Module 5

Ministry of Human Resource Development
Government of India
World Bank Group: Education Global Practice
Toolkit for Master Trainers in
Preparing Teachers for Inclusive
Education for Children
with Special Needs
Making
Inclusion
Work
Module 5:
Including Children
with Hearing
Impairment
Master Trainers Material
Ministry of Human Resource Development

Government of India
This material has been funded by UK aid from UK Government’s Department for International Development, however the views
expressed do not necessarily reflect the UK Government’s official policies.
Cover and inside illustrations in this series of training modules by Navleen Kohli
Design and Print: Macro Graphics Pvt. Ltd.

Table of
Contents
Foreword vii
Acknowledgements ix
Overview 1
Unit I: Understanding Students with Hearing Impairment 3
1. Definition and Understanding Hearing Impairment 4
1.1 Importance of Hearing 4
1.2 The Process of Hearing 6
1.3 What is Hearing Impairment? 5
1.4 Relevant Terms 7
2. Classification of Hearing Loss, Characteristics and Implications 8
3. Myths about Hearing Impairment 10
Unit II: Challenges Faced by Students with Hearing Impairment
in the Classroom and Beyond 13
1. Communication Barriers 13
2. Physical Environment 15
2.1 Listening Environment 16
2.2 Visual Environment 18
2.3 Classroom Seating Arrangements 18
3. Interactions and Activities in the Classroom and School 20
4. Instructional Processes 22
Unit III: Creating Enabling Environments 25
1. Strategies for Addressing Communication Barriers 25
1.1 Alternative and Augmentative Communication 27
1.2 Conventional Hearing Aids 30
2. Socialization and Friendships 33
2.1 Strategies for Overcoming Social Barriers 34
Table of Contents | iii

Making Inclusion Work
3. Concessions and Facilities for Children with Hearing Impairment 35

4. Facilitating Collaboration between Different Stakeholders 36
Unit IV: Curricular Transactions and Pedagogic Strategies 37
1. Curriculum Adaptations 37
1.1 Adapting Curricular Content 39
1.2 Adapting Instruction 39
1.3 Adapting Assessment Practices 42
1.4 Adapting Teaching and Learning Material 46
2. Teaching Literacy Skills 50
2.1 Strategies and Techniques for Developing Reading and Writing 51
2.2 Add-on Techniques 53
3. Developing Writing Skills 55
4. Teaching Mathematics 57
Annexures 59
Annexure 1: Ten Common Myths on Hearing Impairment 59
Annexure 2: Classification of Hearing Loss 62
Annexure 3: Strategies for Overcoming Likely Barriers 68
Annexure 4: Communication Options 71
Annexure 5: Software for Teaching Speech for Children with Hearing Impairment 74
Annexure 6: Concessions 77
Annexure 7: Auditory Assessment 78
Annexure 8: Story of Mr. Cross 79
References 83
Online Resources 85
iv | Toolkit for Master Trainers in Preparing Teachers for Inclusive Education for Children with Special Needs
FOREWORD
The Right of Children to Free and Compulsory Education Act (2009) mandates free
and compulsory elementary education to all children in the age group of 6-14 years. Sarva
Shiksha Abhiyan (SSA) is the key vehicle for implementation of RTE Act. One of the important
components of SSA is Inclusive Education of Children with Special Needs (CWSN). The thrust
of SSA is on providing quality inclusive education to all children with special needs. However,
inclusion implies equal opportunities and full participation of All children with special needs
in school activities. For this, the environment has to be disabled-friendly and barrier free
(77.37 percent of schools under SSA are now barrier-free). Necessary support services are
needed; over 20 thousand resource persons have been appointed and close to 800 non-
governmental organizations are involved in this area. More and more children are being
provided with much needed assistive devices and technologies, large print and Braille books
to facilitate their inclusion in regular classrooms. Over 2.3 million children with special needs
are now enrolled in schools in SSA.
The critical link to making inclusion of CWSN happen in schools and classrooms is the
teacher. Hence, capacities of the teachers need to be built up on those pedagogical practices
that would address the needs of all children with special needs, especially those with high
level support needs in a mainstream classroom. One of SSA’s goals is to ensure that there are
enough trained teachers to respond to and address the challenge of inclusion.
This series of five training modules on Making Inclusion work is a tremendous contribution
to SSA’s ongoing efforts to prepare teachers to work with children of all abilities. Geared
towards master trainers, the modules provide practical information on effective inclusion of
CWSN, especially of children with autism spectrum disorder, cerebral palsy, deafblindness and
hearing impairment in mainstream inclusive environments. They aim to build awareness of the
challenges faced by children with these disabilities and share tested approaches in addressing
these challenges. The modules are full of practical advice on how to create a classroom culture
based on the principles of diversity, belonging and respect for individual differences.
I am very pleased to dedicate this to the teachers of the country who have an immense
role in making school a welcoming place for all children, including these with special needs.
(Prakash JavAdekar)
Foreword
In 2000, the Government of India embarked on a massive endeavor to universalize elementary

