The Mainstream ClassroomEffective Integration of Children with Hearing Loss

Jessica Ledingham

ENGL 138T Professor Kyle King

4/15/15

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Transitioning to the Mainstream Setting

According to Dr. Marc Marschark, professor and director of the Center for Education

Research Partnerships (CERP) at Rochester Institute of Technology, “We’re changing the face of

deaf education around the world.”1 His recent findings suggest that education for students who

are deaf and hard of hearing (DHH) is progressively shifting away from specialized residential

schools and small, self-contained classrooms. Enrollment has evolved from total communication

programs where children use sign language, lip-reading, and visual imagery to now the

mainstream setting. Mainstreaming provides DHH students the opportunity to learn alongside

their hearing peers and to become fully integrated into regular school classrooms.2 As a result of

the legislative, technological, and pedagogical changes that have contributed to such a transition,

85% of children with hearing loss are currently integrated.3 However, this increasing percent

calls for school professionals to pay greater attention to the needs of a student in a mainstream

classroom, ensuring that he or she has the chance to reach full potential.

Federal legislation has played an especially significant role in shaping the transition to

the mainstream classroom. In 2005, 37 states ordered Universal Newborn Hearing Screening

(UNHS), a law mandating that every infant in the United States be tested for hearing loss within

5 days of birth.4 Immediate identification allows for DHH students to access a full range of

intervention services and prepare to be mainstreamed as early as preschool. Additionally, the

Individuals With Disabilities

Education Act (IDEA),

enacted in 2004, requires

that a child with disabilities

be educated in the “least

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restrictive environment” and “to the maximum extent appropriate … with children who are

nondisabled.”6 Therefore, the law stands by the belief that all students, including those with

hearing loss, should be held to the same academic standards and granted equal access to

education in a mainstream setting.

In addition to legislation’s

contributions to the evolution of deaf

education, technological advancements

have positively impacted the lives of

students who are DHH. The major developments of digital hearing aids and cochlear implants

allowed children with hearing loss to access auditory information more efficiently.7 As opposed

to analog instruments, digital hearing aids offer increased audibility of sounds of interest without

the discomfort from high intensity sounds.8 They also contain DSP, a technology that can

calibrate the teacher’s directional microphone, control the shape of the directional pattern, and

improve the signal-to-noise ration.9 On the other hand, the cochlear implant, a device used by

children with severe to profound hearing loss, bypasses the damaged parts of the inner ear

and stimulates the nerve to send information to the brain.10 Due to these extensive

advancements in hearing devices, the technology is now embraced by the regular

education classroom where DHH students can achieve both auditory and verbal success.

Reality of Implementation

With the establishment of legislative acts, such as UNHS and IDEA, as well as the

increase in early cochlear implantation, children who are DHH are no longer “expected” to be

behind in speech and language development.11 Although this progression has resulted in the

option of integration into the mainstream setting, it has drastically raised the expectations of the

VS.

Analog Digital

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regular education school systems. They are now accountable for making changes to their

instruction and services, maintaining the academic growth of the newly integrated student.12

However, many teachers are unaware of the needs of mainstreamed students who access

information differently from their hearing peers. Dr. Carol Flexer, distinguished professor of

audiology at The University of Akron, believes that hearing loss is not only an “ear issue,” but

also a “brain issue.”13 She stated, “Learning to listen also needs to be a component of the

education process if children are to be able to organize information, establish vocabulary and

develop receptive and expressive language.”14 Regular education teachers and speech and

language pathologists lack the support and proper training to address this particular learning

style. In order to keep pace at the level of implementation and close the gap between policy and

practice, mainstream school systems nationwide need to improve their mainstream

environment.15 Dr. Flexer noted that “Today’s training programs cover such broad topics, [so]

there really is a need for more specialized training.”16 Moreover, qualified professionals, such as

itinerant teachers of the Deaf/Hard of Hearing and educational audiologists, should be hired to

provide training for the regular education staff and to monitor the acoustic environment and

ensure that it is optimal for accessing auditory information. By continually updating and

improving such resources, a child with hearing loss can effectively be integrated into the

mainstream classroom.

