# data[].attributes.body
These articles and websites provide information on tools that can be used in the music classroom to implement Universal Design for Learning and "level the playing field" for students with any degree of hearing loss.

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These articles discuss strategies to implement into music classrooms with hard of hearing or deaf students.

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These websites provide information that band directors and teacher may find useful in their research on students with hearing loss.

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Helping students from all walks of life experience music is something that is extremely important to me. Making music as accessible and widespread as possible is one of my main goals as a music educator, and I don't think band should exclude those who have had any level of hearing loss. I have had several peers and students who have some level of hearing loss but still experienced all the positive aspects of the band community. They had to overcome great obstacles to be successful, however, and I would like to lessen or remove some of those obstacles for future students in our band program, as well as others around the state and country.

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These websites will give some insight into what causes hearing loss and why it requires such complex solutions.

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These websites provide information to those looking to purchase assistive technology for students with hearing loss.

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Executive Function Training for Deaf Children: Impact of a Music Intervention

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Executive Function Training for Deaf Children: Impact of a Music Intervention

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The goal of the researchers in this article was to combat the social and academic deficiencies of deaf students aged 7-11. The authors designed a music-based intervention that was to be evaluated alongside a control art class. They used everyday music activities that were mainly repetition and rhythm based to construct the intervention with the aid of two specialist music instructors for deaf children, two teachers of the dear, a primary school music teacher, and a special educational need coordinator. The results of the study deemed that music-based intervention increased the children’s scores from their preliminary evaluation on nearly everything.

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Abstract

Several studies have reported poor executive function (EF) development in deaf children with subsequent impacts on their social and academic attainment. This paper describes the results of a music-based EF intervention designed for deaf children and carried out in two sets of primary schools. This is the first classroom-based EF training study with deaf children, and it also incorporates a replication phase. The intervention was a within-subject crossover design, with 29 deaf children aged 7-11 years who participated in both an EF and an art class control activity, each lasting 10 hours over 5 weeks. Non-verbal EF skills were assessed at pre-test, the crossover point, and post-test. Findings indicated that the EF intervention led to an improvement in participants' working memory and inhibitory skills in comparison with their performance on the same tasks after the control activity. The findings were not uniform for all EFs targeted nor for all cognitive ability levels in the sample. We discuss the implications of our findings for deaf children with different ability levels and for how EF interventions can be further improved.

Executive functions (EF) are a complex set of cognitive abilities, which enable us to coordinate mental processes, manipulate information, solve novel problems, sequence information, and generate new strategies to accomplish goals in a flexible way ( Diamond, 2012; Henry, Messer, & Nash, 2012; Miyake & Friedman, 2012). In addition to storing information in short-term memory, children need to be able to process information flexibly, inhibit non-useful responses, and manage the input in order to achieve success on higher-level cognitive tasks. Much EF research focuses on three core areas: inhibition; flexibility and working memory which some suggest underpin other more complex EFs such as planning and cognitive fluency ( Friedman & Miyake, 2017).

Deaf children, like some other groups (e.g., Autism: Demetriou et al., 2018; language impairment: Henry et al., 2012), are at risk of delayed development of EF, particularly in working memory and inhibition ( Beer, Kronenberger, & Pisoni, 2011; Burkholder & Pisoni, 2003; Figueras, Edwards, & Langdon, 2008; Hintermair, 2013). There is still debate as to whether this delay is a direct result of deafness, or due to other factors affecting cognitive development, especially a delay in language development ( Botting et al., 2017; Figueras et al., 2008; Hall, Eigsti, Bortfeld, & Lillo-Martin, 2016; Jones et al., 2020; Kronenberger & Pisoni, 2020; Morgan & Dye, 2020; Pisoni & Cleary, 2003).

The fact that early experiences can lead to differential outcomes in EF skills suggests that development is sensitive to environmental factors. Consequently, research attention has focused on how to enhance EF skills in different populations, including via computerized training ( Klingberg et al., 2005), aerobic exercise ( Hillman, Erickson, & Kramer, 2008), martial arts and mindfulness ( Flook et al., 2010), and classroom curricula such as Montessori ( Lillard et al., 2017) and tools of the Mind ( Bodrova & Leong, 2007). These diverse activities have been found to have a positive impact on children and adults' EF skills with varying levels of effect size.

Music programs have been studied with a view to them potentially enhancing EF ( Bowmer, Mason, Knight, & Welch, 2018; Habibi, Damasio, Ilari, Elliott Sachs, & Damasio, 2018; Moreno et al., 2011; Williams, 2018). Correlational and intervention studies of hearing children undergoing music training consistently show that they perform better in fine-motor skill, rhythm perception, and auditory discrimination ( Besson, Schön, Moreno, Santos, & Magne, 2007; Costa-Giomi, 2005; Slater et al., 2015). The playing of music is highly complex and includes repetition and practice, and strong motivational and emotional rewards ( Diamond, 2012). A review by Benz, Sellaro, Hommel, and Colzato (2016) reports that musical training can lead to far-transfer effects in domains such as verbal intelligence and EF. In a recent meta-analysis of music training studies, Sala and Gobet (2017) found a moderate improvement in children's memory skills and a small overall improvement in other cognitive domains. Sala and Gobet (2017) highlighted the lack of active controls in past studies as a limitation in determining the true impact of music training. In many schools, music activities with deaf children are popular, especially activities, which include percussion instruments and musical games involving motor skills and rhythm perception.

In sum, deaf children are at risk of delayed EF development, but music-based training could be a way to intervene to improve their EF skills. Music-based training also fits easily into a school day and is an attractive option for many children. The current study evaluated the effectiveness of a music-based EF intervention for deaf children and addressed the following research questions:

1. Does the intervention have a positive effect on deaf children's EF skills?

2. Are some areas of EF more "trainable" than others?

In order to test the reliability of the intervention, it was used with different groups of children in two studies. This part of the research asked:

Can the intervention be replicated in different samples?

We refer to the first instance we ran the music intervention as study 1 and the second occasion as study 2. We first outline the intervention design used across both studies and the tasks used to assess changes in EF, and then describe the participants and results for each study in turn. Then, we discuss both sets of results together in the discussion section.

Method

Both studies had a within-subjects crossover design, with all participants taking part in both a music-based EF intervention and an art class active control condition. Both conditions consisted of hour-long sessions, twice a week for five weeks (i.e., 10 hours in total for each condition). All sessions were led by an experimenter (the first author), supported by a teaching assistant in each of the schools.

Intervention Design

For both studies, school-aged children between the ages of 7 and 11 years were recruited and the intervention was designed to be appropriate for this age range. Everyday music activities with deaf school children formed the basis of the intervention, and these were largely rhythm and repetition exercises using percussion instruments. Advice and feedback was given by both deaf and hearing professionals, including two specialist music instructors for deaf children, two teachers of the deaf (TODs), a primary school music teacher, and a special educational needs co-ordinator who was familiar with the use of EF activities with primary school children. See Supplementary data, Supplementary material 1 for more information on EF activities.

Differentiation and Flexibility within the Intervention

An essential feature of EF interventions is that they should be consistently challenging but not beyond the developmental ability of the child ( Diamond, 2012). We did not exclude any children in the study based on intellectual disability. Two broad cognitive ability groupings were made in consultation with teachers. Teachers considered the academic, language, and social abilities of the children in their classrooms and the demands of the intervention. The two-group memberships were corroborated by parents who completed the Behaviour Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000). This is an 86-item questionnaire, which provides detailed information about eight different aspects of children's EF, arranged into individual scales. Parents are presented with sentences about the child's behavior such as " Tries the same approach to a problem over and over even when it does not work " and is asked to respond by circling N (never), S (sometimes) or O (often). The questions are designed to address children's ability to initiate behavior, inhibit undesirable responses, demonstrate emotional control, shift attention, monitor progress, plan, and organize themselves and their possessions and use working memory.

Raw scores for the first three scales, (inhibition, shifting, and emotional control) are summed to produce a composite called the "Behavioral Regulation Index (BRI)". Initiation, working memory, planning, and organization, and monitoring scores are combined to produce a "Metacognition Index (MI)". The combination of BRI and MI composites provides a "Global Executive Composite (GEC)" for each child. The GEC is an overall summary measure comprising all eight clinical scales mentioned, and is expressed as a T-score. A higher T-score is indicative of having difficulties with EF, with T-scores from 60 to 64 considered to be mildly elevated, and T-scores from 65 to 69 considered potentially clinically elevated. T-scores at or above 70 are considered clinically elevated. GEC T-scores for participants are shown in Table 2.

No children who had been placed in the higher cognitive ability group had any specific EF difficulties reported by their parents. Therefore, low and high cognitive ability versions of each of the activities were developed and thus tailored to children's needs. See Supplementary data, Supplementary material 2 for differentiated lesson plans.

Control Activity Design

The control activity was carefully designed to ensure it involved the same amount of time and adult contact as the EF intervention, but did not specifically focus on or include EF-loaded activities. Previous studies have established art as an appropriate control comparison to music and have not found any EF advantage from these activities ( Moreno et al., 2011). To ensure continuity across the art sessions, the theme "the seasons of the year" was chosen. See Supplementary data, Supplementary material 3. This provided two sessions on each season, an additional session where the children produced a rainbow collage and another where they made a themed folder to contain their artwork. There was no need for differentiation for the control activity as teachers judged all sessions were accessible to children of every level of ability; however, each activity needed to be engaging for children between the ages of 7-11 years. The overall design is illustrated in Figure 1.

