BY J. FREEMAN KING, ED.D.

Author's Note The following is the follow-up article to "Successful Deaf Children: The Parents' Role in Communication and Language Development," which appeared in the September 2018 edition of Exceptional Parent magazine.

The typical school system tends to overlook the obvious needs of the hard of hearing child because the child can speak intelligibly and wears hearing aids, which are assumed will promote normal hearing.

Children who are hard of hearing often do not fit comfortably into either the Deaf world or the world of those who can hear. These children live between the two extremes, deaf and hearing, and resultantly, hard of hearing children tend to be forgotten and overlooked in the school system in comparison to their peers with severe or profound hearing losses. The hard of hearing population is far from small, and children with mild or moderate hearing losses far surpass the number of those with severe or profound hearing loss. Research has shown that a lack of early identification of hard of hearing children plays a major role in the inattention that is often afforded them. In fact, statistics indicate that the smaller the loss, the greater the number of people who are affected.

Research has also shown that parents of hard of the hard of hearing child often state that their child's hearing loss was discovered at approximately 30 months of age, while the loss of profoundly deaf children was discovered by age 15 months. For the child whose loss is minimal, or whose loss is progressive, and does not appear significant during initial hearing screenings, their remaining hearing and their own adaptive abilities often became their worst enemies. The fact that hard of hearing children typically communicate very well in face-to-face interactions, tends to mask the extent of their hearing loss, often lulling parents and teachers into believing that the child understands more than they actually do. For these children, what they hear feels normal. Therefore, the biggest problem facing the child is not what they do not hear, but what they think they hear.

Doctors and parents often assume that once the child is fitted with hearing aids, he/she will function like a child without a hearing loss. Without a doubt, technological assistance has greatly improved and done much to help the hard of hearing child hear better; however, technological assistance has not solved other prob lems, especially behavioral, that might be associated with hearing loss. Studies focusing on social and behavioral issues of these children have reported severe problems. The information presented in various studies concerning behavior problems of hard of hearing children indicate that they do significantly worse on behavior rating scales, even when compared to children with severe losses.

PEOPLE SPEAKING IN SIGN LANGUAGE

SOMETHING TO TALK ABOUT: The use of sign language will not delay or prevent the development of spoken language. In fact, it has been shown that the use of sign language can enhance the development of speech and language.

Accepting the fact that a lack of adequate language skills, due to a hearing loss, can be a cause of behavioral issues, do inadequate language skills also have a negative impact on academic performance? The answer is resoundingly, YES. Research reports that even for students with a mild hearing loss (15-25 dB), the average delay in vocabulary and other language skills is over one year compared to hearing peers; the hard of hearing child performs two to three years behind hearing students on standardized academic tests; and, are commonly held back from grade promotion by an average of one and half grades.

Certainly, parents of hard of hearing children are dedicated, hopeful, and desire only what is most appropriate for their child. The parents are struggling to do their best for children who are only partially able to access spoken language, yet who have the capability to learn a visual language and a spoken language, but are often denied opportunities to do so. A major problem is that the parents are often not given adequate information that would assist them in meeting their child's needs. Research indicates that these parents are less likely than parents of profoundly deaf children to receive information about behavioral development, school choices, opportunities to participate in parent groups, legal rights, or sign language instruction/possibilities.

The typical school system tends to overlook the obvious needs of the hard of hearing child because the child can speak intelligibly and wears hearing aids, which are assumed will promote normal hearing. As a result of these assumptions, the child might be disruptive in class due to frustration at not being able to hear in a noisy environment; feel that what they are able to hear is normal; are not aware of or misinterpret what words are spoken; and, are singled out as being slower than their peers because of lack of access to a full and meaningful language.

The terms language and speech are often used interchangeably, both by professionals and parents. However, it is important that the parent of a hard of hearing child understands these terms are not synonymous. Language is a linguistic system of symbols that can be expressed several different ways, including speech or sign language. Speech is not the same thing as language; it is a tool for expressing language. Many hard of hearing children have a complete language foundation, but might not have the capability of speaking intelligibly. It is important that parents understand that the ability to speak is not related to the child's intelligence. Also, the ability to speak does not interfere with the learning of sign language, and the ability to sign does not interfere with the learning of speech.

Parents of the hard of hearing child are looking for answers and support. They want their child to be able to express and understand language and to be able to communicate what is essential in their lives, as well as be accepted socially and develop meaningful friendships. Some families choose to use sign language with their child as well as spoken communication; others opt for spoken language only. Regardless of the communication option chosen, the child should have as much access to language as possible. It is recommended that the parents follow the lead of the child. Is the child primarily a visual language learner or primarily a spoken language learner? If the child is primarily a visual language learner, then sign language should be incorporated into the communication mode.

What is crucial is that the parent communicates with the child to the best of their ability in a deep and meaningful way. The parent does not have to become an expert in either speech teaching techniques or sign language. The key is consistent and meaningful communication.•

ABOUT THE AUTHOR: J. Freeman King, Ed.D. is Professor of Deaf Education, Utah State University in Logan, Utah.

TIPS FOR PARENTS OF THE HARD OF HEARING CHILD

• If at all possible, the child should be enrolled in an early intervention program as soon as a hearing loss is identified. This can be facilitated by either the local school district or a school for deaf and hard of hearing children in the area. Such a program should assist the parents with ideas and techniques that will enhance the child's language development as well as support the child's self esteem and identity.

• Most hard of hearing children can benefit from hearing aids or other assistive devices, so attempt to have the child fitted with hearing aids. An audiologist should be selected who has experience in working with hard of hearing children and can assist in finding the most appropriate hearing aid.

• Meet other parents of hard of hearing children. They will provide support and information that only another parent can provide. The early intervention specialist should be able to connect you with parent support groups or other parents in your community.

• Elicit the support and experience of hard of hearing adults. You will find that they will be happy to answer your questions about raising a child with a hearing loss and will be able to give practical suggestions for communication, language, and social development.

• Consider using sign language with your child. The use of sign will not delay or prevent the development of spoken language. In fact, it has been shown that the use of sign language can enhance the development of speech and language.

• Continue with approaches that work and modify those that do not. Follow your child's lead; the hard of hearing child will make it evident whether he/she is primarily a visual or an auditory learner. Once this is ascertained, play to your child's strength (vision), not his/her weakness (hearing).