Raising and Educating a Deaf Child

International experts answer your questions about the choices, controversies, and decisions faced by the parents and educators of deaf and hard-of-hearing children.

Educational Technologies

We adopted our daughter when she was seven… no one had ever noticed that she was 95% deaf in her right ear. Now, as a beautiful 14-year-old we have noticed that while she is comfortable in public in our company, she gets overwhelmed in public. While shopping, she needs to stay very close to us, because I think, she doesn’t know how to filter out the sounds that are relevant to her situation. Consequentially, she is reluctant to attend events, activities, or shopping with kids her own age. This fall, she will be attending our local high school with 3,500 other students. Are there some exercises that we can practice to help her prepare for this? We live in a rural area with little or no programs available. She also has some other learning issues.

Question from L.B., California. Posted April 10, 2015.
Response from Elizabeth Jackson Machmer - NTID

Your observations of your daughter are astute, and kudos for being her advocate. Single-sided deafness (one normally hearing ear and one ear with significant or total loss of hearing) results primarily in difficulty localizing sounds and hearing in noise, skills that rely heavily on two ears. Public places are typically very noisy and have poor acoustics; therefore the shopping mall, the gym, and the birthday party all may present challenges for your daughter to understand what people are saying.

Though many children with single-sided deafness develop speech and language on track, we know that they are at increased risk for academic challenges, and many, like your daughter, experience frustration and negative social consequences. Speaking openly to your daughter about her hearing loss and encouraging her to advocate for herself will be of great value to her. There are also actions you can take to ensure she receives the best medical management and social and educational outcomes. The first step is obtaining an evaluation by an otolaryngologist (Ear, Nose, and Throat doctor) and a hearing assessment from a pediatric audiologist. It’s important to receive a diagnosis and explore potential causes of the hearing loss to determine if there are any associated conditions or risk for further hearing loss. There may be medical treatment for certain kinds of hearing loss. There are also several types of hearing technology that may be recommended for children with single-sided deafness, such as a bone-anchored hearing aid (BAHA), which is surgically placed in the bone behind the ear, or a contralateral routing of signal (CROS) hearing aid in which a microphone picks up sounds from the side of the deaf ear and sends them to hearing ear.

The next step is requesting an evaluation for special education services from the school system through an Individualized Education Program (IEP). That should include not only assessments of hearing but also the impact of the hearing loss on academics and social and emotional function. This is especially important if your daughter is exhibiting learning difficulties. Whether or not she is determined to qualify for special education services, the school is required by the Individuals with Disabilities Act to provide equal access to communication for your daughter, both in the classroom and at all school events. In cases of single-sided deafness this could mean, among other things, preferential seating, captioned media, and/or the use of an FM system where the teacher or speaker uses a microphone that transmits sounds directly to an ear piece worn by the student. It is critical that your daughter’s teachers be aware of and monitor her performance in class. Request contact with the school district’s educational audiologist, who will be your daughter’s ally.

Last, but not least, your daughter may benefit from counseling. Depending on her needs, she may be better served by either an aural rehabilitationist (speech-language therapist or audiologist) or a clinical psychologist or social worker, or both. Aural rehabilitation therapy focuses on developing listening skills, communication strategies, navigating hearing assistive technology, and self-advocacy, whereas counseling focuses more on social/emotional concerns.

For more information two great links are:

I am a teacher of a ten year old boy with bilateral BAHAS. In addition to an FM system used in a mainstream classroom, I want to add speech to text where the speaker’s words in real time are transcribed to text on a monitor for the student using a computer or iPad. This student reads and this additional visual reinforcement can serve as amplified feedback. The student could also edit the text to created notes. What technology exists to make this happen? I am thinking a cordless microphone for the speaker, Dragon NaturallySpeaking, and then either a computer or iPad. I also want a word prediction program, but it would be great if this was software or an app that integrated word processing with the voice to text and word prediction all in one platform. Any ideas or suggestions as to best technology to make this a reality?

Question from K.O., Michigan. Posted March 17, 2015.