Study 1

Participants

Three schools in England were approached to take part in the intervention. Teachers identified 16 children between the ages of 7-11 years including 5 with additional special needs. The mean age of the participants was 9 years 3 months (SD = 1.17). This is a small but representative sample as it included children of different ability levels and special education needs. We were limited by the availability of children who could commit to several weeks of testing and training. As described previously, the children were divided into groups according to cognitive ability (see Table 1), with seven children in a lower cognitive ability group and nine in a higher group. All three schools were mainstream schools with specialist provision for small numbers of deaf children. Schools A and C have total communication policies with British Sign Language (BSL), Sign Supported English (SSE), and Spoken English being used. The children spend their mornings in the specialist center with a TOD teaching them the core subjects english, literacy and maths, where they receive additional support from deaf and hearing learning support assistants (LSAs). In the afternoons, they attend mainstream classes supported by LSAs and TODs who use both SSE and BSL. The deaf children at School B participate in all mainstream classes and activities. The children are educated orally, however some sign language is occasionally used. A deaf tutor visits the deaf children once a week, providing lessons in sign language and deaf culture.

Due to the wide variation in language levels, preferred method of communication, and educational experiences of deaf children, matching participants with appropriate control participants is extremely difficult. A within-subjects design whereby each child took part in both the music intervention and art (control) sessions was adopted, enabling each child to act as their own control in a crossover design.

In order to fit into the local dynamics of the schools we worked with, there were different patterns of how the intervention and control sessions were run. School B children began with the music intervention for five weeks and concluded with five weeks of art control sessions. At schools A and C, both group sessions were run concurrently. Table 2 also indicates whether children participated in the control condition first, followed by the intervention (C-I), or completed the intervention activities before taking part in the control condition (I-C). As it was necessary for the experimenter to become familiar with individual children's communication preferences and to build relationships with them, for this study, all children in the lower ability groups took part in the art control sessions first, followed by the music intervention, and all of the children in the higher ability groups completed the music intervention first, before switching to the art sessions.

Executive Function Assessments

Children completed the following six non-verbal EF tasks at baseline, post-intervention, and post-control testing times. Testing took approximately one hour, split into four sessions each lasting 15-20mins.

Spatial span task

The spatial span task is a measure of visuospatial working memory. Children are presented with an array of 10 blue blocks mounted on a platform in an irregular pattern. They are instructed to tap the blocks in the same order as the experimenter (who is able to see numbers on each of the blocks to aid in the administration of the test). Testing begins with two block strings (with two trials at each level), then increases up to nine block strings, or until the child makes errors in both trials of a particular level. The child's score consists of the number of correct trials achieved before the task ends or is discontinued.

A second "backwards" condition requires the children to tap the blocks in the reverse order to the examiner (starting with the last block that the examiner tapped) and is scored in the same manner as the "forward" condition. The task begins with two practice trials in both the forward and backward conditions to ensure that the child understands the task. One point is awarded for each trial correctly repeated ( Wechsler & Naglieri, 2006).

Odd one out task

The odd one out task is a test of executive-loaded visuospatial working memory. Children are presented with three shapes on a power point slide. Two of the shapes are identical, one of them different. Children are asked "which shape is the odd one out?" and to point to the different shape. The following slide has a grid with three empty boxes, and the child is asked to point to the location of the previously identified "odd one out" shape.

Complexity is increased after four trials, when children are asked to recall the position of the missing shapes after being presented with two pairs of stimuli on teach trial. After four more trials, complexity increases again to three stimuli to recall, and continues up to a maximum of six stimuli per trial. The test is stopped when children make an error on two (or more) trials in a set. Prior to the start of the test, two practice trials are administered to help the child to understand the task procedure: a single-item and a two-item trial. Correct responses to the practice items are revealed to the child if they do not initially answer correctly. During the test, children are dissuaded from verbalizing to help them remember the location of the shapes (for example, by repeating the location to themselves "right, middle, right," etc.) and are not allowed to use their hands to mark the location and thus aid their recall ( Henry, 2001).

Sun apple task

Tower of London task

The Tower of London task was administered on a laptop using Psychology Experiment Building Language (PEBL) Test Battery Software ( Mueller & Piper, 2014). This assessment is a traditional problem-solving and planning task, which tests the child's ability to make and follow plans. It is a task that is regularly included in EF test batteries ( Shallice, 1982).

Children are presented with two sets of colored discs, arranged across three columns. The experimenter says to the child- "Look at the discs with different colors. These discs here [pointing to the top array] belong to the computer. You cannot move them. These discs here [pointing to the lower array] belong to you. You need to make your discs look the same as the computer's." To ensure the child understands how to complete the task, the experimenter assists the child with the first trial (which is subsequently excluded from data analysis). The experimenter tells the child to "click on the red disc" and then shows them where to put it. "Can you see, that is the same as the computer's? Now, can you make the rest the same by yourself? Try to use as few moves as possible and do it as fast as you can". If the child struggles on the first trial, the experimenter is able to assist them and give prompts until they complete the trial. On all subsequent trials, no assistance is given other than encouraging prompts (e.g., "You are nearly there") to encourage the children to keep going. There are eight trials, and achievement is measured by time taken to complete the task, the number of moves taken to complete each trial, and the number of extra moves (i.e., moves made on top of the minimum possible) taken to complete each trial ( Shallice, 1982).

Color trails task

As a measure of cognitive flexibility, children were given the color trails task. This is a paper and pencil task consisting of two parts. The first task requires the children to connect 15 numbered circles of alternate yellow and pink colors whilst the experimenter times them. This provides a baseline time of the children's performance on the task. In the second part of the test, they are presented with 30 circles numbered 1-15, 15 of which are yellow and fifteen pink. They are instructed to start on the yellow color and then "connect it to the next number which is a different color". This requires them to remember the rule of switching between colors as they connect circles, and to ignore the distractor circles. The experimenter was careful not to use the words "pink" or "yellow" when giving instructions in accordance with the task protocol. The children are timed on this task, and any color or number errors they make are noted on their score sheet to be included in later analysis. The child's score on the task consists of the time taken to complete each task, and an interference score is calculated by taking their time to complete the second task from their baseline time on the first task ( Llorente, Williams, Satz, & D'Elia, 2003).

The design fluency task, taken from the NEPSY-II battery ( Korkman et al., 2007), is a pen and paper task designed to measure planning, flexibility and self-monitoring skills. The design fluency task has two conditions. In the first condition children are presented with an array of dots set out in a square structure and are told that they need to create different designs by joining the dots. The experimenter demonstrates the task, emphasizing that they can join as many or as few dots as they please (although it has to be at least two) and that every design they create needs to be different. The experimenter demonstrates two example designs on a practice sheet, and then asks the child to create two more different designs. At this stage, if the child replicates a previous design, they are reminded that every design needs to be different. The child is then presented with an array of 35 boxes of dots, and told to "draw as many designs as you can, until I tell you to stop". The experimenter times the child and instructs them to stop after 1 minute. The child's score on this task is the number of unique and accurately drawn designs they produce in 1 minute.

Results

In order to reduce any potential experimenter effects, such as scoring bias, data scoring and analysis began only once data collection had been completed. Scorers were not blind to which participants were in which condition. Children's average scores on each of the tasks according to ability group are shown in Table 2.

The results for each task are reported as changes in children's performance on the task at different testing time points. This was calculated from pre- and post-music intervention test scores and pre- and post-art control test scores ( Table 3). Comparisons are then made between these two change scores, using a repeated measures t-test ( Table 4). Differences in the number of participants on some tasks are due to children not completing the tasks at all three timepoints because of school absences.

Results demonstrate that children's scores on the visuospatial span task, odd one out, number of moves on the Tower of London task, and design fluency improved significantly after the music intervention, but not their accuracy scores on the Tower of London, color trails or sun apple tasks. (Note that in the case of the number of moves in the Tower of London task, a lower score indicates fewer moves and therefore a better performance). The art intervention caused no significant changes in score for any of the EF tasks except for the amount of time taken in the Tower of London task. When the change scores for the music and art intervention were directly compared, change scores were significantly higher for the visuospatial span task, odd one out, and design fluency.

Study 2

Study 2 was carried out to investigate whether the results of study 1 could be replicated in a different set of children, as well as increasing the numbers of participants in the overall intervention. We also wanted to remove the confound between cognitive level and amount of practice on the EF tasks that was present in study 1 (where the lower ability children were all tested in the order control-intervention and therefore had had more practice with the tasks at the post-intervention measurement point compared to the high-ability children, who were all tested in the order intervention-control and who had therefore had less practice with the tasks at the post-intervention measurement point). After considering the results for study 1 and feedback from teachers concerning the time taken to complete the assessments, fewer EF assessments were used in study 2 to reduce time testing while still covering all areas of EF. This reduced the testing time from 60 to 40 minutes. The three main areas of EF (working memory, inhibition and cognitive flexibility) were tested in the spatial span task (visuospatial working memory), the odd one out task (executive-loaded visuospatial working memory), a Simon task (inhibition), and the color trails task (cognitive flexibility).

Participants

Participants were recruited from two primary schools in England. Both schools are mainstream schools with specialist provision for deaf children. The children attending school D remain in mainstream classes throughout the day, supported by specialist teaching assistants. Children from school E spend the morning at an on-site center focusing on literacy skills, before attending mainstream classes in the afternoon.

Information about the children who took part in study 2 is provided in Table 5, including their sex, age, use of aids (hearing aids or cochlear implants), language preference, and the order in which they took part in the intervention and control conditions. In contrast to study 1, all of the children in study 2 had spoken English as their preferred language, and no children had any additional statement of special educational need. BRIEF questionnaires were not administered in study 2.

Executive Function Assessments

Because of technical issues, the sun apple task was substituted with a comparable "Simon task," which is a similar task of inhibitory response but in its running includes a greater number of trials.

The Simon Task (Inhibition)

This task is a measure of response inhibition, and is presented on a laptop using PEBL software ( Mueller & Piper, 2014). In the Simon task, children have to make a rapid judgment of the color of a stimulus while ignoring its horizontal position. A red or blue circle appears on the screen and the children have to respond by pressing the left shift key for a red circle and the right shift key for a blue circle. Colored smiley face stickers were placed over the corresponding shift keys to remind children of the response keys. The task consisted of 140 trials; 70 congruent (where the circle appears on the same side of the screen as the response key) and 70 incongruent (where the circle appears on the opposite side of the screen to the response key). Accuracy of participants' responses was recorded in an output file. Interference scores were calculated for data analysis by subtracting accurate responses to congruent trials from accurate responses to incongruent trials.

