Accommodating Single-Sided Hearing Loss in Mainstream Settings

Children with unilateral hearing loss (sometimes called “single-sided loss”) have typical hearing in one ear and some degree of hearing loss in the other. While that might seem to be an advantage over students with bilateral hearing loss, those with unilateral loss are actually more likely to miss out on needed support because they often can “pass” as having typical hearing.

In fact, unilateral hearing loss can create numerous challenges for students, including localizing the source of a sound, benefiting from incidental learning and having difficulty understanding speakers located on the same side as their hearing loss.

“Educators need to understand that although their students with unilateral hearing loss may appear to be following along with daily routines and participating appropriately in the class, these students are working extremely hard just to keep up with their peers auditorily,” says Sarah Martin, MED, Clarke itinerant teacher of the deaf.

Most Effective Support and Accommodations

Support for these students are vital. Here are ways to best accommodate students with unilateral hearing loss and how to spot their needs in mainstream settings.

Ensure Teacher of the Deaf Support

First, students with unilateral hearing loss greatly benefit from having a teacher of the deaf (TOD) on their team. “Even if the student doesn’t have any other challenges and is on a 504 plan, there can still be consultation with a TOD to recommend accommodations, provide staff support and help the student understand their hearing loss and how they can get help if they need it,” says Sarah.

Are They Struggling?

Within the classroom, teachers should watch for signs the student needs extra support. For example, if they often check what their peers are doing, if they ask classmates what the teacher said, or if they tend to be in the “back of the pack” for activities, those are signs they aren’t hearing well enough to fully access the curriculum.

Pay Attention to Seating Plans

Sarah notes that students with unilateral hearing loss generally require a strategic and fluid seating plan. The plan should account for the seating arrangement in every classroom space they use, to ensure they have the best possible access to the instructor and any auditory media. That may not be the same in every classroom. “[The seating plan] should include where their desk/table is located and also where they sit when they join a small group elsewhere in the room,” Sarah explains. “The student should have their hearing ear facing the majority of the group and the teacher if possible.”

Develop Cues to Identify When Support is Needed in the Moment

Students with hearing loss may need to raise a hand to have something clarified even when “interruptions” would normally be frowned upon. The teacher and student can establish a specific hand signal to indicate the student needs an equipment adjustment or a different seat. (This also benefits students who are working on improving their self-advocacy skills and may not be ready to draw attention to themselves by raising their hand.)

Don’t Rely on Hearing Tech as an Indicator

Personal hearing devices often serve as a visual cue for teachers, reminding them that a student has a hearing loss and to follow best practices (e.g., facing the student when speaking, repeating directions as necessary), but some students with a unilateral loss don’t use any technology to access sound. “For those students who don’t use equipment, and especially the ones who earn high grades, teachers may not always remember to employ those strategies, which can further exacerbate the auditory fatigue that students with unilateral hearing loss can experience,” Sarah says.

In School, but Out of the Classroom

Not all learning happens in the classroom. For an outdoor field trip, safety drill, school play or other special event, students with unilateral hearing loss will need some preparation to ensure they still have great access to sound outside the controlled environment of the classroom. [See “Planning Optimal Field Trips for Students Who Are Deaf or Hard of Hearing” for more information.]

“For any out-of-the-ordinary scenarios, students with unilateral hearing loss should be prepped beforehand,” says Sarah. “This is especially important for safety drills when students are typically required to follow directions silently and not ask for things to be repeated,” she continues. “They need to know exactly what is expected of them and what they should be doing.” Younger students will generally need more repetition of how to handle events like field trips and safety drills since they are less familiar with them.

Older students may need less one-to-one work to prepare since they have more life experience to draw on, but Sarah notes that whenever they transition to new schools, the expectations should be explicitly described again so they know what to do. “For older students, this can often be done before school starts so they’re not highlighted in front of the class as needing further support,” she adds.

Tips for a Successful Year

For educators and support staff who will be working with a child with unilateral hearing loss, a few simple but important steps can make all the difference in ensuring both the child and the teaching staff are set up to have a successful year. Sarah shares the following advice from a webinar she co-hosted titled, “Perspectives on a Listening and Spoken Language Approach to Supporting Children with Unilateral Hearing Loss,” as part of Clarke’s Webinar Series for Professionals.

Plan an Inclusive In-Service:

• Invite as many specialists as possible, including those who may be working with the student soon. Specialists who only see the student occasionally may assume students can “get by” without accommodations.

• Include all relevant professionals (e.g., SLPs, OTs, PTs) in discussions of accommodations used in the classroom.

Explain the Technology

• For younger students who use a hearing device, make sure the teaching staff has a basic understanding of how it works and how to troubleshoot problems such as replacing batteries. For older students, be sure they understand and can troubleshoot on their own.

• If the student uses a Hearing Assistive Technology (HAT) system with a teacher-worn transmitter, explain that scarves, necklaces, shirt pockets, etc., can reduce sound quality and create troublesome background noise for the student.

Make Transitions Seamless

• For transitions between grades, schools and/or support teams, preparation minimizes bumps in the road. if possible, visit the new school with the student before classes begin — even better if the student and their advocates can meet with future school team members before the transition.

• Establish a trusted “go-to” person in the new school — someone familiar with the student’s needs — who they can go to for help if an issue crops up.

“TODs need to impress upon the mainstream teachers that these students will require support even if they appear to be following along and do well in class,” says Sarah. “There are accommodations to help these students alleviate some of the stress that comes with missing parts of a spoken message during their school day.”

Despite the need for some unique support, teachers should never lower their expectations for students with unilateral hearing loss, notes Sarah. “They are capable of achieving anything that a student with typical hearing can, they may just need some support,” she says. “With that being said, it’s even more of an achievement when they do accomplish things knowing how much harder they are working than their peers with typical hearing!“

Watch the Webinar

To learn more about supporting students with unilateral hearing loss in mainstream settings, watch “Perspectives on a Listening and Spoken Language Approach to Supporting Children with Unilateral Hearing Loss,” co-presented by Sarah Martin, MED, Clarke teacher of the deaf and Alexanna Rodgers, consumer engagement manager at MED-EL.

The webinar shares research-based information on the impact of unilateral hearing loss, therapy and advocacy recommendations, and the latest information on how cochlear implants can benefit children with unilateral hearing loss.