education. The Sarva Shiksha Abhiyan—the Government’s Education for All programme—has
supported efforts to ensure that all children ages 6-14 have access to free and compulsory
education throughout the country—in villages, towns, cities and mega cities. All children
regardless of social economic background, gender, and abilities have the fundamental right to
schooling. SSA has a zero exclusion policy. The scale of the challenge was immense; in 2001
there were 205 million children of elementary schooling age.
Fifteen years down the road, and in close partnership with State governments and communities
across India much has been achieved. Access to schools has been nearly universalised and
almost 98 percent of habitations have access to a school within a kilometre. SSA today covers
more than 1.5 million schools and 4.5 million teachers have been added. One of the strongest
pillars of the SSA programme continues to be the focus on equity, and progress has been
significant. An equal number of girls and boys now attend school. The proportion of children
from schedule castes and scheduled tribes enrolled in elementary schools now mirrors the SC
and ST proportion in the general population. At this juncture it is critically important to work
together to secure these tremendous gains for future generations, while continuing to make
more progress on access, equity and quality of education.
Since the adoption of the RTE in 2009, SSA has been increasingly focused on ensuring access
to quality education for Children with Special Needs (CWSN). Despite concerted efforts and
progress, far more needs to be done to ensure that children with disabilities are effectively
included in the education system. Data also indicate that identification processes need to be
strengthened as only 1.22 percent of all children have been identified as CWSN.
SSA supports a multi-pronged strategy for the inclusion of CWSN. Some children are enrolled
in Special Schools, others with severe disabilities are home schooled, and yet others go through
a school readiness programme to prepare them for transition into a mainstream classroom—
the ultimate goal of SSA. However, preparing children to fully participate in an inclusive
education environment is only one part of the challenge. The school’s physical environment
has to be disabled-friendly and barrier-free (82 percent of schools in India are now barrier-
free). Necessary support services are needed; over 20 thousand resource persons have been
appointed and close to 800 non-governmental organization are involved in this area. More and
more children are provided with much needed assistive devices, large print and braille books
Foreword | vii
and other technologies that allow children with special needs to be fully included in regular
classrooms across India.
The critical link to making inclusion of CWSN truly a reality in schools across India is the
teacher. One of SSA’s goals in 2015 was to ensure that there are enough teachers to respond
to the challenge of inclusion and that they have training, teaching-learning materials and
academic support structure at the cluster, block and district levels.
This series of five training modules on Making Inclusion Work is a tremendous contribution
to SSA’s ongoing efforts to prepare teachers to work with children of all abilities. Geared
toward master trainers, the modules provide practical information on effectively including
CWSN, especially children with autism spectrum disorder, cerebral palsy, deafblindness and
hearing impairment, in mainstream inclusive environments. They aim to build awareness of
the challenges faced by students with these disabilities and more important, share tested
approaches—tips and advice from experts in the field—to addressing these challenges. The
modules are full of practical advice on how to create classrooms where all children participate
and are given opportunities to thrive and learn from each other.
I am very pleased to dedicate this to the teachers of the country who can make schools a
welcome place of joy and learning for children with special needs.
viii | Toolkit for Master Trainers in Preparing Teachers for Inclusive Education for Children with Special Needs
Acknowledgments
The World Bank is pleased to support Government of India efforts to include children
with disabilities into regular classrooms. As part of broader, long-standing support to
Sarva Shiksha Abhiyan (SSA), the World Bank helped produce the Toolkit for Master Trainers
in Preparing Teachers for Inclusive Education for Children with Special Needs: Making
Inclusion Work. The series of teacher training resource material comprises five modules
addressing the inclusion of children with disabilities, particularly focusing on children with
autism, cerebral palsy, deaf-blindness, and hearing impairment. The work was possible with
funding from the United Kingdom’s Department for International Development.
The toolkit was developed though a highly collaborative process, drawing on the extensive
knowledge of domestic and international experts in pedagogy. A Writers’ Workshop in December
2014 brought together 13 experts from various institutes, including EdCil, Rehabilitation
Council of India, National Council of Educational Research and Training, as well as Non-
Governmental Organizations (NGO) to conceptualize and prepare early drafts of the resource
material. We would like to acknowledge the immense contributions of all the participants:
Prof. Sudesh Mukhopadhyay, Prof. Anupam Ahuja, Ruma Banerjee, Merry Barua, Bharti
Baweja, Anupriya Chaddha, Dr. Indu Chaswal, Dr. Varsha Gathoo, Prof. Judith Hollenweger
Haskell, Uttam Kumar, Bhushan Punani, Dr. Vandana Saxena, Anamika Singh, and Vinay
Singh. Despite busy schedules, they all found time to contribute to this important initiative.
The work also benefited from the sharing of knowledge from international experience. We
would like to thank Amada Watkins of the European Agency for the Development of Special
Needs and Inclusive Education, Filomena Pereira, Ministry of Education, Portugal, Aleksandra
Posorac, Country Sector Coordinator, World Bank-Philippines, Michael Rosanoff, Autism
Speaks, and Charlotte McClain-Nhlapo, Disability Advisor to the World Bank Group.
The modules would not have been possible without the technical leadership of Dr. Renu Singh,
who was instrumental in making this collaborative process a success. Dr. Singh worked closely
with experts to develop, write and edit all five modules. We would also like to acknowledge the
contributions of Ms. Navleen Kohli, who with her colourful illustrations helped enhance each
module. Ms. Mamata Baruah also provided excellent support to help organize workshops.
This module aims to help teachers identify and successfully remove barriers to learning,
development, and participation faced by many children with hearing impairment. However,
our main focus has been to offer comprehensive information about hearing impairment,
Acknowledgments | ix
as well as how all key stakeholders, particularly the teacher, can respond effectively to the
needs of each child. We acknowledge that including children with hearing impairment in the
mainstream school requires certain preparation and capacity building of the teacher. Since
this module is aimed at master trainers, many of whom will be specialists in working with
children with hearing impairment, each unit has activities that the master trainers can utilise
to foster reflection and support the teacher. Given that children with hearing impairment
are not a homogeneous group, where “one solution fits all,” this module encourages the
teacher to try different strategies to discover the ones that work optimally for the child in their
classroom. By providing resource support to the master trainer to assist teachers in fostering
inclusion of children with hearing impairment. We hope this resource material will facilitate
the development of inclusive barrier-free environments with a comprehensive support system
in every school.
Director: Amit Dar

Practice Manager: Keiko Miwa
Task Team Leaders: Dorota A. Nowak and Shabnam Sinha
x | Toolkit for Master Trainers in Preparing Teachers for Inclusive Education for Children with Special Needs
Overview
Objectives
To enhance teacher knowledge about the social and learning needs of student with hearing
impairment
To develop an understanding about the different challenges faced by children with hearing
impairment in the classrooms and beyond
To develop an understanding of creating enabling environments for learning in the classroom
and beyond
To develop skills for curriculum transaction.
Table 1: Overview of the module
CONTENT METHODOLOGY EXPECTED OUTCOMES
Unit I: Understanding Students with Hearing Impairment
1. Definition and Presentation, group work, Teachers will be able to:

understanding hearing case study approach and zz Identify variations that exist
impairment discussions
amongst children classified as
2. Classification of hearing hearing impaired
loss, characteristics and
implications zz Explain different implications
of hearing impairment on
3. Myths about hearing
various life domains
impairment
zz Differentiate myths from
reality
Unit II: Challenges Faced by Students with Hearing Impairment in the Classroom and Beyond
1. Communication barriers Group activity, Teachers will be able to describe

2. Physical environment, demonstration the ideal situations and barriers
including the listening in:
and visual environment zz Communications
and classroom seating
arrangements zz Physical environment and
infrastructural requirements
Overview | 1
3. Interactions and activities zz Interactions, activities

in the classroom and
zz Instructional processes and
beyond
assessment
4. Instructional processes and
materials
Unit III: Creating Enabling Environments
1. Strategies for addressing Lecture cum The teachers will be able to:
communication barriers demonstration, videos, zz Understand effective modes of
including Alternative case studies
and Augmentative communication, including AAC
Communication (AAC) zz Identify facilitators for
2. Socialization and socialisation
friendships zz Learn about available
3. Concessions and facilities concessions
for children with hearing zz Describe the role and
impairment
responsibilities of different
4. Facilitating collaboration stakeholders
between different
stakeholders
Unit IV: Curricular transactions and pedagogic strategies
1. Curriculum adaptations: Presentation and group Teachers will learn to make

adapting content, activities accommodations and adaptations
instruction, assessment required for a child with hearing
practices, and teaching impairment
and learning material.
2. Teaching literacy skills
3. Developing writing skills
4. Teaching mathematics
2 | Toolkit for Master Trainers in Preparing Teachers for Inclusive Education for Children with Special Needs
Unit I:
Understanding
Students with
Hearing
Impairment
Table 2: Overview of Unit I
Unit I: Understanding Students with Hearing Impairment
1. Definition and Presentation, group work, Teachers will be able to:

understanding hearing case study approach and zz Identify variations that exist
impairment discussions
amongst children classified as
2. Classification of hearing hearing impaired
loss, characteristics and
implications zz Explain different implications
of hearing impairment on
3. Myths about hearing
various life domains
impairment
zz Differentiate myths from
reality
Hearing is the ability to detect the mechanical vibrations referred to as sound. Hearing
impairment is commonly known as ‘deafness’. It is a hidden disability; it is difficult to identify
a child with hearing impairment until interacting with him/her or noticing hearing aids. Aids
may not be conspicuous as some hearing aids are very tiny and placed in or behind the ear or
have surgically implanted cochlear implants. And, not all individuals with hearing impairments
wear hearing aids.
The most prominent feature of this impairment is the difficulty in hearing, understanding
and using spoken language. Those who are born with this impairment or acquire it at a very
young age may not have heard any language at all, even their mother tongue! Hence they do
not learn and use spoken language automatically. Those who have acquired this impairment
later in life may have a better understanding of language, but may still experience difficulties
in using spoken language to communicate. Helen Keller quotes, “Blindness separates people
from things; while deafness separates people from people”.
It is vital to note that hearing impairment does not create insurmountable barriers. Due to
technological developments the impact of impairment on the child can be reduced dramatically.
The philosophy of and policies promoting inclusive education lead to improved access and
participation in schools. If teachers and parents work together cohesively and systematically,
Unit I: Understanding Students with Hearing Impairment | 3

children with hearing impairment can acquire language and achieve their academic goals.
A lack of awareness often perpetuates prejudice and disregard of the rights and capabilities
of people with hearing impairment. The fundamental issue of ‘communication barriers’ is not
realized and therefore many, even in this era of communication technology, may label children
with hearing impairment as ‘dumb’!
PAUSE and THINK
If you visit France or Japan and you do not understand or cannot communicate in French or
Japanese or if you go to a state in India where you do not understand the local language and
others do not understand your language, is it fair to label you ‘dumb’? Certainly not! Same is the
case with deaf children; they simply use a use different language so they should not be labeled
‘dumb.’
1. Definition and Understanding Hearing

