2.1 Characteristics of learners with hearing loss and impact of different degrees of hearing impairment on communication

Characteristics During childhood:

·        Delayed response to sound

·        Cannot hear clearly what others are saying

·        Show difficulty in locating the sound source

·        Pay more than usual attention to speakers’ facial expression and lip movement while listening

·        Give irrelevant answers or misinterpret instructions

·        Request for repetition during conversation

·        Show poorer ability to understand speech ` in a noisy environment

·        Tend to turn up the sound volume of television

·        Incorrect pronunciation

·        Delayed language development

·        Poor attention in class

·        Frequent use of gestures to express themselves, e.g. pointing to what they want

·        Easily irritated as a result of communication difficulty

Some of the common characteristics of deafness commonly found in classrooms include the following:

·        Difficulty following verbal directions

·        Difficulty with oral expression

·        Some difficulties with social/emotional or interpersonal skills

·        Will often have a degree of language delay

·        Often follows and rarely leads

·        Will usually exhibit some form of articulation difficulty

·        Can become easily frustrated if their needs are not met — which may lead to some behavioral difficulties

·        Sometimes the use of hearing aids leads to embarrassment and fear of rejection from peers

·        The child appears to have ‘strange’, ‘different’, ‘unclear’ speech

·        The child appears to have problem paying attention or concentrating in class.

·        The written matter of the child shows missing gaps in places of word endings like ed, ing, ly etc.

·        The child appears to be lonely, isolated, away from group activities.

·        The child brings one ear ahead while listening. (6) The child speaks too loudly or softly.

·        The child who keeps, radio, TV, tape recorder on high volume.

·        The child does not respond to a question asked from behind.

·        The child does not respond to a question asked from a distance.

·        The child does not respond to his name or a question asked from another room.

Motor Characteristics -

·        May have balance problems and these balance problems occur as a result of vestibular damage, not deafness.

·        May have a difficulty of motor speed (i.e., the time it takes the child to process information and complete a motor act).

·        The American Academy of Pediatrics notes that hearing-impaired children might appear dizzy or disoriented because the nerves in the ears also control balance

Impact of hearing loss

Functional impact: One of the main impacts of hearing loss is on the individual’s ability to communicate with others. Spoken language development is often delayed in children with unaddressed hearing loss.They often have increased rates of grade failure and greater need for education assistance.

Social and emotional impact: Exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation, and frustration, particularly among older people with hearing loss.

Economic impact: This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs.





Impact of different degrees of hearing impairment on communication








2.2 Language & communication issues attributable to hearing loss and need for early Intervention

Hearing loss can affect a child’s development of speech and language skills. When a child has difficulty hearing, the areas of the brain used for communication may not develop appropriately. This makes understanding and talking very difficult.

Communication: Communication is about sharing ideas, facts, thoughts, and other important information. Language can be used to share this information either by speaking or signing.

Language: Languages are used to help people communicate. Languages are made up of words and rules (grammar) that tell how these words are used. Words can be spoken, signed or written and thus languages can be spoken, signed or written. Spoken languages are made up of spoken words and grammar that are unique to each spoken language. Examples of spoken languages include English, Spanish and French. Signed languages are made up of signed words and grammar that are unique to each language. Examples of signed languages include American Sign Language, British Sign Language and Italian Sign Language.

Children with hearing loss may have difficulty with:

When hearing loss is identified early and managed appropriately, the child can become an effective communicator. This process involves caregivers and professionals working together.

Individualized Family Service Plan (IFSP): The IFSP outlines all of the early intervention programs and services your family and child will need. The IFSP also outlines how you will receive the services, as well as any equipment and devices you will get. The IFSP should be family focused. The strengths and needs of your child and your concerns and priorities are very important when making this plan. Each child has his or her own plan, so no two plans will be the same. It is very important that your family work closely with the service coordinator and other professionals. The goal is to learn about your child and the interventions available to you in order to get the most out of the IFSP process.

Early intervention is concerned with all of the basic skills that young children typically develop during the first 3 years of life. EI services include the family and will

Communication and language are important in the interaction between parent and child. The development of language and other skills begins with communication. This early groundwork of language then helps the child learn reading and writing in school, as well as social skills. The gift of language will open doors for you and your child and will help your child build communication skills that will last a lifetime.

2.3 Communication options, preferences & facilitators of individuals with hearing loss

Listening and Spoken Language
This approach to language development requires that infants and young children with hearing loss are taught to listen and talk with the support hearing technology, such as hearing aids or cochlear implants. Parents and caregivers are supported in their role as the child’s most important teacher of language, and the goal is for the child to attend mainstream schools. Read more about Listening and Spoken Language.

Cued Speech/Language
Cued Speech is a visual communication system that can be used to demonstrate phonetic information for children who may not be able to learn entirely though amplified hearing. Designed to enhance lipreading ability, Cued Speech combines the natural mouth movements of speech with eight hand shapes (cues) that represent different sounds of speech. For example, the hand shapes help the child distinguish sounds that look the same on the lips-such as "p" and "b". In addition to the eight hand shapes, there are four positions around the mouth, each of which represents several vowel sounds. Some children who use Cued Speech also enroll in programs that emphasize listening and spoken language development.

American Sign Language/Bilingual-Bicultural
American Sign Language is a manual communication language taught as a child's primary language, with English taught as a second language. American Sign Language uses hand symbols and gestures combined with facial expressions to communicate language. American Sign Language is recognized as a true language in its own right and does not follow the grammatical structure of English. This method is used extensively within the Deaf community, a group that views itself as having a separate culture and identity from mainstream hearing society.

