BHI Urges Teachers to Help Children with Unaddressed Hearing Loss

September 2009

Editor: Are there really a million school kids with significant unaddressed hearing loss? If so, that's a major public policy issue that should be addressed right now. Here's a statement from the folks at the Better Hearing Institute (BHI).

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As schools across America open their doors for the start of the new academic year, the Better Hearing Institute (BHI) is urging teachers and educators to stay alert to the needs of children with unaddressed hearing loss. This call to action comes in response to the findings of a national study--Are 1 Million Dependents with Hearing Loss in America Being Left Behind?--in which BHI found that America's children are paying a high price for the pitfalls in how parents, educators, the healthcare community, and policymakers are addressing hearing loss in our youth.

"Too many children with hearing loss aren't getting adequate help and are being put at risk for learning, social, emotional, and behavioral difficulties," warns Dr. Sergei Kochkin, executive director of BHI, and co-author of the study. "Children need to be able to hear, not just in the classroom, but also because hearing affects language competence, cognitive development, social and emotional well-being, and academic achievement. Children who cannot hear well--that is, children whose hearing loss is untreated or under-treated--could face a life of underperformance and broken dreams."

"Based on our findings, I am concerned that a sizeable population of young people in America is being left behind because they do not fit existing paradigms of hearing disability," said otolaryngologist Dr. William Luxford of the House Ear Clinic, a BHI Board member and co-author of the study. "We need a fundamental re-examination of the current hearing health protocols influencing America's children with hearing loss."

The scientific literature is clear that untreated hearing loss affects nearly all dimensions of the human experience. And the pediatric literature demonstrates that even children with "minimal" hearing loss are at risk academically compared to their normal hearing peers.

According to Kochkin, the findings indicate that too many educators, parents, pediatricians, and other healthcare providers underestimate the impact of mild or unilateral (affecting one ear) hearing loss. As a result, hundreds of thousands of children are left vulnerable to a wide range of social, emotional, behavioral, and academic problems.

Hearing loss of any type or degree in a child can present a barrier to incidental learning--and it's believed that 90% of a young child's knowledge is attributed to incidental reception of conversations around him or her. Research confirms that, on any given day, one third of all children, kindergarten through third grade, have impaired hearing and listening. Hearing loss poses a barrier to the child's ability to overhear and to learn from the environment. It causes the child to miss a significant portion of classroom instruction. And it frequently causes a child to miss social cues. Not surprisingly, many of the symptoms of unaddressed hearing loss in children overlap those of Attention Deficit Disorder (ADD/ADHD).

A large part of the problem is that many parents today either don't recognize their child's hearing problem, minimize it, or have been given misinformation regarding the ability to treat the child's hearing loss. In fact, at least 50 percent of parents don't go back for detailed testing when their infant fails an initial hearing screening.

But according to Eileen Rall, Au.D., CCC-A, an audiologist from the The Center for Childhood Communication of The Children's Hospital of Philadelphia , there are things that teachers can do in the classroom to help children with undiagnosed hearing loss: "First and foremost, teachers can pay attention to the listening environment of the classroom and how the students are functioning in it. There are many low cost, creative ways to improve the acoustics of a classroom including something as simple as teaching children to create good listening environments - make eye contact, reduce distance, taking turns speaking and reducing the noise the students are making themselves. Some schools install sound field systems in their classrooms. Sound field systems amplify the teacher's voice and deliver his/her voice through speakers placed strategically in the classroom. Most importantly, teachers who suspect that a child is having difficulty hearing should bring it to the attention of the child's parents and school administrators so the child can undergo a thorough hearing assessment by an audiologist."

Some basic steps that most teachers can take on their own to help a child with a confirmed or suspected hearing loss include the following:
* Arrange the child's seating away from the heating and cooling system, hallways, playground, and other sources of noise. If the child's hearing loss affects only one ear, or if it's greater in one ear, seat the child in front of the room with his better ear toward the teacher.
* Allow the child to move around in the classroom in order to clearly see the speaker.
* Assign a helper, or notetaker, for the child.
* Try to speak clearly and not too fast.
* While you are speaking, don't turn away to write on the board or cover your mouth.
* Write key words or visual aids for the lesson on the board.
* Write assignments on the board so the child can copy them down into a specific notebook used for this purpose.
* If the child does not understand something, rephrase what you have said rather than repeat the same words again and again.

According to Kochkin, some of the most alarming findings from the study include the following:
* Only 12 percent of children under the age of 18 with hearing loss use hearing aids; yet an estimated 1.5 million youth (including adult dependents) under the age of 21 have hearing loss that may be improved with amplification.
* The study found no evidence of the use of any form of hearing assistance in the classroom (e.g. FM systems, hearing aids, speakers), other than front-row seating.
* Hearing loss leaves children vulnerable to other problems, according to three out of four parents of children with hearing loss. Common problem areas include: o Social skills (52%)
o Speech and language development (51%)
o Grades in school (50%)
o Emotional health (42%)
o Relationships with peers (38%)
o Self-esteem (37%)
o Relationships with family (36%)
* Three in ten parents (32%) cite embarrassment or other social stigma issues as a reason their child does not use a hearing aid.
* One out of five (22%) parents says they are unable to afford hearing devices.
* Four in ten parents were told that their child did not need amplification because they had hearing loss in only one ear.
* Two in ten parents were mistakenly told that their child could not be helped because they had high frequency hearing loss. Another 20 percent were told they could not be helped because they had a low frequency hearing loss.

Key educational and public policy questions raised by the study include the following:
* Do educators, medical doctors, and hearing healthcare professionals underestimate the impact of mild and unilateral hearing loss on children?
* Are pediatricians sufficiently trained to measure hearing loss and advise parents of treatment options?
* Is the prevalence of treatable hearing loss among children under-represented in the United States when subjective methodology (e.g., parental awareness) is used to assess hearing loss?
* Do parents have viable options for paying for hearing aids for their children if they can't personally afford them?
* Why are only a minority of children in America with hearing loss recipients of amplification, and what can be done in the medical and hearing health profession to make sure that all children receive adequate help for their hearing loss?
* Are too many young people in America being left behind because they don't fit existing models of hearing disability?

Are 1 Million Dependents with Hearing Loss in America Being Left Behind was conducted by BHI among a national sample of parents of 225 youth from infancy to age 21-all of whom were reported by their parents to have hearing loss and not use hearing aids. The authors of this study also included Dr. Jerry Northern (Professor Emeritus at the University of Colorado School of Medicine), Pam Mason (Director of Audiology professional practices at the American Speech-Language-Hearing Association) and Dr. Anne Marie Tharpe (Professor of Audiology at the Vanderbilt School of Medicine).

Founded in 1973, The Better Hearing Institute (BHI) conducts research and engages in hearing health education with the goal of helping people with hearing loss to benefit from proper treatment.

To download a copy of the study, "Are 1 Million Dependents in America with Hearing Loss Being Left Behind?" or to download a copy of "A Guide to Your Child's Hearing" visit the BHI website at www.betterhearing.org.