Impairment
To address the needs of children with hearing impairment in an inclusive class, it is crucial
to understand the importance of hearing, process of hearing, and definition of hearing
impairment.
1.1 Importance of Hearing
Hearing is a primary sense, which is closely integrated with our daily existence. It helps us
in being safe, in communicating, socializing and enjoying life. Consider all the sounds that
surround you every single day: a child laughing, a bird singing, a friend chatting, or a great
song on the radio. It also helps us to stay connected to the outside world and it keeps us safe
by warning us of potential danger. A telephone ringing, a crying baby or the blare of a car horn
are just a few examples of important signals that we need to be able to hear. Children start
learning to communicate from the moment they are born. They are constantly listening, and
quickly they are able to recognize the voices of their mother and father. They learn to talk by
imitating the sounds they hear.
ACTIVITY
Understanding the importance of hearing
Ask the teachers to think of all situations where hearing is required for a child.
Give them a few minutes then ask them to share their thoughts
After a discussion, emphasize the following: The child has to hear the horn of the school
bus so that he/she doesn’t miss it. In the bus the child has to hear friends calling him
to sit next to them, they have to hear the friends giggling and sharing jokes. They also
have to hear the school bell indicating time to go to class. Further hearing is essential to
them for learning in school, for singing to the rhythm of others, for enjoying the music,
for matching to the drum beats for parade or physical education drills and so on. Hearing
is also important for responding to the door bell and phone calls at home. It helps them
enjoy TV shows and movies and above all talking to their friends and siblings. Thus,
hearing is essential in literally every part of life.
Module 5: Including Children with Hearing Impairment
ACTIVITY
Case study
Sumit is a young child who is very quiet in class. He does not have friends and even during
recess does not go out to play. He prefers to stay in class. When the teacher asks questions,
Sumit does not raise his hand voluntarily. He is often absent whenever there is an oral test.
Sumit wears a hearing aid and responds when called out.
Question for discussion:

Why does Sumit remain quiet?
Why does Sumit refrain from playing with other children?
Why do you think he is often absent during an oral test?
Sumit obviously has a hearing impairment; he wears a hearing aid. Sumit’s behavior could be a
result of his lack of understanding of others’ speech, low self-esteem, fear of failure or fear that
others may not understand his speech and laugh at him, or a lack of accommodations by the
teacher. Or, Sumit hears with his hearing aid but may not be listening!
Questions for discussion:
Is there a difference between listening and hearing?
Which of these—listening or hearing—is more essential for communication?
Hearing and listening are different. ‘Hearing’ is an involuntary act, while ‘listening’ is voluntary.
When we listen, we try to make sense out of the sounds that we hear. Sumit is probably hearing,
but is not able to attach meaning to it and hence is not listening. Because he is not listening
he may find it difficult to understand others and hence is non-communicative. This in turn may
adversely affect socialization, academics and other aspects of a child’s life.
1.2 The Process of Hearing

The ear is the sense organ that helps us hear and communicate with others. It is quite often
described as “a master piece of bio-medical engineering”. The human auditory system is
broadly divided into two main parts: the ear and the auditory or neural pathway.
Figure 1: The Anatomy of the Human Ear
As shown in Figure 1, the human ear has three main parts: outer ear, middle ear and inner ear.

Outer ear: The external or outer ear is the outer most portion of the ear that consists of
two parts:
Pinna, which is visible from outside, is a conical shaped structure attached to the
head, on either side. Pinna collects the sound waves coming from different directions
and funnels them into the external auditory canal.
Auditory canal is the tube that connects the pinna and the eardrum. The canal conducts
the sound waves into the middle ear.
Middle ear: The middle ear is a small air filled cavity located between the outer and inner
ear. The tympanic membrane commonly known as the eardrum separates the external ear
from the middle ear. The middle ear plays a vital role in “bio medical engineering” activities
of the human ear. When sound waves coming through the ear canal fall on the eardrum, it
starts vibrating. The eardrum converts the sound energy into mechanical energy. The eardrum
is connected to the ossicular chain, which is made up of three of the smallest bones in the
human body—the stapes, incus, and malleus. These bones amplify the sound vibrations and
send them to the inner ear of the cochlea.
Inner ear: The inner or the internal ear—the size of a pea—is also referred to as Bony Labyrinth
as it consists of a set of complicated tubes. It is also called a vestibule as it is a passage to
other parts of the auditory system and brain. Both the organs of hearing as well as the organ
of the balance are in the inner ear. It also contains the cochlea, an organ of hearing that is
filled with a fluid called perilymph.
The cochlea in the inner ear also contains the organ of corti or the body’s microphone. The
corti contains for rows of hair cells, which protrude from its surface. The hair cells are the most
important sensory structures as they convert the sounds into electrical impulses. The electrical
impulses are then transmitted to the brainstem through the auditory nerve. These impulses
carry all the necessary information regarding the frequency, intensity and time of the sound
very systematically till they reach the auditory cortex. Sound is perceived and heard once the
impulses reach the various parts of the auditory cortex.
1.3 What is Hearing Impairment?
The Persons with Disabilities Act (1995) states that “Hearing Impairment means loss of
60 decibels or more in the better ear in the conversational range of frequencies”.
Three aspects emerge from this definition:

1. Hearing loss in the better ear: Like the differences in eye sight in both eyes, hearing
levels differ in both ears. The definition directs us to consider hearing loss in the
better ear.
2. More than 60 decibels (dB): The level of hearing is measured in decibels, the unit
of sound. The definition directs assigning a disability certificate to those who have a
hearing loss in the better ear of more than 60 dB. This means their hearing thresholds
lie above 60 dB.
3. Conversational range of frequencies: If we measure our normal speech it seems to fall
under three frequencies: 500, 1000 and 2000 Hertz (Hz). The definition directs us to
consider hearing thresholds at these frequencies.
ACTIVITY
Hearing loss is never the same in any two individuals

Instructions:
1. Ask teachers to read and discuss the case study about Shaila and Amit
2. Ask them to assess why some children like Shaila may get language exemptions while others
like Amit are not eligible?
3. In the discussion emphasize to the group that hearing loss is never same in any two
individuals, hence different exemptions. Children with a certain degree of hearing loss get
language exemptions. Amit may have hearing loss in only one ear (i.e. unilateral hearing
loss), so he was not eligible for concessions.
4. Ask teachers to share the norms for language exemptions in their state.
Case study
Shaila and Amit are children with hearing impairment studying in 10th grade.
Shaila wears hearing aids in both ears, while Amit wears one in only in one ear. As
preparations of board exams are nearing, Shaila’s parents informs Amit’s parents
about the concession their daughter is getting due to her disability certificate. Amit’s
parents also approached the school authorities for language exemptions, however, the
school counsellor found out from the authorities that Amit was not eligible for the same
concession.
1.4 Relevant Terms
Deaf refers to hearing impairments that preclude successful processing of linguistic information
through audition, with or without a hearing aid. A person who is termed as ‘deaf’ usually has
a profound hearing loss (beyond 90 dB) and is pre-lingual.
Hard of hearing refers to impairment in hearing that does not entirely prevent practical
communication by speech. Thus, the person who is hard of hearing generally communicates
by using speech. Using a hearing aid and/or by residual hearing, he/she is enabled to process
linguistic information successfully through audition.
Residual hearing refers to the hearing that remains after a person has experienced a
hearing loss. It is suggested that the greater the hearing loss, the lesser the residual
hearing.
Audiogram is a graphical representation of what the person is able—and unable—to hear. It

is a graphical display of a hearing test. As seen in figures 2 and 3 below, two components
are graphed: frequency or the pitch as measured in Hertz (Hz) is on the X axis and intensity
or loudness measured in decibels (dB) is on the Y axis. The red line represents hearing in the
right ear and the blue represents hearing in the left ear.

