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Advantaged hard-of-hearing children no matter how severe their hearing loss are appearing in increasing numbers in public school programs. Many of these children have intelligible speech and grade-appropriate academic skills. It seems that if we can intelligently apply all that we currently know and use the available technology well, we have at hand all the necessary tools to mitigate the negative educational consequences of severe to profound hearing loss. This is an incredibly exciting time The technologies are in some respects a double-edge sword—they provide the means to get the children into a school with normal hearing children where they can be competitive. These children, however, despite their good speech and language skills, still have a hearing loss and there will be many instances during a school day when they will not respond like a normal hearing child. Many of them are also the only such child within their school and they often experience social isolation. We all need community and if the orally successful child cannot find it within the school context, he or she will seek it elsewhere. We must give these children with hearing loss in integrated settings roots within their social context. Professionals and parents need to work together to provide support groups and social outlets for children who are integrating with normal hearing children. This will allow them to know they are not the only one facing these challenges. Support from a child’s peer group can often be the most important influence. What of the future? It looks incredibly bright. Binaural implants are already here and fully implanted devices are coming shortly. I think we’ll be implanting at increasingly younger ages and with children who are now classified as mildly to moderately hard-of-hearing. I think the surgery will be routine, as they are now doing on an outpatient basis in many surgical centers. It’s possible and even likely that implants will become the dominant form of amplification for people with hearing loss. I think there will still be small pockets of the culturally deaf who will be on the margins. Until we get the mainstreaming model fully operational we will go through periodic cycles whereby the deaf community and the romance of sign language is rediscovered by adolescents with hearing loss. I think some time in this century we will have a cure for sensorineural deafness. I have faith that stem cell research will ultimately be able to regrow damaged hair cells. Despite all our current challenges, I think this is a wonderful time to have been professionally active in early childhood hearing loss. We professionals have seen us move from bleak prognosis to hopeful outcomes, from restricted vocational opportunities to almost unlimited ones, from poor academic skills to grade-appropriate, and from unintelligible speech to normal or near-normal speech intelligibility. I think congenitally hard-of-hearing children will have the choice of being included both within the cultural mainstream and the hard-of-hearing community. Hopefully, they will be able to move seamlessly between both worlds. The contributors and I feel privileged to have been a part of this true revolution and blessed to be living in such interesting times.
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