What to do?
Your child may mishear things you say to them or not respond when you talk to them. You may notice that your child has become quieter than usual or withdrawn.
Alternatively, you may be feeling that your child is becoming frustrated and have noticed changes in their behaviour. Your child's speech may not be as clear as it was or you may be worried that your child is not yet talking, or they may be finding things difficult at school and may be falling behind with their work.
There are many reasons that your child may have problems with hearing; they are not all permanent. Your child may have glue ear, which is when the middle section of your child's ear behind the eardrum becomes filled with fluid, making it difficult for sound to pass through. This is a very common problem for children and can occur many times throughout childhood. See the NHS website for more information
Your health visitor is available until your child reaches the end of reception year at school. They will help you to understand the issues and help you to decide the best course of action.
If your child goes to a nursery or a school, talk to someone there who knows them well and see if they have concerns.
All nurseries and schools will have a SENDCo, this is the person in the setting who works with and helps children who require additional support. Ask your child's school or nursery who this person is and talk to them about your concerns.
In the first instance you should speak to your health visitor or GP. A hearing test is the best way to diagnose hearing loss and it’s severity. No child is too young or old to have a hearing test! Although hearing loss can be harder to spot in babies there is a useful checklist that can help you notice the signs.
Audiolology
The GP or health visitor may refer you to a speech and language therapist, or to relevant specialists at the hospital, such as audiology or ear, nose and throat (ENT)
Whilst the audiology team's website is under review, you can contact them on 01522 573245 or 01205 446478 or email them
Sensory education support team (SEST)
If you are a parent or setting with a child who has been identified with a hearing loss, you can seek support and advice from the SEST team.
Who are we:
We support families and settings with children and young people who have been identified with a hearing loss.
The hearing support team consists of specialist teachers and specialist teaching assistants who have worked and taught in a range of different schools and settings. The team attend a wide range of courses relating to supporting and working with children and young people with a sensory impairment and are highly skilled and experienced.
Our aim is to ensure that children and young people who have been identified with a hearing loss have full access to their learning environment, for them to make progress and achieve their full potential. If your child has had a medical diagnosis for their hearing, we are here to help.
How can we help:
We offer support, advice and specialist teaching to children and young people across a range of educational placements including nurseries, mainstream and special schools, This includes academies.
If your child is not yet in nursery or school the team may visit you and your child in the home. Support is offered during term time in school hours.
Children and young people with a hearing loss can face many unique challenges in accessing the curriculum and their environment. Our role is to identify those challenges and support those involved with the child or young person to overcome them.
As all children, young people, their families, schools, and settings are different, the frequency of visits and level of support offered will vary. The National Sensory Partnership Eligibility Framework (NATSIP) decides how much support is offered to each individual child or young person. This support is described as high, medium, low, monitor or advice.
The level of support is regularly monitored for any changes.
Babies who are identified with a permanent childhood hearing loss following newborn hearing screening are referred to the sensory education support team within 24 hours of an identification and contact is made with the family by a teacher of the deaf within two working days.
Children and young people aged between 0 and 25 can be referred at any other time once identified with a hearing loss. We accept new referrals from parents, ear nose and throat (ENT) and audiology departments, schools, and settings.
Education and what you should expect for your child with hearing loss
If your child has been identified with hearing loss, it’s important to know that schools are required by law (Equality Act 2010) to make reasonable adjustments so that children with hearing loss are not at a disadvantage compared to their peers. Waiting until a child falls behind to put adjustments to support them in place is not acceptable. Schools must be proactive in providing a fully inclusive environment to support deaf children.
Here are some ways that school can and should be helping your deaf child:
- if hearing aids and radio aids are used, they need to be working and checked by a named, trained person to ensure they are working well
- ensure a good listening environment where all children can hear and learn. This would include: closing the door and windows to outside noise; having soft furnishings, carpets and shutting blinds; turning off music which is not part of the lesson; having groups positioned at great distance to each other; and asking all children to work quietly
- position the deaf child near the person speaking, get their attention and face them. It is better to sit directly in front of a deaf child or at right angles to them. Deaf children might not be able to see your face clearly if you sit next to them- hearing aids work best up to 2m. A child sitting at distance to whoever is speaking will not hear them as clearly as everyone else. Deaf children need to know someone is talking so they can actively listen and lipread. If they do not know someone is talking they will not know to look and listen. The deaf child may know the best place to sit- ask them
- position the deaf child with their back to the window so light illuminates the teacher’s face, or shut the blinds. Deaf children cannot lip read and follow conversations if they have to squint to look at the person talking. Lip reading is incredibly difficult and tiring because many speech sounds look the same for example- p, b and m, t and d, k and g
- use visual prompts; for example, real objects, signs, gestures, pictures and notes. Many words sound very similar and can cause great confusion, including pat, mat, bat, hat, cat and sat. Visual prompts can also help with developing vocabulary, spellings and understanding concepts
- check information has been heard and understood - ask them to repeat the information; don’t just ask if they have understood
- give additional time for deaf children to look and listen. Deaf children can not look at the person talking and at the thing they are talking about at the same time like hearing children can. They need time to keep up. This makes listening and concentrating very tiring – regardless of age. Following in group reading is particularly difficult
- write all homework and tasks on the board well before the end of the lesson. Deaf children often get very confused and upset about homework. This is often because they cannot hear a verbal explanation at the end of the lesson while it is noisy and everyone is packing away. Homework must be written on the board and everyone’s attention drawn to it
- let deaf children know it is ok to say if they cannot hear, without fear of being told off – then do something about it. This is so strategies can be put in place to enable them to hear. The school and deaf child may need to agree how this will be done.