Figure 2: Normal hearing

Pitch (Frequency) in Hertz (Hz)
125 250 500 1000 2000 4000 8000
Loudness (Hearing Level) in Decibels (dB) 0

10
20
30 Normal hearing
40
50
60
70
80
90
100
110
Figure 3: Hearing loss in both ears

125 250 500 1000 2000 4000 8000
750 1500 3000 6000
-10
0
10
20
Hearing Level (in dB)
30
40
50
60
70
80
90
100
2. Classification of Hearing Loss,

Characteristics and Implications
ACTIVITY
Differentiation in the type of hearing loss
Let’s meet Rupa and Rohit

Eight year old Rupa and Rohit study in different sections of 3rd grade in the same
school. Both wear hearing aids behind their ears. While teachers are happy to have
them in their class, Rohit’s class teacher has many concerns. Rohit’s speech is not
‘understood’ by other children. Rohit struggles to communicate even in his mother
tongue and uses lots of signs and gestures. His reading and writing skills are not age
and grade appropriate. Rupa on the other hand has no problems in communicating with
others. She speaks fluently in English, Hindi and in her mother tongue, and reads and
writes well.
1. After reading about Rupa and Rohit, ask participants in small groups discuss the following
questions:
Why do Rupa and Rohit differ in communication skills?
Why is Rohit struggling even in his mother tongue?
Why are reading/writing differences of Rupa and Rohit so obvious?
Why does Rupa ask for repetitions and prefers watching speakers?
Rupa and Rohit are not friends. Why do you think that is?
In the larger group discussion stress the following: The answer to all the above questions
lies in the fact that there are differentiations in the type of hearing loss. Rupa and Rohit do
not seem to have similar type of hearing loss. Rupa seems to be using 2 or 3 languages for
communicating, which suggests that she may have acquired a hearing loss at a later stage
in life, perhaps after 5 or 6 years of age. Rohit could have been born with a hearing loss as
he struggles even with his mother tongue. Rohit’s hearing loss could also be more severe in
degrees than Rupa’s because of the fact that his speech is unclear and he does not have age
appropriate reading and writing skills.
Classification terms
Hearing loss is created by obstacles in the auditory pathways. Certain terms associated with
different types of hearing loss may be mentioned in reports or in the children’s individual
education plans. Understanding these terms and the differences in the types of hearing loss
will be helpful for planning instructional strategies. As shown in Table 5, five factors are
considered in the classification of hearing impairment: degree, site of lesion/injury, age of
onset, causal factors and nature. (See Annexure 2 for further details).
Table 3: Five Factors of Classification of Hearing Impairment
FACTORS EXPLANATION CLASSIFICATION
Degree Hearing loss is never the same; it Depending upon the levels of dB
may be different even in both ears. audible to a child, hearing loss is
classified as:
zz Mild
zz Moderate
zz Moderately severe
zz Severe
zz Profound
Site of lesion/ Hearing loss could be caused due to Depending upon the site of injury i.e.
injury injury or harm to various parts of the the lesion, hearing loss is classified
ear. as:
zz Conductive
zz Sensori-neural
zz Mixed
zz Central Auditory Dysfunctioning

FACTORS EXPLANATION CLASSIFICATION
Age of onset Hearing loss could be developed at Depending upon the age of onset,
any time during the lifespan. hearing loss is further classified as:
zz Congenital
zz Acquired
zz Pre-lingual
zz Post-lingual
Causal factors Hearing loss can be caused due to Some of the specific causes leading to
various reasons. hearing loss are classified as:
zz Pre-natal
zz Post-natal
zz Noise
Nature Hearing loss never happens in a Depending upon the nature, hearing
similar manner. loss is classified as:
zz Sudden
zz Gradual
It is important to remember that hearing loss can occur in various combinations. A child may
have pre-lingual congenital hearing loss of a severe to profound degree. Another child may a
mixed profound loss. While interpreting the audiological information, care must be taken to
consider the background of the child such as age of identification, parental participation, and
early intervention, so that one could anticipate and set expectations.
Impairments related to hearing loss do not necessarily result in activity limitations in life situations.
When assessing persons with hearing loss, special emphasis should be put on potential abilities
rather than impairments alone. The WHO International Classification of Functioning, Disability
and Health (ICF) provides a useful framework for such assessments in a person-centred manner
in the given context. The ICF views health, disability and functioning in an integrated and
interrelated way. Individual functioning is not considered the consequence of disease but the
result of the interaction between a health condition such as hearing loss, personal attributes
and environmental influences. Personal attributes and environmental factors ultimately act as
facilitators or barriers to functioning which may have been affected by impairments. The aim is
to eliminate or minimize participation restrictions in any given situation.
3. Myths about Hearing Impairment
ACTIVITY
Myths about hearing impairment
1. Ask teachers to share their views of children with hearing impairment, especially in the
context of education.
2. Note whatever teachers say on a flipchart/board.
3. Give them a handout on the Ten Common Myths on Hearing Impairment (Annexure 1) and
summarized in Table 4 on the next page.
Table 4: Myths and reality
Ten Common Myths on Hearing Impairment
MYTH REALITY
1. A child’s hearing loss cannot be identified Hearing loss can be identified even in newborn
unless the child is three years old. babies.
2. The child will outgrow hearing loss. Most children who have damage in the inner
ear have permanent hearing loss; it cannot be
outgrown.
3. Hearing aids should be fitted when the There should be no gap between identification
child grows old enough to handle it. of hearing loss, fitting of hearing aids, and
language intervention.
4. A child with hearing loss should attend Many children with hearing impairment are
special school. successfully studying in mainstream schools.
5. Children with hearing loss are a No two children are alike and hence no two
homogenous group; all of them exhibit children with hearing loss can be alike.
similarities in terms of educational
challenges.
6. Hearing impairment can be ‘cured’ by Hearing impairment is not a ‘disease’ to be

using a hearing aid. cured.
7. Teachers should speak loudly while talking Speaking loudly to a child using an
to a child with hearing impairment. amplification device such as a hearing aid or a
cochlear implant can cause pain to the child’s
ears, distort the sounds and also damage the
speaker’s voice.
8. Children with hearing impairment have Many children with hearing impairment
‘lower’ cognitive abilities. perform very well in school.
9. Many people think everyone who is Not all people who have hearing impairment
hearing impaired or deaf uses only sign use Sign language to communicate.
language to communicate.
10. Children with hearing impairment cannot Many children with hearing impairment
go to college. succeed academically.
Also see Seven Common Myths on Disability in Unit I of Module 1: Inclusive Education.

