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Deaf & Hard of Hearing – First Steps Guide

All children who are deaf or hard of hearing can thrive! Follow this guide for step-by-step action plans and answers to commonly asked questions from parents and professionals who have been right where you are.

Deaf & Hard of Hearing First Steps Guide

If you have just learned that your child may be deaf or hard of hearing, you may be feeling overwhelmed and confused. We have been there, and now, we are here to provide you with support and guidance in every way possible.

First, you should be confident that your child can thrive! Children with hearing loss can excel at sports, music, and school. They have successful careers and families of their own, and live a life without limits. Your unconditional love and support is the most important factor in your child’s success.

If you are hoping to use listening and spoken language with your child, this guide will walk you through the key first steps to get started down that path. If you have any questions, feel free to reach out to us at URL or to contact your AG Bell chapter to connect with a family local to you.

Step 1 –  Confirm your child’s hearing loss & determine level of severity

Newborn hearing screening is important. Make sure your baby’s hearing is screened before 1 month of age. View our guide to Universal Pediatric Hearing Loss, also available in Spanish.

Hearing loss can impact your child whether it is in one ear or both. Loss can range from slight to mild, to moderate, to severe, and to profound. The chart below visualizes common sounds and the hearing range at which they can be perceived.

Speech Banana

Step 2 –  Build your Team

The first professional on your team is a pediatric audiologist, who will diagnose both the type of hearing loss and frequency. This person will also be the one to discuss hearing technology options with you.

Making connections to other families with deaf children is extremely helpful. You’ve already taken a great first step by joining AG Bell. Reaching out to your local AG Bell chapter can help you to connect, and there may also be schools or community groups for the deaf in your area.

If you choose to use listening and spoken language with your child, you should seek out a a professional who provides early intervention listening and spoken language services. That person can be a teacher of the deaf, speech-language pathologist and/or audiologist who is specially trained to help you help your child develop listening and spoken language.

Professionals who are certified in supporting families and children to develop listening and spoken language are known as Listening and Spoken Language Specialists (LSLS) and are designated as either LSLS Certified Auditory-Verbal Educators (LSLS Cert AVEd) or LSLS Certified Auditory-Verbal Therapists (LSLS Cert. AVT). These professionals support and coach you in your role as your child’s most important teacher of language.

Step 3 – Auditory Stimulation and Hearing Technology

Next, it is important to make sure your child receives consistent access to sound, especially speech. Infants need appropriate amplification as soon as possible. Every day counts. Amplification should be fit, ideally, no later than 3 months of age.

The type of technology your child needs will depend on the type and severity of hearing loss. It is very important that you speak to your audiologist about the options available. Regardless of what technology your family chooses, the goal will be to help your child make the best possible use of their hearing through learning to listen.

Hearing Aids

There is a critical period in which children learn language, from birth to age 3 1/2. Fitting your baby with hearing aids right away must be a priority if your child is to access sound and maximize that window of opportunity to acquire language. Infants as young 2 weeks old can be fitted with hearing aids.

Depending on the degree of your child’s hearing loss, hearing aids will enable your baby to hear many sounds, including environmental sounds (a dog barking or a rattle shaking) and speech. Hearing aids work by boosting the intensity (or loudness) level of sounds at different frequencies or pitches. Hearing aids can also be programmed to fit the needs of individual hearing patterns, such as boosting intensity level for high frequency sounds that your child may not hear at all and less for low frequency sounds that your child may hear better.

It is important to note that hearing aids do not correct hearing the same way that glasses correct vision. Hearing aids amplify all sounds, so individual sounds may be somewhat distorted and it may be difficult for your child to distinguish and understand your voice from background noise in loud environments. Regular sessions with a Listening and Spoken Language Specialist (LSLS) will help your child distinguish these sounds.

Cochlear Implants

Cochlear implants were developed to help individuals who are profoundly deaf and gain little or no benefit from hearing aids.

When hearing is functioning normally, the inner ear converts sound waves into electrical impulses, which are sent to the brain and recognized as sound. A cochlear implant works in a similar manner – when surgically implanted behind the ear and in the cochlea, the electronic device is able to bypass damaged hearing cells and stimulate the auditory nerve to restore partial hearing. Cochlear implants provide enhanced sound detection and a greater potential for understanding speech.

