7.5: Identifying Students Who Are Deaf or Hard of Hearing

Babies are usually subjected to a newborn hearing screening. Children are also screened for hearing problems at regular intervals during their well-child visits. If a pediatrician identifies a hearing problem, the child will often be referred to an audiologist for additional testing, diagnosis, and treatment. ASHA has identified the role of an audiologist in its Scope of Practice in Audiology document. If hearing loss is determined to be congenital, the child’s family may choose to undergo genetic testing to determine a possible cause (Smith & Robin, 2002; Smiley et al., 2022).

Symptomatic behavior of a student who may be experiencing hearing loss includes the following.

• Complaints about the ears
• Frequent infections of the ear, nose, or throat
• Speech articulation problems
• Embarrassment about participating in school activities that require speaking and listening
• Frequent requests to have a verbal message repeated or said more loudly
• Problems attending to the conversation of others

Other possible symptoms that may be observed include turning up the volume on auditory devices, social withdrawal, inattentiveness, and not following directions (Smiley et al., 2022).

Scheetz (2012) identifies four types of testing used to evaluate students who may be experiencing hearing loss. Pure-tone tests are usually conducted once a hearing loss is suspected. Pure-tone tests help to determine the degree and type of hearing loss present. There are two types of pure-tone tests. In a pure-tone air test, or pure-tone audiogram, sounds of different pitches and loudness are transmitted, usually through earphones, directly into the ear. This test is often used to determine whether there may be a conductive, sensorineural, or mixed hearing loss. Speech reception threshold and speech discrimination threshold tests help to determine at what dB a student can hear speech and, once loud enough, how well the student can understand the speech. Audiologists may also determine if an amplification device is appropriate and how amplification might influence a student’s ability to communicate in different environments (Smiley et al., 2022).

Assessment of the Effect on Educational Performance

Identifying students under IDEA requires evidence that hearing loss adversely affects educational performance. In addition to audiologic testing, the multidisciplinary team (MDT) may conduct intelligence tests and other tests of academic abilities. However, there are several problems with these types of assessments. Many of these assessments have not been validated for use with students who are experiencing hearing loss. In addition, few assessments have normative comparison groups for students who are deaf or hard of hearing. The administration and interpretation of these types of assessments require a professional who is well versed in the norms of this particular student population (Smiley et al., 2022).

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Smith, R.H., & Robin, N.H. (2002). Genetic testing for deafness – GJB2 and SLC26A4 as causes of deafness. Journal of Communication Disorders, 35(4), 367–377. https://doi.org/10.1016/s0021-9924(02)00091-6

Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.

Sheetz, N.A. (2012). Deaf education in the 21st century: Topics and trends. Pearson.