Unit II: Challenges
Faced by Students
with Hearing
Impairment in
the Classroom
and Beyond
Table 5: Overview of Unit II
Unit II: Challenges Faced by Students with Hearing Impairment in the Classroom and Beyond
1. Communication barriers Group activity, Teachers will be able to describe the

2. Physical environment, demonstration ideal situations and barriers in:
including the listening zz Communications
and visual environment
and classroom seating zz Physical environment and
arrangements infrastructural requirements
3. Interactions and activities in zz Interactions, activities
the classroom and beyond zz Instructional processes and
4. Instructional processes and assessment
materials
Barriers to inclusion may exist at several levels and therefore must be addressed at several
levels.2 For example, when schools do not provide a rewarding, quality education to meet the
needs of a child and his or her family, the child may drop out. Physical barriers may further
cause difficulty in accessing schools; a wheelchair user, for example, may not be able to access
a school on the top of a hill or cross a river or difficult terrain. Last but not the least, the most
difficult barrier may be the prevailing negative attitude within educational institutions, which
could lead to discrimination and a toxic environment for the child with disability. Inclusive
classrooms need to be barrier-free.
1. Communication Barriers
Students with hearing impairment are likely to face many communication barriers in the
classroom. As Figure 2 shows, communication is a two-way process between a speaker and
listener.
2 See Module 1: Inclusive education for more detailed discussion of barriers to inclusive education.
Unit II: Challenges Faced by Students with Hearing Impairment in the Classroom and Beyond | 13
Figure 2: The Communication Process
Teaching and learning in classrooms requires communication between teachers and students,
and is required even before the actual teaching begins (i.e. checking previous knowledge or
introducing a topic), while teaching and assessing how much students have learned.
Checking previous knowledge and introducing a topic

A teacher discusses various natural and manmade sources of water. She explains where water
comes from i.e. the taps in houses. The teacher may also ask questions to know if the children
remembered the ‘reservoir’ and the ‘well’ they saw while the class went for a field trip in a rural
area. Rohan raises his hand and reminds the class that they also saw a pond and a handpump
during the field trip. On hearing this, Reema wants to know if canal water is manmade or
natural source of water
In this example, communication was happening in the class and facilitated students’ learning.
The teacher elicited answers from students based on their previous experience and knowledge.
Both the teacher and students communicated with each other.
Students tend to be very active during story telling sessions or history class. They converse with
the teacher while predicting incidences in a story. They provide interesting options when the
teacher asks ‘what do you think might have happened next? Besides predicting, children often
speak spontaneously while a teacher is explaining a topic and this brings in new knowledge
and awareness in a class.
Apart from the communication about daily routines, assignments, homework, and information
about the school bus, communication between the teacher and students is essential for
learning. When communication happens, information transfer becomes complete, making
learning easier, joyful, more meaningful and long-lasting. Better communication in classrooms
also enhances interpersonal relations, which in turn, help to create a positive environment in
the class, and the school. Conversely, if communication is ineffective or incomplete, it impedes
learning, and both the teacher and students may find this frustrating.
2. Physical Environment
Children with hearing impairment often face barriers in the physical environment as well as
barriers to interactions and activities within the classroom and beyond. Noise and seating
arrangements in mainstream classrooms create significant barriers for inclusive learning of
children with hearing impairment.
ACTIVITY
Visualizing a typical mainstream school
Ask participants to visualize a mainstream school and typical interactions in the
classroom. Where is the school located? What sounds can be heard inside and outside of
the classroom?
In all probability, the first thing that one would notice is the large class size! Children
may be sitting cramped on benches or perhaps sitting the floor. The teacher is probably
standing near the blackboard. What participants will probably unable to visualize is the
noise level in the classroom, which is collectively generated from the classroom as well
as from adjoining classrooms. It is a common sight in some public schools to conduct a
couple classes in one single hall without any walls! Schools are often located near busy
streets with road traffic, and nearby markets.
To help participants understand the possible noise levels in a typical classroom that comes
from external sources, play this video: (https://www.youtube.com/watch?v=s3BzHO0mT5s)
Now imagine Nitin, a child with bilateral hearing loss, sitting on a bench in your visualized
classroom:
Is this classrooms conducive for this child?
Will learning happen in such a classroom for this child with hearing impairment?
Why is this not an ideal learning environment for Nitin?
What modifications/alterations may be required for a child with hearing impairment, like
Nitin, to improve the learning environment?
ACTIVITY
Why seating arrangements matter
Ask participants:
Why are movie halls ideal for watching movie shows?
What makes a movie hall noise-free?
Why are seats in theatres arranged in ascending order from front to back?
Unlike theatres, why is are seating arrangement in discussion rooms’ often semi-circular
or oval?
The obvious answer is that these arrangements make listening and viewing a movie more
enjoyable. While seated in a movie hall or theatre, one does not hear the outside noise. The
audio of the movie is crystal clear and even the person seated in the last row or a corner can
see and hear things clearly. The seating arrangement in a theatre is different than that of a
boardroom/meeting room, because it serves a different purpose. In boardrooms people have
to communicate with each other and participate in a discussion, so they need to see each
other. In a theatre one has to be a silent spectator so that others enjoy the show! One can draw
parallels to classroom environment and seating arrangements from these illustrations.
2.1 Listening Environment

Room acoustics is a science that creates a good listening environment. Three terms are
essential to differentiate a good classroom from a bad one in terms of room acoustics: noise,
reverberation and signal-to-noise ratio.
Noise creates disturbances in paying attention to what one wants to hear. Unwanted sounds
interfere with listening, paying attention and carrying out conversations in noisy environments.
One would wonder how noise bothers children who have hearing loss! The fact is that many
children with hearing loss are auditory learners. Many wear hearing aids or may use a classroom
amplification device, which amplifies all sounds. Amplified noises may cause pain, disturbance
and in worst situations, further damage hearing. Some sophisticated hearing aids filter out noise,
but not all hearing aids are tuned to do so. Appropriate measures have to be taken to control
the noise in classrooms. Noise levels in the classrooms vary throughout the day, depending
on such factors as hall traffic, street noise coming through open windows, blowing fans, and
general noise caused by a group of children. It is recommended that the noise level in an average
unoccupied classroom should not exceed 30 dB (Nixon, 2002). In most schools however, the
average unoccupied classroom noise level ranges from 45 to 60 dB. When classrooms are
occupied by students and teachers, these noise levels are even greater.
Reverberations are the sum total of original sound and reflected sound in a classroom. Most
classroom surfaces do not have sound absorbing material on the walls, ceiling and floor. So
sounds created during teaching and other classroom activities travel towards walls, floors and
ceilings and revert or reflect back, mixing together to cause a greater amount of mixed sound
waves—noise. These are called reverberations. According to ASA (2000), reverberations are
the arch enemy of speech clarity for two reasons:
Reverberations raise the noise level; and cause a buildup of sound, which includes the
original sound plus the reflected sounds.
Since reflected sounds arrive at our ears after the original sound, they distort everything
in their wake. Our brain can filter out a lot of noise, but it has much more difficulty
with distorted words since they more closely resemble the original sounds.
A simple way of checking reverberations in classrooms is the clapping test. Clap your hands
loudly one time at different points in the room. If you hear a ringing sound or if the clap takes
more than 1/2 second to die down, you may have excessive reverberation.
Signal–to–Noise Ratio (SNR) is a simple comparison that is useful for estimating how
understandable speech is in a room. In the classroom, the SNR basically indicates how much
louder the teacher’s voice is above other noises in the room. For example, if the teacher’s voice is
at 65 dB and the background noises (students, computers, etc.) are at 55 dB, the SNR is 10 dB.
SNR is a critical measure as it impacts speech intelligibility i.e. the ability to understand what
you hear. Children with no hearing loss, require an SNR of +15 dB; the teacher must speak
at least 15 dB louder than the background noise in the room for a child to fully understand
what she/he hears. A simple way for checking sound in classrooms is to read aloud a list of
words and syllables and ask another person to write down what they hear. The percentage of
correctly-heard words is an indication of SOUND in a given room.
2.2 Visual Environment
Several studies have demonstrated that deafness in early years results in specific, compensatory
changes in visual processing. In particular, deaf individuals’ exhibit enhanced performance for
tasks performed in the visual periphery (Dye et al, 2009). Thus, vision enhances learning of
children with hearing impairment as it informs the cognitive system about the knowledge being
imparted. Visual aids enhance learning of all children, not only those with hearing impairment.
Unfortunately, not all classrooms in a typical school have soft boards on the walls. Some may
have a couple of charts hanging on the walls, but these are often not updated to reflect the
current topic being taught. Creative teachers draw on boards or make charts while teaching.
Some use overheads or computers. Some teachers make visual representations of concepts to
be taught. Using visual aids supports universal learning designs. 3
Tips for enhancing classroom acoustics and visual learning