Speech recognition has been advanced as an accommodation option for deaf or hard-of-hearing (DHH) students. With speech recognition, spoken words or phrases are automatically converted into text. Today’s speech recognition software handles continuous speech and allows the speaker to speak naturally at a conversational pace. These features have generated interest in the use of speech recognition by schools to meet the accommodation needs of their DHH students. However, a steno-based (CART) or typing-based (e.g. C-Print) speech-to-text service is a more practical and effective support option than automatic speech recognition because the speech-to-text service produces a more accurate display of information and it formats the information in a more comprehensible manner. Although speech recognition can function effectively in a variety of situations, such as when a person dictates a memo, it functions with limited effectiveness in supporting a DHH student in a class with hearing students. In this situation, highly accurate text must be produced instantly in real-time in order for students to understand the class material.

If speech recognition is to be used as a support for deaf students in a classroom, a teacher may wear a microphone and dictate directly into the speech recognition software but there is limited accuracy, typically 85%. This level of accuracy means that, on average, more than one out of every 10 words is not correct. The limited accuracy of this use of speech recognition means that, for the text produced with speech recognition, students must devote constant effort to (a) figuring out which words are incorrect, and (b) generating the correct replacements for these incorrect words. This effort is attention that the student should be devoting to the learning of class content. One reason for limited accuracy is that, for speech recognition to correctly translate a word, the word must be in the speech recognition software’s dictionary. Thus, before each class the teacher must ensure that all words, including technical words, are in the dictionary and that the software is able to recognize the teacher’s pronunciation of the words.

Demonstrations by a company promoting a product may show higher accuracy, but efforts to apply speech recognition to regular use in the classroom have not yet been very successful.

I am a Teacher of the Deaf in a mainstream setting. I have a teenage student with a cochlear implant. She struggles with feelings of isolation and had a very bad experience at a school for the Deaf a few years ago. She desperately wants to have a friend that actually knows what she is going through but is unwilling to attend any Deaf teen events in the community due to the experience she had at the school for the Deaf. I believed she was bullied pretty severely for having a CI. I would love to help her find a friend that might be going through the same situation so she could videochat or even email. I am having difficulty finding other mainstreamed teens out in the world to with CIs to connect her with and wondered if you had any suggestions.

Question from E.B., New York. Posted February 16, 2015.

Some people at NTID have tried to get funding for a “video buddies” project that would allow students like yours to connect. Students who use different communication modalities, are different ages, have different interests could find friends around the country for video or text chats. Unfortunately, they have not yet found a foundation or organization willing to support the project. In the meantime, here are some possibilities:

Online forums
Hear US Teens https://www.facebook.com/hearusteenspage

There are several active cochlear implant groups on Facebook both brand-specific and general). A few are listed here:
Advanced Bionics www.hearingjourney.com
Connect to Mentor site http://apps.advancedbionics.com/CTM/US
Medel’s Patient Support Group implants@medelus.com
Cochlear Americas: http://www.cochlearcommunity.com/

A new series of captioned interviews with cochlear implant users has been posted on YouTube by an RIT student. The student hopes to educate others about cochlear implant technology and the experience of the users. he first two videos are intended to be educational and humorous.
CI Interview: Braden https://www.youtube.com/watch?v=7CFBOay2tyY
Cochlear Implant: Funny struggles https://www.youtube.com/watch?v=DujSeNPHB48

Leadership Opportunities For Teens http://www.listeningandspokenlanguage.org/LOFT/
Listening and Spoken Language Symposium http://listeningandspokenlanguage.org/
Biennial Northeast Cochlear Implant Conference http://listeningandspokenlanguage.org/

Empowering teens is also addressed with self-advocacy strategies. The document, Self-advocacy for Deaf and Hard of Hearing Students is posted at http://www.handsandvoices.org/needs/advocacy.htm.

My daughter is thirteen and deaf and recently got a cochlear implant. How does she qualify for a free iPad? She attends a school for the deaf and needs the iPad to communicate at school through FaceTime. Please help. I can also provide doctor documentation if you need it upon request

Question from D.K., Delaware. Posted November 24, 2014.

Well, we haven’t heard of free gifts coming with cochlear implants, but a quick google search returns this: http://www.wonderbaby.org/articles/ipad-funding-special-needshttp://www.wonderbaby.org/articles/ipad-funding-special-needs

If the iPad is desired for personal communication with friends and family, I do not think this is something that either insurance or the school system would pay for. You probably qualify for a free videophone based on your daughter’s deafness and use of ASL. Applications can be found here.