Impact of Hearing Loss in the Classroom

Through Marschark’s research in the field of deaf education, he concluded that students

who are DHH learn differently from their hearing peers.17 Although they have slightly stronger

visual-spatial memories, their sequential memories and ability to organize knowledge fall

behind.18 Any degree of hearing loss can delay a child’s progress in school, resulting in learning

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and behavioral problems as early as kindergarten.19 By the third or fourth grade, many may

struggle to cope with the increasing complexity of language and verbal communication.20 If poor

academic performance and communication problems accelerate, low self-esteem or feelings of

isolation or depression can also be an issue.21 Therefore, mainstream teachers must recognize this

population’s specific learning needs, allowing the integrated student to successfully access

information.

In a mainstream setting, educational practice occurs in a large classroom with many other

children and noisy distractions. Children without hearing loss can listen across distance and

comprehend the fast-paced conversations of their classmates, even if it is only a whisper.22

Conversely, those who are deaf and hard of hearing often find communication in the mainstream

classroom to be quite difficult. Auditory-verbal therapist, Lynn Wood, believes that “The

detriment to learning is not […] hearing loss, which [is] technologically and therapeutically well

managed, but instead it [is] the school’s learning environment if left untreated.”23 Wood’s

statement supports the idea that acoustic or listening barriers prevent DHH students from having

full access to auditory information.24 If the factors of distance, reverberation, and background

noise are not ideal, speech perception, on-task behavior, reading and spelling ability,

concentration, and academic achievement will all be compromised.25 Distance hearing is a

problem because a teacher’s voice loses intensity and critical speech elements as the signal

travels away from the sound source.26 On the other hand, reverberation, or sound reflecting off

surfaces within the classroom and persisting in space, muffles the spoken word and reduces a

student’s ability to understand speech.27 Additional background noise issues include poorly

designed heating, ventilation and air-conditioning systems, which compete with important

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speech signals.28 If these communication barriers are overcome, learning can be facilitated to all

integrated children with hearing loss.

Even though deafness and hard-of- hearing are considered “low-incidence” disabilities,

affecting less than 1% of the population, studies have shown that some level of hearing loss will

affect 14.9% of school-aged children.29 Many students who are DHH are able to detect the

presence of speech, but the words may not be intelligible without technological intervention.30

For instance, a student with hearing loss may not be able to differentiate between the words

“walk”, “walked”, “walking,” and “walks.” The high-frequency sounds, “s,” “th,” “f,” and “sh,”

are a crucial component of speech comprehension, but are unfortunately the most common type

of hearing loss.31 Consequently, children with this difficulty struggle to recognize verb tense,

pluralization, possession, and contraction.32 In terms of listening strategies, DHH children utilize

the auditory-oral approach and have to be taught how to listen and distinguish sounds from

inference.33 Normal-hearing children learn incidentally, passively absorbing 90% of their

information from surrounding sounds.34 Due to the fact that a child with hearing loss lacks this

skill, they need to be taught alternative listening strategies. The primary effect of hearing loss on

a student is its tendency to cause difficulties with delayed language, speech, syntax,

intelligibility, and voice quality.35 Oftentimes, DHH students speak with a nasal or atonal quality,

which requires extensive treatment from a speech and language therapist.36 In the mainstream

classroom, hearing loss can also have a negative influence on writing, reading, and vocabulary

development. If a child has inadequate knowledge of vocabulary they will only comprehend one

meaning of multi-meaning words, which can limit their reading abilities and overall academic

performance.37 When a student with hearing loss is integrated into the mainstream environment,

these deficiencies have the potential to become more prominent, requiring the support of

