SENCO Week explains the tell-tale signs of hearing impairment and introduces some support strategies. Also included is SENCO Helpsheet 4 on medical conditions.pdf-9772920

SENCO Week Help Sheet 4 – Medical Conditions.pdf It’s thought that one in five children have some kind of hearing impairment (HI) at some point in their school careers. For many, this will be mild and temporary, for others, it is a permanent condition which they − and their teachers − have to come to terms with. This week we provide information for you to share with colleagues to help them consider the needs of HI learners.

SEN Support The term ‘hearing impairment’ is a generic term used to describe all hearing loss (mild, moderate, severe or profound) and can be classed as ‘conductive’ (sound has difficulty in passing though the outer or middle ear), or ‘sensory’ (the cause of deafness is in the cochlea or hearing nerve).

Chest infections, colds and enlarged adenoids are common among children and such conditions are likely to infect or block the eustachian tube which can cause middle ear infection (otitis media) known as ‘glue ear’. This condition may cause a degree of impaired hearing that may be temporary and vary from day to day, but which may also become a permanent conductive deafness. Fluctuating periods of hearing loss caused by such infections can have long lasting effects on a child’s developing vocabulary and listening skills, and yet the condition can go unnoticed. It is often mistakenly assumed that all hearing disorders have the same characteristics ie hearing all sounds as if through cotton wool. But children may have ‘high frequency’ or ‘low frequency’ hearing loss. Both vowels and consonants are made up of a mixture of frequencies but consonants are mainly high frequencies. In spoken English, consonants play the more important part in comprehension, and without the ability to hear them, speech becomes virtually unintelligible. A child will only produce the sounds that he is able to hear, so this obviously has implications too for his own speech development. Young children often don’t realise that what they hear is different to what others are hearing, but they are more likely to follow other children’s lead, laughing when others do, putting a hand up, or copying their responses to instructions. All pupils with HI have to concentrate very hard in the classroom situation and will tire far more quickly than peers: brief lapses in concentration can mean missing important pieces of information. It is easy to underestimate the ability of a child with HI for this reason.

Look out for children who:

  • seem in a world of their own, ‘switched off’ to what is happening around them
  • sit very nearer the television, or asks for the volume to be turned up
  • do not respond when called or questioned
  • often say ‘what?’ or ‘pardon?’
  • give answers that seem unrelated to the question
  • make mistakes when carrying out instructions.
  • show signs of irritability or frustration
  • are slow in acquiring phonic skills
  • watch speakers’ faces for lip cues and expressions in order to aid understanding

Hearing aids

Hearing aids can be very beneficial but boost all frequencies, and all ambient noise as well as the specific frequency needed: scuffing feet, chairs being scraped across the floor, coughs and sneezes, lorries going by the window − all can interfere with what the child really needs to listen to. Until the child is old enough, the responsibility for effective use of the aid will depend upon the knowledge and alertness of parents and teachers to check that they are working efficiently (batteries, etc). Radio microphone systems and/or loop systems are sometimes used in schools to amplify the teacher’s speech and can be a great help to children with hearing impairments, with or without hearing aids.


Children with severe hearing loss will rely on lip reading and/or signing. British Sign Language (BSL) is the most widely used method of signed communication in the UK and uses both manual and non-manual components − hand shapes and movements, facial expression, and shoulder movement. Fingerspelling is used to spell out names and places. BSL is structured in a different way to standard English and pupils’ written work may reflect this. Specific teaching of the use of articles for example, may be needed. Some people use Sign Supported English (SSE) a kind of English with signs. These ‘languages’ are now more commonly taught in schools to interested groups of pupils, or in some cases, to all pupils, providing them with valuable communication skills.

How teachers can help

  • find out the nature and degree of the pupil’s hearing loss
  • check the best seating position (eg away from the hum of OHP, computers etc) with good ear to speaker
  • check that the pupil can see your face clearly
  • when talking to the child use normal voice at normal speed − it does not help to try to emphasise your lip-patterns or to raise your voice
  • indicate the topic to be talked about so that the child can anticipate the vocabulary
  • talk at a normal rate, not too fast, yet not too slowly
  • provide a list of vocabulary, context and visual clues especially for new subjects
  • during class discussion allow one pupil to speak at a time and indicate where the speaker is: note down the main points on the board
  • check that any aids are working and if there is any other specialist equipment available
  • allow the child to turn around to see other children when they are talking
  • ensure that the child has understood instructions, remembering that high frequency hearing loss often causes ambiguity
  • be aware that difficulty with spelling can result from hearing loss, particularly with word endings − for example: wsalk, walks, walked and walking.
  • consider learning BSL or sign supported English.



British Association of Teachers of the Deaf (BATOD)

Royal Institute for the Deaf (RNID)

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This e-bulletin issue was first published in November 2007

About the author: Linda Evans is the author of SENCO Week. She was a teacher/SENCO/adviser/inspector, before joining the publishing world. She now works as a freelance writer, editor and part-time college tutor.