- let the deaf child know it is ok to tell someone there is a problem with their equipment. Problems with equipment must be acted on immediately. Without working hearing aids, deaf children will not be able to hear and take part in lessons. It is not good enough to say a battery can be changed at the end of the lesson or at break time. Check in with the pupil to make sure things are ok
- examination access arrangements should be applied to all assessments from early years through to the end of schooling. For deaf children to access examinations, assessments and test tasks, they will require a quiet good listening environment and possibly additional time to process. Some examinations may require a live speaker as deaf children cannot hear and follow a recorded voice. National examinations access arrangements must be based on ‘normal ways of working’ for deaf children – these must be well established and used on a day to day basis
- ensuring deaf awareness training for all staff is in place; teaching, nonteaching and supervising. Deaf children are as cognitively able as hearing children. Greater understanding of the condition, knowledge and use of specialist equipment along with specific classroom strategies will allow deaf children to achieve equally as their peers
Communication and language development
Types of communication that can be used with a person with hearing loss
British sign language (BSL)
This is a language that has been formally recognised as an official language and is mainly used by people who are profoundly deaf. BSL is a visual means of communicating by using signs, gestures, facial expressions and body language. The language also has its own grammatical structure and syntax. British Sign Language is an official language of the United Kingdom, recognised in the BSL Act in 2022.
British Sign Language (BSL) awarding body: Signature
Signature is the awarding body for all BSL courses. It is a recognised organisation for anyone that wants to enrol on an accredited course.
British Deaf Association (bda.org.uk) and BSL Act 2022 update - information about events, updates about deaf news in the UK and information about the BSL Act 2022. Also, updates with regards to the process status of the up and coming GCSE in BSL.
British Sign Language - online resources, games, and course
Sign supported English (SSE)
This is a term used to describe a method of communicating by using borrowed signs from BSL and speaking at the same time. Using SSE is useful for a person who follows English as a first language but uses signs to support with understanding.
Bilingual language
This is a term used to describe a person who has a mixed ability to communicate using a variety of methods as described above. This can also include cultural knowledge of both the hearing and deaf world.
Makaton
Makaton is a communication tool that is used with speech, sign and symbols. It can enable people with disabilities or learning difficulties to communicate.
Sign along
Sign along is a communication tool that is used with speech, sign and symbols. It can enable people with disabilities or learning difficulties to communicate.
Deaf CAMHS
The National Deaf Child and Adolescent Mental Health Service (NDCAMHS) provides a specialist mental health service for deaf children with a range of emotional, behavioural and developmental difficulties.
The NDCAMHS team supports children who experience mental health difficulties and are either:
- severely or profoundly deaf
- use British Sign Language (BSL) or Sign Supported English (SSE) as their preferred, first language
- have a significant language impairment related to being moderately or profoundly deaf.
Lincolnshire is covered by the Birmingham NDCAMHS team:
To contact them send an email
Referrals can come from any professional working with the child, young person and family.
This includes schools (both mainstream and deaf), Teachers of the Deaf (ToDs), CAMHS, GPs, paediatricians and other children’s services.
What are the different needs NDCAMHS can support with?
The NDCAMHS team can help if a child or young person is having difficulties that are affecting their life, for example:
- emotional difficulties, such as depression and anxiety
- behavioural difficulties
- trauma and attachment difficulties
- other emotional problems that would typically be seen by a CAMHS team
- they also work with neurodevelopmental conditions, such as autism and ADHD
In addition to this, they will work with local (Lincolnshire) CAMHS services to provide care to children, young people and their families.
What do NDCAMHS offer following accepted referrals?
