It is firmly believed in educational circles that there are many children with special needs for whom the local mainstream school is the best placement. Children with impaired hearing usually benefit from placement in their local nursery, developing alongside their normally hearing peers from their own locality. Hearing impaired children need to experience the natural language of adults and their peers and learn about their environment in the same way as any other child who does not have a hearing loss.
There are two main types of deafness. The first happens when there is a fault in the inner ear – usually in the cochlea. This is called ‘sensorineural deafness’ and is permanent. The level of hearing loss may be described as mild, moderate, severe or profound and may not be the same in each ear, with only a few children totally deaf. Amplification of residual hearing may be made possible with a hearing aid. The more profound the hearing loss, the greater the likelihood that the child will be given a cochlear implant, which allows electrical signals to be sent directly to the auditory nerve, providing a sensation of hearing.
The second type happens when sounds fail to pass efficiently through the outer and middle ear to the cochlea and auditory nerve. This is most commonly caused by a build-up of fluid in the middle ear, often referred to as ‘glue’ ear. This is known as ‘conductive deafness’ and is the most common type of hearing loss. A conductive loss is likely to fluctuate and be temporary. It is often treat by inserting grommets into the eardrum: ventilation tubes which allow fresh air to enter the middle ear to keep it free of fluid.
Most children with a significant sensorineural hearing loss will have been identified before they enter an early years setting. Other children, particularly those with a fluctuating conductive loss, may not. Early years practitioners have an important role to play in noticing and recording aspects of a child’s development, which might indicate a hearing loss. Practitioners will look out for the following signs in children:
• Delayed development of speech
• Watching your face and lips carefully when you’re speaking.
• Often failing to respond when called by name.
• Pausing after an instruction has been given, then watching other children to see what to do.
• Speaking unusually loudly or quietly.
A significant hearing loss can have a major impact on other aspects of a child’s development – particularly on communication and social interaction skills. The child may use sign language, speech or a combination of the two. Unless steps are taken to help the child feel confident in social situations, they are likely to be withdrawn – remaining on the edge of groups of children or preferring a one-to-one activity with an adult.
How can we help?
Firstly, it is vital to work closely with the child’s parents. They will have an enormous amount of information about the nature of their child’s hearing loss and about the best means of communication. Secondly, a child with a significant hearing loss is likely to be having regular input from a specialist teacher or support assistant. It is important to make time to seek their advice.
Practitioners will help the young child with a hearing impairment by:
• providing additional visual clues to support information they give verbally;
• making sure that the child can see their face and lips when they are speaking, and that they gain their attention before speaking;
• checking that the child has understood them, repeating or giving extra clues if necessary;
• consider learning sign language;
• monitor noise levels – a hearing aid amplifies everything, not just your voice.
Britiish Deaf Association: www.bda.org.uk
National Deaf Childrens Society: www.ndcs.org.uk
Royal National Institute of Deaf People: www.mid.org.uk