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.

Question from L.B., California

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:
http://www.asha.org/public/hearing/Unilateral-Hearing-Loss-in-Children/
http://successforkidswithhearingloss.com/resources-for-parents-of-children-with-hearing-loss/unilateral-hearing-loss