Societal Understanding

At the top of the model is the idea that how society understands being deaf or hard of hearing affects everything else. Many people do not fully understand deaf or hard of hearing children, either as individuals or as part of a larger community. This lack of understanding starts with society as a whole; this includes families, professionals who work with these children, government leaders, employers, local communities, and the general public. Survey respondents said that because being deaf or hard of hearing is something that isn’t common for most people, others do not have much experience or knowledge about it. This lack of knowledge can lead to unfair assumptions or biases against deaf and hard of hearing people. That’s why it is so important to have good resources, proper training, and teamwork to help educate people. When people better understand deaf and hard of hearing children, they are more able to support them and more willing to help them grow and reach important developmental goals.

Legislation and Policies

A lack of understanding about important laws and policies (shown in the second layer of the model) can impact where deaf and hard of hearing children go to school and what support they receive. These laws and policies include the Individuals with Disabilities Education Act (IDEA) and Individualized Education Programs (IEPs). This area focuses on the need to review and improve these laws and rules so they better serve deaf and hard of hearing students, their families, and the professionals who work with them. Respondents said better communication between decision makers and deaf and hard of hearing individuals is key. This also means involving deaf and hard of hearing people in leading policy decisions. Until policies are improved, deaf and hard of hearing students, their families, and the professionals who work with them face more challenges in helping these students reach their fullest potential. The importance of laws and policies shows how much this area affects the other six areas in the model.

EHDI

At the top left side of the model is EHDI, another area that lacks understanding. Some families and EHDI professionals do not fully understand how to best support deaf and hard of hearing babies at every step. Families may need support after diagnosis and during early intervention from professionals with the right experience and training. Respondents shared that families might not use all the help EHDI offers because they do not know enough about it. This includes understanding the importance of learning language early or keeping up with follow-up appointments and cochlear implant therapy.

At the same time, some EHDI professionals do not have enough experience, knowledge, or training to work well with deaf or hard of hearing children and their families. A few respondents also pointed out that professionals need to understand these children’s language and communication needs, use the right tools, and share accurate information. Some professionals, such as medical staff, might focus too much on disability as a problem, which can hurt the children’s chances for success. Some might not understand how valuable American Sign Language (ASL) is for babies to learn language early on. This lack of understanding and bias affects how families are supported and how children reach their fullest potential.

Overlaps of EHDI, L&C, and HAT

Based on survey responses, EHDI, HAT, and Language and Communication overlap in how they are understood and how they affect Family Involvement, Schooling, and Collaboration. These overlaps are shown by the three color stripes and the arrows in the model.

Respondents discussed how EHDI includes early hearing screening, early language acquisition, and early language access. These are important for the language development of deaf and hard of hearing children. This includes the use of a visible language and/or wearing HAT. What families and professionals understand about deaf and hard of hearing children’s language and communication needs impacts how they support these children. This includes how families and medical and educational professionals work with each other. For example, some medical and early intervention professionals may focus mainly on spoken language and using devices (e.g., cochlear implants, hearing aids) while leaving out ASL. These biases affect the information and support families get and how they support their deaf or hard of hearing children. This is why comprehensive, accessible, and well-rounded services and information are needed for families and professionals. They need support and education on how to meet deaf and hard of hearing children’s language and communication needs, provide complete language access, and help with language learning at home and in school.

Hearing Assistive Technology

The HAT area is shown on the upper right side of the model. Deaf and hard of hearing students often get HAT to help them hear better. However, respondents said that people have different levels of understanding about these devices and there are many misunderstandings. For example, some do not know how to use or take care of the technology properly. Others wrongly think that HAT can “cure” deafness. This can lead families and professionals to treat deaf and hard of hearing students as if they hear like everyone else. These issues show that even when students have HAT, there are still things that need attention. This includes recognizing that HAT can be expensive, which can be a big burden for families with less money. Due to these challenges, some deaf and hard of hearing students may have trouble accessing the information they need.

Language & Communication

Language and communication (shown at the bottom left side of the model) play a key role in deaf and hard of hearing children’s development. Respondents said that many people do not fully understand the language and communication needs of deaf and hard of hearing children, students, or adults at work. It is important to know how to communicate with these individuals and ensure these children reach expected language skills (e.g., ASL). Wrong ideas about how much language deaf and hard of hearing children can understand or use around them can lead to confusion and less information access.

Some families, especially those new to raising a deaf or hard of hearing child, may not know how to meet their child’s language needs or how to communicate effectively. Families need support in learning the communication methods that work best for their child and to ensure their child has full language access.

