Deaf and Hard of Hearing
This domain tests how well you connect audiological, linguistic, legal, and instructional knowledge to decisions for students who are deaf or hard of hearing. Questions often give a student profile-audiogram, communication mode, school setting-and ask for the most appropriate service, accommodation, or interpretation.
Core rules and concepts
- Hearing loss is described by type (conductive, sensorineural, mixed), degree in dB HL (mild 26–40; moderate 41–55; moderately severe 56–70; severe 71–90; profound 91+), and configuration. The audiogram plots frequency by intensity; speech access depends on the speech range, not just the pure-tone average.
- Communication approaches include ASL–English bilingual, listening and spoken language/auditory-verbal, total communication, simultaneous communication, and cued speech. No single approach is mandated; the IEP team matches the approach to the student's language and communication needs.
- Under IDEA, the IEP team must consider the student's language and communication needs, opportunities for direct communication with peers and staff, and direct instruction in the student's mode. General education is not automatically the least restrictive environment if it denies language access.
- Assessment must be nondiscriminatory and valid for the student's language. Interpret scores cautiously when norms exclude deaf peers, and assess ASL and English separately.
- Instruction uses visual access: FM/DM systems, captioning, preferential seating, clear sightlines, and explicit literacy strategies.
Worked example
A student's audiogram shows bilateral 65 dB HL at 500, 1000, and 2000 Hz. The general education teacher says the student 'hears when seated in front.' The team should not accept that as sufficient. At 65 dB the loss is moderately severe; soft speech and high-frequency consonants are reduced. The team should review speech recognition data, verify an FM/DM system, improve classroom acoustics, and monitor access-not rely on proximity alone.
Traps
- Treating a cochlear implant as a cure; devices do not restore normal hearing.
- Equating least restrictive environment with general education for every student.
- Using an English-language test as a pure reading measure for an ASL user.
- Assuming all deaf students share one communication preference or cultural identity.