Otolaryngology–Head and Neck Surgery
Resources for Students with Hearing Loss and Teachers During COVID-19
The distance learning environment has presented a set of unique challenges for children with hearing loss. As we enter the fall academic year, we will all be learning how to compensate for these challenges in the most effective manner. It is recommended that parents communicate with their child’s school regarding these challenges and make appropriate changes to IEP and 504 Plans to reflect such accommodations. This process will require creativity and flexibility on everyone’s part.
During in-class learning, official guidance from the Massachusetts Department of Elementary and Secondary Education (DESE) requires that all teachers and all students and teachers at grade 2 and above are required to wear masks. The presence of masks creates a hindrance to the use of visual cues for understanding speech. Even children and adults with normal hearing rely on visual cues such as position of the lips and facial expressions to interpret speech. In difficult listening environments, such as cafeterias, gymnasiums and busy classrooms these cues are even more critical.
Read below to find helpful information for students, parents and teachers, including techniques to minimize the impact of mask wearing, as well as how to create an online learning environment to best support student success.
Resources for Teachers
Find tips and information for in-school and online learning during COVID-19.
Important safety precautions must be taken when learning occurs in school buildings during this time of COVID-19. While protective measures are essential for the welfare of all and should be carefully followed, be aware that many of these measures will make communication even more difficult for students who are deaf or hard of hearing. Consider the following:
- Masks - Many students with hearing loss rely on speechreading/lipreading to support comprehension of spoken language, but usage of masks restricts visual access to a speaker’s mouth and also limits the volume and clarity of spoken language that reaches the student. For students who use a remote microphone system (such as an FM, DM, or HAT system) masks may interfere with the device’s ability to deliver clear speech to a student’s receivers.
- Social Distancing - Any increase in distance from a communication partner will also decrease the volume of spoken language that reaches a student.
To limit the negative effects of these or other safety measure at school, teachers and support staff can make changes to help student with hearing loss communicate and learn more effectively. Each student’s Educational Audiologist and/or Teacher of the Deaf should provide personal recommendations. In general, however, below are some tips for teaching that may or may not already be a part of your student’s specific educational plan.
- Review Educational Plans – Be aware of what accommodations a student’s IEP or 504 plan requires. Carefully and consistently provide these while making any necessary adjustments to allow you to also follow your school’s COVID guidelines.
- Mask Considerations – Wear masks that have clear panels to allow for speechreading/lipreading or use a clear faceshield as directed by your administration. Take precautions so that these do not fog and obscure your mouth. If possible, all students should also wear masks or shields that keep their faces visible so that conversation with classmates is less restricted and so that students with hearing loss are not further isolated from their peer groups.
- Limit Background Noise – To make speech easier to access, limit all competing noise. This may require that you close doors and windows, fit table and chair legs with tennis balls or Hush-Up brand covers, enforce that only one student speaks at a time, restrain from playing even soft music in the background during class, and avoid having multiple groups working at the same time. If multiple groups cannot be avoided, keep clusters of students as far from each other as possible. Keep your student from missing information by not talking over videos or giving last-minute instructions while students are packing up their bags to leave.
- Assistive Listening Devices/Remote Microphones – Remote microphone systems (such as a FM, DM, or HAT systems) transmit your voice directly to a student’s hearing aids or cochlear implants, thereby helping to limit the negative effects of background noise. If your student uses this type of system, make sure equipment is charged and properly functioning every day. These remote microphone systems are often capable of connecting directly to a media source such as a computer to give students better auditory access to videos, computer-based lessons, educational games, etc. Contact your student’s Educational Audiologist or Teacher of the Deaf immediately if there is a problem with the equipment or if you have questions about properly using these systems.
- Preferential Seating – Allow students to sit where they can best access instruction through visual and auditory means. This does not always mean that the front, center seat is the most appropriate. Students with hearing loss on one side, for instance, often choose to sit where their better ear faces the front. Prioritize seats that are away from doors, AC or heating units, computer/projector fans, and other sources of noise.
- General Instruction – Face students whenever you are speaking and make sure your face is well-lit and visible as this supports speechreading/lipreading. Walking around or facing the board while teaching severely limits access to instruction. Speak clearly at a normal pace and pause often to allow students to catch up. It is extremely difficult for students to watch a teacher, listen, and take notes all at the same time. You might consider designating a note taker during class so that your student with hearing loss can focus all of his or her energy on listening and learning.
- Repeat, Rephrase, Clarify – Even when all other accommodations are in place, students with hearing loss will still miss or mishear parts of instruction and conversations. Therefore, it is important to frequently repeat, rephrase, and clarify information. Check often for student comprehension by asking open-ended questions and avoid asking “yes/no” questions as these do not show what a student has or has not understood. Additionally, even if peers wear clear masks, it is important that you repeat any comments made by students in class. Always repeat students’ questions before answering these as well. Remember, repetition and clarification will benefit everyone in class, not just students who have hearing loss.
