Early detection of hearing loss or deafness is crucial; the earlier these are identified, the more likely the child will acquire spoken or signed language. Therefore, infants should all be screened before leaving the hospital or at least before they are one month old. If a child fails the screening test, he or she needs to have a follow-up exam which will include precise audiological testing which will determine the severity and type of hearing loss. This follow-up exam will also allow parents and health professionals the opportunity to discuss the possible intervention strategies for the child. “Intervention” involves the different ways that parents and families can rise above the communication barriers they will face.

Parents of deaf and hard-of-hearing babies need frequent and continued interaction with their children. This interaction from the beginning, whether in the form of smiling at or holding, will ensure that the child grows up feeling loved and supported by his or her family.

Information from: National Institute on Deafness and Other Communication Disorders

School-Age Children

Parents must become familiar with the services provided for their children in their community, like programs in preschools or elementary schools. Parents also need to explore their options and determine what would most benefit their children. Creating teams of professionals may benefit the child. Parents should consider speaking to a variety of professionals, including pediatricians, otolaryngologists, audiologists, and speech-language pathologists. Parents should make sure that the team they have assembled is in constant communication about their child’s visits to each doctor. In addition to health care professionals, many parents find helpful is to include social service and educational professionals on their team.

Parents can also look to teachers with experience working with deaf and hard-of-hearing children for help improving their children’s long-term outcomes. It is important for parents to communicate with the teachers at their child’s school in order to understand what kinds of services are offered for their children.

Information from: National Institute on Deafness and Other Communication Disorders

Communicating with Deaf and Hard-of-Hearing Children

There are several options for helping your child communicate.

  • One method is the auditory-oral method which teaches children to communicate by listening, reading lips, and speaking.
  • Another method is auditory-verbal therapy which encourages children to use what is left of their hearing to communicate. This method discourages lip reading as a means for communication.
  • A third method, called bilingualism or biculturalism, involves children learning American Sign Language, thus becoming part of Deaf Culture.
  • Another method is called cued speech, which allows children to “see” English. This method teaches children to use handshapes, which allows the sounds they can’t see by reading lips to be “shown” to them.
  • A last option is combining some of these methods, like talking and signing; this is called total communication.

Parents need to realize that there isn’t one “right” choice for communication. They should look at both their needs and their child’s needs in order to choose what works best for them as a family. Parents should also be flexible with communicating and understand the importance of following their child’s lead.

Information from: Raising Deaf Kids

Picking a School for a Deaf and Hard-of-Hearing Child

There are many options when deciding what type of schooling would be best for your child, including schools for the deaf, mainstreaming, and homeschooling.

  • Schools for the deaf: All students in these schools are deaf and hard of hearing; lesson plans are designed especially for students with hearing loss by teachers with experience working with deaf and hard of hearing students. There are residential schools for the deaf, where students live on campus during the week and go home on weekends and for holidays. There are also day schools where students go to school during the day and return home each afternoon. Sending your child to a school for the deaf will allow him or her to be around other deaf students and learn more about Deaf culture.
  • Mainstreaming: This is when a child attends a regular school; it is also called inclusion or integration. There are several different options to consider when choosing the mainstream route. Total mainstreaming involves having your child attend all classes with hearing children. Partial mainstreaming allows the child to attend some classes with hearing children and other classes in a classroom with a teacher of the deaf. Team teaching has a general education teacher and a teacher of the deaf work together in one classroom comprised of both hearing and deaf students. When thinking about mainstreaming a child, parents should be aware that their child might be the only deaf or hard-of-hearing student attending the school and may find classes more challenging. However, mainstreaming the child would allow him or her to attend school with siblings or friends from the neighborhood.
  • Homeschooling: While homeschooling is legal in all fifty states, parents must realize that there are unique ways to teach children with hearing loss how to read and write. There also may be more paperwork to fill out or special rules that need to be followed.

When picking a school, parents should do their research and find out what their options are in terms of types of schools. They should also talk to other parents of deaf or hard-of-hearing children in order to gain some insight; it would be a good idea to ask the student actually attending the school what he or she thinks of it.

Information from: Raising Deaf Kids (Schools for the DeafMainstreamingHome SchoolingSchool Choices)

Educational Approaches for Deaf or Hard of Hearing Children

Before deciding on an educational approach, the severity of the child’s hearing loss must be assessed. In the education of deaf children, there are three main methods of communication. They are:

  1. Oral/aural: This approach to deaf education stresses auditory training, articulation, and lip-reading.
  2. Total communication: This approach involves using a blend of sign language, voice, amplification, finger-spelling, lip-reading, writing, gesture, and pictures.
  3. Bilingual/bicultural: This approach recognizes both Deaf and hearing cultures and uses elements of both in the classroom curriculum.


