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MedEd Connections Resource Guide: Deaf and Hard of Hearing (D/HH)

What Is Hearing Assistive Technology (HAT) and What HAT Support Is Available for My Child?

Technology may be beneficial for your child who is D/HH. Hearing assistive technology, also referred to as HAT helps people who are D/HH hear in loud or busy places. The American Speech-Language-Hearing Association (ASHA) has a nice explanation of a variety of HAT. This includes amplification devices, telecommunication technology, independent living technology, and much more. Your AT Assessment will help you and your school team to determine appropriate HAT supports. The AT specialist at your school, your teacher of the deaf (TOD) or your speech language pathologist (SLP) can help you better understand the specific supports available to your child.

What Hearing Aids are Available?

Hearing aids help carry and amplify sound. Most now are digital and battery operated. They are made in several styles. The most common hearing aids for children are behind the ear (BTE) because they are more durable and will last for four to five years, with only the earmold needing to be changed due to the child’s growth.

Want more details about hearing aids?
See Types of Hearing Aid Technology (ASHA)

Want a list of hearing aid styles?
See Different Styles of Hearing Aids (ASHA)

How Can FM/DM Systems Help My Child Hear in Noisy Settings?

Frequency Modulation/Digital Modulation (FM/DM) systems are wireless hearing assistive technology devices (HAT) which help children hear speech more clearly in challenging listening situations. FM/DM systems have a receiver, which is attached to your child’s personal HAT through a “boot”. The person your child wants to hear will wear a transmitter with a microphone and the speaker’s voice will be channeled directly to your child’s hearing aid and/or cochlear implant.

The FM/DM system eliminates the loss of intensity due to distance from the speaker and reduces the effects of background noise and reverberation.

The FM/DM can help your child understand speech in noisy settings such as a classroom, a gym, at assemblies, or during sports.

There are a variety of other HAT options, such as sound field systems, infrared systems and induction loop systems, which are used primarily for larger groups, whereas a personal FM/DM system connects directly to your child’s personal hearing aids and/or cochlear implant processors. There are other accessories that can be paired with hearing aids or cochlear implant processors, such as cell phones, MP3 players, computers and tablets via Bluetooth.

An audiologist will fit and maintain FM systems and other hearing assistive technology. this does not fall under the responsibilities of the teacher of the deaf (TOD) or speech language pathologist (SLP). If you have a concern about your child’s hearing technology, consult your child’s audiologist. Want to hear what it sounds like to listen through an FM System?

American Speech and Hearing Association (ASHA) provides a simple, yet more detailed description of the HATS mentioned above.

What are Hearing Implants?

There are two types of implants that can be used for hearing loss. A cochlear implant is (CI) an electronic device that bypasses damaged or nonworking parts of the inner ear (cochlea), and directly stimulates the hearing (auditory) nerve. An auditory brainstem implant provides hearing to people with hearing loss who can't benefit from a hearing aid or cochlear implant.

An implant has two parts, an internal piece and an external piece. The internal piece of a cochlear implant includes two parts, the receiver/stimulator, and the intracochlear electrode array. The internal piece is surgically implanted by an otolaryngologist (ENT). The visible external part of the implant is called a sound processor, and it activates the internal components. An audiologist programs the sound processor to stimulate the internal receiver and electrode arrays.

People with typical hearing receive the benefits of hearing acoustically. Hearing with a cochlear implant occurs through electrical stimulation. Newer implants may preserve some of the acoustic hearing. When that is the case, some people can use a hybrid cochlear implant to hear through combined electro-acoustic stimulation (EAS). Candidates for EAS devices typically have residual hearing in the low frequency ranges.

Children using cochlear implant processors participate in extensive listening and auditory verbal therapy (AVT). The brain needs training to understand the new electrical input. An audiologist, speech language pathologist (SLP), or teacher of the deaf (TOD) may be a certified Listening and Spoken Language Specialist (LSLS), which would make them a qualified auditory verbal therapist. AVT is designed to build good listening skills and acquire spoken language. This is particularly important for children with implants and hearing aids. Some professionals have additional oral listening training yet are not fully certified AVT specialists. You may want to ask your child’s professionals about their training or experience with AVT or working with children who are deaf/hard of hearing (D/HH).

Equal Voice for Deaf Children
This website was designed to teach AVT strategies which families may use at home as an additional resource. Individual lessons with video clips are provided.

Hearing First
Hearing First is multimedia connection point for families and professionals to improve outcomes for children who are D/HH through listening and spoken language. They provide the fundamentals of listening and spoken language, a family support community, and a professional learning community.