Education of the Deaf and Hard of Hearing

EDHH Graduate Project

This page is specifically designed to help families seeking information about living with a child who is deaf or hard of hearing. Communication and family involvement are key components to the child's development in the areas of language, cognition, speech, auditory perceptual and social skills.

Modes of communication

American Sign Language (ASL)

American Sign Language is a language used by many Deaf individuals who are involved in Deaf Culture, meaning in most cases they are born into a Deaf family. It is a fully developed language with unique grammar. It is a visual language, which requires the use of signing and gestures. The shape, placement, and movement of the hands, as well as facial expressions and body movements all play important parts in conveying information.

Pidgin Sign English (PSE)

Pidgin Signed English is a combination of American Sign Language (ASL) and Manual English. Usually signed in English word order and can be used simultaneously with voiced English. It borrows many signs from ASL. PSE is used by Deaf people and hearing people to communicate with each other in social and formal situations. Often said to bridge the gap between Deaf and hearing people.

Signing Exact English (SEE)

Signing Exact English follows English exactly, using word order and grammatical markers such as endings, suffixes and prefixes, and can be used simultaneously with voiced English. SEE is a visual system that exposes Deaf children to English on the hands in formal situations and is rarely used by Deaf adults. Children who are exposed at an early age to SEE are able to learn English, including the many idiomatic expressions and uses of figurative language so unique to English which exposes children to language learning opportunities that are equivalent to those of hearing children.

Cued speech

Cued Speech makes spoken English or language visible, it provides cued phonemes and is sound-based, it uses eight hand shapes (cues) in four locations in combination with the natural mouth movements of speech to make all sounds of spoken language look different. This system allows the individual to distinguish sounds that look the same on the lips.

Auditory oral

Auditory Oral method allows children to learn to maximize their residual hearing through the use of hearing aids, cochlear implants, and educational and therapeutic techniques that support the development of audition and spoken language. Some auditory oral education and therapy programs also have a strong visual component, meaning that, there is an emphasis on using visual techniques to teach speech. In some cases, speech (lip) reading skills are used as an aid to hearing. However, because of the vast improvements in hearing technology, there has been movement away from teaching speech-reading.

Auditory verbal

Auditory Verbal is a method that is very similar to the auditory oral approach in that there is a strong emphasis on maximizing a child's residual hearing and his or her ability to use it. Certified auditory verbal therapists provide individual therapy to a child and his or her parents or caregivers that coaches them how to teach their child to communicate using spoken language. The primary goal is to provide adequate support of the child's development and integration of listening and spoken language into everyday life. The auditory verbal approach also supports a child's participation in regular classroom placements as soon as possible.

Total communication

Total Communication (TC) incorporates all means of communication; formal signs, natural gestures, fingerspelling, body language, listening, speech-reading and speech. Children in TC programs typically wear hearing aids or cochlear implants. The goal is to optimize language development in whatever way is most effective for the individual child.

Assistive technology devices

The Individuals with Disabilities Education Act (IDEA) defines an ‘assistive technology’ “as any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability”. Assistive technology promotes independence and self-advocacy by enabling individuals to perform tasks that they were formerly unable to accomplish by providing enhancements with the aid of technology to accomplish such tasks.

Frequency Modulation (FM) systems

There are two different types of FM systems, a personal FM system, and a sound-field FM system. FM systems can be used in the educational setting to help a child better learn the content that is being discussed. A personal FM system provides sound directly to a deaf or hard of hearing individual. Its design is similar to a hearing aid, or it can also be adapted to an existing hearing aid. A personal FM system must be set for each child by the child's audiologist. A sound-field FM system provides increased and directed sound levels to a group of individuals. Special speakers are placed strategically throughout the classroom (even on a student's desk) to direct amplified sound where needed. As a result, all students sitting within range of the speaker benefit from the teacher's amplified voice.


Infrared is described as a system that utilizes light waves to transmit sound from the transmitter to a special light sensitive receiver. The signal can be broadcast to a whole room through speakers or an individual can wear an individual receiver. There must be a clear line of connection between the transmitter and receiver so that the light signal is not interrupted. The benefit of infrared systems is that they only work in the room where the transmitter and receiver are located resulting in significantly fewer issues with crossover. These systems can be sensitive to external light sources or interfering objects.

