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

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.
Response from Elizabeth Jackson Machmer - NTID

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!

I have a question about personal FM system compared with soundfield. Our school district says that our daughter 3 years old is too young to give accurate feedback on if the Fm is working properly so they do not advice us to use it. Our daughter has severe hearing loss, uses hearing aids both ears, but tests low average on language skills as of now. No other concerns. We will be transitioning into the school system soon. They have a self contained class room with soundfield but we feel that a regular setting is least restrictive for her and want to find out which system to ask for in that setting.

Question from A.R., Florida. Posted March 16, 2012.

I am absolutely flummoxed at the school district’s position, and cannot think of one piece of evidence to support their recommendation.   The FM is an excellent solution in this case. The personal FM has a ‘boot’ which fits onto the individual’s personal hearing aids.  The teacher wears a microphone and transmitter, and the teacher’s voice is transmitted directly to the child’s hearing aid.  The statement that a three-year old is not able to tell if the FM is working correctly makes no sense, because the child is wearing a hearing aid and the child either has the skills to indicate the hearing aid is working correctly or not.  The same premise of operation will be at work with the FM system.  Infants can use FM systems, infants wear hearing aids, CIs and we all learn to read their behavior to assess whether the system works correctly and eventually the child becomes an accurate reporter. I  worked in a preschool classroom where all the 3-year olds used personal FM systems.  The FM system can and should be given a “listening check” each day.  The FM system will allow your child to be placed in a most appropriate environment.  It will cut down on background noise and give her a ‘direct link” to the teacher’s voice, where a sound field system will not.

There are several websites that can inform the district personnel how to do daily listening tests on the hearing aid and the FM system.

http://www.pepnet.org/faq/faq02.asp

http://www.asha.org/docs/html/GL2002-00010.html

http://www.phonak.com/

I am currently working with a 14 yo student who has had a single Cochlear Implant (CI) for a bit less than one year now.
The school district has brought in a Teacher of the Deaf who “Specializes” in working with children who have a CI. In reality the Teacher is from an “Oral Only” school for the Deaf and at a recent IEP meeting it was ‘recommended’ that the Interpreters be removed right away.

With over 15 years of experience interpreting for children, I know that this is the absolute worst thing the school could do. At minimum, the child needs a transition period. And it is entirely possible that the child will use interpreting services for the rest of their life. As the child grows up, that will be their decision. But for now, it is my belief that a Free and Appropriate Public Education (FAPE) should include accommodations that the child has had all along. I can not convince the School of this because “I” am not an “expert”, I am ‘just’ the interpreter.

Can you provide research or other documentation that the path being examined, removal of interpreting services, is a bad choice? Or, documented research of how people with CI continue to use Interpreting Services frequently and the benefits of this?

Question from D.G., Connecticut. Posted January 3, 2011.

You are caught in the middle of an all-too-familiar situation. Unfortunately for all concerned (and the student in particular) the evidence is not as clear as everyone assumes. That is, there are studies showing that children (much younger than this one) with cochlear implants benefit from greater exposure to spoken language compared to those in sign language settings, but there is no evidence that there is any particular amount of exposure that is necessary or sufficient. In contrast, the only study we are aware of in which students with cochlear implants (including those who receive them relatively late) were performing academically at a level equivalent to their hearing peers was one in which the students all had access to sign language interpreting in the classroom (see below).

With young children, there is evidence that neural pathways associated with hearing are still developing, and greater exposure to language through the cochlear implant is important. That is not going to be the case with a 14-year-old, however. As you point out, the student is in need of transition. In fact, there is abundant research indicating that sign language together with a cochlear implant either facilitates spoken language or is independent of it. There is no evidence of any harm. Those who argue for “total auditory immersion” with the implant typically rely on a “laziness” argument, suggesting that the child will not utilize hearing if they have the easier route of sign language. In theory, the two together should be beneficial, allowing the child to use sign language to fill in the gaps of the auditory input from the implant (which is significantly degraded from normal speech) – and vice versa.

Because of the diversity of students and educational settings, there is not going to be any research demonstrating that either removing interpreting services or keeping them in a situation like this is going to make a significant difference one way or another. However, given the lack of evidence for sign language creating any difficulties in the evidence indicating its benefits for students with implants, removal doesn’t seem like a very good idea. Perhaps most importantly, however, the student is 14 years old; his/her preference needs to be taken into account.

Suggested reading:

Spencer, L.J., Gantz, B.J. & Knutson, J.F. (2004).  Outcomes and achievement of students who grew up with access to cochlear implants.  Laryngoscope 114, 1576 –1581.

Spencer, P. E., Marschark, M., & Spencer, L.J. (2011). Cochlear implants: Advances, issues and implications. In M. Marschark & P. E. Spencer, Editors (in press). Oxford Handbook of Deaf Studies, Language, and Education, Volume 1, second edition. New York: Oxford University Press.

Can you help? I have requested an FM system for my 13-year-old deaf daughter, who uses spoken language. The school is offering an oral interpreter/transliterater. I’m afraid that that would make her overly dependent, whereas an FM system would make her use her hearing.

Question from A.B.. Posted September 7, 2010.

The first question is whether this child has sufficient hearing to benefit from an FM system. If so, you should be aware that most FM systems are “one-on-one” between the teacher and the student. Given the importance of classroom discussions for a student at this age, the FM system preferably would be a sound field system which would allow her access to everything going on in the classroom. Once again, the question is whether the child has sufficient hearing to benefit from a sound field system.

There is no evidence that a transliterater is going to make this child “dependent” or in any way have negative consequences. This kind of argument is similar to one often made by speech-language pathologists, who argue that if young deaf children are forced to use their hearing they will benefit, whereas if they rely on a transliterater or sign language interpreter, they will essentially become lazy, and not use their hearing (or speech). There there is absolutely no evidence to support this view. The myth of sign language interfering with spoken language is just that, a myth, propagated by peple unfamiliar with the research literature. Transliteraters (often called oral interpreters) can provide a child with access to ongoing instruction and discussion in the classroom with no fear of the child becoming too lazy to utilize speech and hearing.

Unfortunately for your purposes, there is no evidence to indicate whether a transliterater or FM system would be generally preferable, and such decisions have to be made based on the individual child (e.g., does she have any attention deficits that would prevent her watching a transliterater?).

All of that said, I would expect that an FM system is far less expensive than employing a qualified transliterater, even assuming you can find one. Unless you have a highly-qualified transliterater, it’s a very bad idea! All too often, school systems assume that almost anyone can do oral transliteration. Not so. Further, purchase of an FM system would mean that the equipment is in place for other students or this particular student, as she moves forward in school.

One more note: Frequent difficulties associated with the utilization of FM systems in the classroom include bad classroom acoustics, the teacher neglecting to ensure that the system is turned on, and failure to frequently test and maintain equipment. If all of these pitfalls are avoided, an FM system can be a wonderful tool.