Every child is different so there is no “one size fits all” for services and accommodations needed for the child with hearing loss in the mainstream. What each child requires is dependent on so many different things.
We need to consider at what age the child’s hearing loss occurred. Was the loss present at birth, was it progressive, or did it occur later (as in the case of meningitis or other viruses)? What is the degree of loss? At what age was the child first amplified? At what age was the child provided with adequate amplification? When a child with a profound bilateral loss is fit with hearing aids after diagnosis, then implanted closer to one year of age, it is the age of implantation when adequate auditory access was achieved. We also need to look at the child’s current age/grade in school, mode of communication, and current language level in relation to his/her peers. Additionally, the child’s cognitive level and any other diagnoses may impact services required. It is only with the knowledge of all of the above that appropriate programmatic recommendations can be made.
That being said, a “menu” can be created which provides insight into the possible services and accommodations which should be considered for the child with hearing loss that is mainstreamed. Some children may require all of the listed services in their educational program, while others may only require consultative services. Often, as a child with hearing loss moves up through the mainstream, the amount of services required decreases.
The following list is meant to be a general list of service possibilities for most children within the mainstream. It is not, by all means, exhaustive, especially for children with multiple disabilities.
- Teacher of the Deaf and Hard of Hearing (TOD)
Depending on the child, these services can be as little as consultative, to as much as team-teaching with the regular education teacher. The TOD can pull the child out to pre-teach/re-teach concepts and academic skills, monitor and trouble-shoot equipment, in-service staff, provide auditory therapy, work on self-advocacy skills, and monitor accommodations and modifications to the classroom and curriculum.
- Educational Audiologist
The Educational Audiologist is responsible for audiological equipment fitting and management. If there is not a TOD within the district, the educational audiologist may take on some of the roles of the TOD.
Depending on mode of communication, the child with hearing loss might require an interpreter who uses ASL, Signed Exact English, Total Communication, Cued Speech, or might use an oral interpreter.
- Speech Language Pathologist (SLP)
The school SLP can provide services to work on speech and language skills including vocabulary, sentence usage, language understanding, articulation, and social language. Services can be provided individually, in small groups, or within the mainstream classroom. Depending on the experience of the SLP in working with children with hearing loss, he/she may take on some of the TOD’s roles.
- Special Education Teacher (SPED)
The SPED teacher can provide academic support in the areas of reading, writing, math, spelling, social studies, science, and any other academic. These services can be provided within the resource room or in the regular education classroom.
- Occupational/Physical Therapist (OT/PT)
Services from an OT or PT might be needed if the child has delays in fine/gross motor skills or difficulties with sensory integration.
- School Psychologist
The School Psychologist can provide individual, group and consultative services to work on social skills, advocacy, and the child’s acceptance of the disability.
While the specific accommodations needed depends on the classroom environment, the following is a list of some of the typical accommodations that might be needed for the child with hearing loss in the mainstream.
- Team in-service at the start of each year by hearing specialist
- FM system (with or without pass around microphone for peers)
- Preferential seating
- Classroom noise reduction (tennis balls/hush ups, close classroom door)
- Teacher to teach facing class (not with back turned)
- Support auditory with visuals within the classroom
- Gain attention prior to speaking
- Check for understanding
- Encourage student to ask for clarification
- Provide listening breaks to reduce auditory fatigue
- Closed captioning
- Note takers
- C-PRINT/CART (real time captioning)
- Testing accommodations (i.e. extended time and/or separate location)