The Speech Banana: Frequencies that affect Speech Comprehension40

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knowledgeable professionals. Contradicting popular

assumption, if a child who is DHH is placed in an optimally regulated classroom, he or she will

still be faced with a difficult listening environment. Ideal listening conditions require the

teacher’s voice to be 20 to 30 dB louder than the background noise.38 However, a typical

classroom speaking voice is 55 to 70 dB, which is, in most school settings, the same decibel level

as the background noise.39 Regardless of the degree of deafness, whether mild, moderate, severe,

or profound, this inconvenience presents challenges to the entire population of hard of hearing

students. Children who have a mild hearing loss miss sounds below 25 dB, such as running water

and chirping birds, while children who are moderately to profoundly deaf miss sounds in almost

all decibel ranges. When these children are integrated into the mainstream classroom where they

are forced to localize speech

and distracting background

noises, their need to access

auditory information becomes

more important. As long as

the communication conditions

of their new environment are

improved, they have the

ability to thrive alongside

their hearing peers.

Self-Image and Social Adjustment

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Aside from the impact of hearing loss on a child’s speech and language development, the

disability can also have an effect on a child’s self-esteem. Entering into the mainstream setting

can cause some to perceive themselves as “different” from their peers, specifically if they wear

hearing aids and cochlear implants.41 Their reduced ability to communicate may even interfere

with their abilities to socially interact, appearing less attentive, less confident, and easily

frustrated.42 Irritable behavior can also be evident due to their level of effort needed to simply

listen. However, with appropriate information, regular education teachers can educate their class

members about the situation to allow the student to have an easy transition into the mainstream.

In-service Training for the Mainstream Classroom Teacher

Due to the lack of support and training for the regular education staff, teachers are

unprepared to support the mainstreamed student in the “least restrictive environment.” The

public and private school systems that embrace children with hearing loss need to design

programs centered on a specialized teacher of the deaf and hard of hearing. This itinerant teacher

would be hired to provide in-service training for the regular education staff and in-class and pull-

out support for the student who is DHH. Their services also involve monitoring the acoustic

environment of the classroom, ensuring that it is optimal for accessing auditory information. At

the start of a new school year, the itinerant teacher would organize an in-service training session

for the regular education staff.43 The goal of the presentation is to make the case that a student

with hearing loss needs accommodations that will allow them to keep pace with their maximum

learning ability.44

During the training session, the itinerant teacher would predominantly focus on

demonstrating the experience of having a hearing loss via computer simulations. To offer a more

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individualized simulation or recording, the presenter can enter specific hearing thresholds,

particular to the student at hand.45 In addition to technological demonstrations, earplugs are

effective tools to understand the effect of a unilateral or mild hearing loss. The itinerant teacher

would also explain the fact that if a child with hearing loss does not have “equal access to

information,” they cannot be held to the same expectations as their classmates. Most importantly,

the itinerant teacher would emphasize the relationship between teacher and student. Although the

regular education teacher is responsible for making appropriate accommodations and

modifications, the student who is DHH needs to improve his or her self-advocacy skills.46

Communication is a “two-way street,” so the child should remind the teacher to use the

amplification device, or FM system, and let them know when noise is interfering.47

In addition to helping the student who is DHH with auditory training and vocabulary and

language development, the itinerant teacher will continue to educate the mainstream classroom

teacher on how the student can efficiently access information:

Communication Strategies

If a child has a “better” ear, seat him/her with the better ear towards the teacher.48

Try not to seat the student near air conditioners, heaters, open doors or windows, computers, overhead projectors, or near other high noise areas of the room.49

Speak naturally at normal volume. Exaggeration and over emphasis of speech will hinder the student’s ability to speech-read and auditorily process language.50

Repeat key points and rephrase using different words.51

Since DHH students have difficulty following conversations that move around the room, identify who is speaking and repeat peer comments during class discussions.52

Set up a signal so the student can let you know when he’s struggling.53

Identify a buddy that can repeat a page number or simple instruction, but only as necessary… the student needs to learn to advocate for himself!54

Yelling ≠ Ideal

Natural Speaking Voices Only!