Results

As with study 1, data scoring and analysis began only once data collection had been completed, in order to reduce any potential experimenter effects or scoring bias. Children's average scores on each of the tasks according to ability group are shown in Table 6.

The changes in children's performance on the tasks at different testing time points were calculated from pre- and post-music intervention test scores and pre- and post-art control test scores ( Table 7). Comparisons were then made between these two change scores, using a repeated measures t-test ( Table 8) to determine whether the music intervention was effective.

Results show that children's scores on all tasks except for the color trails task increased significantly after the music intervention. The art intervention led to no significant changes in score for any of the EF tasks. When the change scores for the music and art intervention were directly compared, changes scores were significantly higher after the music intervention for all tasks, with the exception of color trails.

Discussion

The first research question asked: Does the music-based intervention have a positive effect on deaf children's EF skills? The results revealed improvement in deaf children's visuospatial/executive-loaded visuospatial working memory. Significant improvements were also found in post-intervention design fluency scores (a measure of flexibility and planning) in study 1. In the second study inhibitory skills also improved. This is the first study to find that EFs can be improved in deaf children. This finding is strengthened by the inclusion of an active control condition and replication in two separate samples. It is also promising that improvements were found following a relatively short intervention of 10-hours duration. The possibility of an EF intervention being successful is important, considering the negative impact poor EF has on a range of outcomes for deaf children ( Botting et al., 2017; Figueras et al., 2008; Hall et al., 2016; Jones et al., 2020; Morgan & Dye, 2020). These abilities are an important part of children's wider success in controlling and regulating social and emotional skills ( Andersson, 2008; Blair & Razza, 2007; Thorell, Lindqvist, Bergman Nutley, Bohlin, & Klingberg, 2009). At the same time, we did not find large improvements, nor across all EFs, for all deaf children.

The final research question asked: Can the intervention be replicated in different samples? We observed improvements to EF in both studies, which suggests the intervention was robust enough to transfer to other samples. Replication entailed a range of school settings and across a heterogeneous group of deaf children using different languages and communication systems. We did not find large effect sizes across all EFs and for all deaf children. Both studies were small scale and included children of different abilities. The inclusion of a wide range of children in both studies strengthens the ecological validity of the intervention, and its suitability for real-world classroom environments. This is positive in terms of how representative the sample is but can make any consistent group effects difficult to attain.

There are some limitations to our study that we raise here. Any research design carries strengths and weaknesses. We chose a crossover design because matching participants with appropriate control participants is extremely difficult with deaf children due to the high heterogeneity. Our design enabled each child to act as their own control in a crossover design. However, crossover designs are less powerful in producing lasting impact on the outcome of interest. There is also the limitation imposed by the necessary test-retest methodology of assessment ( Chan, Shum, Toulopoulou, & Chen, 2008). The improvements made by children on some of the tasks over time may represent expected practice effects as a function of increased familiarity with the tasks, and this was a particular limitation of study 1 where ability group and intervention order were conflated, meaning that the low-ability group had more practice with the task at the post-intervention testing point. As a result, it is possible that the effectiveness of the intervention for the low-ability group was over-estimated and, conversely, its effectiveness for the high-ability group under-estimated. This limitation was addressed by the way we allocated children in study 2, where we decoupled ability grouping from intervention order. Future work in this area might instead beneficially use a single-subject design. Single-subject designs are frequently used in intervention studies, which involve atypical populations, as they provide a powerful tool for determining the effects of different treatment conditions ( Lee Swanson & Sachse-Lee, 2000, for a meta-analysis of single-subject interventions). Such designs are less vulnerable to the concerns about practice effects that were a limitation of our study 1, and are more suitable for interventions that are expected to have a lasting impact.

While we observed the EF intervention had a positive impact, by looking at EF performance in the group that had the control then intervention activity we see these effects were not maintained once intervention was completed. There is the possibility that our crossover design requiring time between conditions to allow consolidation before a control condition phase. Future replications of our intervention might usefully include a period of consolidation between conditions. Additionally, the short-term effects we observed suggest the importance of continued EF intervention in deaf children so as to achieve sustained results. It is assumed, longer interventions will produce more robust effects ( Bowmer et al., 2018; Diamond & Lee, 2011). Thus, future replications could consider more than a 5-week intervention period.

In conclusion, working memory and inhibition can be improved through short time-scale, classroom-based musical training. Future studies should include more time between intervention and control conditions, as well as, post intervention in order to evaluate maintenance. Related to varying cognitive abilities of deaf children, our research shows improvements after training were not uniform across all participants. The study highlights the importance of supporting the development of EF skills alongside or in tandem with any therapy work around speech and language in educational settings.

Funding

Grant 620-28-600 Deafness, Cognition, and Language Research Centre.

References

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

# data[].attributes.attachment_link.title
Executive Function Training for Deaf Children: Impact of a Music Intervention

# data[].attributes.attachment_link.description
Several studies have reported poor executive function (EF) development in deaf children with subsequent impacts on their social and academic attainment. This paper describes the results of a music-based EF intervention designed for deaf children and carried out in two sets of primary schools.

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And the Beat Goes On: Using Music to Transform Classes for Deaf Students with Multiple Disabilities through Universal Design

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And the Beat Goes On: Using Music to Transform Classes for Deaf Students with Multiple Disabilities through Universal Design

# data[].attributes.body
The article dictates that musical instruction has long been associated with the education of deaf students. It has been discovered that music education can provide language benefits, as well as social-emotional, particularly for students with disabilities. The author found that Universal Design for Learning was necessary to provide access for music to deaf and hard of hearing students by removing the barriers in curriculum. The Deaf Music Project focuses on feeling music rather than hearing it. The article also discusses the benefit of remote learning and more use of technology.

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Music is a way of representing the patterns of frequencies and vibrational relationships--and at St. Francis de Sales School for the Deaf, it is used it to promote language learning and transform students' educational experiences. Traditionally defined through the medium of sound, music has been seen as an approach that excludes deaf and hard of hearing people. By expanding the perception of music, the school has provided a transformative instructional experience for deaf and hard of hearing students with disabilities, allowing them to learn and grow in the music classroom.

Descriptors: Deafness, Multiple Disabilities, Students with Disabilities, Special Schools, Access to Education, Music Activities, Music Education, Interdisciplinary Approach, Assistive Technology, Deaf Blind, Sensory Experience, Concept Formation

Laurent Clerc National Deaf Education Center. Gallaudet University, 800 Florida Avenue NE, KS 3600, Washington, DC 20002. Tel: 800-526-9105; Tel: 202-651-5340; Fax: 202-651-5708; e-mail: odyssey@gallaudet.edu; Web site: http://clerccenter.gallaudet.edu

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ERIC - EJ1362087 - And the Beat Goes On: Using Music to Transform Classes for Deaf Students with Multiple Disabilities through Universal Design, Odyssey: New Directions in Deaf Education, 2022

# data[].attributes.attachment_link.description
Music is a way of representing the patterns of frequencies and vibrational relationships--and at St. Francis de Sales School for the Deaf, it is used it to promote language learning and transform students' educational experiences. Traditionally defined through the medium of sound, music has been seen as an approach that excludes deaf and hard of hearing people.

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An Assistive Technology Based on Pierce's Semiotics for the Inclusive Education of Deaf and Hearing Children

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An Assistive Technology Based on Pierce's Semiotics for the Inclusive Education of Deaf and Hearing Children

# data[].attributes.body
This article aims to create a more inclusive learning environment for deaf and hearing children. The goal was to create a model based on Peirce’s semiotics (the study of signs and symbols) and incorporate it into an assistive technology. The technology itself was a game where students could learn content related to the alphabet using interaction with a 3D character. The technology was designed to create an equitable learning environment for deaf and hearing children. Even though hearing children tend to use auditory and visual cues while deaf children use sign and visual, both groups can understand graphics, images, and body language.

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Appendix

In this section, the analysis of the results obtained with the controlled experiment will be presented. For this purpose, a proper statistical tool was used to treat and to understand the data. The first method being was the Anderson-Darling Test (ad) [ 19], which tests whether the data comes from a normal population. Therefore: Anderson-Darling test (ad): \(F(x) = P(X \le x)\) being the cumulative distribution function of a normal population. G( x) being the empirical data distribution function (EDF), which can be defined as the cumulative distribution function of the relative frequencies. The test evaluates if \(G(x) \approx F(x)\). So, our hypotheses are:

1. H0:
data comes from a normal distribution

2. H1:
data does not come from a normal distribution

It is noticeable from Table 3 that more than half of the p-values are smaller than 5%, indicating that we rejected the normality hypothesis for these variables at a 5% level. In this sense, we can use non-parametric tests to compare if the variables of the sample without technology and sample with technology and teacher come from the same probability distribution. For this purpose, we will use the Wilcoxon test [ 19] for two populations. The test hypotheses are described below, where \(F_x\) represents the probability distribution of the random variable X and \(F_y\), represents the probability distribution of the random variable Y. The test is performed considering a level of significance of \(\alpha = 0.05 = 5\%\).

Table 3 Anderson darling normality test

Our main goal is to test the equivalence of the populations regarding the samples without technology and with technology and teacher, therefore we will have the hypothesis of the type:

1. H0:
\(F_\text {UseOfSign-WithoutTechnology} = F_\text {UseOfSign-WithTechnologyTeacher}\)

2. H1:
\(F_\text {UseOfSign-WithoutTechnology} \ne F_\text {UseOfSign-WithTechnologyTeacher}\)

Taking as basis Table 4, we noticed that only the Use of Signs samples-Without and With Technology (use of signs by the students) and the Use of Libras-Without and With Technology samples (use of Libras among students) are considered to come from different populations. The p-values are equal to 0.002364 and 0.001366, respectively, and smaller than 0.05.

We can conclude from these samples that the use of Libras signs and signs created among children before the use of the technology and after the use of technology and assistance from the teacher are statistically different at a 5% level. The same conclusion is true when using only Libras signs. We will perform some graphical analysis to validate the conclusions above.

