Supporting Children with Hearing Difficulties

🦻 3 types of hearing difficulty

• Permanent — sensorineural. Usually diagnosed at birth via newborn screening. Hearing aids or cochlear implants worn.
• Fluctuating / conductive — glue ear (fluid behind ear drum). Extremely common in under-5s. Hearing comes and goes.
• Temporary — ear infections, wax build-up. Resolves with treatment.

👁 Signs of undiagnosed hearing difficulty

You may notice a child:

• Doesn't respond when called from behind (looks for visual cues instead).
• Turns their head to hear better on one side.
• Watches faces intently — reading lips even if they don't know they're doing it.
• Speaks unusually loudly or quietly.
• Delayed speech or unclear speech ("wa-wa" for water).
• Frustration + big feelings that seem out of proportion — communication is exhausting.
• Doesn't respond to their name from across the room.
• Turns TV / music louder than seems needed.

If you notice these — tell your room leader + SENCo. They'll speak with parents about a hearing check.

🏠 Environmental adaptations

• Reduce background noise during focused activities. Music off. Radio off. Move to quieter area if needed.
• Soft furnishings absorb echo — cushions, rugs, curtains help.
• Position with light on your face — so the child can see your mouth clearly.
• Round tables + small groups for group activities so the child can see everyone speaking.
• Visual supports — pictures, objects, gestures alongside speech.

💬 Communication adaptations

• Get their attention first — tap gently, wave in their eye line, use their name. Then speak.
• Face them. Not from behind. Not across the room. Not while walking away.
• Clear speech at normal volume — not shouted. Shouting distorts words.
• Slow slightly. Pause between phrases.
• Use gestures + Makaton signs alongside speech (see the Makaton course).
• Repeat if needed — but rephrase, don't just say it louder.
• Check understanding visibly — a nod isn't enough. Ask them to show you.

🔊 Hearing aids at nursery

• Check they're on and working at drop-off — parent will show you how.
• Battery check — parent guides on timing. Spare batteries in a labelled box.
• Water safety — remove for water play, bath, sensory play that involves getting wet. Parent guidance essential.
• Feedback whistling means the aid isn't in properly or the mould is loose. Ask the parent for guidance on how to check.
• If it falls out — return it to the child if they're OK to put back in, otherwise put in the child's designated box.

🎧 Cochlear implants

• External processor + magnetic coil on the head.
• Static electricity can disrupt — avoid dry sliding on plastic slides in warm weather.
• Water safety same as hearing aids — remove for water play unless waterproof cover in use.
• Follow parent + audiologist guidance closely.

🤝 Working with specialists

Children with hearing needs often have a wider support team:

• Audiologist — technical specialist. Fitting + programming aids.
• Teacher of the Deaf (ToD) — visits the setting, supports strategies.
• Speech and Language Therapist — specific language work.
• ENT consultant — medical decisions.

Your role: welcome them into the setting. Follow their advice. Report back to parents. Your JLK SENCo coordinates.

💡 Resource: National Deaf Children's Society (NDCS) has excellent free resources for early years settings. Ask your SENCo for the JLK-adapted guidance.