By Andrea Dunn, Erin C. Schafer, and Alexandra Lavi


Many students with hearing loss receive instructional accommodations, curricular modifications, and school-related hearing technology as outlined in their Section 504 or individualized education plans (IEPs). Historically, however, these plans did not account for a student’s online learning needs. As a result, school personnel are struggling to ensure equal access to education across varied learning environments during the pandemic for students with hearing loss.

Safety measures intended to reduce COVID-19 transmission inadvertently created new educational challenges for students with hearing loss. Some examples include the loss of visual cues and auditory-signal attenuation from face masks, reduced access to sign language interpreters, and lack of captioning or transcripts for online lectures or meetings (American Speech-Language-Hearing Association, 2020; Goldin, Weinstein, and Shiman, 2020; National Association of the Deaf, 2020; Rudge, Sonneveldt, and Moog Brooks, 2020; Atcherson, Finley, McDowell, and Watson, 2020).

To quantify these and other recent educational challenges, a school-based pilot study was conducted to identify the frequency of various learning situations (i.e., remote virtual, in person, blended), document the accessibility of course content and technology, and quantify hearing issues associated with safety measures and technology use. Identifying current educational challenges will enable audiologists, teachers of students who are d/Deaf or hard of hearing, and other school personnel to improve educational access, learning, and engagement for students with hearing loss.

Survey Methods

The targeted survey respondents were school personnel who teach and work with school-aged students with hearing loss. Key issues informing survey statements were identified from existing publications and articles (e.g., American Speech-Language-Hearing Association, 2020; National Association of the Deaf, 2020; Wolfe et al, 2020), the Educational Audiology Association (EAA) Listserv, and social media groups focused on pediatric audiology.

A draft of the online survey was created in Qualtrics XM (2005), sent to two pediatric and four educational audiologists for review, and subsequently revised based on feedback.

The online survey was distributed nationally in September 2020 via social media platforms, email communication, and the EAA Listserv. The results that follow include data collected within three weeks of survey distribution and focus primarily on the experiences reported by respondents working with elementary-school-age students (Kindergarten through grades 5 and 6).

Survey response numbers (N) vary because they are based on the total responses for each question. In this article, the survey results are followed by a brief discussion of strategies to mitigate the most common issues encountered by the students represented in this study.


General Respondent Information

Respondents (N=202) included educational audiologists (42 percent of respondents), teachers of students who are d/Deaf or hard of hearing (36 percent), special education teachers (five percent), school-based speech-language pathologists (four percent), general education teachers (two percent), and other school personnel (10 percent). Some individuals were dual certified and most respondents (78 percent) served elementary-school students.

The responses (N=192) indicated that, since the beginning of this academic year, only about five percent of respondents’ (N=10) schools were offering fully in-person learning. Fully remote learning was reported in 27 percent of schools and 68 percent of schools used blended learning including both remote and in-person situations.

Categories of Remote Learning

FIGURE 1 displays the percentage of time students with hearing loss engage in asynchronous (pre-recorded) and synchronous (live) remote learning. Asynchronous refers to prerecorded, teacher-led lectures or lessons that are uploaded onto the student’s online learning platform (e.g., Schoology, Google Classroom, Canvas, etc.). Synchronous represents live, teacher-led lectures or lessons presented via Zoom, Google Meet, Teams, Webex, etc.

FIGURE 1. Approximate percentage of time students with hearing loss participate in asynchronous (pre-recorded) and synchronous (live) remote learning.
FIGURE 1. Approximate percentage of time students with hearing loss participate in asynchronous (pre-recorded) and synchronous (live) remote learning.

There were a total of 131 responses to this question. Respondents selected not applicable (NA) if they did not know the answer or if a question did not apply to their students.

Overall, 83 percent of respondents to a question specific to elementary-school students reported that their schools offer synchronous learning opportunities and 60 percent of respondents to the question reported that their schools offer asynchronous learning opportunities. It should be noted, however, that more missing data (NA) was observed for asynchronous learning.

According to the study results, roughly half of students (55.7 percent asynchronous, 56.5 percent synchronous) engage in one to five learning sessions per week for both formats, but higher session frequencies (10+) are more commonly delivered through the synchronous (26 percent) versus the asynchronous (four percent) format. In general, based on the available data, synchronous sessions are offered more frequently.

The left side of FIGURE 2 illustrates the responses (N=124) to a question about the approximate percentage of elementary students who have online group meetings (N=124) and delineates group-meeting frequency. The majority (85 percent) of students participate in online group sessions at least once a week, with 30 percent participating two to three times per day. More than half of online group meetings include less than 15 students (53 percent) and nearly one quarter involve small groups of one to four students (24 percent).