Audio loop

An Audio Loop, also known as a hearing loop, is another assistive technology that parents might want to use for their child in the educational setting. It is a wire that circles a room and is connected to the sound system. The loop transmits the sound electromagnetically. The electromagnetic signal is then picked up by the telecoil in the hearing aid or cochlear implant. Audio loop is easily accessible to an individual all they must do is flip the telecoil switch on their cochlear implant or hearing aid. No additional receiver or equipment is needed.

One-to-one communicators

One-to-one communicator as a system that allow a person to hear, through a hearing aid or set of headphones, only what one specific person is saying. The person speaking speaks into a microphone and the sound is communicated directly into the one-to-one device. The person using the system can adjust the volume as needed to hear conversation from another person, listen to TV, or while riding in the car.


Behind-the-ear hearing aids (BTE)

Typically, young children will wear BTE hearing aids because they have flexible adjustment and are more durable. The ear mold of the BTE can be extracted from the hearing aid and new ear molds can be made as a child grows, which can save a tremendous amount of money.

In-the-ear hearing aids (ITE)

Adults more commonly use ITE hearing aids because they are less durable and cannot easily be manipulated to fit a child’s growing ear. Also, the ITE hearing aids are not suitable for some hearing loss, most beneficial to individuals with a mild to moderate hearing loss.

Middle Ear Implants (MEI)

With technology advancing daily experts are finding different ways to improve the hearing ability for individual with a hearing loss. One-way this is happening is through Middle Ear Implants (MEI) which is a small device that is inserted into the middle ear and rather than amplifying the sound traveling to the eardrum, an MEI moves these bones directly. MEI devices are designed for people whose hearing loss is primarily located in the outer or middle ears, in situations where there is little damage to their inner ears.

Cochlear Implants (CI)

Cochlear Implants are an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain. A child must go through extensive therapy to learn what the sounds they begin to hear are. Children must meet a criterion before they can be implanted. Children can be implanted as young as 12 months old. For young children who are deaf or severely hard-of-hearing, implantation while young exposes them to sounds during an optimal period to develop speech and language skills.

Ling sound checks

Daily device checks and Ling Sound Checks should be completed with the child when they are wearing their hearing aids to ensure that they are providing children with the proper sounds. Depending on the child’s age, there are different ways to complete a device check. When the child is in infant it will be the parents responsibility to check the hearing aid for any malfunctions. As the child mature they will be able to communicate the problems with the hearing aid. The parent should also complete a Ling Sound Check. The parent should say the sounds “ah” as in saw “ee” as in tree “oo” as in shoe “ss” as in sat “sh” as in shoe “mm” as in gum. These are sounds that are heard daily and ensuring that they are being properly transmitted through the hearing aid will help the child be exposed to the appropriate language.

Apps in speech and language development

In recent years the development of technology has played an increasing role in the education of students in the classroom.  The expansion of applications (apps), software tools, has created a rich learning environment on technology devices.  The most popular, used in the educational setting, is the iPad.  The apps have been viewed as educational tools with the ability to enhance students’ skills in a wide variety of areas.

Hearing loss in children can have a significant impact on their learning abilities, language, and speech.  Incorporating apps into daily instruction not only can be used as a motivator for students, but as a tool to stimulate and increase the development of speech and language skills. There are countless learning apps for children to utilize to help improve speech and language development. 

Spoken language

Spoken language is learned through listening.  Typically developing children learn and pick up spoken language quite easily because they can hear themselves and others speaking around them on a daily basis.  However, a child who is deaf or hard of hearing is at a disadvantage.  They often cannot hear themselves and miss the spoken language being used by those around them. It is crucial the child learns the language through other methods. This is where speech and language apps can play an important role in developing these skills.


What makes an app successful?  There are many components of apps that determine the effect they will have on a child's speech and language skills. It is important to make sure the app is providing instruction at the child’s appropriate level. If the material presented on the app is above the student’s instructional level they may become frustrated and this could result in zero positive learning outcomes. Thus, for apps to be successful in increasing the education of children it needs to fall within their instructional or independent level. 

First, teach the concept without the use of the iPad. It is important to make sure the child is already familiar with the concept the app is focused upon.  Secondly, explain and model the app for the child. Let the child know what they are doing and why.   Next, guided practice should be used with the app. During this time, guidance and feedback play a crucial role in the success of the instruction.  Lastly, the app should be used as independent practice.

Other key components to consider when choosing apps are that it is has highly digitized speech and colorful graphic images, interactive tasks requiring an active response, clear instructions, practice tasks, consistent intervals of time for each learning task, encouragement, reinforcement and modeling, and feedback to right and wrong responses.