By Andrea D. Warner-Czyz This article is a part of the January/February 2020, Volume 32, Number 1, Audiology Today issue. Our clinical concerns for children who are deaf or hard of hearing center on providing audible and comfortable access to sound. Our counterparts in speech-language pathology focus on developing receptive and expressive communication skills. Although our field excels at helping children with hearing loss who use auditory technology (i.e., hearing aids and/or cochlear implants) acquire speech, language, and hearing skills, we do not necessarily shine in addressing how these children use their communication abilities in the real world. Can children and adolescents who are deaf or hard of hearing apply the communication skills evaluated in the clinic to everyday social life outside of the clinic? Impressive improvements in speech perception, speech production, and language skills have been observed in children with hearing loss who have consistent listening experience with adequately and appropriately fit auditory technology (e.g., Dettman et al, 2016; Eisenberg et al, 2016; McCreery et al, 2015; Niparko et al, 2010; Tomblin et al, 2015). The communication skills of children with hearing loss, however, continue to lag behind peers with typical hearing, even over time (Dettman et al, 2016; Geers et al, 2017; Leigh et al, 2013; Niparko et al, 2010; Nittrouer and Caldwell-Tarr, 2016; Nittrouer et al, 2016; Poursoroush et al, 2015). Furthermore, adolescents with hearing loss exhibit challenges in social contexts, evidenced by pragmatic deficits and more peer problems than same-age-mates who have typical hearing. Historically, children and adolescents with hearing loss experience lower rates of peer acceptance and higher rates of peer victimization, social isolation, and loneliness compared to peers with typical hearing (Bauman and Pero, 2011; Huber et al, 2015; Kouwenberg et al, 2012; Percy-Smith et al, 2008; Punch and Hyde, 2011; Stinson and Lang, 1994; Warner-Czyz et al, 2018; Wiefferink et al, 2012). They also show less proficiency at making and maintaining friendships compared to hearing age-mates (Bauman and Pero, 2011; Percy-Smith et al, 2008). Lower levels of successful interactions with peers have cascading short-term and long-term effects on mental and social well-being (Coyne and DeLongis, 1986; Kohlberg et al, 1984). This content is an exclusive benefit for American Academy of Audiology members. If you're a member, log in and you'll get immediate access. Member Login If you're not yet a member, you'll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!