Table 4 Wilcoxon test-group without technology and group with technology and teacher

In the current study, the involved variables are:

Common Communication between the children, using standard language or any type of language. Ex: notes; group games; gestures; etc;

Port Use of written or spoken Portuguese;

Libras Use of standard Libras signs;

PortLibras Use of Portuguese languages and Libras in the same time frame;

WithoutCod If there was communication without the use of a standard language or code;

Deaf If there was interaction with deaf students;

Hearing If there was interaction with hearing students;

DeafHearing If there was interaction with deaf and hearing students in the same time frame.

One of the objectives of the study is to check if the model and technology used to stimulate the use of Libras signs and the Signs inherent to the children. Since both are variables that present characteristics of the Poisson distribution, it is possible to think of a Generalized Linear Model, based on the Poisson distribution and with logarithmic connection function.

The methodology adopted in the data analysis considers generalized linear models (GLM) proposed by P. McCullagh and J. A. Nelder, Generalized Linear Models, Chapman and Hall, London, 1989. Furthermore, every regression model in fact explains the mean of the response variable, instead of the response variable itself, as presented as follows.

The classical regression model considers that

where \(\epsilon \) is a random error that have to satisfy \(\mathrm{{E}}(\epsilon ) = 0\), that is, the mean of error must be zero. Here, \(\mathrm {E}(\cdot )\) represents the mathematical expectation of a random variable, or expected value, or population mean of the random variable. The consequence of this assumption is that

in which \(\mu \) is the mean of response variable. In time series the same occurs, however the practitioners do not know about this mathematical particularity. Our regression model considers that the response has gamma distribution instead of the normal distribution, and for this reason the model becomes

$$\begin{aligned} g(\mu ) = X\beta \end{aligned}$$

since \(\mu \in (0,\infty )\) and the function \(g(\mu ) = \log (\mu )\) is appropriated to become the regression similar to normal models in which \(\mu \in (-\infty ,\infty )\).

The first model to be tested will try to explain the behavior of the random variable Libras by considering the other study variables as covariates (therefore, they are not considered random variables) and, additionally, the two associated groups, namely: Without technology and With technology and teacher. With this goal, we will create a new covariate, which will have values equal to zero for the group Without technology and values equal to one for the group With Technology and Teacher. This variable is known as the Dummy Variable. Here we will represent it by "ID". After testing some models, we found out that it was more appropriate to explain the average of Libras with:

Note that the data we have are the covariate values: ID, Sign and Deaf and the values of the response variable, for each one of the thirty observations in the sample. The estimation process of the coefficients of the model considers exactly the values of the covariates and the values of y to obtain the estimates of the \(\beta \)'s and consequently the estimates of \(\mu _{1}\), \(\mu _{2}\), \(\mu _{3}\), \(\mu _{4}\), \(\mu _{5}\), \(\mu _{6}\) ... \(\mu _{30}\), where each \(\mu \) represents a different moment of observation.

The method used to obtain an estimate of \(\beta \)'s is the model of maximum likelihood and to test the significance of the \(\beta \)'s the quasi-t tests are used, being asymptotic tests (approximately).

In Table 5 we present the estimates of the \(\beta \)'s if the p-Values associated with the quasi- t tests.

Table 5 Estimates of the \(\beta \)'s if the p Values associated with the Quasi-t tests

Using Table 5 as basis we notice the rejection of all the hypotheses

Therefore, all the covariates are considered important to build a group model that does not use technology in the same way as the group that used the proposed technology associated with the help of the teacher. This final model is defined as:

Another statistical hypothesis that we still must test is: Is the estimated model adjusted to the data of good quality? We can do this based on residue analysis to check if a given model is an adequate representation of the data. The construction of a regression model involves the definition of the distribution of the response variable, choice of the binding function, and choice of covariates. Typically, residues are based on the differences between observed responses ( y) and the estimated average \(\hat{\mu }\). For instance, \(r_{i} = y_{i} - \hat{\mu }_{i}\) with the residual being a measure of discrepancy between the actual data and the adjusted model. Here we will use the residual component of the deviation, the one used with the highest frequency for generalized linear models.

An important residual graphic is the one of normal probability with simulated envelope, which can be used even when the empirical distributions of the residuals are not normal ([ 13]). If the model is suitable for the data, we expect that most of the residues are randomly distributed within the envelope bands. Based on Fig. 17 a, we see that this occurs with the proposed use of the Libras model, confirming the quality of the adjusted model.

Given that another important variable in the study is the quantity of signs, it seems plausible to fit a regression model with the purpose of explaining the number of signs performed by the students while providing a contrast between the use of signs without the intervention of technology and the use of signs with the intervention of technology. The estimated model for quantity of signs was \( \hat{\mu }= \mathrm{exp}\{-2.54 + 2.15ID_{i} - 0.10\mathrm{Common}_{i}\} \). From Fig. 17 b, we find that the model is well fitted to the data since the residues are mostly inside the envelope and randomly distributed around zero.

We should emphasize the effect of the covariates on the average number of communication made among the students using Libras, and this effect is measured based on the estimates of \(\beta \)'s. If the estimate of a \(\beta \) associated with the given covariate is negative, the estimated value of \(\beta \) will be as larger as the reduction in the average amount of Libras. On the other hand, if the estimated \(\beta \) is positive, it is important to increase the student's performance the higher this estimate became to be. The opposite happens when the estimate of \(\beta \) is positive. For instance, \(\hat{\beta }_{2} = 1.08\), with this indicating that the increase of one unit in the indicator covariate implies on increase of \((\mathrm{exp}(1.08) -1) \times 100\% = 195\%\) on the average amount of Libras usage. But this is a covariant indicator, which only assumes the value equal to zero (group without technology) and value equal to one (group without technology and teacher). Thus, adding a unit in this covariate implies going from zero to one, or going from the moment without technology to the moment with technology and teacher. If the child is part of the group using technology and teacher, the use of Libras increases by approximately 195%. If the child uses several signs other than Libras for each additional sign used, the average use of Libras increases by 101% and the communication between deaf and hearing students increases in 12% the use of Libras.

The model \( \hat{\mu }_{i} = \mathrm{exp}(-2.99 + 1.08ID_{i} + 0.68\mathrm{Sign}_{i} \) \( + 0.10\mathrm{Deaf}_{i}) \) also allows to estimate the quantity of Libras signs used for the i-student. For example, let's consider the student \(i = 23\). The covariates values for this student are \(x232 = 1.0\), since this is a student who has experienced method interference. \(x233 = 4.0\) and \(x234 = 4.0\), we have \(\hat{\mu }_{23} = 3.3 \approx 3.0 \), with the true value of the response being \(y23 = 3.0\) This is a good example of the model being set correctly.

The model interpretation for the quantity of signs, \( \hat{\mu }_{i} = \mathrm{exp}(-2.54 + 2.15ID_{i} + 0.10\mathrm{Port}_{i} + 0.10\mathrm{Common}_{i}) \) is interesting. Notice that \(\hat{\beta }_{2} = 2.15\), with this implying that the student experimenting interference of the associated technology with the teacher increases in \((\mathrm{exp}(2.15)-1) \times 100\% = 758\%\) the average quantity of signs used by these students. On the other hand, in a logical way, the communication made through the Portuguese language decreases in \((1.0 - \mathrm{exp}(-0.10)) \times 100\% = 9.5\%\) the use of signs.

We conclude that both through the applied tests and through the regression model generated to verify possible inconsistencies, the process of communication between hearing and deaf children improved quantitatively, with increased use of signs, and qualitative, because with the use of these signs, the children had a larger common vocabulary, making the communicative process more semantic. We also conclude that the generated regression model is adjusted to reality, so that the experiment can be scalable, or easily reproduced in other schools that have similar conditions, obtaining similar results.

1.1 Qualitative analysis

This section describes the qualitative analysis of the performed experiment. As previously mentioned, our experiment lasted for five days, with sections of thirty minutes per day recorded, and aimed to observe how communication between deaf children and hearings would occur before and after the technological intervention.

Based on these observations, we tried to understand whether there was some kind of communication or interaction pattern between deaf and hearing children, and how these patterns would have occurred. In the first two days, we have wanted the children to get used to the environment since they were isolated from the other children in the school. From the third day, we have observed the behavior of the children to identify whether there was any pattern of communication between them. We summarize the most significant moments in our experiment by observing the possible patterns of communication among the target children. We group these moments into 3 categories of communication to show to the reader the most significant points according to the opinion of the researcher: (i) gesture communication; (ii) common vocabulary; and (iii) Signed Formal Communication.

We have observed that moments of communication between the hearing children and their deaf colleagues had a significant semantic gain, because the communication that happened before through notes and gestures created by the children, now happens with the addition of signs of Libras thus making the possible moments of conversation extending even further. We also noticed that there was a greater engagement of the deaf student in class time, especially in relation to her colleagues. A priori, when we idealized this experiment, we imagined that the deaf student would be isolated at the beginning, and with the gradual learning of the signs language made by her and her colleagues, the number of interactions would increase. However, we were wrong about this hypothesis because from the very beginning the deaf student communicated with her colleagues without any difficulties. However, we realized that the moments of communication were limited due to the lack of vocabulary. We realized then that the improvement provided by the technology and help of the teacher was related to the quality of the moments of communication. With the increase in the repertoire of the Libras signs, the children had a greater understanding of the situation in which they were involved. With this, we feel that the objectives proposed in this research were achieved.

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An assistive technology based on Peirce's semiotics for the inclusive education of deaf and hearing children - Universal Access in the Information Society

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In the contemporary educational scenario, heterogeneous classrooms have students with different communication needs. Whether we consider the inclusive education area, one of the most relevant drawbacks is that deaf children have needs that are normally ignored for not fitting with the pattern of other students.

