early. Although intervention with hearing aids or cochlear implants can be done while language centers are active, these medical treatments are not complete without education in settings that are specially designed to promote listening and spoken language development.
Progress has allowed medical decision making to take the lead role in guiding the futures of these children. In the past, early decisions surrounding childhood deafness required primary guidance from deaf educators. However, this is no longer the case. In the 21st century, parents of a child with hearing loss go to their doctor, who advises them whether or not it is possible for their child’s hearing loss to be treated in a way that listening and spoken language can be achieved. If so, then either hearing aids or cochlear implants are advised, and an education mode is recommended that will support listening, speech and the success of the child.
Your Doctor Will Tell You if You and Your Child Should Learn Sign Language
Approximately 10% of children with severe to profound hearing loss cannot be treated successfully. This means they may not be able to develop language listening skills and speech, even with the help of hearing aids, cochlear implants and listening and spoken language based education. The reasons vary. For some, hearing loss may have been detected too late, after critical periods for language acquisition have passed. Others have complicated health issues or cognitive impairments that prevent successful medical treatment of hearing loss. These children are recognized by the medical community and those families are advised, by doctors, of the wisdom of enrolling in a signed education program as early as possible.
Don’t make the mistake of deciding on your child’s educational setting before you have discussed the treatment possibilities and language goals with an Ear Nose and Throat doctor who is a specialist in the treatment of pediatric hearing loss. If your child has a medical problem like hearing loss, seek medical advice to determine the best course of treatment and then tailor your child’s education plan to maximize the results of that treatment and your child’s academic success.
Is it possible that the experts coming to my home and counseling me about what to do with my child are wrong?
Yes. Since the treatment of hearing loss has been undergoing a dramatic transformation in the last 25 years, (from treatment with education 30 years ago, to treatment with early detection and cochlear implants or hearing aids), not everyone is transitioning at the same rate and are up to date. This means you may hear different advice from different individuals, including state and other agencies in the educational system. However, the most current model of treatment of hearing loss is based on the effective use of medical treatments of hearing loss with hearing aids and cochlear implantation, followed by listening and spoken language education. These models of hearing loss work exceptionally well when hearing loss can be detected very early (in the first 2 years of life).
What is mainstreaming?
Mainstreaming refers to attendance a regular neighborhood school rather than a school for the Deaf. Your child’s ability to follow his hearing peers at their appropriate education level will determine if he is ready for mainstream placement. Most children with hearing loss using hearing aids go to mainstream schools. Most children with cochlear implants are able to thrive in mainstream classrooms by the 3rd grade. There is a big advantage to mainstreaming as Deaf children who use ASL (American Sign Language) typically graduate from Deaf schools with a fourth grade reading level. In a mainstream classroom your child will be more challenged and is more likely to have academic achievement comparable to their hearing classmates.
I was told my child was born Deaf and that I should not take that away from him. Is that true? My doctor says it is possible for him to learn to hear and speak like me.
You will sometimes hear arguments that your child with hearing loss has an “innate” deafness and that deafness should not be taken away from them. Any attempt to convince you that your child is different from you and belongs to another culture is misguided and wrong, especially in the medical age of hearing loss treatment.
This kind of argument was helpful 30 years ago to help parents accept the eventuality that their child with deafness would not be able to hear and speak and would do best in life joining a Deaf culture because medical science did not have anything better to offer at the time. These arguments are no longer true or helpful in the 21st century medical era. Hearing loss is a medical problem and can be treated.
Children with Severe to Profound Hearing Loss Are Not Born Culturally Deaf
A child with severe to profound hearing loss born to normal hearing parents will do better in the world when he/she can hear and speak like his parents. Most every hearing parent will choose to have their child hear and speak if it is medically possible. Fortunately, in the age of early hearing loss detection and intervention, this is possible 90% of the time with hearing aids or cochlear implants. When language learning is reinforced in a listening and spoken language preschool and a mainstream school environment, these children will graduate almost on par with their normal hearing peers.
Signed Deaf education used to be relied on for education of these children before advances in medicine occurred. Some proponents of Deaf education will continue to argue that they are still in charge of treating these children, but with signed education rather than medical intervention. This is an outmoded view point. Cultural groups, including educators representing the Deaf community, should not infringe on the civil rights of parents to access medical treatment for their own children. This influence often takes the form of an “Informed Choice” offered to a family in crisis. It is very stressful for a parent to discover that his newborn or young child is deaf. Suggesting to these vulnerable parents that their child has a cultural identity that is innate, that is rooted in deafness, and is different from that of the parent by any party is wrong. Cultural deaf issues are complex and there is no need to embroil the families of newborns with hearing loss in the cultural struggles of a Deaf community of which they are not a part.
Will sign language hurt my child if I eventually want him to hear and speak?
