Hearing impairment (HI)

Children with a hearing impairment range from those with a mild hearing loss to those who are profoundly deaf. Some may pass the hearing screen tests in school, but be subsequently labelled lazy or disruptive because mild hearing loss has gone undetected.

It may not be easy to spot the difference between a disaffected, dreamy child and one with a hearing loss.

We advise on key indicators, and types of, hearing loss.

Defining HI

For educational purposes, pupils are regarded as having a hearing impairment if they require hearing aids, adaptations to their environment and/or particular teaching strategies in order to follow the curriculum. Deafness alone is not defined as a special educational need, although, as with any SEN, there may be an associated disability or learning difficulty, for which you can get a statement of SEN.

Warning signs of a hearing impairment include:

• limited attention span
• daydreaming
• slowness of responses
• breathing through the mouth
• irritability.

Categories of HI

Four categories of hearing impairment are generally used: mild, moderate, severe and profound. Some pupils with a significant loss communicate through sign language (British Sign Language (BSL) is in widespread use) instead of, or as well as, speech. Children with mild or intermittent losses will not receive specialist educational support (even if they attend outpatient clinics) and neither will their families and schools.

Types of hearing loss

Conductive deafness

This occurs when there is some abnormality in the outer or middle ear. Transmission and amplification of sound vibrations are affected as they are conveyed to the inner ear. Generally, conductive deafness involves mild hearing loss, and is temporary.

Any blockage of the outer ear – glue, wax or a cyst – will cause a degree of deafness. The most common cause is otitis media, or glue ear, associated with an infection of the upper respiratory tract that leads to inflammation of the middle-ear cavity. If this becomes chronic a thick fluid develops in the middle ear. Glue ear is treated with antibiotics, and/or surgery to ventilate the middle ear by inserting a grommet in the drum.

About 20 per cent of primary age children suffer from conductive hearing loss caused by middle-ear problems; this reduces to 2 per cent by secondary age.

The consequences on development of undetected hearing impairment may be long lasting.

Children who do not hear clearly or whose hearing varies may:

• be late to start talking
• have immature language and difficulties with speech sounds
• fail to develop good listening skills, making learning in school very difficult
• have poor memory and language-processing skills, resulting in more basic vocabularies, reading and spelling problems, sentence structure and comprehension, with lower attainments in reading and maths.

Pupils with a conductive hearing loss have a higher tendenc...