Dr. Anderson was an educational audiologist for 15 years, consulting with parents and teachers about the needs of children with hearing loss, managing amplification device wear, and providing aural habilitation services to children. She is the author or co-author of the Screening Instrument For Targeting Educational Risk (SIFTER), Preschool SIFTER, Secondary SIFTER, Listening Inventory For Education (LIFE), Children’s Home Inventory of Listening Difficulty (CHILD), Early Listening Function (ELF) test. Her writing and research has focused on the listening needs of children with hearing loss in the regular classroom. She participated on the ANSI 12 Work Group that developed the 2002 Acoustical Performance Criteria, Design Requirements, and Guidelines for Schools and is the 2003 recipient of the Educational Audiology Association’s Fred Berg Award. Dr. Anderson currently serves as the early hearing loss detection and intervention audiology consultant and coordinator of early intervention services for children with hearing loss in the State of Florida.

Due to the success of newborn hearing screening and early identification of hearing loss, parents now have the opportunity to spend countless hours arranging the world of a child with hearing loss so that he or she can learn language from listening in everyday situations. During early intervention services, parents come to understand that the child’s sensory devices, whether it be high technology hearing aids or cochlear implants, are the lifeline that the child uses to learn language and the meaning of the many sounds that provide important information. Parents typically become aware of the size of their child’s listening bubble—how close the parent needs to be for the child to be able to detect a sound and the distance needed for the child to really hear the parent’s speech well enough to understand what is said (see Figure 4-1).

In the early years of the child’s life the parents also develop an awareness that background noise in the car, grocery store or fast-food restaurant causes the child’s listening bubble to be much smaller and conversation much more challenging. After all of the many hours of interacting with the child—talking, teaching, listening and learning—parents can be proud of their son’s or daughter’s hard earned success as a communicator. This success is a credit to early dedication to the child’s future and to providing the child with a rich listening and language environment.

During the first few years of life many children with hearing loss master repeating the Ling sounds (/oo/, /ah/, /ee/, /s/, /sh/, /m/) as the parents and children work together to check the functionality of the hearing aids or cochlear implants. The child may have become very dependable, reporting to the parent when a problem occurs with a hearing aid or the speech processor on the implant. This is evidence that the child can recognize that malfunctioning technology is a break or weakness in the lifeline to a world of sound. Although some children may rely on attending to visual cues or sign language, most children who are identified with hearing loss shortly after birth will develop skills to allow them to learn and monitor their world through what they hear with amplification.

Children identified with hearing loss today can experience a future that is much brighter than most children with hearing loss from previous decades. Early hearing loss detection, early hearing aid fitting, appropriate early intervention services and truly involved parents communicating effectively and frequently have been found to be the four keys to preventing language and learning delays in children with hearing loss. The result is an increasing number of children with all degrees of hearing loss who have normal or near-normal language skills by the time they start preschool or kindergarten. After all of the work, time, care and expense invested during infancy and “toddlerhood,” many parents begin to feel confident that their child with hearing loss has learned what is needed to communicate, socialize and be educated side-by-side with other children of his or her age who do not have a hearing loss.

Entering the Educational Environment

Listening is a vital gateway to learning. The purpose of this chapter is to discuss factors in the educational environment that can be barriers to learning for the child with hearing loss. This chapter will first describe the challenges that the child with hearing loss will face in perceiving speech as clearly as possible in a school setting. These different issues interrelate to create a unique ability to perceive speech and cope with hearing loss for each child. Although the mounting challenges can seem overwhelming and depressing, solutions or a means to address a child’s intrinsic and extrinsic challenges to listening will be described later in the chapter.

Successfully developing communication skills by age 3 has resulted in many children with hearing loss spending their preschool years (3 to 5) in community preschool settings. In preschool, children are typically provided a variety of structured activities. However, there’s one constant when young children gather together—noise. In these early learning situations, the confidence many parents feel in their child’s communication skills can begin to falter. This change occurs because when young children gather together, noise and its extra challenge to listening enters the scene.

• Sam’s teacher says that he plays alone most of the time but I know he loves it when Robert comes to our house and they play together so well!
• He is always so exhausted when he comes home from preschool.
• Jasmine’s teacher said that she wasn’t following directions. I know that Jasmine knows the words the teacher is using and she usually tries so hard to please.
• Jamal has always been so chatty with us at home. He and his sister play house together and build with blocks. In preschool his teacher said he hardly says a word and just watches the other children as they play.
• He pushed a child down! We’ve always taught him to share and to ask for toys and today his teacher said Travis just pushed another little boy down and pulled a toy out of his hands!
• The teacher says that Maria often acts as though she is in her own little world. . .