We have created this page as a reference for Vermont’s educators working with Deaf or hard of hearing students.
Note: this page is not intended to substitute consultation services
Please let us know if there is additional information you would like to see on this page.
Contact Jen Bostwick with your ideas.
What services do Consultants for Deaf and Hard of Hearing Students provide?
DHH Consultants provide a wide range of services to the child’s educational team, including:
- Informing teams about what the child will need to be a successful learner
- Working directly with the child on development of language and communication skills, if these direct services are not provided by school staff
- Observing classrooms and recommending accommodations necessary for the child to best access their learning
- Helping with fitting and troubleshooting equipment, such as FM and DM systems, hearing aids, cochlear implants, and BAHA
- Serving as a liaison between the child’s audiologist and the school
- Assisting with interpreting audiological testing information
- Discussing hearing loss and its impact with the student and their educational team (advocacy skills)
- Assisting school in hiring appropriate staff to work with DHH students
Why do I have to check the student's equipment? (They can tell me when it isn't working.)
- Not only is it a requirement under the IDEA that the school ensure the student’s hearing equipment is working properly, but a child learning language needs them to be working properly to have the best chance of learning at an adequate rate.
- Hearing aids and cochlear implants can malfunction for a variety of reasons including daily wear and tear. The child may not notice or inform you if there is a problem.
- Checking the equipment on a regular basis reduces the time the child may be using malfunctioning equipment.
What is the best protocol to follow to check a student's equipment?
- We recommend performing daily checks of hearing aids and FM/DM systems.
- It is important for an adult with normal hearing to listen to a student’s amplification to ensure that it is functioning adequately.
- The student may check the battery but should not do the listening check as he/she should not be responsible for detecting problems with the equipment.
- Simply asking the student if he/she can hear while he/she is wearing the hearing aids is not sufficient to check the functioning of the equipment.
Download and follow our Step-by-Step Guide to Hearing Aid Daily Check.
After checking the student’s hearing aid, you can next check the FM/DM System.
Download and follow our Step-by-Step Guide to FM/DM System Daily Check.
What is the difference between FM and DM systems?
- These are 2 different ways that sounds can be transmitted over a distance. FM stands for frequency modulation and DM means digital modulation. FM utilizes radio waves and DM utilizes a digital signal (2.4GHz).
- FM systems have specific channels assigned to students. It can be problematic or challenging when there are several students within one school setting.
- DM is an all or nothing signal. The signal is shown to have better sound quality than FM.
Why does the student need services from a specialized SLP?
- Speech language pathologists, while very highly trained, do not systematically participate in coursework about working with children with severe to profound hearing loss, the auditory hierarchy or auditory habilitation. Specialized training could include coursework, on-going mentoring or supervision, and practicum experience.
- Consultants for children who are Deaf and Hard of Hearing come from the fields of Deaf education, audiology, and speech-language pathology and are specially trained for educational settings for ages 3 through high school graduation. This includes assessing, planning, implementing and evaluating educational outcomes, effectiveness of accommodations, and hearing assistive technology. (These roles apply to the developmental, communicative, linguistic and academic domains.)
- A related resource can be found at: http://www.asha.org/policy/GL2004-00202/#sec1.1
How can I purchase "chair slippers" for my classroom?
- If it has been recommended that you utilize “chair slippers” to reduce classroom noise, there are several online vendors.
- Here are a couple of options:
Can I use alcohol wipes to clean a hearing aid?
- This is not recommended. Alcohol, solvents, or cleaning products can damage your hearing aid.
- It is best to gently clean your hearing aid with a soft, dry towel.
- Audio-wipes or other gentle cleaning wipes approved by an audiologist may also be used.
What are the best headphones to use for students with hearing aids or cochlear implants?
- Whenever possible, use a direct audio cable instead of headphones for the best sound quality. (https://www.amazon.com/Direct-Audio-Binaural-Hearing-Instrument/dp/B00IBLPX8E)
- If this is not possible, here are some good resources that have information about headphones…
How long do hearing aid batteries last?