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In my lifetime, Band has always been a welcoming place to everyone. I have seen students from all walks of life come together and find common ground. They have experienced friendship, team-building, responsibility, competition, and personal growth on a level that they would not have had they been excluded from Band. Because of this, and because we live in a world that seems to get more and more divided by the day, I find it extremely important to make sure that everyone has a place in Band.

With the advancements in easily accessible technology, bridging the gaps between students with normal ranges of hearing and those who have hearing loss has never been easier. There are a plethora of free tuning apps, decibel readers, and visualizers that make those with even the most severe hearing loss capable of participating in Band.

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This article sums up all the reasons why band and music are so instrumental (ba dum tss) in the lives of all students and why it is especially important we ensure Band is available to anyone.

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Maybe you've been taking instrumental lessons since you were a young child or in grade school. You've learned the basics of playing the instruments and even some advanced techniques. You love making music, but you've been focused on making music alone.

Now you're in middle or high school and considering joining the school band. After all, if making music by yourself is great, making music with a group of other music lovers has got to be even better.

We think you're right!

Being a part of the school band yields all sorts of benefits - benefits you should definitely take advantage of. Join us as we dive into the top 15 reasons why participating in the school band is a valuable experience.

Table of Contents

What Are the Benefits of Band in School?

The benefits of playing your instrument in the school band are numerous. Not only will you experience musical benefits, but joining the school band can also deliver social, emotional, academic, and creative advantages. Playing an instrument in the school band is a rare opportunity to experience such a vast array of bonuses - all in one place.

15 Benefits of Participating in a School Band

#1: Belonging and Connection

Everyone longs for connection with others and wants to belong to something greater than themselves. For students - and especially for middle schoolers - making those vital connections can be challenging.

The school band is a unique way to bring together students who share the same interest in music. Joining the school band makes it possible for students to thrive with meaningful connections by:

Giving natural introverts a safe place to "come out of their shells."

Engaging with others who have musical interests.

Providing a place to build friendships.

Being a part of a close-knit group.

Music has an amazing way of connecting people. You've likely experienced it yourself on some level. And if you were ever part of a school band, you can probably testify to the family atmosphere, may have fond memories of those days, and may even still enjoy lifelong friendships with other former band members.

#2: Leadership

School bands, even those of modest size, involve a group of people working together for the same goal. Succeeding in that goal is often due to various leadership roles.

As the ultimate leader, the best band directors look for student leaders to aid them in their roles and foster an atmosphere of camaraderie and healthy competition.

As students excel in the group setting of a band, they may have opportunities to act as leaders for their instrumental sections or even as drum majors or conductors. Older students always have an opportunity to help lead the younger ones.

#3: Teamwork

Since making music as part of a school band is a collaborative effort, it gives students an excellent opportunity to learn how to work as a team toward a common goal.

Of course, there are opportunities to play solos in a school band, but a majority of the music is played by working together, listening to one another, and responding to everyone's playing to create a unified sound and rhythm.

Because everything you do affects what others do and the sound of the whole group, student musicians learn patience, responsibility, and endurance as members of the band.

When the band works together as a unified team, there's no boundary to the beautiful music they can produce.

#4: Creativity and Self-Expression

The fact that a student is interested in the arts hints at the creative abilities that may be innate in them. On top of that, studying music and playing an instrument in the band can further spur on their creative juices and provide more creative outlets.
Participating in the school band can also nurture creativity and self-expression by:

Creating beauty

Teaching artistic skills

Providing an outlet beyond athletics

Providing a musical foundation

Expressing emotions through music

Learning to solve problems by thinking outside the box

#5: Cognitive Development

Because making music requires multitasking and keeping up with several things at once, band musicians get lots of opportunities to activate cognitive activities.

Musicians engage their mental capabilities when they do the following - all at the same time:

Read music

Play with the correct and often changing tempo

Keep rhythm

Adjust the pitch to be in tune

Listen to the other instruments

Watch the conductor and follow his instructions

Musical training is also known to develop the left side of the brain - the part of the brain associated with reasoning and language.

Additionally, a performed by Christian Gaser and Gottfried Schlaug showed a noticeable difference in the amount of grey matter - the part of the brain involved in muscle control and sensory perception - in the brains of musicians and non-musicians.

#6: Socialization

Playing in the school band gives students an abundance of socialization time. Whether it's during band rehearsal, a concert, or other special events like playing at football games or in a parade, playing in a band means time well spent with other students and friends.

For students who are more quiet and introverted, being in the band gives them an excellent opportunity to connect with others who share their interests in a non-threatening and comfortable environment.

#7: Time Management

Being a part of a school band may involve setting aside time for at-home practice, after-school practice, and concerts.

Student musicians practice mastering time management by learning how to fit all those activities into their school, family, and extracurricular schedules.

#8: Life Skills

Many skills students acquire by being in the school band also translate to important life skills used as they continue to grow and mature.
Some of these skills include:

Superior communication skills

Relational strength and connections

Striving for excellence

Emotional intelligence

Discipline

Ability to work as a productive team member

Responsibility

Persistence

Critical thinking

Leadership

Work ethic

Cooperation

#9: Balance

Without a doubt, academics are important and should be a priority for every student. But when academics become the only focus, students can become overwhelmed and consumed.

Being involved in the school band can help add balance to life at school, where academic performance can be heavily emphasized.

For those who may not excel academically, playing in the band gives them another area to succeed. Because the school band joins together physical activity, math, and science, it's a great way to balance education and creative output.

The school band is also a way to serve a variety of students. Students with different abilities and interests - athletics, singing, drama - can join together doing one thing they all enjoy.

#10: Performance Opportunities

Those who take private music lessons on their chosen instrument may have limited opportunities to perform - usually at a recital or two throughout the year.

In addition to regular band practice at school, musicians who are part of the school band will have many performance opportunities to play in concerts and other events. They may even get some solo opportunities!

If you're currently playing in the school band and want to hone your musical skills, lessons with a personal instructor can help. The team at Northwest School of Music provides lessons for students playing woodwind, brass, and percussion instruments. Let us help you polish school band solos so you can shine during performances.

#11: Enhanced Academic Performance

It's true. Students who have been involved in the arts - particularly music performance groups - score higher on SAT scores than their non-arts peers.

According to a from the College Board, "Students who took four years of arts and music classes while in high school scored an average of 92 points higher on their SATs than students who took only one-half year or less."

Additionally, students who were involved in art and music classes for four years scored an average of 61 points higher on the writing portion of the test than those who were in music or art classes for one-half year or less.

#12: Discipline and Perseverance

Band gives students a unique opportunity to practice responsibility, discipline , and perseverance.

Whether you play in a band, small ensemble, or just play on your own, making music (and mastering it) takes lots of discipline and perseverance to practice - and keep practicing regularly.

Not only do band musicians need to practice at regular rehearsals, they will need the discipline to set aside time to practice at home. And don't forget about the concerts on the schedule and setting aside time to participate in those.

#13: Music Appreciation

As a part of a band, members will get to play all sorts of music styles and will likely get some music theory and music history thrown in from time to time with the conductor's instruction.

Most bands include a mixture of music styles, from classical to jazz to popular songs and movie soundtracks. Band musicians may also play music from other cultures and seasonal music, like music played for a Christmas concert.

#14: Relaxation and Lower Stress

The fact that music can help people relax and de-stress should be no secret. Think about your own experience. How often do you listen to music to unwind from a busy day or to drift off to sleep?

show that playing an instrument can lower cortisol levels, which can lead to a decrease in anxiety levels.
Playing an instrument in the band can help with relaxation and stress because it:

Involves mindfulness, which keeps your mind focused on the present activity (playing music) rather than other stressors.

Means musicians need to focus on their breathing and posture, which can calm the mind and body.

Means we spend less time on screens and digital technology and find ways to unwind without the constant technological barrage.

Involves being with people in a social setting and connecting over a shared interest.

#15: Self-Confidence

Who hasn't felt that sense of pride and confidence when accomplishing something challenging you've set out to do?
Playing an instrument as a band musician can boost self-confidence as you work toward a goal and reach it.
Maybe you've worked on a difficult flute passage in your band's rendition of Leroy Anderson's . Finally playing all those quick-moving notes perfectly is certainly worth celebrating.

Improving your musical abilities, performing for audiences, and growing in communication skills are all ways playing in the school band can instill pride and raise self-confidence.

Enhancing Your School Band Experience With Private and Group Lessons at Northwest School of Music

If you're participating in a school band, you're already enjoying many, if not all, of these 15 benefits. Northwest School of Music can make your band experience even better with our private and group instrument lessons.
Our team of educated and seasoned instructors is ready to help you achieve your goals by offering lessons for band instruments like:
We can plan your lessons around your schedule at a time that's convenient for you and offer pricing packages for any budget. Online classes are also an option, where you can benefit from our lessons right from the comfort of your own home.Ready to get started? Register today and get a free lesson.

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15 Reasons Why Band Is Important in Schools

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Is your child considering joining the school band? Making music as part of a school band delivers all kinds of benefits. Learn more here.

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One gap that I have located in the research that I have perused, is that none of the tuners, visualizers, or decibel reading apps integrate into a sheet music reader software. Apps like TonalEnergy and Decibel X are fantastic and are key to impementing Universal Design for students with hearing loss, however, if students have the layered responsibilities of reading their music, watching their conductor, and paying attention to the plethora of apps they have running all at the same time, well, there are only so many places the eyes can look. If apps like TonalEnergy could be integrated into apps like forScore, which is a sheet music reader app, this would give students one less place to look while in class or performing.

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Towards Inclusive Streaming: Building Multimodal Music Experiences for the Deaf and Hard of Hearing

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Towards Inclusive Streaming: Building Multimodal Music Experiences for the Deaf and Hard of Hearing

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This article focuses on how music can be expressed through a multitude of modalities. Music can be translated from a purely audio experience to one that is also tactile and visual. It also delves into how hard-of-hearing students can enjoy music through these different modalities and makes note of how limited current digital media forms are. The authors use a program called “BufferBeats” to translate audio files and create a variety of different modal experiences. The article's goal is to highlight the exclusivity of music streaming interfaces regarding those with hearing loss.

