Using Amazon Smile? Click this link instead!
Shop Hoagies' Page before you visit your favorite on-line stores
and many more of your favorite stores. Thanks for
making Hoagies' Gifted community possible!
Your donations help keep Hoagies' Gifted Education Page on-line.
Support Hoagies' Page!
Educating Children Who Are Deaf or Hard of Hearing:
Additional Learning Problems
The ERIC Clearinghouse on Disabilities and Gifted Education (ERIC
ERIC EC Digest #E548
Author: B.J. Pollack
What Is Meant by "Additional Learning Problems" in the Deaf
Or Hard of Hearing Population?
Hearing loss has far-reaching, critical effects on childhood
development of cognitive (thinking) and linguistic (language) skills.
The occurrence of other disabilities in combination with diminished
hearing creates "additional learning problems" which significantly
add to the complexity of educating the student who is deaf or hard
of hearing. The prevalence of other disabilities in addition to
hearing loss is approximately three times as large (30.2%) in the
deaf or hard of hearing population as in the general school
population. Some of this may be explained by the varying causes
of hearing loss. Some of the current documented etiologies of
childhood deafness include maternal rubella (2%), prematurity
(5%), cytomegalovirus (1%), and meningitis (9%)(Moores, 1987).
It is logical to assume that the population demonstrating a hearing
loss is at a high risk for additional disabilities since the previously
mentioned etiologies are also known to be associated with
The prevalence of several specific disabilities occurring with
diminished hearing has been documented over time (Craig &
Craig, 1993, 1983, 1973). The three additional disabilities most
often reported in children who are deaf or hard of hearing are
learning disabilities, intellectual disabilities, and emotional/
behavioral disabilities. The 1993 reference issue of the American
Annals of the Deaf reports learning disabilities as the largest co-occurring disability at a
prevalence of 9%. The prevalence of
intellectual disabilities occurring with a hearing loss followed
closely at 8%. The co-occurrence of emotional/behavioral
disabilities was the least at a 4% occurrence rate.
Although there are difficulties in definitively characterizing
these frequently co-occurring disabilities, the following definitions
may apply. Students with co-occurring emotional/behavioral
disabilities are described as displaying inappropriate, disruptive,
aggressive behaviors that interfere with learning. Students with
hearing loss and intellectual disabilities are characterized by a
generalized delay in development across all areas of learning with
limited problem-solving abilities and lowered adaptive or functional
skills. Students diagnosed with learning disabilities and hearing
loss are generally found to be in the average or above average
range of intelligence displaying skills and abilities in many different
ways while displaying specific learning deficits that restrict
accomplishments. They are described as exhibiting unusual
learning characteristics considered atypical of students who are
deaf and hard of hearing in general; these greatly affect their
progress. These students are not progressing academically in
comparison to the documented parameters of delayed language
and concept learning found in the general population of students
who are deaf or hard of hearing (Bunch & Melnyk, 1989). In an
effort to recognize this subgroup's uniqueness, the field appears
to be moving away from using the label "learning-disabled hearing-
impaired" and, instead, is beginning to label these students "deaf
or hard of hearing with additional mild disabilities," "atypical
learners with hearing loss," and "deaf or hard of hearing learners
with additional learning problems."
How Are Additional Learning Problems Identified in Children
Who Are Deaf or Hard of Hearing?
Identification of additional learning problems among children
with diminished hearing is a difficult and complex task. Part of the
difficulty arises from the fact that a hearing loss by itself creates
pervasive learning problems that usually result in very delayed
language acquisition and consequently delayed academic skills.
Therefore, the identification of any other interfering or additional
influencing factors affecting the students' learning can pose difficult
issues. What difficulties come with the hearing loss and what
difficulties are caused by another source or element?
Furthermore, recognizing the additive effect of co-occurring
disabilities, what unique learning profile is created by the
combination of a hearing loss and the additional disability that are
above and beyond any profile characterizing each individual
Sound assessment practices using interdisciplinary teams are
important when identifying additional disabilities in students who
are deaf or hard of hearing (Paplinger & Sikora, 1990). This is
particularly true when one considers that the characteristics
displayed by students with co-occurring disabilities are often the
same. A consistent lack of language learning, attention problems,
retention difficulties, and delayed academic skills are phrases that
are heard when professionals in the field describe students who
have hearing losses and learning disabilities, intellectual
disabilities, or emotional/behavioral problems. Therefore,
differential diagnosis is critical to determining an accurate learning
profile for the individual student, which includes a clear
determination of the disabilities influencing that profile. The
assessment should consist of teacher observations and
appropriate standardized assessment measures as well as
informal assessment procedures. Professionals involved should
include school psychologists, classroom teachers, occupational
and physical therapists, speech/language pathologists,
audiologists, and any necessary medical personnel such as
nurses, psychiatrists, etc. The team should provide careful
interpretation of the assessment results with recommendations and
suggestions for educational programming.
What Are Some Questions to Ask in Deciding Whether or Not to
Refer My Child/student for an Evaluation?