- Hearing aid batteries will last between 1 – 2 weeks depending on the child’s hearing loss and if an FM/DM receiver is being used.
- Use of an FM/DM receiver will drain a hearing aid battery more quickly.
How/where can I recycle hearing aid batteries?
- Zinc air batteries are considered non-hazardous waste and can be disposed of in the regular waste, but it is recommended to bring them to a collection site for recycling.
- Audiology offices, pharmacies, and hearing aid dispensers are common collection sites.
What is the best way to replace a hearing aid battery?
- First, remove the sticker from the battery and let it sit.
- A fresh battery needs a full minute to “air up” (sit with the sticker taken off) so that it can reach a voltage level that is optimal for battery performance in the device.
There are a variety of professionals serving Vermont’s schools by working with students who are deaf or hard of hearing.
Nine East Network employs DHH Consultants to primarily consult with teams and schools, and we have some specialized staff who provide direct services as well.
Our DHH Consultants are licensed as either Teachers of the Deaf, Speech Language Pathologists, or Educational Audiologists.
A Teacher of the Deaf is someone with specialized training, usually a master’s degree, that focuses on the learning needs of deaf and hard of hearing children. TOD’s may have expertise in auditory habilitation or bilingual education to serve this population.
SLP’s are highly trained individuals who evaluate and treat people with disorders in speech or language. They are qualified to case manage and provide traditional speech and language services.
Some SLP’s receive specialized and extensive training about working with children with hearing loss – especially severe to profound loss. They are able to provide direct services around a child’s language acquisition, articulation, as well as the auditory hierarchy and habilitation.
Educational audiology is a sub-field of audiology that is responsible for managing audiological issues for children in schools. The educational audiologist’s primary purpose for being involved in students with hearing loss is to facilitate the maximum use of auditory input during the learning process. They can be involved with choosing and fitting equipment as well as looking at classroom acoustics.
Nine East Network also provides direct services to schools in Vermont with Educational Interpreters, Communication Facilitators, Deaf Mentors, and Sign Instructors.
An educational interpreter is someone who is able to clearly and effectively communicate classroom information between the student, teachers, and peers.
A communication facilitator is someone who works with children who may not have the skills needed to work with an educational interpreter or may not need full time interpretation. They are available throughout the child’s day to ensure that communication between the student and their teachers and peers, is fluid. Communication facilitators are fluent in the child’s mode or language of choice, such as ASL or contact sign.
A deaf mentor’s primary job is to provide linguistic and cultural support to the families of the child outside of the school environment. The deaf mentor is also a language model and provides resources and activities related to hearing loss.
A sign instructor’s primary job is to teach American Sign Language, or an English-based sign system to individuals who do not know ASL, as well as other linguistic and cultural aspects of ASL. An ASL instructor will teach signs through ASL-based grammar and structure. An English-based instructor will teach signs in English-based grammar and structure.
Deaf and hard of hearing children have many communication options available to help them learn and thrive using language. In general, students use Signed Communication, or Listening and Spoken Language, or they follow the Total Communication Philosophy. These are described in more detail below.
Signed Communication Options
Also referred to as Manual Communication, Signed Communication uses visual and gestural communication, and can be used alone or accompanied by speech. With signing, the brain processes linguistic information through the eyes.
American Sign Language
ASL is the visual/gestural language used by many people in the Deaf community in the U.S. and Canada. ASL is a language in its own right. It has its own grammar and syntax and incorporates the use of facial expressions and body movements.
Manually Coded English
Signed English, Seeing Essential English (SEE I), and Signing Exact English (SEE II) are all systems of Manually Coded English. These systems visually represent each English word in its correct tense through signs and gestures. These systems are tools to make everything that is not heard visible.
