DHH Assessment & Instruction Resources

Nearly half of children with hearing loss have additional needs. Children with hearing loss are considered at risk for communication deficits as well as vestibular (balance) dysfunction, vision problems, and reading difficulties related to phonemic skills. When children display additional needs, they are often referred to as DHH Plus (i.e. Deaf/Hard-of-Hearing Plus additional disabilities). It is important to consider all potential areas of assessment for children with hearing loss.

In 2015, The National Institute on Deafness and Other Communication Disorders (NIDCD) published 10 major conclusions in the Outcomes of Children with Hearing Loss (OCHL) longitudinal study. This research was conducted following recognition that children who are hard of hearing are underrepresented in the scientific research. Highlighted conclusions are as follows:

1: Children with mild-to-severe HL are at risk for depressed language development, and the risk increases with the severity of unaided hearing levels.

6: Qualitative dimensions of caregiver input influence child language outcomes.

7: Both receptive language abilities and aided audibility influenced children’s functional auditory and speech recognition skills.

8: Children who are hard of hearing appear to be at particular risk for delays in structural aspects (i.e., form) of language.

9: Sole reliance on norm-referenced scores may overestimate the outcomes of children who are hard of hearing.

10: Aided audibility, HA use, and characteristics of the language environment interact to moderate the influence of HL on children’s outcomes.

When children who are hard of hearing are matched to their same age and same socioeconomic status peers, the size of the effect of hearing loss on language averages 2/3 of a standard deviation. Normative testing is unlikely to reflect the level of effort that students with hearing loss are expending to maintain competitiveness with peers.

Approximately 20,000 hours of listening to speech are necessary for a child's brain to develop representation for speech sounds. These prepare the child to develop phonological awareness skills and the cognitive basis for reading. Dehaene S. Reading in the Brain: The Science and Evolution of a Human Invention. New York: Penguin; 2009.

A study from 2017 concluded that 1/3 of children with reading and writing difficulties, specifically related to phonology skills, were also found to have repeated ear infections, suggesting fluctuating hearing abilities can negatively contribute to a child's reading development. Coventry University. "Screen children with reading difficulties for hearing problems." ScienceDaily. ScienceDaily, 5 October 2017.

Video Discussions: Test Equity Highlights from the 2008 Test Equity Summit by the National Deaf Center

Common Assessments for Students who are Deaf/Hard-of-Hearing

Expanded Core Curriculum for Students who are Deaf or Hard of Hearing, Iowa 2013

Learner Variability Project - a free model for using learner factors to identify instructional strategies

Communication

Areas of Vulnerability: speech perception, listening comprehension, syntax, morphology, phonological awareness, conversational language, & pragmatic language.

Webinar: Assessment Considerations for Children who are Deaf/Hard-of-Hearing by Dr. Kristina Blaiser, Ph.D., CCC-SLP

Reading

Students taking the Idaho Reading Indicator (IRI) can qualify for accommodations, based on specific need. Please refer to the Idaho IRI Test Administration Manual and view the IRI Administration for Students Who Are Deaf or Hard of Hearing tutorial.

Reading in Children with Hearing Loss: The Importance of Teaching the Language of Theory of Mind for Reading Success, presented by Nemours Children's Specialty Care