Is the student who is deaf or hard of hearing progressing as
would be expected when compared to his/her hearing impaired
peers? This should be the first question when considering
evaluation for a student with a hearing loss. Researchers
(Kretschmer & Kretschmer, 1989; McAnally et al., 1994; and
Yoshinaga-Itano, 1986) have documented parameters of delayed
language acquisition and academic progress commonly seen in
learners who are deaf or hard of hearing. Given the opportunities
to learn language and academic skills through appropriate and
efficient modes of communication, a learner with a hearing loss
should progress in expected patterns of growth and achievement.
If this is not happening, questions should be raised as to the
Is the student with a hearing loss displaying any characteristics
that are not usually seen with a hearing loss? Having a hearing
loss brings with it many characteristics that affect the learning of
the student. However, the hearing loss alone is not necessarily
accompanied by such characteristics as visual-perceptual
problems, attention deficits, perceptual-motor difficulties, severe
inability to learn vocabulary and English structures, consistent
retention and memory problems or consistent distractive behaviors
or emotional factors. If any of these kinds of behaviors characterize
the student who is deaf or hard of hearing, then an investigation
into the possible influencing factors should be requested.
What Are Common Strategies Used to Help These Students?
It is very difficult to determine common strategies for students
with additional learning problems primarily because each individual
learning profile will be different depending on the number and
nature of the various influencing factors. After some time spent
looking for "fix-it" strategies, the professionals in this field appear
to be moving toward the belief that all students with hearing losses
should have individualized approaches to instruction, including
those with additional learning problems (Powers, 1993). It is
indeed a challenge to the professionals in the field to match the
assessment learning profile with appropriate educational strategies
to address the delineated problems. Generally speaking the
following strategies may be useful. For those students with
additional learning problems that include severe lack of vocabulary
and simple syntax knowledge, work using pictures and picture
symbols to support speech and/or signs has proven beneficial
(Chalk, 1996). For those hard of hearing students who display
characteristics more commonly associated with processing or
understanding of sound, learning disabled students have
benefitted from many of the aural/oral remediation techniques used
to improve listening skills (Roth, 1991). Behavior techniques that
include clearly defined choices and expectations with natural
consequences have proven effective. Addressing emotional
factors through the educational program and individual or group
counseling when appropriate have also proven beneficial (Gage,
et al, 1994; Rasing & Duker, 1993).
References and Additional Resources
Bunch, G. & Melnyk, T. (1989). A review of the evidence for a
learning-disabled, hearing impaired sub-group. American Annals
of the Deaf, 134, 297-300.
Chalk, P. (1996, Oct). New says of using communication symbols.
Paper presented at the Fall LEA Workshop, Cave Spring, GA.
Craig, W.N. & Craig, H.B. (Eds.).(1993). Tabular summary of
schools and classes in the U.S. American Annals of the Deaf,
Craig, W.N. & Craig, H.B. (Eds.). (1983). Tabular summary of
schools and classes in the U.S. American Annals of the Deaf,
Craig, W.N. & Craig, H.B. (Eds.). (1973). Tabular summary of
schools and classes in the U.S. American Annals of the Deaf,
Gage, S., Lou, M.W. & Charlson, E.S. (1994). A social learning
program for deaf adolescents. Perspectives for Teachers of the
Kretschmer, R. & Kretschmer, L. (1989). Communication
competence: Impact of the pragmatics revolution on education of
hearing impaired children. Topics in Language Disorders, 9(4), 1-16.
McAnally, P.L., Rose, S. & Quigley, S.P. (1994). Language
learning practices with the deaf. Boston: Little, Brown and
Moores, D.F. (1987). Educating the deaf: Psychology, principles,
practices.(3rd ed.). Boston: Houghton Mifflin.
Paplinger, D. & Sikora, D. (1990). Diagnosing a learning disability
in a hearing impaired child. American Annals of the Deaf, 118,
Powers, A. R. & Elliott, R. N. (Eds.). (1993). Deaf and hard of
hearing students with mild additional disabilities. Monograph.
Tuscaloosa, AL: The University of Alabama.
Rasing, E.J. & Duker, P.C. (1993). Acquisition and generalization
of social behaviors in language-disabled deaf children. American
Annals of the Deaf, 138(4), 362-369.
Roth, V. (1991). Students with learning disabilities and hearing
impairment: Issues for the secondary and post-secondary teacher.
Journal of Learning Disabilities, 24(7), 391-397.
Yoshinaga-Itano, C. & Downey, D. (1986). A hearing-impaired
child's acquisition of schemata: Something is missing. Topics in
Language Disorders, 7(1), 45-57.
For more information about the assessment process, see ERIC
Digest E550 on assessment of students who are deaf and hard of
hearing. For more information about services available in your
state, contact your state's school for the deaf. A listing of these
may be found annually in the April edition of the American Annals
of the Deaf periodical.
Dr. Pollack is the educational diagnostician on the Diagnostic
and Evaluation Team, Atlanta Area School for the Deaf.
Top of Page Back to ERIC Menu Back
to Hoagies' Gifted Education Page
ERIC Digests are in the public domain and may be freely reproduced and disseminated,
but please acknowledge your source. This publication was prepared with funding from
the U.S. Department of Education, Office of Educational Research and Improvement,
under contract no. RR93002005. The opinions expressed in this report do not
necessarily reflect the positions or policies of OERI or the Department of Education.