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Towards Inclusive Streaming: Building Multimodal Music Experiences for the Deaf and Hard of Hearing | Extended Abstracts of the 2021 CHI Conference on Human Factors in Computing Systems

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Authors: Thomas Barlow McHughThomas Barlow McHughInclusive Technology Lab Northwestern University, United States, Abir SahaAbir SahaTechnology and Social Behavior Northwestern University, United States, David Bar-ElDavid Bar-ElLearning Sciences Northwestern University, United States, Marcelo WorsleyMarcelo WorsleyNorthwestern University, United States, Anne Marie PiperAnne Marie PiperUniversity of California, Irvine, United StatesAuthors Info & Claims

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ViTune: A Visualizer Tool to Allow the Deaf and Hard of Hearing to See Music with Their Eyes

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ViTune: A Visualizer Tool to Allow the Deaf and Hard of Hearing to See Music with Their Eyes

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The goal of the study is to determine how members of deaf and hard-of-hearing community experience music through different modalities, as well as discover if these experiences can be enhanced using visuals. The researchers developed a visualizer tool called ViTune that uses a visualizer to generate effects with music. They investigated how members of the DHH community experience music, then observed how their experiences were augmented using the visualizer.

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Development of information and communication technology has offered new horizons to the deaf and hard of hearing for their integration into working, social and economic environment. Despite the positive attitude of international guidelines, the lack of ...

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ViTune: A Visualizer Tool to Allow the Deaf and Hard of Hearing to See Music With Their Eyes | Extended Abstracts of the 2020 CHI Conference on Human Factors in Computing Systems

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Development of information and communication technology has offered new horizons to the deaf and hard of hearing for their integration into working, social and economic environment. Despite the positive attitude of international guidelines, the lack of ...

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TonalEnergy is an application that incorporates a tuner, metronome, and visualizer. It can be a helpful tool for students with hearing impairments because it provides real-time feedback on what they are playing.

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TonalEnergy Tuner & Metronome, a musician’s best friend in practice.

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Oklahoma ABLE Tech - Making Life Accessible to Oklahomans of All Ages and Abilities

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Key Takeaways

What is Hearing Assistive Technology (AT)?

Many devices have been designed and developed for people with hearing loss.

Such technology enhances sound or substitutes sound with visual or tactile signals.

Hearing AT can be helpful anywhere that effective communication is needed.

Hearing AT can assist with communication when face-to-face, on the telephone, and on other media platforms and includes alerting devices.

Common No-Tech and Low-Tech Hearing AT Solutions:

Consider the environment - where is the person sitting relative to the information that needs to be heard? Can the individual see to read your lips? Is the room well-lit? Is there a lot of background noise? Can any of these factors be controlled?

Can visual cues be provided? For instance, can captioning be provided if a video is being played? Can written materials of what is being said be provided? Additionally, consider dictating a lecture and provide it in writing.

Use good communication skills:

Face the person

Have a well-lit room

Avoid noisy background

Speak clearly

Get the person's attention first

Ask what works best for that person

Give clues when transitioning topics

Rephrase rather than repeat

Don't shout (it distorts the words)

When Do I Need to Use Hearing AT?

Listening needs vary with the situation and the individual's level of hearing loss.

Challenging environments, such as restaurants, meetings, classes, houses of worship, social gatherings, public presentations, lectures, theaters, and home environments - TV, telephone, doorbell, smoke alarm, etc.

Who Needs Hearing AT?

Anyone who needs help with:

Face-to-face communication with others

Enjoyment of electronic media (radio, stereo, television, movies, etc.)

Telephone

Awareness of environmental sounds

Why are Hearing Aids / Cochlear Implants not Enough?

Situations may cause the need for additional AT, such as environmental factors including distance from the speaker, background noise, size and acoustics of the room.

Hearing aids or cochlear implants may prevent the use of earbuds or other sound source receivers.

Situations for Using Hearing AT:

Commonly Asked Questions about Hearing AT:

Q - If a student wears hearing aid(s) or cochlear implants, there may still be a need for additional hearing AT such as sound amplification for particular situations or settings. How does the sound amplification system work with hearing aids or cochlear implants?
A - Most audiologists will consider the age of the person when determining how the AT is paired with hearing aids or cochlear implants. Ear-level amplification, such as an FM System, is a great solution to assist in amplifying sound and may be necessary even if the person has hearing aids or cochlear implants. It would require transmitter(or microphone) that transmits the sound to the receiver. This can be via telecoil in the hearing aid or a special receiver that connects directly to the transmitter being used. Many receivers can connect universally to any hearing aid or cochlear implant. Eliminating the sound to noise ratio can be beneficial to anyone - whether living with a documented hearing loss or other barriers to receiving sounds such as auditory processing disorders or attention deficit disorders. Coupling hearing AT with hearing aids and choclear implants helps achieve this.

Q - Are there any laws to provide an accommodation or prevent discrimination in the workplace based on having a disability?
A - Yes. The Americans with Disabilities Act (ADA) and other federal laws have provisions covering the workplace. The ADA, Title 1, requires employers to make reasonable accommodations to the known disability of a qualified applicant or employee unless such an accommodation would impose an undue hardship on the employer. Reasonable accommodations include a wide variety of actions - making worksites accessible, modifying existing equipment, providing new devices, modifying work schedules, restructuring jobs, reassigning an employee to a vacant position, and providing readers or interpreters.

Q - What is a hearing loop?
A - A hearing loop is a wire that circles a room and is connected to a sound system. The loop transmits the sound electromagnetically. The electromagnetic signal is then picked up by the telecoil in the hearing aid or cochlear implant. To use a hearing loop, connect to the t-switch on the hearing aid or cochlear implant to activate the telecoil. Usually, no additional receiver or equipment is needed. Using a telecoil and hearing loop together is seamless, cost-effective, unobtrusive, and requires no additional equipment. Hearing loops are also called audio-induction loops, audio loops, or loops. If a hearing aid does not have a telecoil, a headset plugged into a loop receiver will be needed. Additional technology that has telecoil in it can alsoconnect to ones hearing aids to achieve the same effect.

Q - What concerns should someone with a hearing loss consider when looking for or maintaining employment?
A - Excerpt from the Hearing Loss Association of America (HLAA) Employment Toolkit: "Looking for a job, landing a job, and keeping a job can be difficult under the best of circumstances. Whether you are a graduating student seeking employment for the first time, looking to change jobs, returning to the workplace after an absence, or you are concerned about keeping a job, you might find employment issues more challenging if you have a hearing loss. There are ways to be successful in the workplace with a hearing loss. Landing a good job, fitting into the workplace, and successfully advocating for the kind of accommodations that will make you a productive and valued employee can all be accomplished. But you need the right tools, do your homework, find out what's right for you and your employer, and find ways to successfully advocate for yourself."

* It is always important to consult with the audiologist or manufacturer for more specific details and special circumstances.

AT Solutions at ABLE Tech:
Visit ABLE Tech's Hearing Inventory Visit ABLE Tech's Hearing AT/DME Reuse/Exchange Inventory
Helpful Links & PDF Resources:

Videos and Webinars:

Check out these videos highlighting hearing devices available to borrow from ABLE Tech.

Education

Case Studies of Individuals with Hearing Needs and Recommendations

Case Study #1

A student in Pre-K, uses hearing aids, continues to have difficulties in the classroom setting, gymnasium, and art class

This student has recently been fitted with hearing aids but needs additional assistance in multiple environments including the classroom, gymnasium for physical education, and art class. The student is having a hard time staying focused in the general classroom and is not able to follow directions while in the gymnasium and art class where room acoustics are very noisy with excessive reverberation.

Possible Recommendations:

In this case study, the student is very young, and the audiologist is involved in the recommendations. The AT need is very specific because it needs to be able to go into multiple environments. The recommendation is an ear-level receiver, that could also be used at home. The school is considering adding a classroom amplification system to the general classroom. In this case, the SETT framework (see below) becomes even more valuable in comparing tools and features. The audiologist does not want to see the student using headphones with the hearing aids, as it blocks the microphone in the hearing aid. She also thinks the student would benefit from an ear-level receiver, such as a Roger X receiver with the Phonak Roger Pen.

Goals and Outcomes:

The student will show increased participation in all classroom settings, including the gymnasium, art class, music class, etc., by using the personal amplification system. Some suggested goals to track outcomes are to track the percentage of questions answered appropriately on topic; track the increase in social interaction with peers during group work with verbal exchange; track the student's initiative to ask for the pass around mic or independently request that peers repeat statements.

See the attached SETT Framework for feature-matching solutions based on the Student, Environment, Task, and Tools.

Case Study Form - SETT Framework

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Case Study #2

A student in elementary school with moderate hearing loss and difficulty listening in class or group settings

This case study is based on a student who is in the classroom where learning occurs by listening to teacher lectures and participating in group work and group discussions. The student's participation is marginal, and the teacher would like to see the student benefit from more classroom participation. The student's challenges are hearing the teacher over the other classroom noise and hearing the other students as group discussions take place. The student wears hearing aids but still needs assistance with decreasing noise to sound ratio and hearing discussions well and clearly.

Possible Recommendations:

An AT solution would be a sound amplification device that accommodates wide area listening. The transmitter and receiver are two separate units: 1) The speaker wears a microphone/transmitter which sends a signal through FM, digital, infrared, or induction loop to the receiver. 2) The listener wears a receiver that captures the signal through earbuds, headphones, or a neck loop that couples with the telecoil of the hearing aid/cochlear implant. Wide area listening systems reduce the impact of background noise, poor acoustics, and distance. Consider also the environment: noise, room acoustics, distance, visual access, and lighting, along with AT.

Goals and Outcomes:

The student will show increased participation in classroom discussions by using the personal amplification system. Some suggested goals to track outcomes are to track the percentage of questions answered appropriately / on topic; track the increase in social interaction with peers during group work with verbal exchange; track the student's initiative to ask for the pass around mic or independently request that peers repeat statements.

