• not being startled by a loud noise

• only noticing you when they see you and not when you say their name

• appearing to hear some sounds but not others

• not responding to or turning toward a sound source after they’ve reached 6 months of age

• not saying simple single words by 1 year of age

Symptoms in children can include:

• having unclear speech or talking very loudly

• often replying with “huh?” or “what?”

• not responding to or following directions

• a delay in speech development

• turning up the volume too high on the TV or headphones

Symptoms in adults can include:

• feeling like speech and other sounds are quiet or muffled

• having trouble hearing other people, particularly in noisy surroundings or when more than one person is speaking

• frequently needing to ask others to repeat themselves or to speak more loudly or slowly

• having to turn the volume up on your TV or headphones

  
  

Seladi-Schulman, J. (2020, March 17). Hard of hearing vs. deaf: Differences, symptoms, treatment. Healthline. https://www.healthline.com/health/hard-of-hearing#symptoms

DHH students -

• Delayed speech and language skills

• Learning problems in school

• Feeling bad about themself

• Having trouble making friends

Peers of DHH students -

• Difficulty communicating

• Not knowing how to socialize with DHH students

• Not knowing appropriate accommodations (eye contact while speaking, ASL, Hearing amplifications, etc)

  
  

American Speech-Language-Hearing Association. (n.d.). Effects of hearing loss on development. American Speech-Language-Hearing Association. https://www.asha.org/public/hearing/Effects-of-Hearing-Loss-on-Development/

Hands & voices. Hands & Voices :: Socialization. (n.d.). https://www.handsandvoices.org/needs/socialization.htm

• Hearing aids: Hearing aids are small devices that sit in the ear and come in a variety of types and fits. They help amplify sounds in your environment so that you can more easily hear what’s going on around you. (This will be discussed with the student's parent and doctor)

• Other assistive devices: Examples of assistive devices include captioning on videos and FM systems, which use a microphone for the speaker and a receiver for the listener. (This should be discussed if the student has a diagnosis from the doctor and the AT department at your school - FM systems will depend on the type of hearing loss and the availability within the district)

• Cochlear implants: A cochlear implant may help if you have more severe hearing loss. It converts sounds into electrical signals. These signals travel to your acoustic nerve, and the brain interprets them as sounds. (This will be discussed with parents and doctors. This is an invasive surgery that will need careful discussion. If the student does have a cochlear implant, it will be important to have AT part of the school discussion with appropriate accommodations)

• Surgery: Conditions affecting the structures of your ear, such as the eardrum and bones of the middle ear, can cause hearing loss. In these types of cases, doctors may recommend surgery. (This could be 'tubes' in the eardrum to prevent fluid build-up)

• Earwax removal: A buildup of earwax can cause temporary hearing loss. Your doctor may use a small tool or suction device to remove earwax that’s accumulated in your ear. (If the students just started experiencing some symptoms of hearing loss, this should be the first course of action. It will be important for teacher/parent communication if the teacher starts noticing these symptoms.)

  
  

Strategies:

• Slow down the pace of instruction

• Repeat instructions/directions

• Use body language and good facial expressions

• Do not place anything in the way of mouth while teaching

• Speak towards the student

• Seat the student for their best advantage

• Minimize background noise

  
  

Accommodations:

• Interpreters

• Speech-to-text services

• Assistive listening devices

• Note takers

• Captioned media

• Frequent breaks

• Extended time

• Scribes

Access & Accommodations. National Deaf Center. (2024, January 17). https://nationaldeafcenter.org/resources/access-accommodations/

Seladi-Schulman, J. (2020a, March 17). Hard of hearing vs. deaf: Differences, symptoms, treatment. Healthline. https://www.healthline.com/health/hard-of-hearing#treatment

Tips for teaching students who are deaf or hard of hearing. UTSA. (n.d.). https://www.utsa.edu/disability/faculty-staff/tips-teaching-deaf.html#:~:text=Slow%20down%20the%20pace%20of,the%20back%20of%20the%20room.

• Memory problems: Students display issues with long-term and short-term memory.

• Maintaining Focus: Student struggles to pay attention and stayed focused

• Slower processing speed: Taking longer to understand and respond to information

• Executive Function deficit: Student is unable to solve problems, organise or plan

  
  

Psychical Challenges:

• Fatigue and stamina issues: Student gets tired easily and requires frequent breaks

• Sensory sensitivities: Becomes agitated quickly with bright lights and loud noises

• Coordination and balance problems: Difficulty with physical activities for instance riding bikes and physical education

Behavior and Emotional Challenges:

• Mood swings and emotional dysregulation: Inappropriate behaviour that can lead to aggressive behaviour

• Reduced stress tolerance: Emotional outbursts when there is uncertainty

• Changes in social skills: changes in relationships with family members and friends, struggle with social skills.

• Develop an Individualized Education Program (IEP)

• Regular meetings and communication between teachers, parents, and medical providers

• Support staff with training on TBI for better understanding and to implement support strategies

• Teaching students about TBI for better understanding

A. The pupil demonstrates below average adaptive behavior in school and home, and, if appropriate, community environments. For the purposes of this item, "below average" means:
1. a composite score at or below the 15th percentile on a nationally normed, technically adequate measure of adaptive behavior; and
2. documentation of needs and the level of support required in at least four of the seven adaptive behavior domains across multiple environments. Systematic observation and parent input must be included as sources to document need and level of support. All of the following adaptive behavior domains must be considered:

(a)daily living and independent living skills;

(b)social and interpersonal skills;

(c)communication skills;

(d)academic skills;

(e)recreation and leisure skills;

(f)community participation skills; and

(g)work and work-related skills.

Other sources of documentation may include checklists; classroom or work samples; interviews; criterion-referenced measures; educational history; medical history; or pupil self-report.

B. The pupil demonstrates significantly below average general intellectual functioning that is measured by an individually administered, nationally normed test of intellectual ability. For the purposes of this subitem, "significantly below average general intellectual functioning" means:
1. mild-moderate range: two standard deviations below the mean, plus or minus one standard error of measurement; and
2. severe-profound range: three standard deviations below the mean, plus or minus one standard error of measurement. 
Significantly below average general intellectual functioning must be verified through a written summary of results from at least two systematic observations with consideration for culturally relevant information, medical and educational histories, and one or more of the following: supplemental tests of specific abilities, criterion-referenced tests, alternative methods of intellectual assessment, clinical interviews with parents, including family members, if appropriate, or observation and analysis of behavior across multiple environments. 

Northland Learning Center