In schools, some teachers may not have enough experience or training with sign systems, communication supports such as accommodations, or effective communication. Families and schools need to work together. When schools do not listen to families or when families do not have the knowledge or tools to advocate for their child, the child’s needs may be overlooked. As a result, deaf and hard of hearing students may not achieve age-appropriate language, social, and academic skills.

Overlaps of Language & Communication and Hearing Assistive Technology

Language and Communication and HAT are connected in the model because HAT is meant to help meet the language and communication needs of deaf and hard of hearing students. How these two areas overlap affects how families support their deaf or hard of hearing children.

Respondents shared that families often receive one-sided or biased information about language and communication choices. As a result, many deaf and hard of hearing children get HAT (e.g., hearing aids, cochlear implants) but are not encouraged to and may even be prevented from learning ASL.

Schooling

Schooling, shown on the lower left side of the model, focuses on how classrooms, programming, teaching methods, and school systems try to meet deaf and hard of hearing students’ learning needs. Respondents shared concerns about knowledge and experience gaps in how to educate deaf and hard of hearing students, especially those with disabilities. The gaps affect lawmakers’ and school leaders’ decisions and the actions they take. This includes following the rules of the IDEA, what staff to hire, and what resources to provide. Often these students might not get the academic and language support they need because tools and support are not created for them.

Many professionals (e.g., school principals, teachers, audiologists) may not have enough training to meet the needs of deaf and hard of hearing students, especially in mainstream schools. Some respondents noted how low expectations and wrong ideas about what these students can do limit their learning and communication. This includes how these students’ hearing levels can be connected to their school experiences and success. Some professionals do not know sign language or understand how important language access and Deaf culture are. Classmates may also treat deaf and hard of hearing students unfairly if they do not understand what it means to be deaf or hard of hearing. Some of these issues may be because there are not enough university programs or training, especially in rural areas.

Supporting deaf and hard of hearing students effectively includes:

• Setting up and carrying out IEPs
• Properly assessing students and placing them in the right educational setting
• Using the best teaching methods
• Encouraging incidental learning and ways for students to socialize
• Working together more effectively
• Providing and using accommodations (e.g., interpreters) correctly

Collaboration

Respondents talked about how families and schools need to work together—to collaborate (shown as a double-arrowed shape in the lower center of the mode)—better to support deaf and hard of hearing students. Often both families and schools do not have enough understanding or resources, making it hard for them to give the best support. This includes keeping realistic expectations and meeting the student’s needs.

Good teamwork between educators and families is important to ensure deaf and hard of hearing students get the best education possible. This means the right school placement, good planning, proper accommodations, and help with both learning and social-emotional growth. However, there are challenges in building and keeping this teamwork going. Sometimes families and schools do not do enough to work together. They may have wrong information or they may not clearly understand their roles and responsibilities. As a result of this gap in working together, deaf and hard of hearing students may have a harder time reaching their fullest potential.

Family Involvement

Family Involvement, shown on the lower right side of the model, is another important part in supporting deaf and hard of hearing children. Respondents pointed out that many families do not fully understand how to meet the needs of their deaf or hard of hearing children or how to best support their development. This affects how involved they are and how much support they give. For example, some families may not realize how helpful learning ASL can be or how important it is to follow up with care after a cochlear implant. Respondents stressed that family involvement is important, but many families do not have previous experience with deaf or hard of hearing children. These families need information, resources, and support to make good decisions. Also, negative attitudes in society about deaf and hard of hearing people can mislead families and affect how they see their child’s abilities and support needs. Additionally, families may not know about important laws, such as the Americans with Disabilities Act, or how to stand up for their child’s rights.

Deaf and Hard of Hearing Children's Development and Potential

The Lack of Understanding model was created using feedback from parents and caregivers of deaf and hard of hearing children as well as from professionals who work with these children and families. They shared their thoughts on the challenges that stop deaf and hard of hearing children from reaching their full academic, language, and social-emotional potential. One major problem they identified was a lack of understanding.

Since many people do not fully understand the unique needs of deaf and hard of hearing children, these children may not get enough support to learn language, grow emotionally, succeed in school, and develop skills for life after school. This can cause delays in important areas of their development. This shows why it is important to provide training and education—from society as a whole down to families and educators.. Without better understanding, deaf and hard of hearing children may struggle with communication, fitting in at school, and getting the right resources, which can hold them back from reaching their fullest potential.