Kid Confidential: Tips for Working with Students with Hearing Impairment in the Schools

This month I revisited the topic of classroom difficulties and possible accommodations and modifications for students with hearing loss in the School Matters column of the ASHA Leader.  As there is so much to discuss on this topic, I was unable to share some of the inside tips I have learned when working with students with hearing impairment in the academic setting.  So I thought I would share this information with you today.

Here are the top five lessons I learned when working with students with hearing impairment in the schools:

1. Work with the student’s audiologist.  I am not a specialist in the area of hearing.  Therefore, every time I have a student with hearing loss referred to me or placed on my caseload, the first thing I do (after reading the audiological evaluation report) is contact the audiologist to ask all of my questions and voice any concerns.  I know, as school-based speech-language pathologists, you struggle to have enough time in the day to do everything you need to do but this is the first and foremost important piece of advice I can give you when working with children with hearing loss of any severity (including children with sound field amplification systems, hearing aids, and cochlear implants-CI).  Audiologists do not expect us as SLPs to know everything about their field.  In fact, they are more than happy to share their wealth of knowledge.  I have learned so much regarding simple tests I can perform for quick assessment of my student’s hearing perception at varying distances to determine how they are perceiving that audiological input (i.e. Ling 6 sound test), how and when to recommend a student with CI to return to their audiologist to once again MAP their CI, what classroom behaviors are evidence of improved hearing and understanding and conversely which suggest possible malfunction of hearing equipment.  Without an audiologist’s guidance, I would not be able to do these things today.
2. Consult with your district’s teacher of the hearing impaired frequently.  Although, the teacher of the hearing impaired may not be an audiologist, he/she knows the practical strategies and techniques to use while teaching students with hearing impairments in the academic setting.  I have learned how to teach speech and language skills effectively in 1:1 therapy, small group therapy, and in-class therapy for children with hearing loss.  I have learned how to troubleshoot if a hearing aid isn’t working correctly, how to hook up the FM system “boots” to a CI, and what to look for in the classroom and therapy setting that may indicate the need for further analysis of hearing equipment.  Using the teacher of the hearing impaired as a frequent resource to share ideas and answer your questions can be an invaluable and integral part of your therapy plan.
3. Record in-depth observations:  This is a technique I use to determine if growth is being made in all observed areas even if not specifically targeted on current IEP goals (e.g. improvement in social skills, changes in responding to environmental noises, changes during large group classroom lessons, etc.) or if current progress is not yet quantifiable.  Quality records can help you to share the changes effectively (positive or negative) in your student’s speech, language, or academic skills with the student’s audiologist and hearing impaired teacher to determine the next steps in the therapy process.  I have found emailing my in-depth observations to audiologists for my clients with CI is an enormous help when they are working on MAPping my client’s CI. Parents cannot notice nor may they fully understand the big and small improvements or difficulties a child may exhibit in the school environment.  Therefore, it can be a challenge for audiologists to determine MAPping changes and needs based solely on parent report and child response.  Noting these observations, such as environmental and speech sounds, to which the child no longer responds, assists the audiologist in making the appropriate adjustments to the students CI so as maximal learning can occur.  Don’t underestimate the importance of functional observations.
4. Get the classroom teacher on board.  Many times classroom teachers just feel lost when expected to appropriately modify for students with hearing loss in their classroom.  They may be anxious about working with this population, which can manifest itself in what seems to be uninterest or even noncompliance.  However, the truth is the classroom teacher may not know what do to and may be looking to you, the SLP, for assistance.  Showing how simple modifications made in the classroom, in real-time, result in improved learning opportunities for their student is one of the quickest ways to get your student’s teacher on board.  Also frequent classroom visits can help you in identify and address additional situations that may be inhibiting your student’s learning (e.g. environmental noises affecting hearing, lack of sufficient visual support in the classroom, classroom instructional language used is too complex, instructor not appropriately amplified at all times, etc.).  Helping to address and make the appropriate changes and adjustments needed in the classroom environment throughout the school year, can be extremely helpful for your student as well as for the classroom teacher.
5. Do not be afraid to say “I don’t know, but I’ll find out.”  This is the best tool to use when working collaboratively with a number of various professionals.  You can bring your current knowledge and clinical experience to the table, however, no one expects you to know everything about treating every disorder or deficit.  It really is OK to say “I don’t know,” but just make sure you follow that with “but I’ll try to find out for you,” because ultimately classroom teachers, parents, staff members, and other therapists just want to know you are there to help and support them.  Since you already established a great working relationship with your student’s audiologist, I would recommend you start there when you have additional questions you cannot seem to easily answer or research.

Those are my top five tips for working with students with hearing impairment in the school environment.  Do you have additional tips you’d like to share?  Feel free to comment below.