- Closed Captioning/CART – Make sure that all media is closed-captioned (CC). Be aware that automatically generated captions are not 100% accurate and that you may still have to repeat and clarify essential information. While it is not ideal and should be used sparingly, in the event that an essential video, podcast, or other media cannot be captioned for some reason, plan ahead; prepare a full transcript and give this to your student in advance. Additionally, many students will benefit from realtime captioning services such as CART (Communication Access Realtime Translation). Given the increase in barriers to education that have arisen due to COVID, realtime captioning services are recommended if they are not already in-place.
- Put it in Writing – To supplement spoken information, put all assignments, directions, and homework in written form. If you make any modifications to previously-distributed materials, make sure to provide updated, written information for students.
- Emergency Plans – With masks and other protective measures in place during COVID, emergency situations may become more confusing and dangerous for students with hearing loss. Therefore, the school should clearly create and post protocols for all real emergencies and practice drills (e.g. fire drills, active shooters, etc.). Ensure that your school is equipped with visual ways to alert students in the event of an emergency (e.g. flashing lights, scrolling banners, beepers). Ask your administrator what alerts are in place and how you can recognize and use these appropriately. During drills and emergencies, if any information is given over loudspeakers, repeat this information clearly. Use the remote microphone system to talk your student through procedures. Do not assume that students will simply follow others and remain safe. Lack of planning and reliance on having students follow their peers may lead to confusion, injury, or worse.
If you have a student with hearing loss, modifying how you teach over the computer can significantly impact a student’s ability to learn. So that your instruction can best support student success, consider these recommendations.
Know the Supports – Be aware of what in-school accommodations are required by a student’s IEP or 504 plan. Adhere to these as closely as possible while adjusting for an online learning format.
Set the Stage – Choose a quiet teaching location as free from background noise as possible (e.g. turn off music and televisions, sit far from open windows/doors, place pets in separate rooms).
Put your Best Face Forward – To improve their understanding, students with hearing loss need to see your face clearly so they can speechread/lipread. Make sure that your face is always clearly visible. Do not sit with windows or lights shining from behind you. Try to speak only when your face is turned toward the camera.
Give Guidelines – To help maintain order and to limit extra noise and confusion for your student with hearing loss, establish clear expectations for all students participating in your online class, such as:
- Mute yourself when entering the virtual classroom
- Unmute only when called on so that just one person speaks at a time
- To limit noise, raise your hand to be called on or type your questions in the chat box
- Video must be turned on (this allows students with hearing loss to also speechread/lipread with peers)
- Put away phones or other distractions
- Stay in one place; walking around or doing other tasks during class is a visual distraction
Closed Captioning – Ensure that any virtual platform used by your school (Zoom, Google Classroom, YouTube, etc.) is capable of captioning. Please note that automatically generated captions are not 100% accurate. You may wish to contact the school to arrange for a realtime captioning services, such as CART (Communication Access Realtime Translation). Before assigning any videos, podcasts, or other media, check to verify that closed captioning is available. Only as a last resort, if closed captioning is absolutely not available for an essential assignment, prepare a full transcript beforehand and send it to the student ahead of time so that he or she can attempt to follow along even if no captions are available.
Instructional Advice – Give students the best possible access to your instruction by doing the following:
- Turn on the closed captioning feature or remind students to enable this on their computer.
- Speak in a clear voice at a normal pace. This will help closed captioning be as accurate as possible.
- Avoid rushing through information as this makes it more difficult to take notes while listening.
- Repeat questions and comments from classmates.
- Review and summarize information periodically throughout the class.
- Check for comprehension by asking comprehension questions; avoid “yes/no” questions or asking for students to give you a “thumbs-up,” as this does not show if they truly understood what they heard.
- Include visual information and written directions.
- Consider providing some individual time to your student after class to summarize lessons and to give him or her an opportunity to ask questions.
Resources for Students and Parents
Find tips and information for in-school and online learning during COVID-19.
Masks – While teachers and other students wear masks, it will be harder to understand them when they speak. If teachers are not already wearing masks with clear windows that allow students to see their mouths, parents may need to advocate for the school to purchase deaf/hard-of-hearing friendly masks or clear faceshields. View updated recommendations from the Department of Education.
Hearing Equipment – Check hearing devices, such as hearing aids or cochlear implants, every morning to make sure they are working before school. Keep all equipment charged and always carry extra batteries with you or keep them in a safe place (maybe with a homeroom teacher or school nurse). If there is a problem with your devices, tell a teacher right away. Do not ignore problems because this will make it even harder for you learn. Teachers need to know if your hearing aids or cochlear implants are not working so that they can adjust how they teach until your devices are fixed.
Remote Microphone Systems – If using a remote microphone system (such as an FM, DM, or HAT system), check this and connect it as soon as you arrive at school. Ask a trained teacher for help if you cannot connect this to your hearing aid or cochlear implant receiver by yourself. Do not be afraid to tell a teacher politely if the FM/HAT system is not working or does not sound right. When the FM/HAT system is not used the right way, it will make listening and learning even harder. If something does not work or a piece is broken/missing, tell a teacher right away. Remember to plug-in your FM/HAT system at the end of every school day so that it can charge. It’s important to use your system every day! A working system will better help you hear the teacher. Be sure that the microphone is adjusted as needed so that any masks, lanyards, scarves, or other objects are not preventing you from hearing the teacher’s voice.
