Considering the Classroom: Educational Access for Children Fitted with Hearing Assistive Technology

By Kimberly Peters

This article is a part of the January/February 2017, Volume 29, Number 1, Audiology Today issue.

As a rehabilitative audiologist, speech-language pathologist, and the mother of a child who is deaf, I expect to get a lot of questions about how to improve listening performance for children in schools. Classroom listening and educational access are complicated issues. We know most children with any degree of hearing loss fall into the category of hard of hearing; children who are in mainstream education settings tend to have more residual hearing; and that about 75 percent of children with hearing loss in public school settings rely on speech for communication and listening to learn (Karchmer and Mitchell, 2006).

We also know that poor signal-to-noise ratio affects learning for children who are deaf, hard of hearing, who are learning English as a second language, or who have learning challenges such as attention deficit hyperactivity disorder (ADHD). Despite this, mainstream unoccupied classroom noise levels often exceed those recommended by the American National Standards Institute (ANSI, 2002) for optimal speech recognition for young children with typical hearing and those with hearing loss (see Crandell and Smaldino, 2000 for a review; Knecht et al, 2002).

Research shows that high levels of classroom noise negatively impact reading comprehension, auditory and visual attention, and short-term memory in typical hearing children, and that children in noisier school settings demonstrate more oppositional behaviors and poorer social skills than children attending quieter schools (Howard et al, 2010; Ferguson, 2013). High background noise levels can reduce acoustic access to and recognition of conversational speech cues by children who are deaf or hard of hearing (Eisenberg et al, 2004; Finitzo-Hieber and Tillman, 1978; Litovsky et al, 2004) and slow, verbal processing speed (common in children who are deaf) further reduces speech recognition in noise.

We know that even when a child who is deaf or hard of hearing (DHH) can hear what is being said, this does not mean that he or she has equal communication access to his or her typically hearing peers or complete access to the curriculum. In school, children need to hear the teacher, their peers, and other adults with whom they interact (e.g., instructional assistants, specials teachers, recess and lunch monitors, and the school nurse). They need to navigate a dynamic linguistic environment all day that often includes variable and unpredictable background noise. That noise can be generated by outside sources such as traffic, children on the playground, children in the gymnasium, children passing in the hallway, music room noise; or it can be generated by inside sources, such as heating and ventilation equipment, desks moving, or other children making noise. Depending on the location of the child who is DHH, background noise can vary across multiple acoustic dimensions such as intensity, frequency, and duration. The child with hearing loss encounters multiple learning and social situations throughout the school day with which noise can significantly interfere.