- assessment of a child’s emotional and developmental needs
- therapeutic support which could include individual work, group work, working with families and medication
- advice and consultation which may include deaf awareness
- advice and consultation for teachers, residential care staff and mental health professionals or any professional involved in the care or support of the young person
Due to the large geographical region covered, the NDCAMHS team mostly support via online platforms such as Teams or Zoom. Contact the Lincolnshire CAMHS services if you would prefer face to face contact.
The NDCAMHS website is a good source of advice and further links for information and support, such as websites, Apps, videos, books and materials supporting deaf identity.
Help when preparing for adulthood
The teachers of the deaf work closely with audiology colleagues in local audiology departments.
Teachers of the deaf will support students with an independent skills checker, which is a teaching programme focussing on independence. By the end of this programme, students should be able to check and maintain their own equipment and make their own appointments.
At 16, the young person will sign their own consent form to work with the teachers of the deaf and to enable sharing of information with families and audiology.
Paediatric to adult SEST and audiology transition pathway
SEST | Age | Audiology |
---|---|---|
|
14 years old - year 9 | Routine paediatric hearing aid Follow up appointment· If Young person is developmentally ready, begin giving early transition written and verbal information -record preferred communication method |
|
16 years old - year 11 | Young persons group transition review· - all YP not just SEST caseload - SEST member of staff present Named transition audiologist present |
|
18 years old - year 13 | Final paediatric audiology review
|
|
6 months later | First adult hearing aid review
|
1 year later | Second adult hearing aid review
|
|
Young adult transitioned to adult service
|
Note this pathway is specific to Lincoln and Boston audiology departments. Others may differ slightly
Further help
National Deaf Childrens Society provide national resources which may differ from what can be provided locally. This service is offered to all families to gain advice and guidance in relation to deafness. Their website has a wide range of resources and contacts including diagnosis, education and living with deafness.
Lincolnshire Sensory Services - sight and hearing loss support. This service offers specialist support to enable people with a sight or hearing loss to live life as independently as possible. The service offers support, information, guidance and issues equipment specific to the client's sensory loss needs
Lincolnshire BID services - Lincolnshire Sensory Service is delivered by BID services on behalf of Lincolnshire County Council. BID is a sensory loss charity. We work with families, carers, organisations, and other professionals to promote wellbeing and independence.
Chance to meet Lincolnshire BID services - this service enables families who live with sight or hearing loss to meet for events and share lived experiences. This is also an opportunity to access information, guidance and support.
Lincolnshire children's therapy services -
Speech and language therapy
Speech and language therapy aims to help all children to communicate as well as possible and develop their speech and language skills.
A speech and language therapist will work as part of a team with your child’s audiologist, teacher of the deaf and teaching assistants (SEST) and other professionals to help your child.
Lincolnshire NHS has a specialist speech and language therapist (SALT) who works with deaf children.
A speech and language therapist can:
- assess how well your child’s speech, language and communication skills are developing
- identify if your child is experiencing any difficulties and the reasons why
- develop a plan to address those difficulties and work with you to carry out the plan
- give advice on your child’s progress and the next steps
- work with teaching staff to support language-based aspects of the curriculum
All teachers of the deaf will also have had training on supporting deaf children’s language development and will be able to give you advice on what you can do at home to make sure your child makes good progress.
They’ll also be able to advise staff working in any settings that your child goes to.
Teachers of the deaf and speech and language therapists work together closely to meet the needs of deaf children
If you’re concerned about your child’s speech and language development, talk to your teacher of the deaf, GP, health visitor or nursery or school staff to ask if your child needs a referral to a speech and language therapist. Or, you can contact your local speech and language therapy service yourself to make a referral
Lincolnshire Family Hubs programme: This programme aims to make a positive difference to families by providing high-quality, joined-up support services from pregnancy, through a child’s early years and up until they are 19 (or 25 for young people with special educational needs and disabilities). Family Hubs are based in children’s centres across the county.
Lincoln Deaf Children's Society (Facebook page) is a voluntary service that enables families and children to meet and socialise. Information sharing and guidance can also be accessed
RNID is a national service which is available to people who live with a hearing loss. They offer a digital service with a wide range of resources to access
DELTA - Deaf Education through Listening and Talking are providing monthly online drop in events for parents, guardians and grandparents through Google Meet. You can be a part of the DELTA community, to ask questions, discuss and share experiences of raising your deaf child at home and at school using the language of the home and community.
CODP -Midlands - children of deaf parents group for children 0-10 and their deaf parents, to meet up across the Midlands
The Lincolnshire Parent Carer Forum works alongside the local authority and health partners to improve the services that they plan and commission.
It is a charity that ensures that the needs of children with SEND are met
Children’s Hearing Services Working Groups (CHSWGs) are groups of parents and professionals who work with deaf children and young people. They meet regularly to help improve health, education and social care services for deaf children, young people and their families. If you would like to become involved as a parent representative please email them