Total Communication Method
Total Communication uses a combination of methods to teach a child, including a form of sign language, finger spelling, speech reading, speaking and amplification. The sign systems used in Total Communication are typically based in English word order and follow English grammatical structure, and do not represent a separate language as with American Sign Language, but an artificially constructed sign system following English grammatical structure.

2.4 Issues & measures in literacy development and scholastic achievement of students with hearing loss

Learning difficulties-

·        Inappropriate use of grammar when talking or writing Teacher, Why no class? Have sun.

·        Has problems understanding rules and patterns for sentence formation

·        Grammar follows different syntax and order.

·        Has difficulty breaking words into sounds and syllable

·        Poor spelling skills

·        Has problems understanding rules and patterns for word formation

·        Word substitutions may occur frequently in reading and writing

Vocabulary Deficits

·        May see a word but not be able to understand its meaning

·        Vocabulary develops more slowly in children who have hearing loss.

·        The gap between the vocabulary of children with normal hearing and those with hearing loss widens with age.

·        Improper use of words and their meanings

·        Difficulties with figurative language (such as alliteration, similes, metaphors, personification, and idioms)

·        Difficulty understanding abstract concepts

·        Has difficulty with concepts of time, space, quantity, size, and measurement

·        Word knowledge may be below expectancy

·        Asks questions and/or responds inappropriately

Difficulties in classroom participation

·        Is slow to respond during verbal interaction or following verbal cues

·        May isolate themselves from social situations

·        Hesitates or refuses to participate in activities where speaking is required.

·        Is inattentive and has difficulty with concentration

·        May not initiate or maintain eye contact

·        May become easily frustrated

Interventions and teaching strategies

·        Make sure you are aware of the learners’ language abilities and preferred learning style to ensure inclusion into the group.

·        When you have a student with HI in the group, reduce background noise or, request for a classroom that is away from noise. Make sure you have the whole group’s attention before starting the session.

·        Allow HI students to sit where they wish. HI students who can lip read should sit near the front. (Optimum distance for lip-reading is considered to be about 6 feet.)

·        Face the HI student when speaking.

·        Use clear speech.

·        Make sure the room is well lit to allow the student with HI to see your facial expression, signing and/or lip read

Suggestions for Inclusion of a HI Child-

·        Get to understand the nature of your HI student’s hearing loss and how you can include the student with the rest of your class.

·        Focus on development of language, communication and concepts in students with HI.

·        If possible, seek assistance from locally based experts, educators, family members, special educators, speech and hearing specialists, to enhance teaching in the inclusive classroom.

·        Use assistive device where available, to facilitate teaching-learning in the classroom

2.5 Restoring techniques using human (interpreter) & technological support (hearing devices)

Assistive listening devices (ALDs) help amplify the sounds you want to hear, especially where there’s a lot of background noise. ALDs can be used with a hearing aid or cochlear implant to help a wearer hear certain sounds better.


Hearing aid

A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations. However, only about one out of five people who would benefit from a hearing aid actually uses one.

A hearing aid has three basic parts: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker.

Different styles of hearing aids

Behind-the-ear (BTE)-  hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic earmold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the earmold and into the ear. BTE aids are used by people of all ages for mild to profound hearing loss.

In-the-ear (ITE) hearing aids fit completely inside the outer ear and are used for mild to severe hearing loss. The case holding the electronic components is made of hard plastic. Some ITE aids may have certain added features installed, such as a telecoil. A telecoil is a small magnetic coil that allows users to receive sound through the circuitry of the hearing aid, rather than through its microphone. This makes it easier to hear conversations over the telephone. A telecoil also helps people hear in public facilities that have installed special sound systems, called induction loop systems.

Canal aids fit into the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is made to fit the size and shape of a person’s ear canal. A completely-in-canal (CIC) hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing

Analogue hearing aids are the cheaper of the two, and are able to increase all sounds. However, this can be a drawback as it can increase background sounds you do not want to hear.

Digital hearing aids are highly thought of but more expensive. They are able to boost the sounds of speech, while reducing other unwanted sounds. The sound quality is similar to that of a CD, and with the use of a computer doctors are able to programme hearing aids to individual patient condition.

Interpreter for the hearing impaired

A Deaf Interpreter is a specialist who provides interpreting, translation, and transliteration services in American Sign Language and other visual and tactual communication forms used by individuals who are Deaf, hard-of-hearing, and Deaf-Blind. As a Deaf person, the Deaf Interpreter starts with a distinct set of formative linguistic, cultural, and life experiences that enables nuanced comprehension and interaction in a wide range of visual language and communication forms influenced by region, culture, age, literacy, education, class, and physical, cognitive, and mental health. These experiences coupled with professional training give the Deaf interpreter the ability to effect successful communication across all types of interpreted interactions, both routine and high risk. 

Currently, Deaf Interpreters work most often in tandem with hearing interpreters. The Deaf-Hearing interpreter team ensures that the spoken language message reaches the Deaf consumer in a language or communication form that he or she can understand, and that the Deaf consumer’s message is conveyed successfully in the spoken language.

American Sign Language (ASL): This is the primary language of people who are deaf. It consists of a combination of hand movements and positions to express thoughts and phrases.

·        Finger spelling: This is a manual form of communication in which the hand and fingers spell out letters of the alphabet to form words.

·        Lipreading: This is a difficult skill used only by about 10% of people with hearing impairments. Therefore, don't assume that a deaf person to whom you are speaking can lip read. Even if a person cannot lip read, however, being allowed to see the speaker's mouth provides helpful visual cues.

·        Written communication ("Pad and Pencil"): This is a fairly simple way to communicate with a person who is deaf. Remember, however, that sign language is the primary language for most persons who are deaf; English is a second language, so keep your words simple.