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Hearing impairment

  • Approximately 3 in 1,000 babies are born with permanent hearing loss[i]
  • Children can have different types of hearing loss as detailed below:-
    • Sensorineural-hearing loss in the inner ear. This usually means that the cochlea in the inner ear is not working effectively. Sensorineural deafness is permanent.
    • Sound cannot pass efficiently through the outer and middle ear into the inner ear. Conductive deafness can be temporary (e.g. glue ear), or permanent (e.g. some structural abnormalities).
    • Mixed – hearing loss is both conductive and sensorineural in nature.
    • Auditory Neuropathy Spectrum Disorder (ANSD) – sounds are received normally by the cochlea (inner ear), however become disrupted as they travel to the brain.[ii]
  • Children can have different degrees of hearing loss as detailed below:-
    • Mild 21-40 dB
    • Moderate 41-70 dB
    • Severe 71-95 dB
    • Profound >95 dB[iii]
  • Your child’s hearing levels will be determined and updated by your local Children’s Hearing Service (Audiology).

This video shows what is heard at varying degrees of hearing loss:

ASHA – American Speech and Hearing Association
[1] NDCS – National Deaf Children’s Society
[1] BATOD – British Association of Teachers of the Deaf
[i] ASHA – American Speech and Hearing Association
[ii] NDCS – National Deaf Children’s Society
[iii] BATOD – British Association of Teachers of the Deaf

Strategies and advice

  • Check the child’s equipment, i.e. hearing aids / cochlear implants (ask the Teacher of the Deaf to show you how).
  • Gain the child’s attention before starting a conversation.
  • Consider the environment:-
    • make sure the room is well lit and avoid bright light behind the speaker (e.g sitting in front of a window), as this causes a shadow and makes lip reading difficult.
    • make sure you are facing the child and on the same level; keep good eye contact.
  • Speak clearly and normally. Do not shout or over-articulate sounds as this distorts lip patterns.
  • Do not cover your mouth or eat when speaking to the child, as they may well find it difficult to follow what you are saying.
  • Try to limit background noise as hearing impaired children may find it difficult to pick out what is being said. Carpets, curtains and other soft furnishings will help to reduce echoing in a room.
  • Check that the child has heard and understood what you are saying and repeat or rephrase as necessary.
  • Encourage the child to let you know if they don’t understand
  • Some words may not be within the child’s vocabulary so be prepared to use a different word with the same meaning.
  • Reinforce by visual means where necessary, e.g gestures, picture cues, signs.
  • Make sure you let the child know when there is a topic change as this can be difficult for hearing impaired children to track.
  • In group situations, make sure only one person is talking at a time. It is also helpful for the speaker to raise their hand so that the child knows who is talking.

Useful film clips

Supporting auditory discrimination

Useful websites

  • National Deaf Children’s Society
    Organisation providing advice and support to families, children and young people and professionals. Includes information on family sign language.
  • The Listening Room
    Free, fun activities and resources to support the development of speech, language, and listening skills in people of all ages with a hearing loss.
  • NDCS Buzz
    Aimed at deaf children and young people 8-18 years and includes help and support information, details of events etc.


This overlaps with the role of the Specialist Teacher of the Deaf. Recommended by Specialist Teachers of the Deaf for TAs.


The Hearing Impairment Specialist Speech and Language Therapists provide assessment and/or therapy for children and young people with the following (provided hearing loss is regarded as their primary area of need);

  • Moderate to profound bilateral Sensorineural Hearing Loss
  • Permanent moderate conductive hearing loss
  • Auditory Neuropathy Spectrum Disorder (ANSD).

To refer your child to receive support to develop their communication skills please use the Children’s Therapies Service referral form.

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