There many alternatives to Facetime that can be used on computers (Mac or PC), other tablets, or smartphones, including Skype and Google Hangouts. If your daughter has access to a computer or smartphone with a video camera, then there is no need for the iPad specifically as alternative video chat software can be used.

If there is a specific therapeutic reason for having the iPad, such as a communication training app or other educationally based app, it may be possible to request that the school system purchase it for her. First, the IEP would have to be changed to indicate the specific need for it. The iPad would be school property in this case but it may sometimes to be possible for the student to use it outside of the classroom, situationally-dependent.

Lastly, some low-communication individuals do use alternative and augmentative communication devices like a DynaVox, but these are costly devices. There are some alternative apps that may be useful for these individuals, and in these cases it may be possible that health insurance might approve the iPad as medically-necessary. It doesn’t sound to me like that’s the circumstance here.

Our district audiologist wants to put all DHH students on personal FM and remove the class soundfields altogether. I find conflicting research on this. The DHH teachers don’t want to get rid of the class soundfield systems. Can you please confirm either the benefits or detriment of keeping the soundfield in place in addition to personal FMs?

Question from E.W., California. Posted June 12, 2014.

By class soundfield system, I assume you mean a room equipped with two or more speakers that broadcast the desired signal into the desired space.  The problem with these systems is that everyone in the room is exposed to the signal and, depending upon where the deaf or hard-of-hearing student is sitting, there could loss of signal strength over distance.  Personal FM systems have the advantage of being set up specifically for the user, whether the individual is using a hearing aid (s), a cochlear implant, or both.  The signal is clear, coming directly from the teacher to the student.  The signal does not lose strength over classroom distance, and the teacher can use one microphone to connect to several students at the same time.  Also, there is no “carry over” into adjoining classes as there might be with a sound field system (depending upon the decibel level of the signal).  In my opinion, the FM is superior though more expensive. Two additional notes:  (1) Students with milder hearing losses may do best with soundfield system while those with severe to profound losses are likely to do better with FM. (2) It is unclear why a person would remove an existing soundfield system unless maintenance is an issue.

I work in schools in Madrid Spain. We are debating the usefulness of Cued Speech for reading in deaf children with CIs. What are the latest results on this and how generalizable to Spanish children are these results?

Question from M.P., Spain. Posted February 5, 2014.

There are reasons to believe that Cued Speech may help deaf children with cochlear implants to learn to read and write. Cochlear implants provide auditory information that may be not precise enough to develop accurate phonological representations. Consequently, the reading and spelling skills of children with implants may be delayed compared to the acquisition of these skills by hearing children (with the same instruction). Those children who receive Cued Speech combined with the audio-visual input may develop more precise phonological representations, and better phonemic awareness which is an important skill for learning to read.

There are at least two empirical studies showing better reading, spelling, and reading related skills in deaf children with cochlear implants exposed to Cued Speech compared to deaf children with implants and not exposed to Cued Speech:

Leybaert, J., Bravard, S., Sudre, S., & Cochard, N. (2009). La adquisicion de la lectura y la orthographia en ninos sordos con implante coclear : Efectos de la Palabra Complementada. In : M. Carillo & A.B. Dominguez (Eds). Dislexia Y Sordera. Lineas actuales en el estudio de la lengua escrita y sus dificultades  (pp. 201-219). Malaga: Aljibe.

Bouton, S., Bertoncini, J., Serniclaes, W. & Colé, P. (2011) Reading and reading-related skills in children using cochlear implants: Prospects for the influence of cued speech. Journal of Deaf Studies and Deaf Education, 16, 458-473. 

I have a 5 year old son with mild to moderate, sensorineural bilateral hearing loss. He is currently in private school and his teacher identified him as needing an FM system. Who is responsible for providing/paying for the system – the public school, private school or parents? He does not have an IEP, only a 504 plan with the private school. Thanks for any guidance or information.

Question from M.R., New York. Posted January 16, 2014.

Given the fact that your five year old son does not have an IEP, the public school does not have any responsibility to provide equipment. A 504 plan includes  accommodations to the academic program. You may consider referring your son to the home district for an evaluation. If it is determined that his hearing loss is effecting his progress through the academic program, he would receive an IEP, and the school would be responsible for providing such equipment.

A word of caution, however: If the loss is minor and he is doing well in school it is unlikely he will be found to be eligible. As his teacher was the one who recommended an FM system, I would suggest you meet with the private school and investigate how they can provide it. I would also suggest if that fails if the home district could be approached about offering a loaner.