zz Furniture should have strong rubber fittings so that it does not move and cause noise.
zz It is best not to pair up doors to adjacent rooms.
zz Walls in classrooms, corridors and other activity rooms need to be covered by soft boards to
absorb noise and could also be used to put up charts, and reading material.
zz Where possible, classrooms need to be fitted with a public address system so that all students
hear well and teachers do not have to raise their voice. This is mutually-beneficial to teachers
and students, alike. The teacher’s voice is not damaged!
zz Gaps between walls, floor and ceiling should be sealed with an acoustical sealant.
zz Classroom noise level indicators should be installed.
2.3 Classroom Seating Arrangements
In most mainstream classrooms, children are seated one behind the other in rows and columns,
most probably according to height, with the shortest child sitting in the front. Many schools do
not allocate fixed seating and the seats are rotated or changed every week.
3 See Module 1: Inclusive Education to learn more about Universal Design for Learning.
Teachers need to remember that proper seating arrangements facilitate speech reading,
communications and learning. Speech reading or the ability to recognize different sounds
of speech by observing movements of lips, tongues, and jaw. It includes understanding a
person by watching the facial and body movements and using the information provided by the
situation and the language.
ACTIVITY
Classroom seating arrangements matter
1. Ask teachers:
What, in their opinion, is the best seating arrangement to enhance learning?
Would seating arrangements where children sit one behind the other in rows and
columns bother children with hearing impairment?
How would a teacher’s movement bother children with hearing impairment?
2. During the discussion, stress that when seated in rows or columns, many children with
hearing impairment lose out on opportunities to lip read their classmates. They miss out
on how fellow classmates respond to a teacher’s question, apart from enjoying any jokes
shared by a classmate! Often a teacher moves up and down the classroom so that children
remain attentive. The teacher may talk while writing on the blackboard, and may stand near
a window facing the children to get some fresh air. This may pose problems for children with
hearing impairment.
Remember that the intensity is inversely proportional to the distance, so the closer the child
is seated to the teacher the better will the teacher’s voice be heard.
3. Interactions and Activities in the Classroom

and School
ACTIVITY
Ask teachers to visualize a typical day in a mainstream school.

Ask teachers to identify common day-to-day activities and human interactions in a
classroom and beyond.
Ask them to identify barriers children with hearing impairment are likely to face.
Share Table 6 next page on the likely barriers children with hearing impairment face at
school.
Share Annexure 3, which includes a list of strategies for addressing these barriers.
(Addressing barriers will be covered greater detail in Unit III of this module).
Table 6: School interactions, activities and likely barriers
Interactions and activities Likely barriers
Permission for entering class or Teacher may not understand the child’s speech when he/
Principal’s room she is seeking permission to enter the class. The child may
also miss out on the teacher instructing him/her to enter
the classroom.
Attendance/roll call Students with hearing impairment may miss out his/her
name while teachers call out numbers. This is because
many names have phonemes which are inaudible (e.g./
sh/ in Shishir), some sound the same (e.g. Mohan and
Rohan), while others sound the same due to a similar
starting phoneme: /p/b/m/.
Announcements Students with hearing impairment may not only miss

out on the content of an announcement, but may also
not realize that there are common announcements from
the principal’s office—announcements about change in
timings or visitors in school or dress code for a special day.
Prayers time Students with hearing impairment may not be able to

sing the national anthem or school prayers at the same
pace as others.
Assembly School assemblies have speeches and lectures, which

students with hearing impairment may find difficult to hear
and comprehend.
Subject classes Subject teachers are different for each subject. Each
teacher has a different teaching style. Adjusting to
speech reading of different teachers becomes difficult for
a student with hearing impairment, if teachers change
too frequently.
Art and craft classes Students with hearing impairment are very creative;
they work with concentration and perfection and hence
are less distracted. However, they may lose out if an
activity is time bound. Many art and craft teachers give
oral instructions, which may not be ‘understood’ by the
student.
Physical education and sports Students with hearing impairment enjoy and excel in
physical activities; however, oral instructions are often
a barrier. Many sports teachers blow a whistle to signal
the start/end of a game or an activity. A whistle has a
very high frequency and are not audible to students with
hearing impairment.
Tiffin time/Recess time Students with disabilities encounter barriers in

understanding jokes and take time to understand rules of
games of other students during Tiffin or recess times. This
may lead to social isolation.
Library time A library has rules around book issue and return. They are
noise free and require silence. Whispering is a difficult skill
for students with hearing impairment.
Interactions and activities Likely barriers
Laboratory work Laboratory technicians sometimes give only oral

instructions for use of equipment or carrying out an
experiment. A student with hearing impairment not fully
understand oral instructions. Laboratory technicians might
also speak and manipulate objects or perform a task
simultaneously. Students with hearing impairment may not
completely understand the process due to split attention.
Functions and festivals in school As part of co-curricular activities, schools organize

competitions, festivals and other functions that include
performing arts such as dance and dramas. Due to
communication barriers, students with disabilities are
often not given a role—or at best, given a very insignificant
one such as becoming a tree in a stage act or a servant
who does not have to speak.
Outreach and extension activities Community activities, such as awareness about

cleanliness or water and energy conservation are fun for
all children and also broaden their social horizon and
commitment. Outreach activities are also some times
undertaken by schools for fund raising. These may require
communication with the general public, which may create
embarrassments due to misinterpretations for the student
with hearing impairment.
School administration including Communication barriers of students with hearing