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Improving the Listening Environment

One of the biggest limitations of hearing aids

and cochlear implants is their inability to enhance the

signal-to-noise ratio when the listener cannot be

physically close to the speaker.62 The signal-to-noise

ratio (S/N ratio) is the relationship between the

loudness of the message or signal and the background

noise it must overcome to be understood.63 Average

classroom S/N ratios are only +4 or +5 dB, but

children who are DHH require a +15 to +20 dB S/N

ratio.64 Many teachers feel that if they raise their voice, a child will sufficiently hear what they

are saying. They don’t realize that yelling simply creates audibility, and that the student will still

Result of Preferential Seating61

Visual Considerations

Allow the child to move to another seat, chair or place in the room that allows him or her to see better as classroom activities change.55

Avoid standing in front of a window so that your face can be seen without outside distractions or glare from the sun.56

All new directions, concepts, and information should be presented from the front of the room, not when the teacher is transitioning around.57

Write all assignments on the board.58

If a visual is used, like a map, graph or a projected image, allow students a chance to look at the visual, describe what they are seeing, and provide short silences so they can process the meaning of both the visual and what is being said.59

All videos need to be captioned for the student to have access to the same information as his/her peers.60

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be unable to hear differences among speech sounds.65 Ideally, the distance from a child’s ear to

the sound source should not exceed 6 inches, but since this situation is not realistic, an assistive

learning device is needed. Specifically, an FM system, which includes a remote microphone that

is worn close to the sound source, is used to improve the speech-to-noise ratio.66 This device

allows the teacher to move freely about the classroom while the FM unit receives and transmits

information to the student.67 Since the system often contains various settings, the itinerant teacher

must train the classroom teacher on how to manipulate it throughout the school day. Sound-field

technology not only controls the acoustic environment for a DHH student, but it also promotes

speech accessibility to all children present.68 If children with hearing loss require more than oral

input to fully access a curriculum’s information, sign language interpreters may be assigned to

them.69 Regardless of the types of listening accommodations for integration into the mainstream,

all auditory needs and goals should be specified in the student’s Individual Education Program

(IEP).70 The school system must follow this legal document to ensure that the student with

hearing loss can function efficiently in a typical classroom environment.

Fostering a Positive Mainstream Experience

The most challenging task for teachers who embrace a student with hearing loss is

assisting with the social integration practice. They need to encourage positive peer-to-peer

communication and help the particular student feel accepted and welcomed. Such a process

involves educating the class members about the mainstreamed student’s disability and promoting

activities that foster inclusion.71 For example, a teacher would enthuse the students by

explaining, “hearing devices are like little computers and high-tech phones rolled into one

(cool!).”72 Classroom teachers should also support daily use of hearing aids and cochlear

implants and know how to respond when the child might be teased for wearing the device.73

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Although a student with hearing loss may not listen in the same manner as their peers, they

deserve the right to be accepted as an equal.

The “Teacher Perspective” and Moving Forward

To be granted the title of a “good” teacher, one must meet the expectations of all students

present, including those who may access information differently. Unfortunately though, research

has revealed that some teachers have expressed negative emotions, such as frustration, regarding

the inclusion of students with hearing loss.74 The only solution to this obstacle in “teacher

perspective” is to continue to develop positive experiences between regular education teachers

and children in the mainstream.75 Auditory verbal therapist, Donald M. Goldberg, believes that

“Children ‘grow-up’ in typical listening and learning environments that enable them to become

independent, participating, and contributing citizens in mainstream society.” Students who are

DHH need to be integrated in diverse settings for preparation of the world ahead of them. If this

message is understood by all individuals involved with the mainstream classroom, the hearing

impaired population will achieve success.

