Profound Hearing Impairment

Strategies for the Classroom & Tools for the SLP

Focus of Intervention

Interventions for children with profound hearing loss are primarily focused on the following goals:

  • Preventing or reducing the communication problems that typically accompany early hearing loss.
  • Improving the child's ability to hear with amplification devices etc.
  • Facilitating family support and confidence in parenting a child with a hearing loss (Paul, 2007).

Types of Instruction

Interventions focused on developing a child's communication skills and abilities differ according to the type of communication approach that will be used by the child and family.
1.) Oral approaches- Emphasize spoken language as the primary mode of communication through the use of strategies such as speech reading, amplification, auditory training, and explicit speech-language instruction (Roth & Worthington, 2011).
2.) Manual approaches- Focus is on the earliest possible acquisition of a linguistic system generally by use of American Sign Language, finger spelling, and/or manually coded English systems (Roth & Worthington, 2011).
3.) Total communication approaches- Encourages using a combination of approaches/modalities such as speech, writing, signing, gestures, and facial expressions. Focus is on using whatever methods are most effective for the child (Roth & Worthington, 2011).
4.) Bilingual/bicultural appraoch- Children are exposed to ASL as their primary language for communication and then learn English in the school setting in order to develop reading and writing skills (Roth & Worthington, 2011)

Improving Their Ability to Hear

Parents also must choose a means for improving their child's access to sound. The assistive devices most commonly used to amplify sound are hearing aids. Other assistive devices include FM systems and tactile aids. Some children with severe to profound hearing loss who have demonstrated little benefit from conventional hearing aids may receive a cochlear implant, an electronic device that is surgically placed in the inner ear (Culbertson, 1997).
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Strategies for the Classroom

There is a range of teaching strategies that can benefit all students to learn but there are some specific strategies that are useful in teaching students with profound hearing impairment. For example, providing content in various modalities will help these students who often rely on other senses to compensate for their hearing loss. Other examples include:
  • Keep instructions brief and uncomplicated as much as possible.
  • Use an FM system, pass it around to students when they answer questions when possible.
  • Teachers should present lecture information in a visual format.
  • Repeat the comments and questions of other students, especially those from the back rows. Acknowledge who has made the comment so students who are deaf or hard of hearing can focus on the speaker.
  • If possible, provide transcripts of audio information.
  • Allow several moments extra for oral responses in class discussions because it may take longer for them to comprehend what the teacher's asking.
  • Face the class while speaking; if an interpreter is present, make sure the student can see both you and the interpreter.
  • People who are deaf or hard of hearing often use vision as a primary means of receiving information. Captioned videos, overheads, diagrams, and other visual aids are useful instructional tools for students with hearing impairments.
  • Be flexible: allow a student who is deaf to work with audiovisual material independently and for a longer period of time.
  • Assist the student with finding an effective notetaker from the class.
  • Provide hand-outs (preferably electronically) in advance of lectures and seminars.
  • Circular seating arrangements offer students who are deaf or hard of hearing the best advantage for seeing all class participants.
  • When desks are arranged in rows, keep front seats open for students who are deaf or hard of hearing and their interpreters.
    (Teaching Strategies for Hearing Impaired Students, 2015)
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Techniques & Tools for the SLP

Speech-language pathologists in conjunction with audiologists are qualified to provide aural rehabilitation components. Therefore SLPs can provide training and treatment in communication strategies, speech-perception training (speech-reading, auditory training, and auditory-visual-speech-perception training) and comprehension of oral, written, and sign language (ASHA, 1984). SLPs also work on improving children with profound hearing impairments speech and language abilities such as:
  • Improving speech production and increasing their phonetic inventory because children with profound hearing loss often reach an early plateau in their speech skill development. For instance, the speech characteristics of many children with profound hearing loss demonstrate little improvement in sound inventory and intelligibility after 8 years of age (Hudgins & Number, 1942).
  • Increasing their vocabulary development
  • Increasing expressive and receptive language
  • Increase Syntax skills
  • SLPs also do daily checks of hearing aids and cochlear implant speech processors.
  • SLPs advocate for the appropriate educational placement of all students with hearing loss such as making sure they get accomadations like an FM system, front row seating, and making sure they are in environments with little background noise. SLPs collaborate with teachers to implement educational strategies, including improved classroom acoustics, that optimize students' ability to learn (Roth & Worthington, 2011) .

Helpful Tools/Strategies in Therapy:

  • Hearing First- The SLP should talk about pictures, objects etc. before showing visual supports. This will help the student focus on listening and not rely solely on visuals. After materials are show, repeat and rephrase the content so the child can make the connection between the auditory and visual content
  • Sit beside the student so they can hear better, especially if one ear is better then the other.
  • Allow wait time for the student to process the auditory content and attach meaning to it.
  • ASL- if the SLP is fluent in ASL, may try as a means of communication

( Gomez & Goldberg, 2009).