See the attached SETT Framework for feature-matching solutions based on the Student, Environment, Task, and Tools.

Case Study Forms - SETT Framework

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Case Study #3

A student in high school with moderate to severe hearing loss who uses hearing aids

This high school student is transitioning to higher education and has moderate to severe hearing loss. He's having difficulties hearing in the classroom and also difficulties with supplemental videos and computer work that is required in the classroom. His hearing aids make it difficult for him to wear headphones for audio output on the computer, and the noise to sound ratio in the classroom makes it difficult for him to hear his peers in group discussion.

Possible Recommendations:

An AT solution would be a sound amplification device that augmentshis hearing aids to improve his hearing in group discussions as well as on the computer or video. Ideally, it would be a unit where the transmitter and receiver are two separate pieces: the speaker wears a microphone/transmitter and there are also additional microphones in the classroom for peers to use when speaking. The student wears the receiver that captures the sound coming from the microphones and creates better noise to sound ratio. The most effective receiver would be an ear-level receiver such as a boot receiver that attaches to the hearing aid. The receiver could also be used with a neck loop feeding directly into the hearing aid telecoil.

The transmitter can also be used to plug directly into the audio output to receive direct sound from the computer or other source of video replay via the worn boot or neck loop receiver.

Additionally, best practice is for students who wear hearing aids to consult an audiologist for recommendations.

As always, consider the environment: noise, room acoustics, distance, visual access, and lighting, along with AT.

Goals and Outcomes:

The student will show increased participation in the classroom with learning topics and peer participation. There should also be increased accuracy in computer use, as evidenced in computer assignments; increased initiative in independently asking for the device, using the device, and returning the device to the primary teacher for ongoing charging and maintenance.

See the attached SETT Framework for feature-matching solutions based on the Student, Environment, Task, and Tools.

Case Study Forms - SETT Framework

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Funding Sources for Individuals with Hearing Needs

Public Sources

Private Sources

Employment

Case Studies of Individuals with Hearing Needs and Recommendations

Case Study #1

An adult who is deaf entering employment with support from a Vocational Rehabilitation (VR)counselor at the Department of Rehabilitation Services (DRS)

She applies for a housekeeping position at a hotel. She uses American Sign Language (ASL) and can read/write English messages. She receives services through VR to gain new employment.

Possible Recommendations:

The job interview would require ASL or Communication Action Realtime Translation (CART) if interviewing in person; however, she could interview over the telephone using video relay services that she already has set up through VR. In regard to daily job performance, little AT will be needed. Since the employee can read/write text, the company will review policy on allowing personal cell phones on the job to text, email, or use other types of written communication to complete daily assigned tasks. The phone could also be equipped with video relay calls for communication on the job. If there is a policy against personal cell phones, consideration could be made to provide one while at work instead of using a radio or walkie-talkie. Additional supports for new employee orientation or additional job training could include: captioning of any video training materials, CART, remote CART, or ASL services. Coordination and timely notification should be considered when offering these services.

Goals and Outcomes:

She will perform daily tasks and maintain gainful employment. She will perform job functions alongside her peers. She will erceive appropriate training side-by-side with her peers.

See the attached Human Activity Assistive Technology (HAAT) Model form to see how to match the employee to needed AT.

Case Study Form - HAAT model

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Case Study #2

Bank teller who is deaf, wears cochlear implants, and uses English, lip-reading, speech to text, and ASL for communication

An employee working as a bank teller has to communicate with hearing customers, co-workers, and supervisors. She is capable of performing the basic job functions for banking transactions. She is deaf but has cochlear implants. She can communicate with spoken English, ASL, written text, lip-reading, and speech to text.

Possible Recommendations:

Looking at her communication needs, there are several solutions to consider. Valid solutions include: personal sound amplification systems, portable or permanent looping systems, or devices that provide text-to-text communication from customers and peers to the individual and vice versa. The employer would want to consider providing CART or an ASL interpreter for staff meetings, or mandatory in-services.

Goals and Outcomes:

The employee will perform job functions and maintain customer satisfaction. She will perform work tasks at the same rate as her peers, and will receive training in a clear way to ensure a compentent work performance. She will have improved job performance, job satisfaction, and will be able to communicate effectively with customers.

Case Study Form - HAAT Model

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Case Study #3

Service provider trainer in higher education with moderate hearing loss

This person is hard of hearing; works in a higher education setting. She has moderate hearing loss and wears hearing aids. She performs most job functions independently but finds challenges in certain circumstances such as working in a cubicle office setting or where there is excessive noise while on telephone calls. Phone calls, staff meetings, online training, and in-person group trainings all present challenges with her hearing loss.

Possible Recommendations:

A simple low tech/no tech solution to be considered when lots of time is spent talking on the phone includes relocating the employee to an office. This will provide a quieter space as it decreases the sound to noise ratio. A phone amplifier can be used as well as a desktop captioning service that transcribes telephone calls received at her desk. Requesting written materials or agendas will help in staff meetings as well as follow-up written documentation summarizing the results of the meeting. For staff meetings and large group trainings, using the Roger Pen and MyLink will help with sound amplification. She can also request that all training videos be captioned or written transcripts of videos be provided.

Goals and Outcomes:

The employee will interact on the phone and in person (in one-on-one and group settings)along with peers and have successful job performance.

See the attached HAAT Model form to see how to match the employee to needed AT.

Case Study Form - HAAT Model

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Funding Sources for Individuals with Hearing Needs

Public Sources

Private Sources

Community Living

Case Studies of Individuals with Hearing Needs and Recommendations

Case Study #1

A child whose hearing loss is identified before the age of 3, candidate for hearing aids and is receiving speech therapy services

After seeing an audiologist and awaiting hearing aids, she needs amplification for speech therapy sessions so she can interact and receive aural stimulation from the therapist.

Possible Recommendations:

A small handheld amplification system would work well in therapy sessions. Options include a pocket talker, comfort duett, or a two-piece uni, such as the Phonak pen and ear-level receiver.

Goals and Outcomes:

She will hear sounds and speech around her and develop language skills. She will participate in music therapy, or other therapy, to increase her language skills.

Case Study Form - HAAT Model

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Case Study #2

52-year-old, has progressive loss of hearing, family complains of her challenges during daily activities

The TV is too loud; she can't hear on the telephone, and she can't hear the oven timer when cooking dinner. The family is afraid she may catch the house on fire.

Possible Recommendations:

Several pieces of hearing AT could be recommended . Consider visiting an audiologist to decide the best path or recommendation for hearing aids. Once that is determined, the individual can still benefit from additional hearing AT in her everyday setting. Something like ClearSounds Quattro 4.0 can assist her in amplification for conversations, TV, and landline phones.

She could also consider comparable hearing AT, such as a cell phone amplifier and an amplification system that connects only with the TV. In regards to cooking, she could utilize a visual or tactile alarm, such as a Time Timer, or cell phone alarm clock with vibration. In the case of a fire, she could benefit from a specialized alert device, such as a Lifetone that listens for the smoke alarm and has visual and tactile alarming of the smoke alarm, or a smoke alarm that provides strobe light notification in addition to sound alert.

Goals and Outcomes:

She will have much-improved relationships with those around her when she can hear them clearer. She will be able to resume her life activities safely and enjoyably!

Case Study Form - HAAT Model

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Case Study #3

72-year-old with severe hearing loss, wears hearing aids

His hearing aids need to go in for repair, and he will have difficulty communicating during this time. He needs a solution to help him hear when he does not have access to his hearing aids.

Possible Recommendations:

A personal sound amplification system would be beneficial for communication between him and his wife. A two-piece unit should be considered, so he can hear sounds around him but also be able to amplify his wife when she is speaking directly into the transmitting microphone. He has a smartphone, so a captioning app, such as Ava, or a nonverbal app, such as Flip Writer, would be helpful so he can see written text to support sound output.

Goals and Outcomes:

He will be able to have conversations with his wife and fully participate in his daily routines with those around him while his hearing aids are being repaired.

Case Study Form - HAAT Model

Sample Solutions:

If you are interested in these recommended devices, please visit our Device Loan Program webpage to apply for a short-term loan.

Funding Sources for Individuals with Hearing Needs

Public Sources

Private Sources

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Table of Contents Key Takeaways Situations for using Hearing AT (all environments) Commonly Asked Questions AT Solutions at ABLE Tech Helpful Links/PDFs/Videos/Webinars/Podcasts Education Case Studies Education Funding Employment Case Studies Employment Funding Community Living Case Studies Community Living Funding Virtual Hearing Demonstration For more information, please contact Shelley Gladden, Assistant Director of Accessibility Programs, at

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It’s hard for students to learn in noisy classrooms. However, there are ways to reduce noise and improve classroom acoustics. Audiologists can provide additional information. Visit ProFind to locate a professional in your area.

On this page:

About Classroom Acoustics

Problems Caused by Poor Classroom Acoustics

Good Classroom Acoustics Helps Everyone

Improving Classroom Acoustics

Other Resources

About Classroom Acoustics

Hearing and understanding are important parts of the learning process. A noisy classroom can make these tasks difficult. Noise in the classroom is more than students talking. There are other factors that make it hard to hear and understand in the classroom.

Acoustics is a term used to talk about how sound travels in a room. There are factors in the room design that may make sounds louder or softer. Examples include floor rugs, ceiling type, and air ducts. Classroom acoustics is the term for these issues in schools.

Background Noise and Reverberation

Two things cause poor classroom acoustics: too much background noise and/or too much reverberation.

Background noise is any sound that makes it hard to hear. In a classroom, background noise can come from many places, including the following:

Sounds from outside the building, such as cars and lawnmowers

Sounds from inside the building, such as students talking in the hallway

Sounds from inside the classroom, such as air conditioning units and students in the room

Reverberation describes how sounds act in a room after they first happen. Sounds stay in the room when they bounce off desks or walls. If many sounds do this at once, it can get very loud.

Problems Caused by Poor Classroom Acoustics

When classroom acoustics are poor, it can cause problems with how a student

understands speech;

reads and spells;

behaves in the classroom;

pays attention; and/or

concentrates.