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1 “Deaf Education: A New Philosophy.” Rochester Institute of Technology. http://www.rit.edu/ showcase/index.php?id=86.2 “What is Mainstreaming.” Clarke Schools. http://www.clarkeschools.org/programs-and-schools/clarke-campuses/jacksonville/jacksonville-mainstreaming.3 Krywko, Krystyann. “The Changing Landscape of Deaf Education.” Listening and Spoken Language Knowledge Center. http://www.listeningandspokenlanguage.org/Document.aspx?id =17605 Ibid.6 Zirkel, Perry A. “What the Law Says About Educating the Disabled.” The New York Times. http://www.nytimes.com/roomfordebate/2011/07/31/do-states-need-schools-for-the-deaf.7 Krywko.8 Ricketts, Todd A. “Digital Hearing Aids: Current “State-of the-Art” American Speech-Language-Hearing Association. http://www.asha.org/public/hearing/Digital-Hearing-Aids-Current-State-of-the-Art/.9 Ibid.10 Doyle, Melanie, and Linda Dye. “Mainstreaming the Student who is Deaf or Hard-of Hearing: A Guide for Professionals, Teachers, and Parents.” Hands and Voices. http://www.handsandvoices. org/pdf/mainst_cal.pdf.11 Krywko.12 Krywko.13 Krywko.14 Krywko.15 Krywko.16 Krywko.17 “Deaf Education: A New Philosophy.”18 Ibid.19 “Impact of Hearing Loss at School.” Cochlear. http://www.cochlear.com/wps/wcm/connect/ in/home/understand/my-child-has-hl/hl-at-school.20 Ibid.21 Ibid.22 Anderson, Karen L. “Children with Hearing Loss –Helpful Adaptations in the School Environment.” Supporting Success for Children with Hearing Loss. http://successforkidswith hearingloss.com/wp-content/uploads/2011/08/Adaptations-Children-with-Hearing-Loss.pdf.23 Hubert, Greg. “Classroom Acoustics: The Untreated Learning Environment.” Hands and Voices. http://www.handsandvoices.org/articles/tech/V12-3_acousticsHubert.htm.24 Ibid.25 Doyle, and Linda Dye.26 Ibid.27 Ibid.28 Hubert.29 Doyle, and Linda Dye.30 Ibid.31 Ibid.32 Ibid.33 Ibid.

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34 Ibid.35 Ibid.36 Ibid.37 Ibid.38 Kaderavek, Joan N., and Lori A. Pakulski. “Minimal Hearing Loss is Not Minimal.” Council for Exceptional Children. ProQuest LLC. (2013): 16.39 Ibid.40 “The Speech Banana.” Listening and Spoken Language Knowledge Center. http://www.listen-ingandspokenlanguage.org/SpeechBanana/.41 Doyle, and Linda Dye.42 Ibid.43 “Inservicing the Classroom Teacher.” Supporting Success for Children with Hearing Loss. http://successforkidswithhearingloss.com/inservicing-the-classroom-teacher44 Ibid.45 Ibid.46 Ibid.47 Anderson.48 Doyle, and Linda Dye.49 Ibid.50 Ibid.51 “Inservicing the Classroom Teacher.”52 Doyle, and Linda Dye.53 “Inservicing the Classroom Teacher.”54 Ibid.55 Anderson.56 Ibid.57 Ibid.58 Ibid.59 Ibid.60 Ibid.61 “My child has a hearing loss. What can I do to help him at school?” WTAQ. http://wtaq.com/ blogs/health-fitness/992/my-child-has-a-hearing-loss-what-can-i-do-to-help-him-at-school/.62 Doyle, and Linda Dye.63 Ibid.64 Ibid.65 Ibid.66 Ibid.67 Ibid.68 Ibid.69 Ibid.70 Anderson.71 Doyle, and Linda Dye.72 “Inservicing the Classroom Teacher.”73 Doyle, and Linda Dye.

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74 Vermeulen, Jorine A., and Eddie Denessen, and Harry Knoors. “ Mainstream teachers about including deaf or hard of hearing students.” Teaching and Teacher Education. Elsevier. 2012: 174.75 Ibid., 181.