FIGURE 2. Approximate percentage of time elementary-school students with hearing loss participate in online group meetings and online videos/lessons from outside sources (e.g., YouTube) during remote learning.
FIGURE 2. Approximate percentage of time elementary-school students with hearing loss participate in online group meetings and online videos/lessons from outside sources (e.g., YouTube) during remote learning.

Larger online group meetings of 16 or more students made up an additional 22 percent of reported sessions. The responses indicate that these meetings typically involve multiple speakers and varying group sizes.

The right side of FIGURE 2 shows the proportion of time elementary-school students are asked to review videos or lessons from online sources such as YouTube. There were a total of 118 responses to this question. More than three-quarters of students (80.5 percent) represented in this survey use outside sources for learning and nearly 20 percent (19.5 percent) use outside sources between one to three times per day.

For each learning situation included in FIGURES 1 and 2, additional questions were asked to assess the accommodations provided to elementary students  and the types of face masks worn (TABLE 1). Across all learning situations (i.e., asynchronous, synchronous, group meetings), closed captioning or transcripts were most frequently reported as being provided some of the time. The responses included: synchronous closed captioning reported at 41.5 percent, synchronous transcripts at 31.5 percent, asynchronous closed captioning at 40.5 percent, and asynchronous transcripts at 28.7 percent.

The results indicated that recordings of lectures and meetings are consistently provided in a minority of cases for teacher-led (25 percent) and group meetings (16 percent). During synchronous, teacher-led lessons, some teachers wear transparent masks and others wear non-transparent masks that limit the use of visual cues. In online group meetings, most students are not wearing masks and very few wear transparent masks. Finally, across the learning situations, interpreters are provided to most students who normally have an interpreter at school (TABLE 1).

TABLE 1. Percentage of time that specific accommodations were provided and types of masks used in various learning situations.
Asynchronous, Pre-Recorded Lessons:Teacher Led Yes: 18%

No: 13%

Some: 41%

NA: 28%


Yes: 10%

No: 27%

Some: 29%

NA: 34%


Yes: 47%

No: 1%

Some: 5%

NA: 47%


Synchronous, Live Lessons: Teacher Led Yes: 24%

No: 18%

Some: 42%

NA: 16%


Yes: 11%

No: 35%

Some: 31%

NA: 23%


Yes: 25%

No: 28%

Some: 22%

NA: 25%


Yes: 20%

No: 30%

Some: 31%

NA: 19%


Yes: 23%

No: 25%

Some: 30%

NA: 22%


Yes: 55%

No: 0%

Some: 5%

NA: 40%


Group Meetings Yes: 20%

No: 21%

Some: 37%

NA: 22%


Yes: 5%

No: 43%

Some: 30%

NA: 22%


Yes: 16%

No: 30%

Some: 25%

NA: 30%


Yes: 15%

No: 39%

Some: 15%

NA: 31%


Yes: 5%

No: 46%

Some: 18%

NA: 31%


Yes: 49%

No: 1%

Some: 5%

NA: 45%


Online Videos/ Lessons Yes: 30%

No: 7%

Some: 39%

NA: 24%


Yes: 4%

No: 42%

Some: 24%

NA: 30%


Yes: 39%

No: 5%

Some: 6%

NA: 51%


A blank cell indicates that a question was not asked for that learning situation. N=number of responses. NA=not applicable. NA indicates that respondents did not know the answer to a question or a question did not apply to elementary students. Some=sometimes.

The Technology

The most frequently dispensed technology for home use included remote-microphone systems, laptop computers, and technology-associated chargers.

The types of technology and accessories used at home by school-age students with hearing loss appear below, in order of most to least often reported by respondents:

  • Remote-microphone technology (N=116)
  • Laptop computers (N=111)
  • Chargers for school-related hearing technology (N=93)
  • Direct audio input (DAI) cords (N=80)
  • Batteries (N=79)
  • Tablets or iPads (N=75)
  • Remote microphone streaming accessories for hearing aids or cochlear implants (N=61)
  • Headphones (N=58)
  • Splitters to allow for multiple audio inputs or outputs (N=56)
  • Hearing aids (N=48)
  • Other (e.g., telecoil or Bluetooth neck loops, multimedia hubs, external speakers, television streaming devices) (N=53)

More than two-thirds of the respondents (68 percent) reported a policy change enabling students to take technology home during the pandemic. Overall, 91 percent of the respondents indicated that technology could be taken home, with only nine percent of respondents reporting no such access for students at their schools.