Seating – Sit where you can always see and hear your teacher. Stay away from noisy areas like doors to the hallway, open windows, computers, heaters or air conditioners, and even other students who are talkative during class. Lights might cause glare on clear masks or faceshields, so choose to sit where glare is minimal. If you cannot see or hear well where the teacher puts you, politely ask to move to a different seat.
Learn to Advocate – Know what things your school is supposed to do to help you. If you have an IEP (Individualized Education Plan) or a written 504 Plan, read about the supports that the school provides. It is a lot for teachers to remember, so sometimes you might need to remind them. Practice ways to ask for changes that will make it easier for you to learn. Always be polite and respectful. Here are some things you might need to advocate about:
- Using the remote microphone, FM/HAT system
- Asking for repetition if you don’t understand
- Changing seats to better hear or see
- Using Closed-Captioning
- Asking for information to be written down
- Taking a listening break (because listening all day with hearing devices can be exhausting)
- Request for more help or explanation
Learning Atmosphere – Create a workspace to support learning by doing the following:
- Choose a quiet spot and limit noise in the background. Turn off TVs or radios, direct other children or pets to a different room, and avoid phone calls during school sessions.
- Sit in a comfortable spot at a table or desk. This will prepare students for learning better than when they choose to lounge on a couch or bed.
- Write a schedule or set up reminders to encourage responsibility with classes and schoolwork.
- Whenever possible, use desktop computers, laptops, or tablets, instead of smartphones for classes.
Internet Access – Slow internet can interrupt sound or video, making students miss information and making it much more difficult to learn. To improve internet quality as much as possible:
- Seat students close to the Wi-Fi router.
- Keep other family members off Wi-Fi as much as possible while students are attending school online.
Direct Connection of Microphone System – If your student already uses an assistive listening, remote microphone system (sometimes called an FM, DM, or HAT system) while in the school building, it may be possible to use this at home. This equipment enables students to hear their teachers and classmates better over the internet by directly connecting the device to a computer or tablet.
- Contact the school’s Special Education Department about using remote microphone systems at home.
- If the school agrees, check with them about getting all the necessary parts, such as the charger, microphone, receivers, and AUX cables or other pieces required to connect to a computer or tablet.
- Make sure you know how to connect and use the system. Contact the school for help; if you have a Teacher of the Deaf and/or an Educational Audiologist on your student’s team, you might need to contact them directly.
Closed Captioning – For students with hearing loss, listening and learning over electronic devices can be difficult. To help students better follow the teacher’s instructions and any conversations online, please first:
- Check to see if Closed Captioning is available on the learning platform your school wants to use (such as Google Meet, Zoom, etc.).
- Turn on the captioning feature at the beginning of all classes. Make sure computers or tablets have updated software if required for these captions to work.
Advocacy – An IEP (Individualized Education Plan) or 504 Plan should include what supports the school must provide. Talk about respectful ways to advocate when these supports are not given during an online class. It helps some students to practice what to say. You might ask your student what he or she would do if:
- The speaker’s face is hard to see
- Too many students are talking at the same time
- The closed-captioning is turned off or stops working
Communicate – Talk with teachers before school about what supports a student needs to be most successful with learning online. Revisit this conversation if needed during the school year. It might also help if a student is given time to talk one-to-one with a teacher after classes to review information or ask questions.
At this time, the Centers for Disease Control (CDC) is recommending the public wear cloth face coverings in public. Due to the current scarcity, FDA-approved medical-grade masks are currently being reserved for healthcare workers and other medical first responders.
Unless specified otherwise, the masks listed below or that you find online are cloth masks combined with clear vinyl. They are NOT medical grade masks and they are NOT FDA-approved. The choice to make and/or wear these masks is your own. Mask styles may be different from the one pictured.
Helpful tip: For many masks, rubbing a small drop of dish soap on the inside vinyl of the mask can help prevent fogging (check your specific mask instructions for use and care).
Where to Buy Clear Communciation Masks
Etsy.com and Amazon.com are places you could search using the terms: "clear face masks" or "clear communication masks". Some clear masks may touch your lips while you are speaking while others will leave extra space. Be aware of which type you are purchasing. Some clients have referenced masks obtained from theclearmask.com
The Massachusetts based businesses below offer masks with clear vinyl (last updated 7/21/2020). You should contact them directly if you have any questions regarding their masks.
- The Tailor Pros 160
Worcester-Providence Turnpike, Sutton, MA
$15/mask (added cost for shipping)
Mask sizes: adult male or female
238 Highland Avenue #3, Needham, MA
- Union Square Custom Tailoring
36 Union Square, Somerville, MA
857-258-1327 (call or text)
$25/mask or 5/$100
Mask sizes: S=7"x6" (average child), M=8"x7" (average adult female), L= 9"x7" (average adult male)
Pick up preferred but will ship (added cost) if needed