Contact Sign/Pidgin Sign English
Contact Sign/Pidgin Sign English (PSE) can be described as a combination of English and ASL. PSE uses ASL signs, but in English word order. Words that do not convey meaning, such as am, the, or is, and word endings, are often dropped. It is sometimes used simultaneously with spoken English, but is also used by many people who have learned ASL later in life.
Listening or Spoken Language Options
These approaches teach children to use their hearing to develop spoken language for communication and learning. Traditionally, signs are not used, although natural gestures that are used in typical conversation may be included. Below are some of the different strategies and supports used by children with hearing loss who are developing spoken language skills.
Auditory-Verbal Therapy (AVT) works to teach children to use their residual hearing (with the aid of amplification) so that they can learn in a mainstream spoken language environment. AVT does not use signs or gestures, and exclusively provides listening and spoken language instruction.
Cued Speech is a visual communication system using mouth movements of speech in combination with simultaneous hand “cues” that help the child distinguish sounds that look the same on the lips.
Visual Phonics is a system of 46 unique hand cues and symbols that represents the sounds of English without regard to spelling. Each hand cue is associated in some way with the production of the particular speech sound.
Total Communication Philosophy
The Total Communication Philosophy is a teaching philosophy that supports the use of a combination of methods including sign language, sign supported speech, lipreading, body language, gestures, and speech.
The goal of Total Communication is to optimize language development in whatever way is most effective for each individual child. It is typically used for children who wear hearing aids or cochlear implants.
There are many options available for mainstream schools and educators to accommodate the wide range of needs of students with hearing loss.
Some accommodations are simple adjustments to communication practices or the classroom environment, and some accommodations incorporate technology and/or other support personnel.
Our specialists and the educational teams we serve recommend accommodations which reflect and respond to the unique circumstances of each individual student.
Examples of Physical Classroom Accommodations
- Preferential seating for D/HH students
- Providing a quiet setting for speech/language/reading sessions
- Ensuring that the room has noise absorption materials, such as carpets, acoustic tiled ceilings, and curtains
- Reducing background noise
- Enhance classroom lighting
- Other room design modifications
Examples of Classroom Communication Accommodations
- Standing in one place and facing the student when speaking
- Clearly enunciating speech
- Enhancing speechreading conditions (avoiding obstacles to clear view of face and mouth)
- Repeating other students’ responses during question and answer time
- Making sure only one student speaks at a time during discussions
- Identifying the speaker in a class discussion by calling their name or pointing
- Checking in with the student to see that they are not missing the content of the discussion
- Maintaining a slow pace to discussions or lectures, including pausing
- Frequently using visual materials – graphic or written
- Allowing time for the student to review visual materials when lecture or discussion is not underway
- Providing outlines of lectures
- Writing homework and other assignments on the board
- Teaching peers about hearing loss awareness and some of its implications
- Providing for breaks to alleviate student fatigue
- Providing a notetaker in the classroom
- Allowing additional time for test taking
- Providing extra help or arranging for a tutor
- Pre-teaching classroom vocabulary and concepts
- Buddy system for notes, extra explanations, or directions
- Providing an interpreter or communication facilitator
Examples of Accommodations Incorporating Technology
- Personal hearing instruments (i.e., hearing aid, cochlear implant, Baha, or tactile device)
- Amplification systems such as FM/DM systems with or without personal hearing instruments
- Speech-to-text software or other classroom captioning
- Videophone or text phone
- Alerting devices, flashing fire alarms
- Using captions or providing scripts for videos or movies
- Ensuring that equipment is checked daily by an adult
- A loss of approximately 20dB equates to a normal hearing person listening with their fingers in their ears.
- A child may have difficulty hearing faint or distant noise.
- The amount of information missed will be greater when background noise is present, especially in the younger years when a great deal of information is verbal and they are less adept at listening in noise.
- They are also more likely to look to their peers to get the information rather than listen to directions that may be fragmented from the teacher.
- Children can “hear” but will miss bits of speech which can lead to misunderstandings.