Repairs of school technology were handled by student caregivers who drop off equipment at the school and pick it up at a later date (34 percent), caregivers who drop off and wait for “curbside” service (27 percent), or by school personnel who pick up and drop off technology at students’ homes (20 percent). Less frequently reported were in-person repair appointments at a school facility (13 percent) and shipping equipment to and from the school, either at caregiver (two percent) or school (three percent) expense.

FIGURE 3 displays information about student- and caregiver-reported technology issues (N=122), as well as overall comfort with technology and online learning software (N=137). Respondents reported that 23 percent of their students’ families and caregivers  are comfortable with the technology and software supporting virtual learning. An overwhelming majority of students and caregivers—74 percent—report technology issues several times per week.

Audiological Exams

For new audiological exams needed as part of a student’s IEP, more than half of schools (54 percent) are asking caregivers to obtain the hearing test from a personal audiologist or at a doctor’s office. Slightly more than one quarter of schools (29 percent) are completing hearing tests at a school facility. Other schools are either postponing appointments for hearing tests (15 percent) or completing them during a home visit (two percent).


Remote learning opportunities are available to most students during the pandemic. The respondents indicated that their students spend all (27 percent) or part (68 percent) of their time learning remotely.

The focus on remote learning brings its own challenges. Eighty-five percent of students reportedly experience technology issues at least several times a week. Only five percent of respondents indicated that all of their students’ families are comfortable with the technology and software (FIGURE 3).

FIGURE 3. Approximate percentage of time students and caregivers report technology issues and an assessment of caregiver comfort with the technology and software required for virtual learning.
FIGURE 3. Approximate percentage of time students and caregivers report technology issues and an assessment of caregiver comfort with the technology and software required for virtual learning.

Access issues arising from technology problems and pandemic-associated adaptations (e.g., the use of masks, virtual meetings that may lack closed captioning, etc.) may have significant implications on student understanding and increase educational risk for students with hearing loss.

The students represented in this survey participate in a variety of different learning situations (FIGURES 1 and 2). Accommodations (e.g., transcripts, captioning, etc.) were often provided only some of the time (Table 1). Increasing the availability and consistency of effective accommodations such as transparent masks, for example, can offer students visual cues to clarify speech and promote understanding (Rudge et al, 2020; Samuel et al, 2020; Wolfe et al, 2020).

Although many students have been provided hearing and other technologies for home use, additional family support may be needed. Seventy-seven percent of the respondents reported that fewer than half of the students’ caregivers are comfortable with these technologies (FIGURE 3). Lack of caregiver confidence may compromise the use and benefit of the technologies provided, particularly in the case of elementary-aged children, where technology ownership, care, use, and hearing-related self-advocacy may just be beginning to emerge.

One of the limitations of this survey is the varying response rate across survey items due to the different professions and roles of respondents. Teachers were best equipped to answer educational questions, while educational audiologists were more familiar with hearing technologies, resulting in variable response rates and missing data (NA) across fields.

Data collection is still in progress and updated results with larger samples are expected to reduce the influence of missing data. In addition, future analysis will elaborate on the state of learning, accommodations, and the needs of secondary students with hearing loss and will encompass both in-person and remote pandemic-related observations.

Recommendations and Strategies

To address the remote-learning challenges of students with hearing loss, school personnel could consider administering a situational learning inventory for each student. This may help identify situation-specific needs and solutions to ensure equal access across the varied instructional settings for children during the pandemic.

Currently, children are highly dependent on virtual-learning platforms, but their caregivers’ baseline competence with technology and confidence troubleshooting technology issues may be limited. Student check-ins and family-directed resources (e.g., troubleshooting guides) may help address technology issues hindering access. An individualized approach to identifying student and caregiver needs can help ensure that students with hearing loss receive equal access to education across learning environments, even during these unprecedented times.

Recommendations for improving access to speech have been discussed by others (e.g., American Speech-Language-Hearing Association, 2020; Educational Audiology Association, 2020; Wolfe et al, 2020). Examples of adaptations include the use of clear face shields/masks; providing transcripts, notes, and closed captioning; and using remote-microphone or classroom audio-distribution systems for in-person learning.

Effectively serving students with hearing loss during the pandemic is challenging. The swift adaptation of support can promote access to the curriculum across varied learning environments.

This article is a part of the January/February 2021 Audiology Today issue


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