No. Sign language is a mode of language development that is a great alternative for any child and is essential for children who may never get access to listening and spoken language. Experience has shown that children who learn to sign early do well if their parents also learn to sign. Children who learn to listen and speak with the help of hearing aids and cochlear implants and special supportive education do slightly better if they sign very early as well. However, that slight advantage is irrelevant if they cannot practice listening and speaking in the classroom, which is the practice in most Deaf schools. This slight advantage may be because they have access to some form of language before their hearing aids or cochlear implants are placed.
The language learning differences from early signing may go down to very small or non detectable as age of detection and placement of hearing aids or cochlear implants goes down below 1 year because language learning in hearing children is so dramatically fast. Those few children whose parents sign fluently will also experience rapid language growth. If your household is a listening and speaking environment and you are simultaneously learning sign language, your child will not have the benefit of modeling fluent signing and cannot be expected to do as well as children who live in homes of culturally Deaf families where signing is the daily language. This makes sense: it is hard to teach your child a language you do not know yourself, and it is hard to learn a new language yourself in a short time.
Children who sign early, and who learn to listen and speak, typically stop signing early because they simply no longer need it. The reason most continue signing is their placement in a school for the Deaf. There appears to be no benefit to continue to sign if your child is developing speech and language at a level that allows for auditory communication and participation in regular classrooms. In fact, there may actually be more harm to your child’s auditory development if he is in a classroom where he is not permitted to speak or to listen because all of the instruction is only signed. This is an important point because in many states the emphasis on early signing is coupled with a tendency to place children with hearing aids and cochlear implants into signing schools.
In short: If hearing and speaking are the goal, early signing is a little bit good for them, and being placed in a signing school is quite harmful. Don’t make the mistake of getting trapped in a system that offers something that sounds very good early on and becomes something very harmful later.
If I do not want my infant with hearing loss to hear and speak, do I need to learn to sign or will he learn in school?
If listening and spoken language are not your goals because your family is culturally Deaf or if your doctors have determined that hearing will not be possible, then it will be essential for you to learn sign language as early as possible. Your child cannot wait to learn sign in school and neither can you. Your child will learn to sign better if you learn to sign. Children perform best in the language that is spoken and practiced in the household. By starting early, you will prepare your child with a better language foundation to start learning when they get to kindergarten age. Signing practice in specialized preschools and using the help of state agencies will be essential, not only for your child but for you and your partner as well.
What is an individualized education plan (IEP), and who is in charge of it?
An individualized education plan is a recommendation made by a panel of education experts that customizes the education adjustments that need to be made to address your child’s disabilities. If your child has hearing loss, their IEP may say that they need to sit in the front of the classroom, wear hearing aids at all times in the classroom, or be connected to an FM system so that the teachers’ voices go directly into the child’s ear during instruction. It may also recommend that they attend speech therapy to make sure that his word recognition and articulation are developing optimally. However, the panel rarely includes a doctor. This is a problem in the case of hearing loss because today, hearing loss is addressed medically. Although educational adjustments are still necessary, the type of education (listening or signed) depends on the goal of the medical treatment you have set with your ENT hearing doctor.
An IEP for a deaf child should take the following factors into consideration:
- Communication needs and the child’s and family’s preferred mode of communication
- Linguistic needs
- Severity of hearing loss and potential for maximizing auditory ability
- Academic level
- Social and emotional needs, including opportunities for peer-to-peer interaction and communication.
You are in charge of your child’s IEP. The IEP meeting can be intimidating: a room full of experts and you. Still, there is no legal obligation to follow the recommendations of the IEP committee. If, for example, you know that you want your child to develop listening and spoken language and the IEP team recommends your child attends a signing school for the deaf, you may refuse that recommendation. Your child has the legal right to attend the most normal school possible and to receive classroom accomodations to make that possible. If hearing loss is your child’s only problem and access to spoken language with hearing aids or cochlear implants is possible, then it is unacceptable for your child to attend a school for the Deaf. If you are having difficulty accepting the recommendation of the IEP team, then you do not have to make a final decision at the time the IEP meeting. You can tell the IEP panel that you will get back to them to accept or reject their recommendation at a later date. You can then discuss the recommendations of the IEP panel with your ENT doctor, who is a hearing specialist, and make an appropriate plan of action for your child.
Here is an example of how a recommendation may not make sense. If Children who use glasses, don’t go to Schools for the Blind, then why should children who use Hearing Aids or Cochlear Implants go to Schools for the Deaf? Most children with hearing loss can use hearing aids or cochlear implants and and attend regular schools. They do not need to go to a school for the Deaf.
What is Early Hearing Detection and Intervention (EHDI)?