- Many experience challenges with early reading skills, such as sound/letter association. These challenges will be greater when there is background noise and the teacher is at a distance from the student.
- Some children may experience difficulties with self esteem as they can be accused of “listening when they want to,” “daydreaming” or “not paying attention.”
- Children with this level of hearing loss will be more fatigued than normal hearing students by the end of the day, because listening is more difficult for them.
- Children with this level of hearing loss may benefit from a hearing aid and/or other accommodations in the classroom.
- At this level of hearing loss, consistent use of hearing technology is crucial if the child is going to develop speech and language at a normal rate.
- Children will struggle to understand conversation at more than 3-5 feet without hearing technology.
- Visual supports will be extremely helpful/important.
- Even with hearing technology, children will miss a great deal in a typical classroom and are at risk for falling behind. An FM/DM system is typically required in these settings.
- Social challenges may arise due to social situations often being loud and chaotic which make listening and joining in conversation more difficult.
- Some children may experience difficulties with self esteem as they can be accused of “listening when they want to,” “daydreaming” or “not paying attention.”
- With this level of hearing loss, there will be challenges listening even with hearing aids. They will know that someone is talking, but will miss bits and pieces of words, which will make verbal communication in many situations difficult. Speech must be very loud for them to hear without hearing technology.
- If hearing loss is not diagnosed before the age of one, delayed language, syntax, speech intelligibility and flat voice quality are likely. A visual communication system may be needed especially if there are significant language delays or additional disabilities.
- The use of an FM/DM system will make listening more manageable for the child when there is background noise or from a distance.
- Children with this level of hearing loss will also struggle in social situations when there tends to be a great deal of background noise, such as lunchtime, recess, parties. Social immaturity may occur and they may require direct instruction in some of the basic social skills/pragmatic language skills.
- These children require consistent hearing technology use and also a concentrated effort from parents/caregivers to provide a rich language environment throughout their everyday activities if they are going to have relatively typical spoken language development.
- Without amplification, children with 71- 90 dB hearing loss may only hear loud noises about one foot from the ear. Even with hearing technology, children with a 71-90dB loss will typically not be able to hear and discriminate some of the high frequency sounds (although this is improved with the use of FM/DM technology).
- Typically, if there is a loss greater than 90dB, traditional hearing aids will not be enough benefit to develop spoken language. These children may be a candidate for a cochlear implant.
- A visual language, or visual supplements to English, will most likely be needed, and the family should be involved in decision making and learning the language or mode from a very early age.
- Socializing with hearing peers will be more difficult, but socializing with deaf peers will not be if they have been learning ASL from a young age.
- Children with this level of hearing loss, who are in a mainstream environment, may become more dependent on adults for support in the classroom. Relationships with peers and adults who have hearing loss can make positive contributions toward the development of a healthy self-concept and a sense of cultural identity.
- Children with this type of hearing loss have normal hearing in one ear and can have any level of hearing loss in the other ear.
- They will do well in many situations, but will struggle in situations where background noise is present, speaker is on their poor side and/or when the speaker has a faint/quiet voice.
- It will be very difficult/impossible for them to localize where sound is coming from.
- They may also struggle in social situations when there is a lot of background noise, which can in turn affect their self esteem. These children may appear inattentive, distractible or frustrated, and behavior or social problems may occur.
- Fluctuating hearing loss occurs when a child has frequent ear infections/fluid in the ears, wax build up, congestion, etc. This is most concerning for children who have had frequent episodes lasting more than 3 months in early childhood.
- They are able to “hear” but can struggle on a day-by-day basis depending on what their hearing levels currently are.
- They may experience fatigue or frustration due to more effort being needed to listen and learn. They frequently miss unstressed words, word endings, and consonants. They may also be accused of “selective hearing” or “listening when they want to.”
- With inconsistent hearing, the child may learn to “tune out” the signal. They are more likely to be thought to have attention issues, distractibility, and insecurity. They may remove themselves from group activities and be more socially immature.