If your child receives little to no benefit from hearing aids and has a severe-to-profound hearing loss, he or she may be a candidate for one or two cochlear implants.

Step 4 – Listening and Spoken Language Therapy

The most important step after providing your child with access to sound through hearing technology is to begin listening and spoken language therapy. Although your child is hearing sound, he or she still needs to learn to understand the sounds by learning to listen and then translate those sounds into spoken language. This type of therapy will help your child learn how to hear and speak.

Family-centered early intervention services promoting the use of listening and spoken language should start as early as possible, and no later than 6 months of age. If your child’s hearing loss is found at a later age, the priorities to focus on include the fitting of hearing technology and enrollment into early intervention within 1 month of diagnosis.

As your child’s parent, you can expect to actively participate in your child’s listening and spoken language learning process. Through parent guidance, coaching and demonstration, you will become the primary facilitators of your child’s listening and spoken language development. It is important that you establish an environment at home that facilitates listening and spoken language. This includes speaking to your child even when his/her eyes are focused away from you, ensuring your child’s hearing technology is working properly, practicing a variety of listening activities with your child as learned during therapy sessions, and including other family members in the therapy at home.

With time, you’ll will see that your child can have access to a full range of academic, social and occupational choices – they will live a life without limits!

Summary of First Steps

  • Early identification of the child’s type and degree of hearing loss. There are now very simple tests that can be performed with infants to identify hearing loss. They do not hurt and the child doesn’t have to actively participate.
  • Fitting of hearing aids as soon as possible after the hearing loss has been identified. Ask if your child’s audiologist has a hearing aid loaner program or whether a statewide hearing aid loaner bank exists.
  • Use of amplification 100% of your child’s waking hours within two to three weeks of the initial fitting. Remember, hearing is something we do all the time and it is critical for your baby’s learning brain to have constant, meaningful access to sound.
  • Observation of your child’s response to sound. You will work with your team to determine how well your child is learning through hearing. These observations will help determine whether the hearing aids need adjustments, or if a cochlear implant is recommended.
  • Enrollment in early intervention with a professional who specializes in facilitating listening and spoken language in infants and young children. To learn more about early intervention services in your local area, contact the National Center on Hearing Assessment and Management and click on States.
  • Strong parent support and attention to your child’s hearing, speech, language and academic needs across childhood – with your love and support, your child will thrive!

AG Bell membership for families is always free!

Family membership benefits:

  • Financial Support

    Scholarships for technology, therapy, and education

  • Professional Guidance

    Speak to a parent who's been there or search for a certified therapist.

  • State Chapters

    Connect with and get support from local families like yours!

  • Resource Library

    Get answers with access to our information library

  • Volta Voices

    A bilingual magazine with in-depth stories about growing up with hearing loss

  • Loft & Leap

    Access to unique leadership & educational programs for teens

Seeking an AG Bell professional membership?

Get listed on our searchable professional directory, find educational and research resources, scholarships and mentorship.

Professional Membership Has Its Benefits

Join today to connect with fellow members, exchange insights, get listed in our global directory, and celebrate the journey of listening & spoken language.

Professional benefits include:

  • Continuing Education Units (CEUs)

    Earn CEUs through the AG Bell Academy, at our yearly Symposium, or through events held throughout the year for members

  • $100 off Exam Fees

    Take your Listening and Spoken Language Specialist (LSLS®) certification exam for less!

  • Event Discounts

    Discounted registration to AG Bell’s symposium and other events, plus special discounts on travel, restaurants, retail shops and more

  • LSL Professional Directory

    Get listed and found by families that need your services and students that want your mentorship

  • LSL Leading Edge

    An exclusive e-newsletter for AG Bell professional members packed with the latest news and developments in hearing health and the listening & spoken language field

  • Volta Voices 

    AG Bell’s award-winning, quarterly digital magazine in English and Spanish

  • Access to AG Bell’s Network

    Connect with 40+ state chapters located throughout the United States and Puerto Rico

  • Professional Opportunities

    Get involved in AG Bell through committees, task forces, councils and other venues for members to interact and contribute meaningfully

  • The Volta Review 

    Stay current with the latest research through our peer-reviewed, online professional research journal

Seeking membership as a friend or family member?

Membership is always free for family & friends of people who are deaf or hard of hearing and helps connect individuals to our professional community!