What Are the Foundations of Deafness and Hard of Hearing?

• The terms "Deaf," "deaf," "hard of hearing," "hearing impairments," and "hearing" all have specific implications related to perceptions concerning differences versus disabilities and membership in the Deaf culture.
• Education of students who are deaf or hard of hearing was formalized in the United States in the 19th century. The oralist movement began the debate of what language individuals who are deaf or hard of hearing should use.
• Clinical definitions of deafness and hard of hearing focus on describing hearing loss in terms of type and degree. Types of hearing losses include conductive, sensorineural, and mixed.
• Hearing losses can be congenital, adventitious, prelingual, or postlingual.
• The IDEA 04 definition states deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child's educational performance. Hearing impairment means loss in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance.
• Hearing impairments is a low incidence category of disability. Less than 1% of school-aged children are served under the hearing impairments IDEA category.

What Are the Causes and Characteristics of Deafness and Hard of Hearing?

• Hearing losses can result in conductive, sensorineural, or mixed hearing losses. Causes of conductive losses tend to be in the outer and middle ears and include blockage of the ear canal, otitis media, and perforated tympanic membrane. Causes of sensorineural losses tend to be in the inner ear or the auditory nerve.
• Genetic causes of sensorineural losses account for only a small percentage of cases of deafness and include Usher syndrome.
• Environmental causes of sensorineural losses include infections such as rubella.
• Deaf community and culture can have a major impact on an individual's perceptions about his or her own characteristics.
• Intellectual capabilities of students who are deaf or hard of hearing are difficult to assess because IQ tests tend to include many verbal performance items, but nonverbal tests indicate no significant differences between students who are deaf or hard of hearing and hearing students.
• Reading and comprehension skills tend to be delayed compared to those of their hearing peers.
• As a group, students who are deaf tend to have lower achievement than hearing peers although many are on or above grade level.
• English speech and language skills tend to be lower in students who are deaf or hard of hearing; this is affected by age of onset, type and degree of hearing loss, and language experiences at home and school.
• As a group, students who are deaf can develop appropriate social and emotional skills.

How Are Students Who Are Deaf or Hard of Hearing Identified?

• Hearing losses are typically identified by medical professionals. Identification of newborns and infants requires special audiological techniques.
• Identification of older children usually occurs through screening followed by standard audiological assessments that establish the degree and type of hearing loss. The effects on educational performance is the primary concern of teachers.

What and How Do I Teach Students Who Are Deaf or Hard of Hearing?

• Academics should include all subject areas although literacy may be of particular importance. Constructivist approaches that challenge students are preferable to rote memory learning.
• Literacy skills should be emphasized from early childhood. Students should be able to comprehend, remember, and communicate information from reading.
• Deaf studies is an area of learning for both students with hearing losses and hearing peers. Information about technology use, Deaf culture, and ASL could be incorporated into traditional curriculum areas such as science, social studies, and language arts.
• Transition planning should include key factors such as access to the general education curriculum, assessment of career interests, internships, and high expectations for success.
• Oralism is an approach that focuses on speechreading and other techniques to emphasize the development of oral English speech and language over ASL. This approach is controversial among some people within the Deaf culture.
• The bilingual-bicultural approach emphasizes ASL as the first and natural language with English language being taught as a second language.
• Total communication involves using both oral English speech and language along with ASL during instruction so that skills in both areas may be developed or used by students. The student's preferred mode of communication is emphasized.

What Are Other Instructional Considerations for Teaching Students Who Are Deaf or Hard of Hearing?

• Determining a student's least restrictive environment should consider communication mode, academic level, and socialization needs.
• Deaf culture considerations may influence student and family preferences as to the least restrictive environment.
• Environmental arrangements should include consideration of such factors as visual materials, posting of rules and class jobs, and using cards and charts to establish schedules and routines.
• Interpreters should be trained and collaborate with the teacher, but not be responsible for ensuring student learning.
• Hearing aids are commonly used to amplify sounds and it is important to know how they work and should be maintained.
• Loop or FM systems also aid listening and are helpful in large or noisy environments.
• Cochlear implants can aid listening in students with sensorineural losses, but their implantation is invasive and may not be preferred by Deaf culture members.
• Closed captionings produce typed words on a television screen to accompany what is being said orally.
• Telecommunication relay services allow a person with a hearing loss who has a text telephone to communicate through an operator with hearing persons who have traditional telephones.
• Instant messaging and e-mail can bypass the need for telecommunication relay services.
• Word processing, databases, spreadsheets, and computer based publishing programs can aid students in producing written products.

What Are Some Considerations for the General Education Teacher?

• Most students are educated in general education settings at least part of their day.
• Teacher awareness of the impact of hearing loss and teacher attitudes can affect successful inclusion.
• Teachers should promote family involvement especially during early childhood.
• Self-determination skills are important as are activities to promote social skill development.