paying fees, filling scholarship impairment may lead to misinterpretations and cause
forms delays in payments of fees. For higher class students or
those who are parents with hearing impairments, reading
comprehension may also cause a barrier in filling up
forms.
4. Instructional Processes
Inclusive classrooms are diverse and include students with different interests, needs, learning
styles, and cultural backgrounds. Apart from addressing these differences among students
with hearing impairment, teachers have to also bear in mind the impact that deafness has
on both receptive and expressive language. 4 Because of their deafness, and the fact that they
do not hear the language, children’s reading and comprehension may be impacted, which in
turn impacts their academics in social studies, science, and math.
Certain teaching methods adopted by teachers may also create barriers for children with
hearing impairment. These include:
Using reading of text as the only method of teaching: Often teachers simply read from
textbooks. They do not discuss, explain or demostrate. This can be very frustrating for students
with hearing loss, as holding a book in front of the face while reading may impede their
speech/lip reading of the teacher. They may also find it difficult to concentrate on listening,
speech reading and following the textbook along with the teacher.
4 Receptive language means the ability to understand or comprehend language heard or read. Expressive language means
being able to put thoughts into words and sentences, in a way that makes sense and is grammatically accurate.
Too many instructions: Teachers often give multiple instructions in one go. For example, “Open
your history text book, read silently the second to last paragraph on page 30, while I prepare
a video for all of you to watch. After you are done do not talk amongst yourself but raise your
hand to tell me quickly ‘Who was Afzal Khan and why did Shivaji Maharaj kill him?” Teachers
need to remember that students take time to absorb each instruction or a question, process
the information and respond to it accordingly. Too many “cluttered” instructions might confuse
the children, especially those with hearing impairment. When such long multiple instructions
are given the child may miss out on some and not raise his/her hand at all even if he/she has
read the paragraph and has the correct answer.
Not knowing the learner: Teachers often assume that their teaching is very effective. They
explain the content and proceed further, assuming that all the students understood the content.
It is best to avoid such assumptions, and accept that each student has unique learning needs
and that one teaching method may not work for all students. All too often teachers do not
adapt instructions for diverse learners and do not check comprehension.
Animation, expression and eye contact: Children lose interest if teachers do not use multiple
means of communication. An animated face, eye contact, body language and facial expressions
help children understand a teacher. For instance, making eye contact is a very basic skill while
communicating. However, many teachers forget to make eye contact with all learners while
teaching and often look at only one group of students from whom they expect answers and
active participation. This limits the range of a teacher’s communication. Other students lose
interest in the teaching and may not pay attention. And then, when suddenly they are asked
a question, they do not have the correct answer.
Language of the learners matters: A common language between the teacher and student is
essential for communication. Even if they share the same language, the level and complexity
of language that teachers use also matters. Both aspects need to be taken into consideration to
effectively impart knowledge to students. The language aspect of communication is especially
significant for children with hearing impairment. While many may understand and use sign
language, others may prefer oral communication. If teachers and other students do not have
an understanding of sign language, it could result in a communications breakdown. Children
with hearing impairment may have telegraphic speech i.e. they may speak in single words and
in a distorted voice. There are often omissions and substitutions of speech sounds, resulting
in speech that may sound unclear to teachers and peers.
See “Understanding Different Learning Styles and Approaches in Developing Inclusive Pedagogy”
(Unit III) of Module 1: Inclusive Education.
ACTIVITY
Understanding how children with and without hearing loss communicate
Instructions:
Ask teachers to discuss how children with and without hearing loss communicate.
Ask them to identify the differences in how they communicate and give reasons for these
differences.
Share the Table 7 to generate more discussion.
Table 7: Communication
Students without hearing loss Students with hearing impairment
Knowledge of language
zz Hearing students acquire adult-like zz Hearing impairment is a hidden disability, and

vocabulary and an adequate language is often not immediately detected in a child.
base naturally, mainly through listening, Delay in identification often means that critical
daily routines, and listening to parents time for language acquisition is lost.
and others talk to them continuously. zz When children are placed in mainstream
zz Even before starting school, children use schools, they may not have age appropriate
adult-like language to communicate. language skills.
zz In school, they learn to read and write zz Many children with hearing impairments
the language already known to them. may learn language simultaneously through
Hearing children first acquire language, reading in school. They learn two skills at one
and later learn to read it at school. They time: learning a language and reading that
learn one skill at a time. language.
zz Their communication skills and academic
progress may be delayed as a result.
Use of communication mode
Hearing children use a uniform single mode Children with hearing loss are a heterogeneous
of communication—listening and speaking group and may use different communication
which is called aural-oral mode. modes such as aural-oral or manual (i.e. using
a sign system or sign language). Some may
use a combination of both, also called “total
communication.”
UNIT III: Creating
Enabling
Environments
Table 7: Overview of Unit III
Unit III: Creating Enabling Environments
1. Strategies for addressing Lecture cum The teachers will be able to:
communication barriers demonstration, zz Understand effective modes of
including Alternative and videos, case studies
Augmentative Communication communication, including AAC
(AAC). zz Identify facilitators for
2. Socialization and friendships socialisation
3. Concessions and facilities zz Learn about available
for children with hearing concessions
impairment zz Describe the role and
4. Facilitating collaboration responsibilities of different
between different stakeholders stakeholders
Schools are institutional spaces for communities of learners. As public spaces within a web of
social relationships, schools must create enabling learning environments where children feel
secure and where there is an absence of fear (National Curricular Framework, 2005). The
white paper on 21st century learning skills also emphasizes that learning must take place in
contexts that promote interaction and a sense of community. Hence, teachers shoulder a huge
responsibility of creating a supportive classroom environment to facilitate learning in schools.
Teachers should nurture their classroom spaces as places where children can ask questions
freely and engage in a dialogue with the teacher and peers (NCF, 2005). To engage fully in
the learning process, all students need to communicate by sharing their experiences, clarifying
their doubts and asking questions to teachers and peers.
1. Strategies for Addressing Communication

Barriers
Putting in place strategies that address the many communication barriers faced by children
with hearing impairment is critical to creating an environment that allows all children to
participate and learn. For the teacher, the starting point is to understand the three main
UNIT III: Creating Enabling Environments | 25

communication options—all based on distinct philosophies—available for children with

hearing loss. As detailed in Annexure 4, the three communication options are oralism, total
communication and educational bilingualism, each requiring different types of support in the
classroom. Specialists and parents tend to follow a particular philosophy, and work together to
enhance the language of a deaf child and help him/her develop that particular communications
modes.
Strategies to support children following different communication options

Oralism
zz Audiological support for maintaining hearing aids, cochlear implants and other amplification
devices
zz Hearing aid trouble shooting and spare parts kit
zz Installing assistive listening devices like a hard wire system or a loop induction system in the
classroom
zz Auditory verbal therapist and/or special educators for facilitating smooth communication
between the student with hearing impairment and hearing peers.
Total communication (TC)
zz Specialist or parents can help train fellow students, teacher and other concerned school
authorities in sign systems to enhance communication with the student using TC.
zz Installing simple charts of fingerspellings, signs of sign system in the classrooms, canteen, and
playground.
zz Signed English dictionary of almost 3,000 words, where each word is illustrated with
corresponding image and its description. (Refer to the resources for details)
zz Install Sign 4 Me, a signed English translator, in computers for student use in schools. (Refer
to the “other resources” section in this module for details.)
Educational bilingualism
zz Certified Indian sign language teacher and Indian sign language interpreter.
zz Installing simple charts of signs of the Indian Sign Language (ISL) in the classrooms, canteen,
and playground.
zz Availability of supported E-text—digital texts which involve a variety of supports like video
of ISL translation; display grids with combinations of words and ISL graphics; and include
embedded questions that prompt comprehension strategies. These e-texts make instructional
materials more accessible to students with hearing impairment.
zz Signing avatars are digital animated characters that provide sign language interpretation. The
user can customize the avatars with different “skins” personifying different characters and with
adjustments of signing speed and viewing perspective. They can be embedded in a multimedia
product to provide ISL translation. They are best alternatives for mainstream schools, where it
is difficult to get the services sign language interpreters.
zz Sign to text, speech to text options in the computer system enable the translation of signs
used in sign language or of spoken words into text. If installed in the computers of mainstream
classrooms, such options will definitely prove to be a boon for students with hearing
impairment.
Some other common strategies to address communication barriers for all children with hearing
loss in mainstream schools are as follows:
Sensitizing teachers and peers about the strengths of a child with hearing impairment,
including the “do’s and don’ts” associated with the child’s augmentative and assistive
devices
Noise-free classrooms
Preferential seating in classrooms
Opportunity for speech reading teacher’s face
Sufficient light in the classrooms, especially on the speaker’s face
Assistive devices, such as smart boards, and alarms, such as glowing bells
Multimedia and other graphic/visual aids
Need-based adapted textbooks and other audio video support material
Captioning in computer-assisted instructions
Overheads, visuals, handouts and outlines of topics
Use of note takers or other forms of recorders
Resource teachers
See Annexure 5 in this Module on different software and online resources available to teach
speech and enhance communication skills of children with hearing impairment.
1.1 Alternative and Augmentative Communication