I am working with a preschool student who has bilateral cochlear Implants. His audiologist is recommending an FM system for him. What is the appropriate funding source? The County or the school district? Neither party accepted responsibility for this at the CPSE meeting. Can you refer me to some documentation of the regulations for this funding?

Question from M.W., New York. Posted April 26, 2013.

For this, you will want to contact the New York State Regional Associate for Preschool Education: http://www.p12.nysed.gov/specialed/quality/regassoc.htm. You are probably best off contacting the Western Regional Office directly by telephone:

NYS Education Department
P-12: Office of Special Education Special Education Quality Assurance (SEQA)
2A Richmond Avenue
Batavia NY 14020
Telephone: (585) 344-2002 — Fax: (585) 344-2422

If you have any difficulties, the Upstate Coordiantor is Christopher Suriano, (315) 476-5645.

My son is 11yrs old and is entering 4th grade he attends a private school that doesn’t offer any services. He was left back in kindergarten and third grade. He has moderate to severe hearing loss in both ears. He has a hearing advocate that supplies him with an fm system. However this year I was told he would have to sit in the back of the classroom because the fm system might distract the other children. I’m trying to explain to them that he needs to read the teachers lips. Is there anything I can do to help him or them to understand his hearing loss?

Question from G.B., New York. Posted August 24, 2012.

First, let’s consider the most usual situation, in which your child is in a public school. Then, it is a matter that has to be taken up in an IEP meeting, to which you have a legal right. In developing a child’s IEP (Individualized Education Program) under the Individuals with Disabilities Education Act (IDEA), the IEP team must consider a child’s individual needs. Children with significant hearing losses, whether or not they utilize FM or similar assistive technologies, will benefit from being able to see the mouth of the teacher. (Hearing people as well as deaf people use “lipreading” in understanding spoken language.) This means, for example, not only sitting at or near the front of the classroom, but also ensuring that the teacher understands the needs of the child. As we have described in response to earlier questions on this site, IDEA guarantees a child with special needs a free and appropriate public education (FAPE) in the least restrictive environment. That means a public school is required to meet a child’s audiological, academic, and other needs as outlined in the IEP. If your son a public school, you could have a pediatric audiologist or speech-language therapist involved in the IEP meeting, as well as perhaps a school psychologist experienced in working with deaf children. If public schools are not open to this is part of their legal responsibility a parent can seek assistance from the state through a Due Process Complaint (in the State of New York http://www.p12.nysed.gov/specialed/publications/) or obtain legal advice.

Children who are placed in private schools by their parents receive a Services Plan, not an IEP.  Local Education Authorities (LEAs) must spend a certain amount of money to address the needs of such children. LEAs must consult with the private schools and the parents to determine what services it will provide. That’s what goes into the services plan. is no requirement for FAPE in this situation.  If the private school does not feel the consultation was sufficient it may file a complaint, but there is no right of due process for these students. (Of course, if the student is placed in the private school by the LEA, the school must follow IDEA.)

To give things an interesting twist, the Americans with Disabilities Act does apply in the case of private schools.  So, for example, if the parent wanted an FM system for their child the school would have to provide it unless it could show it was an undue burden.  The school would be required to provide effective communication under the ADA regardless of whether the child has an IEP.

A two-fold question:
1. Is there a quality note taking device on the market for use in a classroom setting?
2. What is your take on note taking (note taker) and /or note taking technology (if even developed) for a freshman boy going into highschool with a moderate to moderately severe hearing loss. He wears hearing aids and currently has an FM and classroom amplification in his middle school classrooms.

Question from M.D., New York. Posted April 25, 2012.

With regard to the first part of your question, Microsoft Onenote may be used with a tablet PC, networked or not networked with a second computer so that the deaf student may view the notes as they are taken during class (assuming there are the two networked computers.) C-Print research conducted at NTID (http://www.ntid.rit.edu/cprint/) has a notetaking prototype that is part of the C-Print Pro tablet version that the local BOCES and Rochester City Schools prefer to OneNote, but it is not yet on the market.

On the second part of your question, I would strongly urge you to request a notetaker for your son. And that should be a qualified, paid notetaker, not another student taking notes for him. If the school system resists, this is worth fighting for!