A Parent’s First Decisions for a Hearing-Impaired Child

For many parents, the news that their child is hearing-impaired comes as quite a shock. But, with early intervention, it need not be a setback.

Many parents discover a child’s hearing loss early, but this condition can occur at any point and for a multitude of reasons. You may experience grief when you first learn the news, but it is crucial to begin determining educational options for your child right away.

First Steps

First and foremost, you need to decide if you want to obtain auditory amplification, such as hearing aids, cochlear implants, or a Bone Anchored Hearing Aid (known as a Baha system) — and if so, which option is suitable for your child. If your physician determines that amplification is possible, then the earlier you pursue it, the better.

Babies can wear aids as soon as their hearing loss is discovered, but before they will approve cochlear implants, most doctors (and insurance companies) require children to undergo a trial with hearing aids to confirm that the auditory loss can be addressed through such supports. Cochlear implants can also be controversial, with some critics maintaining that the quality of sound they enable is not necessarily excellent and that the choice to use them is made for young children before they are old enough to participate in the decision. For others, these devices are the most suitable option to address the type of loss their child has. And, indeed, many parents note that cochlear implants successfully enable their child to hear.

Toddlers can usually receive cochlear implants after they are 1 year old. By contrast, the Baha system is not FDA-approved for children under the age of 5, although very young children may be able to use an external version of the device secured with a soft strap until they are old enough to have it implanted. Both cochlear implants and an internal Baha system require surgery, but like hearing aids, they offer children the possibility of hearing.

The decision of which option to pursue will depend on the underlying cause of a child’s hearing loss, as well as considerations of cost and efficacy. For example, a child with a severe to severe profound loss is unlikely to have success with hearing aids, and a cochlear implant will be the only appropriate option if the family has opted for amplification. At the same time, the degree of coverage for all of these devices varies by state and health insurance provider, with some states mandating inclusion in benefit plans and others leaving the choice to individual insurance companies. Because early auditory experiences are vital for the development of language and speech, though, many experts recommend investigating these options as soon as your child is diagnosed with hearing loss.

You’ll next want to ask your pediatrician, audiologist, or ear-nose-and-throat doctor (ENT) about free or low-cost early intervention services, which babies and toddlers who have developmental delays or disabilities are entitled to through the federal Individuals with Disabilities Education Act (IDEA). It’s important not to postpone this research until your child reaches the age of 3 (or older), as some parents do. Families occasionally believe — mistakenly — that they don’t need to seek or cannot afford early therapies, and many simply wait until their child becomes eligible for special education services in school. But the early years are crucial for the development of language, and waiting until your child turns 3 means that she will miss a crucial window for linguistic growth.

Appropriate Education

While it may feel overwhelming, it’s equally important to enroll your child in an appropriate preschool as soon as she is old enough. You’ll first need to consider which form of communication for hearing-impaired individuals your family wants to choose, since this will, in part, affect your options. There are three primary forms: American Sign Language, cued speech, or listening and spoken language, all of which may be used singly or in combination.

  • American Sign Language (ASL) is a language that utilizes hand signs and facial expressions in the formation of letters, words, and grammatical structures.

  • Cued speech uses a combination of hand shapes, hand placements, and movements of the mouth to make visual representations of the auditory building blocks of spoken speech. These cued phonemes are, in turn, assembled to create “visible words.”

  • Listening and Spoken Language is a method of teaching a child spoken language by listening to sounds and learning to convert these into speech. This approach is taught through auditory-verbal therapy with trained specialists, as well as continuous family support, and typically accompanies the use of an amplification device.

Remember, as you explore these alternatives, that you need to make the choice that is best for your family — no decision is the wrong one. While one form of communication may work well for one family, it doesn’t mean it’s necessarily right for yours. An early intervention specialist can be a valuable resource for helping you decide which mode of communication is best-suited for your child’s and family’s circumstances. Moreover, these professionals are required to provide specific supports to hearing family members, such as ASL training for parents and other relatives, if requested.

Once you’ve settled on a form of communication, there are several educational options available, though some of these may not exist in all communities. Occasionally, families decide to relocate to enable their child to experience the type of educational environment they are seeking.

Preschools for Children With Special Needs

Again, IDEA entitles students with special needs, such as a hearing impairment, to begin preschool in their local public school system when they turn 3. When you meet with representatives from your district, these are several questions to pose:

  • Does the district offer the type of classroom setting you want for your child? Is there space for your child?

  • If you’ve chosen a complete sign language approach, will your child be in a class exclusively with signers or in a total communication classroom — that is, one in which all forms of communication including ASL, spoken language, lipreading, and so on, are present?

  • If you have opted for a listening-and-spoken-language approach, is this mode truly practiced, or is a hybrid of signing and speaking used?

  • What additional support services, such as a translator or a speech-language therapist, will your child receive?

  • If the school system does not offer the type of setting you are seeking, what other options are available, within a reasonable distance, that meet your needs? How will your local district accommodate the educational goals your family has?

  • As your child progresses, will there be opportunities to mainstream at the preschool level or in a higher grade?

Private Schools

Many private schools for hearing-impaired children — both oral schools for the deaf and sign language–based schools — offer preschool programs. Some may be uniquely preschools, while others extend through elementary school or beyond. These questions are helpful to ask directors:

  • If the school only extends through preschool, does it have a specialist to help you transition to the next school (whether this is public or private)? Where do children typically go next, and what types of classrooms are available in these schools?

-At the preschool level, what is the student-to-teacher ratio? If the school extends to K–12, what are the ratios in higher grades?

  • What is the maximum number of students in a class at different grade levels?

  • What is the cutoff age for students to be able to enroll in the school — that is, does it only enroll children up to a particular age or grade?

Public Schools

There are several possibilities for classrooms in a district setting, but one important educational requirement that public schools are required to meet is that your child must be in the least restrictive environment possible in order to maximize her learning. For example, she may participate in mainstream classes for all or a portion of the school day. Be sure to ask the principal about these issues:

  • Apart from the classroom teacher, will there be another professional like an interpreter, teacher of the deaf, or additional support person with your child?

  • What is the the student-to-teacher ratio at each grade level?

  • What is the maximum number of students in a class at different grade levels?

  • Which periods or classes will your child mainstream for?

If your child will be in a self-contained class for some or all of the day, here are questions to consider:

  • Will the class be taught by a teacher of the deaf?

  • Is it a total communication classroom, or are students divided based on mode of communication?

Homeschooling

Homeschooling is also an option for hearing-impaired students, and these are some factors to consider:

  • Does your child qualify for any services, like speech therapy, provided through the local school district?

  • Is there an appropriate curriculum for your child — that is, one that takes into account her hearing issues to provide suitable supports?

  • Will your child have opportunities to be around peers her age to model communication? For example, will a child who uses a listening and spoken language approach have the opportunity to be around peers her age who can model spoken language?

As a parent, you may feel apprehensive to learn that your child has a hearing impairment. But with an understanding of the different methods of communication and the importance of early interventions, you’ll quickly find that your child can have just as fulfilling an academic and social life as her hearing peers.

Noodle is home to a wealth of (free) resources about learning disabilities and differences. Find further advice from Laura Martin and other Noodle Experts, such as Jules Csillag's Speech Sound Disorders in Children: Essentials Parents Should Know.

Additional Resources for Parents