It is important to keep the classroom as quiet as possible for all children.

Good Classroom Acoustics Helps Everyone

A quiet classroom helps teachers and students. It is especially important to have a quiet room if a student has

hearing loss in one or both ears;

an ear infection or fluid in the ear;

a learning disability;

auditory processing disorder;

speech and language delay; and/or

attention problems.

Teachers also do better if there are good classroom acoustics. Talking in a loud classroom strains the teacher’s voice and may lead to voice problems.

Improving Classroom Acoustics

It is important to think about background noise and reverberation in any space used for learning. Some simple ways to make a classroom quieter include the following:

Place rugs or carpet in the room.

Hang curtains or blinds in the windows.

Hang soft materials such as felt or corkboard on the walls.

Place tables at an angle around the room instead of in rows.

Turn off noisy equipment when it is not in use.

Replace noisy light fixtures.

Show students how hard it can be to hear when many children talk at the same time.

Place soft tips on the bottom of chairs and tables.

A brochure on The Noisy Classroom is available through the ASHA bookstore.

Other Resources

Acoustical Society of America

ASHA Practice Portal on Classroom Acoustics

It's a Noisy Planet

National Clearinghouse for Educational Facilities

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It’s hard for students to learn in noisy classrooms. However, there are ways to reduce noise and improve classroom acoustics. Audiologists can provide additional information.

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Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing loss and might need to have your hearing checked.

Do you sometimes feel embarrassed when you meet new people because you struggle to hear?

Do you feel frustrated when talking to people because you have difficulty hearing them?

Do you have difficulty hearing or understanding co-workers, clients, or customers?

Do you feel restricted or limited when you have a problem hearing?

Do you often think, "I can hear but I don't understand what is being said?"

Do you have trouble understanding the dialogue on internet videos, movies, or in the theater?

Does a communication issue due to poor hearing cause you to argue with family members?

Do you ask people to repeat what they say?

Do you think others mumble?

Do you have difficulty hearing on the phone?

Do you have trouble hearing the TV or radio and turn up the volume that is too loud for others?

Do you feel your personal or social life is limited?

Do you have trouble hearing your dining companions when you are together in a restaurant?

Adapted from: Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The Hearing Handicap Inventory for Adults [HHIA]: Psychometric adequacy and audiometric correlates. Ear Hear, 11, 430-433.

Hearing depends on a series of events that change sound waves in the air into electrical signals. Your auditory nerve then carries these signals to your brain through a complex series of steps.

1. Sound waves enter the outer ear and travel through a narrow passageway called the ear canal, which leads to the eardrum.

2. The eardrum vibrates from the incoming sound waves and sends these vibrations to three tiny bones in the middle ear. These bones are called the malleus, incus, and stapes.

3. The bones in the middle ear couple the sound vibrations from the air to fluid vibrations in the cochlea of the inner ear, which is shaped like a snail and filled with fluid. An elastic partition runs from the beginning to the end of the cochlea, splitting it into an upper and lower part. This partition is called the basilar membrane because it serves as the base, or ground floor, on which key hearing structures sit.

4. Once the vibrations cause the fluid inside the cochlea to ripple, a traveling wave forms along the basilar membrane. Hair cells-sensory cells sitting on top of the basilar membrane-ride the wave.

5. As the hair cells move up and down, microscopic hair-like projections (known as stereocilia) that perch on top of the hair cells bump against an overlying structure and bend. Bending causes pore-like channels, which are at the tips of the stereocilia, to open up. When that happens, chemicals rush into the cells, creating an electrical signal.

6. The auditory nerve carries this electrical signal to the brain, which turns it into a sound that we recognize and understand.

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Hearing Loss Basics - How to tell if you have hearing loss

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Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing loss and might need to have your hearing checked. Do you sometimes feel embarrassed when you meet new people because you struggle to hear?

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Hearing is important to speech and language development and to learning. Audiologists can check your child's hearing and help with any problems.

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Alexander Graham Bell Association - A life without limits for children with hearing loss

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We had so many questions when our son was diagnosed with profound hearing loss as an infant...Fast forward to today and he has graduated from college, is professionally employed, married, happy and living the life we had always hoped he would.

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Help America Hear | Providing Access to Hearing Aids and Resources for the Hearing-Impaired Community

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Help America Hear is dedicated to improving the quality of life for individuals affected by hearing loss. Our mission is to provide access to hearing aids and resources to those in need and support the hearing-impaired community. Discover our programs, events, and initiatives aimed at making a diffe

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Miracle-Ear® is committed to helping underserved people with hearing loss and giving them the gift of sound. Our eligibility requirements are designed to reach those who need our help most. In order to qualify for our program:

Applicants must have a hearing loss that requires amplification (hearing aids).

Applicant must be denied financing options available at the Miracle-Ear store.

Applicant must have exhausted all resources available for their hearing health; including, but not limited to insurance, state Medicaid program, VA, vocational rehab, state or local programs, and other charity sources.

Applicant's total household income must be at or below 200% of the federal poverty guidelines on the on the income chart provided to qualify. Please note this is not the only eligibility criteria, this is only one component of the overall requirements. Scroll down to see the household income chart below.

Applicant must possess a family commitment to intervention, rehabilitation, and necessary follow-up services, which is especially important for a child applicant as they grow.

Applicant must be a resident or citizen of the U.S. or Puerto Rico.

Repeat adult applicants (19 & older), who still meet all eligibility requirements may reapply every 5 years from when they last received hearing aids from the Miracle-Ear Foundation. Child applicants (18 & younger) may reapply every three years if the family still fits the eligibility criteria.

Children (18 & younger) must provide a current audiogram (dated within the last 6 months) and medical clearance dated within the last six months, and signed by a physician (MD, ENT). While medical clearance is encouraged for adults, a signed medical waiver is acceptable.

For Adult applicants (19 & older) only; a $150 non-refundable application is required. It must be in the form of a cashier's check or money order made payable to the Miracle-Ear Foundation.

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Miracle-Ear Foundation: Eligibility Criteria | Miracle-Ear

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Read about Miracle-Ear Foundation eligibility criteria. Explore resources and help for those who are hearing impaired through the foundation's work.

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Table of Contents

Preface

Section I:
Introduction to Assistive Technology & Oklahoma ABLE Tech

Section II: Funding Strategy

Developing a Funding Strategy (direct links to topics below are on this page)

Steps and Strategies to Acquire Funding for Assistive Technology

Step 1: Define and document the need.
Step 2: Identify the equipment and/or services needed.
Step 3: Determine if an alternative device will meet the need.
Step 4: Determine potential funding sources.
Step 5: Gather all essential information to be submitted including prescriptions and other justifications
Step 6: Seek appeals as appropriate.

Appeals and Advocacy (direct links to topics below are on this page)

Client Disability Program (CAP)

Office of Disability Concerns

Special Education Resolution Center (SERC)

Oklahoma Parents Center (OPC)

Legal Aid Services of Oklahoma, Inc.

Office of Client Advocacy

Alternative Dispute Early Settlement Mediation Programs

Oklahoma Disability Law Center (ODLC)

Potential Funding Sources at a Glance Glossary of Assistive Technology Terms
Section III: Public Sources of Funding

The following pages contain fact sheets on public or governmental sources of funding. To determine the most likely agencies to pay for the AT you need, look closely at the eligibility requirements and financial criteria of each source and what types of AT devices and services the agency will fund. Due to eligibility requirements, funding for AT from public sources is far from guaranteed. You will have to build a strong case for the AT you need. Most agencies will have an internal appeals process if you disagree with the initial decision made in your case request.

Section IV: Private Sources of Funding

Public sources of funding have been exhausted and appeals have been rejected. Private insurance or the insurance that you do have will not cover the assistive technology needed. The next step should be to search for private nonprofit organizations and foundations that may be able to assist. There are many such sources in the state and nation, but they have restrictions on what they will provide, vary widely on eligibility requirements, and the resources available to them are limited. A person who needs funding for assistive technology may turn to a private nonprofit agency, organization, trust, or foundation for assistance. This Section describes such groups and lists contact information, but there may be others in your local communities that are not listed here.

Appendix A: Laws that Impact AT

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Developing a Funding Strategy (direct links to topics below are on this page) Steps and Strategies to Acquire Funding for Assistive Technology Step 1: Define and document the need. Step 2: Identify the equipment and/or services needed. Step 3: Determine if an alternative device will meet the need.

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McHugh, T. B., Saha, A., Bar-El, D., Worsley, M., & Piper, A. M. (2021). Towards Inclusive Streaming: Building Multimodal Music Experiences for the Deaf and Hard of Hearing. Extended Abstracts of the 2021 CHI Conference on Human Factors in Computing Systems, 1–7. https://doi.org/10.1145/3411763.3451690

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Mason, K., Marshall, C. R., & Morgan, G. (2021). Executive Function Training for Deaf Children: Impact of a Music Intervention. Journal of Deaf Studies and Deaf Education, 26(4), 490–500. https://doi.org/10.1093/deafed/enab026

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Deja, J. A., Dela Torre, A., Lee, H. J., Ciriaco, J. F., IV, & Eroles, C. M. (2020). ViTune: A Visualizer Tool to Allow the Deaf and Hard of Hearing to See Music With Their Eyes. Extended Abstracts of the 2020 CHI Conference on Human Factors in Computing Systems, 1–8. https://doi.org/10.1145/3334480.3383046

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Silvestri, J. A., & Falk, J. L. (2022). And the Beat Goes On: Using Music to Transform Classes for Deaf Students with Multiple Disabilities through Universal Design. Odyssey: New Directions in Deaf Education, 22, 76–81.

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Rocha, D. F. S., Bittencourt, I. I., de Amorim Silva, R., & Ospina, P. L. E. (2023). An assistive technology based on Peirce’s semiotics for the inclusive education of deaf and hearing children. Universal Access in the Information Society: International Journal, 22(4), 1097–1116. https://doi.org/10.1007/s10209-022-00919-2