Best Practice

Spotting and supporting pupils with hearing issues

Inclusion Disability
It is estimated that as many as 1 in 5 children will have a hearing deficit, affecting their education and development. Suzanne O’Connell looks at spotting the signs and supporting these pupils
Image: Adobe Stock - Adobe Stock

Hearing loss in childhood is common and can affect almost one in five children – with the majority developing problems during childhood rather than having problems from birth. In fact, hearing loss is much more prevalent in 6 to 11-year-olds than most current estimates (Moore et al, 2020).

Even when cases are mild, it can have a profound impact on speech, language, developmental and educational outcomes (Lieu et al, 2020; Moore et al, 2020). As such, speed in spotting and diagnosing problems as well as making necessary adjustments is crucial.

Deafness is not a learning disability. There is no reason why a child with any level of hearing loss cannot achieve as highly as their peers. However, the reality is that their educational outcomes do often suffer – with the National Deaf Children’s Society (NDCS) telling us that for several years now deaf children (including those with hearing deficits) have achieved an average of a GCSE grade lower than all children.

Maintaining expectations and ensuring that the child has the technical aids, support and school backing to reach the outcomes they deserve is crucial.

 

Recognising there is a problem

All school staff should be made aware of the signs to look out for. Glue ear, in particular, is a very common condition in young children. If it remains undiagnosed then children can lose out on important educational milestones. Children who are experiencing some form of hearing loss may:

  • Not respond when their name is called.
  • Constantly ask for speech to be repeated.
  • Be slow to follow instructions.
  • Watch lips closely when you speak.
  • Speak too loudly or quietly.
  • Demonstrate delayed speech and communication development.
  • Mishear or mispronounce words.
  • Make minimal contributions in class.
  • Seem startled when people come into their line of vision.

Pupils with hearing deficits may become increasingly withdrawn and frustration can begin to affect their behaviour. They may prefer to watch others carry out a class activity before attempting to do it themselves and background noise is likely to have a notable impact upon them.

Slight hearing loss can be particularly hard to diagnose because in a one-to-one environment pupils may respond easily to questions and may only be affected when more distant to the speaker and in larger groups.

 

Working with families

In most cases, family members will have noticed differences and may already be working with health professionals. To others it may come as a surprise. Where this is the case then schools should suggest that the GP is contacted for a referral to the local audiology clinic for a hearing test. Many cases may be simply resolved once spotted and referred for medical intervention.

A hearing test might also be one of the checks for children referred for other reasons, such as those being supported by a speech and language therapist or educational psychologist. It can be beneficial for schools to keep a diary of their concerns and their observations to share with professionals and support a diagnosis.

Once a diagnosis is reached it is important that families remain positive about educational outcomes and that they are engaged and involved in their child’s education, including clubs and school community.

 

In-school screening

A recent Headteacher Update webinar (still available to watch – see further information) offered advice on identifying and supporting pupils with mild or moderate vision and hearing loss.

The webinar features Discovery Primary Academy in Peterborough, which has already used technology to screen all of its 550 pupils for vision deficits and is planning to screen for hearing deficits this academic year. Headteacher Michelle Siequien told the webinar: “If we can identify these barriers particularly at a young age then we can ensure these children get the provision and the checks that they need and encourage home to do that.”

The webinar also features advice from Dr Sebastian Hendricks, a consultant in paediatric audiovestibular medicine at Great Ormond Street Hospital. He told us that Covid has led to more hearing problems going undiagnosed.

Ms Siequien added: “One of the difficulties at primary level, particularly with the younger children, is that they are not aware themselves that there is a difficulty. It can be down to teachers and parents picking up on that and that in itself is quite challenging in a very busy classroom. By screening you are eliminating those issues which lead to children struggling with reading, not being able to pick up phonics, their speech can be quite poor, there’s a lack vocabulary, and they can disengage with the class.”

 

Involving professionals

A teacher of the deaf may be available to provide advice and guidance. They can also deliver training for members of staff and help you evaluate the learning environment. Where particular situations arise, such as external exam time, they can provide the specialist information you need. 

You may also be able to access support from a speech and language therapist who will focus on how well the child’s speech, language and communication skills are developing. Your SENCO should be closely involved with coordinating any additional external support and work in partnership with other health and education specialists.

 

In the classroom

Once the diagnosis is made there are many ways in which the class teacher can manage the classroom and their delivery to help the child, whatever their level of hearing loss.

Most children do not want to be singled out as being different and putting some of these adjustments into place can help their level of understanding without drawing attention to it. For example, having their attention before starting to talk, speaking clearly, and making sure that the child can see your face. Visual aids such as word mats, writing frames and prompt sheets in literacy can help and are beneficial for other children too. 

Standing in front of a window or other light source can make your expression more difficult to read and teachers should ensure that instructions are given before turning out lights to watch a video.

Teaching assistant and peer support can be used to help ensure a deaf child has really understood the instructions and they might repeat and clarify when they have not. This is especially important during PE and playground activities.

 

When more is needed

Personal hearing technology might include hearing aids, cochlear implants and bone conduction aids. Whatever is used, a member of staff needs to be trained to monitor that it is working effectively and to support others in its use. Having an aid does not mean that the child’s hearing will be the same as for others and additional adjustments should still be made.

If there is no use of a cochlear implant or hearing aid then a pupil might use sign-language as their main means of communication. A teaching assistant should have at least a Level 3 British Sign Language qualification or equivalent for pupils who need signed support. BSL for these pupils may be their first language. 

Lip-reading is also beneficial but children differ in the extent to which they are able to learn and apply the skill. Radio aids can help to reduce background noise and assist in combination with other technology. They include a microphone that the teacher speaks into and the voice is directly transmitted to a receiver attached to the pupil’s hearing technology.

 

A whole school issue

There is a key role for senior and site management. Background noise is a particular problem for deaf children including those with mild hearing loss. There are a number of measures that can be taken to reduce the impact this has on pupils. Even plumbing sounds can be a problem aside from the more obvious issues of noisy corridors or indeed things like schools being cited under flight paths or in high traffic areas. The NDCS has a “preliminary noise survey document” and a “pupil survey document” to help schools assess their listening environment (see further information).

Although some recommendations might be expensive – changing ceiling tiles or adding absorbent wall panels – others might be applied at minimum cost, for example, adding rubber compression seals to doors. 

Ideally, you should aim to include more significant improvements in your on-going refurbishment schedule – if you are lucky enough to have one. Replacing windows, for example, can help save on energy costs as well as improve sound insulation.

Consider how the child with hearing difficulties is supported in other parts of the school, not only the classroom. Are all staff aware of their particular needs and the best ways of addressing them? You might also establish a “quiet zone” where pupils can go with their friends to communicate without background noise at playtimes and lunchtimes. 

Deaf awareness week can be built into your annual calendar of events and the issues surrounding hearing loss should be incorporated into the curriculum. 

 

Further information & resources