The purpose of EHDI is to detect hearing loss early so that something can be done about it early, resulting in better speech, language and educational outcomes. EHDI programs are formal, publicly-supported programs which involve Pediatric Diagnostic Audiology (including OAE and ABR tests), Early Intervention, Family Support, Patient Data Management, and Program Evaluation. Funding for these programs began with the National Newborn and Infant Hearing Screening and Intervention Act of 1999. EHDI programs were established after the discovery of new early infant screening technology, which led to early detection and better outcomes of medical treatments. In some states existing EHDI programs are used to recruit children into Deaf schools without consultation of the medical team. This interferes with medical treatment and eventual educational outcomes, and is inappropriate in the medical era of hearing loss treatment.
What is American Sign Language(ASL)?
American sign language is a signed manual communication system used by the culturally Deaf and in most schools for deaf education in the United States. It has a different syntax and grammar than English.
What is Bilingual-Bicultural education?
Bilingual bicultural education is an education style used is some schools for the deaf in which all instruction is both signed and spoken. Theoretically, this system is better for children with cochlear implants and hearing aids because they can practice listening and speaking. Very few deaf schools have achieved this high educational standard because of resistance to change among the educators themselves.
What is the difference between deaf and Deaf?
While the word deaf refers to an inability to hear, the word Deaf(capitalized) refers to the Deaf community which sees their deafness as a difference rather than as a disability to be remediated. Members of the Deaf community communicate with sign language. Deaf culture is rich and is centered around Deaf schools where Deaf children are educated.
What is the Individuals with Disabilities Education Improvement Act (IDEA)?
The Individuals with Disabilities Education Improvement Act (IDEA) guarantees students with disabilities a free and appropriate public education and the right to be educated with their non-disabled peers in the Least Restrictive Educational Environment. The original legislation for IDEA was passed into law in 1975.
What is meant by the Least Restrictive Educational Environment?
To the maximum extent as appropriate, children with disabilities are to be educated with children who are not disabled. Special classes, separate schooling in a school for the Deaf, or other ways of removing children with disabilities from the regular educational environment should only occur when the nature or severity of the disability is such that education in regular classes cannot be achieved sufficiently with the use of supplementary aids and services. The education plan offered must also, by law, be both free and ambitious as regards the child’s educational goals.
What are Listening and Spoken Language Specialists?
Listening and Spoken Language Specialists (LSLSs) help children who are deaf or hard of hearing develop spoken language and literacy, primarily through listening. LSLSs focus on education, guidance, advocacy, family support and the rigorous application of techniques, strategies and procedures that promote optimal acquisition of spoken language through listening by newborns, infants, toddlers and children who are deaf or hard of hearing. If your communication goal for your child is Listening and Spoken Language, make sure to specify in your child’s IEP that a LSLS certified teacher will be helping them in the classroom.
What is Auditory-Verbal therapy?
This method of therapy emphasizes the exclusive use of hearing (auditory) skills through one-on-one teaching. It does not encourage speech reading. Children learning to hear are taught to distinguish sounds from one another by listening alone with exercises that eventually allow them to distinguish all 46 parts of the spoken English language. It excludes the use of any type of sign language, and emphasizes the importance of placing children in the regular classroom (mainstream education) as soon as possible to develop and practice auditory and verbal skills. This form of speech therapy is not performed by traditionally trained speech therapists and is, instead, administered by trained and licensed auditory/verbal therapists.
What is an itinerant teacher of the deaf?
An itinerant teacher is someone who travels from school to school to provide extra support for children who are deaf or hard of hearing. This includes assisting with assignments, pre- and post-teaching, and serving as a liaison between general education teachers and parents. The aid of an itinerant teacher is specified in a deaf child’s individual education plan(IEP).
What is an FM System or an Infrared System for the classroom?
An FM or infrared system is a wireless assistive listening device that transmits the teacher’s voice directly to the deaf or hard-of-hearing person’s personal hearing aids or cochlear implant. This reduces the problem of background noise interference and the problem of hearing at a distance from the teacher.
What is an Individual Family Service Plan (IFSP)?
An IFSP is a process of providing early intervention services for children ages birth to age 3 with special needs. Family-based needs are identified and a written plan is developed and reviewed periodically. According to IDEA, an IFSP should address:
- Assessment of the child’s strengths and needs, and identification of services to meet such needs.
- Assessment of family resources and priorities, and the identification of supports and services necessary to enhance the capacity of the family to meet the developmental needs of the infant or toddler with a disability.
- A written individualized family service plan developed by three members of a multidisciplinary team including the parent or guardian
What is an Independent Educational Evaluation (IEE)?
School districts are required by law to formally assess students who may be eligible for special education. If the parent disagrees with the results of the school district’s evaluation of their child, then they have the right to request an Independent Educational Evaluation. The district must provide the parent with information about how to obtain an IEE. An independent educational evaluation is an evaluation conducted by a qualified examiner who is not employed by the school district. Public expense means the school district pays for the full cost of the evaluation and that it is provided at no cost to the parent.