When meeting with the parents, inquire about any evaluations that may have been done. Has he been seen by a pediatric neurologist? Pediatric ear, nose, and throat physician? Skilled audiologist? Speech pathologist? If so, ask what these evaluations have shown. For example, what frequencies does the child hear at? Is his problem more in the detection of sounds in certain frequencies or is it more in the processing and comprehension of those sounds?
Hopefully, conversations with his parents will help you learn how much the hearing impairment has influenced the child's over-all functioning. Ask questions about his basic capacities:
- Can he sustain attention and focus?
- How well does he engage with adults and with other children?
- Is he able to exchange gestures in a purposeful way?
- Can he read social signals?
- Can he sequence and problem-solve?
- Can he point to something he wants, for example, and lead an adult to a toy to show that it's what he desires?
- Can he communicate ideas through actual words, making sounds, or using sign language or pictures?
- To what degree can he build bridges between ideas?
- Can he answer "what," "who," and even "why" questions?
- How logical can he be?
If possible, observe the child playing with his parents to see how he processes information. Notice how well he takes in sounds and articulates in return. How well does he solve visual-spatial problems, such as figuring out where to search for something? How well does he plan his actions?
You'll also want to inquire about his relationships with his parents, other caregivers, and other children. This will help you know what he'll need in school to promote his over-all development. Will he need a teacher aid to work one-on-one with him? Will he need a lot of support for developing relationships and for following verbal directions? What kind of accommodations will he need to help him be a meaningful member of the classroom? All this can be learned simply by talking with (he parents, reading expert evaluations, and observing the child directly.
Find out, too, whether the child is in appropriate therapeutic programs to help improve his hearing and communicating. These could involve anything from the provision of hearing aids to cochlear implants and various technologies that filter out certain sounds or clarify the meaningful speech of others. You'll want to make sure that he is in an appropriate intervention program and has the proper support geared to his challenges.
Don't forget to draw on the help of the other children in the classroom. For example, if the little boy is indistinct in his sound making, the other children may have to learn to be patient and listen very carefully. If you model such patience, everyone will benefit.
In working with this child, concentrate on a few general principles:
Create a nurturing, supportive environment from which all the children will benefit. This should be an environment in which everyone is patient and focuses on understanding one another.
Use multiple channels to communicate with the child who is hard of hearing, including a lot of visual support through very animated gesturing.
Be alert to one potential problem. It's very easy for a hearing impaired child to have short bursts of communication rather than long, pretend play sequences or long conversations. The child may become distracted, because he is not used to attending for a long period of time. This is where visual supports can be very helpful in augmenting the back and forth communication.
Ideally, you will focus on all of the six levels of the functional-emotional development: attention, engagement, gesturing, sequencing, a lot of creative activities including pretend play, and lots of opinion-oriented conversations geared to solving problems. It will be important, too, to be in constant communication with the parents and to coordinate the program in the classroom with any outside help the child is receiving. And don't forget to enjoy him and his gains in mastery as you move along together!