Historically, the oral/aural approach is the oldest in the United States. In order for the following approaches to work, students must experience a speech-intensive environment both at school and at home.

Auditory/Oral Approach

With this method, students are trained to use their hearing while developing expressive speech. Pure oralism encourages speech as the only acceptable means of response. In order to achieve success with this method, there must be five elements: parental involvement, appropriate amplification, consistent, quality speech training, development of appropriate language instruction, and range of placement option.

Auditory/Verbal Approach

With this method, students are first taught to listen. They are not required to look at a speaker’s mouth. Students are able to learn to listen, process verbal language, and speak through the use of amplified residual hearing.

Lip Reading (Speech Reading) – Cued Speech

With this method, students read the lips and mouths of others. Also known as speech reading, this method involves reading body language and facial expression. With cued speech, there are eight hand shapes that represent groups of consonants. These are placed in four positions around the face, indicating groups of vowel sounds. Cued speech allows students to recognize accent, duration, pronunciation, and rhythm of speech. However, students who learn cued speech will also need to learn American Sign Language (ASL) in order to communicate with the majority of Deaf culture.

Total Communication

Total communication is not necessarily a communication method, but more a philosophy of communication. Although sign systems vary, they do have three things in common: they tend to draw on some ASL signs for vocabulary; they invent new signs to convey grammatical concepts that are not included in ASL; they generate sentences that mimic English’s syntax.

Total communication allows students to utilize every mode of communication available in order to receive and communicate information; it is often the first approach recommended for students. In the education of deaf students, simultaneous communication is most popular because it leaves it up to the students depending on their particular needs.


Deaf students who are bilingual are able to communicate in both ASL and English. Bicultural students are able to thrive in Deaf culture as well as majority culture.

Bilingual/Bicultural programs draw on English as a Second Language programs as a models. These programs also emphasize the appreciation for both ASL and English. With this type of education, students are taught ASL as their first language. After the students are able to communicate effectively in ASL, they are taught English language skills. These students are also taught about Deaf culture. These programs tend to be found in schools for the Deaf.

Mainstreaming vs. Residential Schools

When deciding whether a Deaf student should attend a neighborhood school or a school for the Deaf, there are important facts to know about mainstreaming and residential schools.

With this option, deaf students attend regular classes in addition to special education classes which are taught by specially trained teachers. If mainstreamed, a student may miss out on feeling like part of the Deaf culture that is so heavily emphasized in residential schools. However, they may feel more connected to their hearing peers. One issue some have with mainstreaming is that deaf students are typically only in regular classes for subjects like physical education and art.

Residential Schools
These schools are specifically for those who are deaf or are severely hearing impaired. The students live at these schools and are thus constantly being exposed to Deaf culture. Residential schools also provide opportunities for peer interaction through after-school activities. Students are also able to come into contact with Deaf teachers or house parents who may serve as role models. But, because of the option of mainstreaming, many residential schools have shut down.

Information from: Educational Approaches

Gallaudet University’s 15 Principles for Reading to Deaf Children

Studies have shown that deaf children with deaf parents are more successful in their academic achievements, reading and writing, and social development than deaf children with hearing parents. Therefore, hearing parents and teachers can use deaf parents’ read-aloud strategies to read with their children and students. The following 15 principles are based on research from deaf parents and teachers reading to deaf children:

  1. Deaf readers use ASL to read to their children.
  2. Deaf readers make sure that both ASL English are visible.
  3. Deaf readers do not allow the text to restrict them and often elaborate to make sure the children understand the story.
  4. Deaf readers rely less and less on elaboration and stick to “story reading” the more they read the text.
  5. Deaf readers let children take the lead in read-aloud sessions.
  6. Deaf readers take what is implicit and make it explicit.
  7. Deaf readers adjust the placement of the signs for the sake of interest and variety.
  8. Deaf readers adjust their signing style to portray characteristics and personalities of characters.
  9. Deaf readers connect the story’s concepts to their real-world experiences.
  10. Deaf readers use strategies to maintain children’s attention.
  11. Deaf readers use eye contact to ensure that children are participating.
  12. Deaf readers draw on role playing to clarify concepts.
  13. Deaf readers use variations of ASL to sign repeated English phrases.
  14. Deaf readers provide children with an environment that is positive and reinforcing.
  15. Deaf readers believe in children’s abilities to become literate.

More detailed descriptions of the principles can be found at: Gallaudet University

Boys Town National Research Hospital

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