Communication Decision

One of the most difficult decisions that you might have to make for your child would be the method of communication that he/she would use. The choices vary from the Aural-oral which relies totally on normal spoken language to Sign language that is a language that uses visual hand signs only. Other communication methods that are in between these two choices would include Total Communication and Cued Speech.

No single approach would work with all children. Thus, a thorough discussion with your audiologist and speech language pathologist would help you decide the primary communication method your child would use.

Visits to centers where these particular methods are taught before deciding would also help. A good audiologist would never presume to suggest the best option for your child. Instead, he would provide you with all the information you require to decide the best option for your child and your family.


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Communication method chosen would also bear an important impact on your child’s school placement when he is older. A child with hearing impairment with good amplification and acquisition of speech and language can be considered to be placed in normal schools. Others might be placed in integrated schools while those who use signing as their primary communication mode have the choice of attending special school for hearing impaired children.


Assistive Listening Devices (ALD)


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As your child’s needs changes, hearing aids alone might be insufficient for all situations. Devices that are designed for specific needs of a hearing impaired person are often termed as assistive listening devices.

The most popular ALD would be the FM system. This system which usually couples to your child’s hearing aids is important in situations that are noisy and there is a significant distance between the speaker and the hearing impaired person. Examples would be classrooms, meetings and lecture halls.

Although a hearing aid amplifies speech and modern digital hearing aids are capable to reduce some background noise, the challenges of a noisy classroom is more difficult. Imagine a teacher that is standing at the front of the classroom at a distance that is more than the optimum amplification region for the hearing aids.



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In addition, background noise that is highly speech noise. When the speech signal from the teacher reaches your child’s hearing aids, the loudness is greatly reduced; it is then further degraded by competing background noise. It would be very hard and tiring for your child to continuously pay attention to understand the teacher.

An FM system which consists of a microphone worn by the teacher and a receiver worn by the hearing impaired child ensures that the speech signal is transmitted directly to the child’s hearing aid, thus ensuring no degradation of signal due to noise. FM systems are routinely recommended to school going children to aid their studies.

Other ALD devices would include vibrator alarms that wake up the child in time for school as he would not hear the normal alarms because he does not wear his hearing aids to sleep. More examples would be blinking lights for fire alarms, teletext phones and many others.



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Hearing loss is a condition that could be managed by you. The important thing to remember is that your child is just as normal as the next child with the only problem being he does not hear sounds as clearly. In every other aspect he has the same potential to be whatever he wants. It is up to parents and professionals to ensure that the impairment does not become a handicap.

As parents, you face the heavy burden of being your child’s teacher, mentor, friend, therapist, advocate and support system. However, you have the assistance from a whole range of professionals, ever improving technologies for amplification and other communication needs as well as the growing knowledge on hearing impairment and ways of managing it.

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Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon


Mr. Saravanan Selanduray

Mr. Saravanan Selanduray