When parents first learn their child has a hearing impairment, many thoughts and questions arise. Will my child be able to learn? Can they be successful in life? Will they be able to go to college? Will they have friends? How will they learn? Will they be able to have a job one day?

The answer is yes. With the appropriate education, deaf/hard of hearing students will be equally as successful as their hearing peers and will be afforded to same opportunities in life.

When parents learn of their child’s hearing loss, they must make many decisions as quickly as possible in order to set their child up for success. Once the hearing loss has been diagnosed, the parents should connect with local early intervention services (if the child is under the age of three) or with the local school system (if the child is over the age of three) in order to begin services for their child.

Success of a hearing impaired child depends on early intervention.

After deciding which form of amplification is to be used (hearing aids, BAHA system, cochlear implants), the family must decide which form is communication is best suited for their family – sign language, cued speech, listening and spoken language (WOULD THIS BE A GOOD PLACE TO PUT A LINK TO MY FIRST POST OR SHOULD I GO INTO THE SAME DETAIL ABOUT AMPLIFICATION AND COMMUNICATION MODES?) It is important to remember that any form of communication is the right choice. Just because a family chooses sign language doesn’t mean that is the right choice for all families. Just because another family chooses listening and spoken language or cued speech does not mean that is the right choice for all families.

Our son, Joseph, was born at 24 weeks gestation and diagnosed with Auditory Neuropathy Spectrum Disorder (ANSD) at six months of age while still in the NICU. Upon meeting with the ENT for the first time, he explained that hearing aids may or may not work for Joseph and that cochlear implants sometimes work for ANSD but sometimes they do not. He explained that Joseph may be able to learn speech and language through auditory verbal training or that he may need to use sign language. Because of his extreme prematurity, Joseph’s vision was in question so we were not sure if sign language would even be an option. We were very much in a “wait and see approach."

As soon as Joseph was discharged from the NICU, we began in home therapy through a local D/HH early intervention service. After much detailed conversation with our early intervention specialist and ENT, my husband and I made the decision to have Joseph fitted for hearing aids knowing they may or may not work and that he may need a cochlear implant(s). We also made the decision to start with an auditory verbal approach knowing he may need sign language later if it did not work.

Joseph received his first pair of hearing aids at the age of one and began auditory verbal therapy shortly thereafter. At the age of two, we enrolled Joseph in a private school for deaf/hard of hearing children. The school only used the auditory verbal/listening and spoken language approach. Joseph’s hearing aids began no longer working for his hearing loss and he became a candidate for a cochlear implant. He received his first cochlear implant at the age of three. He continued at the private school through preschool. He received his second cochlear implant just before starting public school kindergarten.

Joseph is now in kindergarten. He is in public school and goes to the school in our county that houses the deaf/hard of hearing classroom (it is not our home school). He is in a self-contained class with two other students who are deaf/hard of hearing. He mainstreams with a para-professional for music, art, and PE. (He has a para-professional with him because of health complications and multiple food allergies – not necessarily because of his hearing loss.)

We have continued with the auditory verbal and listening and spoken language approach for our family. This does not mean we are opposed to sign language or cued speech. They were not the best options for Joseph or our family. As Joseph got older, it became clear that he was an extremely visual learner despite a slight vision impairment. We knew that if we tried to teach him sign language, he would become dependent on it and not use spoken language (he also has verbal apraxia which made speaking difficult in the beginning but through countless hours of speech therapy, he has made great strides in speech and talks non-stop).

Again, every family has to make the choice that is best for our family. This is what worked best for Joseph and our family but may not be the best choice for another family.

Once an amplification system and mode of communication have been chosen, the family can then begin to decide on school choices for their child. The key to success is early intervention. The earlier a child begins to receive an appropriate education after their hearing loss diagnosis, the more likely the child will be just as successful as their hearing peers.

No matter the mode of communication that is chosen, there are many considerations a family should take into account when deciding on the appropriate school environment for their child:

• Do you want your child to be in a private school, public school, or homeschooled? o Just like choices in communication modes, there is no right or wrong answer to this question. Parents must make the decision that is best for their family and all options may not be available to the family depending on where they live. There are pros and cons to all types of schools.
• If choosing a private school, how long will the student be able to stay in the school? Does the school provide a mainstream specialist? Where do students typically attend school once they leave the private school? o If choosing a private school for your child, it is important to find out how long your child will be able to stay in the school. Is it just for preschool aged children or is there an elementary through high school component? If the school does not accommodate students through high school graduation, it is necessary to determine if the school has a mainstream specialist to help you when it is time to leave the school. Will they go with you to IEP meetings or will they send a representative from the school? Will they assist you in collecting all of the testing and documentation necessary for transition to a public school or other private school? Another important question to ask upon looking at the school is where students go to school once leaving the private school. Do they attend their local elementary school or do most attend another type of private school? It is important to know the answer to this question before enrolling in a private school to ensure that your student will have a seamless transition upon leaving the deaf/hard of hearing private school.
• If choosing a public school, how long can the student remain in a deaf/hard of hearing class? Is their opportunity for the student to mainstream? When can this begin? Is an interpreter provided if needed? o These are all key questions to ask in your initial meeting with the public school system and representatives. Ideally, you want your child in the least restrictive learning environment but in the learning environment where they will best succeed. Is there a D/HH class all through high school or just in the elementary schools? Does the school system expect the students to be mainstreamed by a certain age? Can your student began mainstreaming as soon as they are ready? Is it possible for your student to mainstream for just one class a day if they are ready? As your student progresses through school, they will need less and less support services but it is important to ask what it looks like if they still need some support (for example, if they need extra time in English, how will this work?) If your student signs, it is important to ask how it works for your student to have an interpreter at all times.
• If choosing to homeschool, will your child have opportunities for socialization? If you have chosen a listening and spoken language route, will there opportunities for your child to have an age appropriate language model? Is your child eligible to receive services such as speech therapy in your local school system? o If choosing to homeschool, you must find a curriculum that is best suited for your child and your family. If you have chosen a listening and spoken language approach, it is imperative that your child has opportunities to be around age appropriate language models for your child to have maximum opportunities to communicate with other peers their age. It is also important to be evaluated by your local school system to see if your child qualifies for any services such as speech therapy.
• What is the student/teacher ratio? o This is important to know. It is also important to ask what the maximum number of students allowed in the particular class is. Does the class have a paraprofessional in addition to the teacher? Is there an interpreter? Are there any co-teachers?
• Is the classroom located in a quiet area of the school to allow for maximum listening of the student? If it is located on a major hallway, why? Can the class be moved? o This is crucial. There could be two students and one teacher in the class but if it on an extremely noisy hallway, it doesn’t matter that there are only two students. The noisy coming from the hallway into the classroom will be distracting and will not give the students the maximum opportunity for hearing. Before committing to sending your child to the school, visit the classroom. Take note of where the class is located in relation to other classes. How often do classes walk down the hall beside the D/HH class? If the classroom is located in a high traffic area of the school, ask the teacher or administrator why the classroom is not located in an area that facilities learning in a quiet environment. Ask them if it’s possible for the classroom location to be moved during the next summer vacation.

A family must ultimately decide which form of communication and subsequent education are best for the family. As stated, there is no wrong decision. You have to decide what route is the best for your child and your family. The only wrong decision is not taking advantage of learning opportunities as early as possible in order to give your child maximum learning potential and opportunities.