While studies show that many children with hearing loss are academically comparable to their peers with normal hearing, active participation in classroom and group activities, as well as social integration, is more complex. Even with advanced sensory devices such as hearing aids and cochear implants, it can be difficult for children to pick up on all the necessary information in a busy atmosphere, leaving them with a sense that they're being "left out" by hearing classmates.

In a study designed to explore the social competence and the perceived sense of loneliness of children with hearing loss in a regular classroom with normal hearing children, Prof. Most and her fellow researchers discovered that successful integration is dependent on a child's level of speech intelligibility. The results have been reported in the Journal of Deaf Studies and Deaf Education.

Closing the gap

Modern technology has allowed children with hearing loss to access more auditory information and develop better spoken language than ever before. And because advanced screening for hearing loss is now performed at birth, children can receive intervention from a young age. "In the regular classroom, the more they are intelligible, the more their social skills and competence rise, and it's easier for them to make hearing friends," Prof. Most reports.

In their study, the researchers measured social competence and perceived sense of loneliness in children with hearing loss in two educational settings: individual inclusion where one child with hearing loss joined a regular classroom, and group inclusion, where a number of children with hearing loss joined a regular classroom. Sixty-four children between the ages of 4-7 participated, 22 in the individual inclusion and 42 in the group inclusion. All results were analyzed in light of the child's speech intelligibility.

Researchers discovered that individually integrated children had a higher social competence with the children with normal hearing than those in the group inclusion scenario. Speaking abilities played an important role in both groups, and had specific importance for children who were individually integrated. The poorer their speech intelligibility, the more likely they were to feel lonely in the classroom, something that the group inclusion children did not experience as part of an hearing loss enclave.

These findings suggest that development of intelligible spoken language has the power to close the gap between children with hearing loss and their hearing peers, resulting in increased social interaction, an improvement in group work, and a change in the teachers' and students' perception of the child with hearing loss, adds Prof. Most.

Meeting the needs of each child

Taking her years of research and in-field experience into account, Prof. Most says that there is an advantage to integrating children with hearing loss with hearing children, provided that their special needs are met. Each child must be assessed on whether to be integrated individually or in a group, she counsels, noting that a "one size fits all" strategy could be harmful for some students.

"I prefer to see kids integrated into the regular school system, allowing them to be closer to home and interact with children in their neighborhood. They would then have access to broader programming and activities," she says. But if a child's spoken language and cognitive abilities indicate that a regular classroom would be difficult for him or her, pushing integration could result in failure.

Children with hearing loss, parents and specialists can aid successful integration by focusing on speech development, advises Prof. Most. And teachers can also do their part to create a more welcoming environment by creating small work groups and setting up meeting points in advance so the child won't be left out. The more children with normal hearing are exposed to those with hearing loss, the more understanding and accepting they will become, she says.