Augmentative and Alternative Communication (AAC) is a term used to describe items
that are used to help or ‘augment’ a child’s ability to communicate. More precisely,
alternative communication is an approach that is a substitute for (or alternative to) natural
speech and/or handwriting. Augmentative communication is an approach which is an addition
to speech or writing. AAC is used by people who some or all of the time cannot rely on their

speech. AAC is used when children with severe speech or language problems arising from
hearing loss or any other disability need a form of communication to replace or supplement
speech that is not functional to express thoughts, needs, wants, and ideas. AAC devices help
an individual to interact with others and participate. Allows a person who does not have
speech or language to ask questions and share feelings and views and provides independence
and opportunities for spontaneity.
There are two broad types of augmentative and alternative communication systems: unaided
and aided:
Unaided communication systems rely on the child’s body to convey messages,
including gestures, body and sign language.
Aided communication systems require the use of tools or equipment in addition to the
child’s body. Aided communication systems can range from a pencil and paper, books
and boards to devices that produce voice (i.e. speech generating devices) or written
outputs. Electronic communication aids allow the child to use picture symbols, letters,
and words and phrases to create messages. In the last ten years there have been
great advances in the world of electronic communication, making communication for
individuals who need help much more effective.
For a fuller discussion on AAC see “Use of Assistive Devices, ICT and Other Resource Support
to Meet the Specific Needs of CWSN” in Module 1: Inclusive Education and “Augmentative and
Alternative Communication” in Unit III in Module 3: Including Children with Cerebral Palsy.
Understanding the different communication systems is especially important when a child with
impairment also has additional disabilities. Let us meet Sameer, a 3rd grader with hearing
impairment and cerebral palsy.
Sameer is a child with multiple disabilities. He has both hearing impairment and cerebral palsy.
He is a 3rd grader and is known in the school for throwing fits of anger. The intensity of anger
is highest when the teacher is undertaking recapitulation of a lesson, i.e. asking children what
they have learnt. Sameer is also seen frequently disrupting the class, while other children are
narrating a story in the class.
Sameer wears a hearing aid. His teacher notes that she and other children find it difficult
to understand Sameer’s speech. Sameer finds it difficult to hold and use a pen or even
communicate in signs as his hand movements are uncoordinated due to cerebral palsy.
ACTIVITY
Communication challenges for a child with multiple disabilities
Why does Sameer throw temper tantrums?
What can the teacher do to help Sameer?
What types of AAC aids could be used to help Sameer communicate better?
During the discussion, stress that Sameer’s temper and fits of anger are likely due to his
inability to participate in the class. The inability to communicate may have a significant
impact on daily living skills, educational access and may lead to behavioural challenges.
Sameer probably wants to add his ideas/thoughts or reasoning to the story or wants to let the
teacher know that he knows the right answer! However, Sameer’s attempts to communicate
are not understood by his teachers. This must be truly a frustrating situation for Sameer!
Examples of alternate communication options
Communication board may comprise symbols and words

and can be in the form of a booklet, flat display or chart.
Listeners should be aware of the symbols that the child
uses. The child points out the symbol to express him/
herself. If the child points to a water bottle, that may
mean he/she is thirsty.
Object symbols represent an activity, object or person.

Different types of object symbols include: miniature
versions of the real objects (e.g. a plastic cup or biscuits
to represent snack time), parts of real objects (e.g. piece of a jigsaw to represent a puzzle),
or an object that is associated with an activity (e.g. pencil to represent writing activity).
Picture Communication System are another AAC widely used with non-verbal children.
Transcense, a speech translator available as a smartphone application, is widely used by

deaf individuals across the globe to help with communication. It is a useful tool even for deaf
students who excel at lip reading who need some help when in the classroom or in group
conversations. Transcense can translate speech into written words and transcribe it on screen
in near real time. It can help a teacher in a mainstream class communicate with children with
hearing impairment.

Tips for creating and using AAC in the classroom

It is very easy for teachers to design and prepare their own AAC systems. AAC systems need
to be designed in a way that address the communication needs of each individual student. A
communication board of simple day-to-day commands/questions and corresponding pictures (e.g.
‘May I drink water? May I go to toilet? May I wash hands? Don’t talk. Pay attention, May I come in
the class?’) can be made and installed in the class. The use of such communication boards allows
students with communication difficulties to more easily express their needs in the class.
1.2 Conventional Hearing Aids
There is a range of conventional hearing aids, and chances are that a teacher may have
students using different types of hearing aids. Due to technological advancement, a variety of
amplification devices are available. Hearing aids are fitted based on an audiological evaluation,
and children with hearing impairment are given auditory training to learn how to use them.
Examples of hearing aids include:
Body-worn hearing aids are commonly used by students with hearing impairment. However,
these are bulky and outdated. Today, there is a variety of modern hearing aids that are much
smaller and less noticeable.
Behind the ear (BTE) hearing aids are worn behind the ear. Various types of digital and analog
BTE aids are now available.
Cochlear implant is a device that is surgically implanted. It is designed to stimulate the

hearing nerve with electrical impulses. Children who have cochlear implants may hear clearer,
but still require auditory training to attach meaning to the language heard.
Induction loop system could be installed in a mainstream classroom, if resources are

available. The system is installed along the walls of the classroom. The teacher’s voice from
the microphone is amplified and transmitted through the coil to the child’s hearing aid. It
provides better flexibility to the student with hearing impairment.

Frequency Modulated (FM) System:

Some private schools also use a
frequency modulated system that picks
up the voice of the speaker—in this
case the teacher—via a FM wireless
microphone and transmits it to the
student’s hearing aid. The system
also has a matching frequency chip,
and helps to reduce background noise
considerably, allowing the student
to clearly hear the teacher’s speech.
As it is a wireless system, it allows
freedom in movement to both teachers
and students and is ideal for inclusive
classroom.
Tips for Teachers: Usage of Hearing Aids

Hearing aids should be:
zz Worn At All Times.
zz Handled gently and protected from moisture and dust.
zz Removed if it is raining or if the child is swimming.
zz Removed if the child is engaged in a rough outdoor sport.
Hearing aids should not be:
zz Removed while carrying out experiments in the laboratory or other school activities.
Body worn hearing aids have to be protected when eating or drinking. If for any reason the hearing
aids are not used for a long time, the battery must be removed from the battery compartment.
ACTIVITY
Familiarizing teachers to handle hearing aids
Allow teachers to explore different models of hearing aids
Ask teachers to put them on and off
Ask them to check whether they are working
Ask teachers to change the volume
Ask teachers to change batteries
2. Socialization and Friendships

Beyond their immediate family, children with hearing impairment may find it difficult to
communicate with others, which is necessary for socialization. As a result, the child may have
difficulties developing relationships, making friends, and participating in social activities.
If you have a child with hearing loss in your class, it is helpful to ask yourself the following
questions:
Will this child have friends?
Will he/she be teased?
Will he/she play sports?
Will he/she understand what is taught in the class?
ACTIVITY
“What is that in your ears?” and “What type of hand language is this?”
Instructions:
Ask teachers to read the three case studies about Pooja and Sheetal, which highlight the
barriers faced by children with hearing loss in mainstream schools.
Case Study
Case Study 1: After completing four years of special pre-schooling, Pooja was enrolled in the 1st
grade of Navoday, a mainstream school. On the very first day, Pooja’s parents dropped her at
the school. Nitish, another 1st grader, like most other children, had completed preschool from
Navoday. He seemed confident and was busy talking to other classmates. While Nitish passed by
Pooja he looked at Pooja’s hearing aids and asked his father “What are those things in her ears?”
Nitish’s father looked embarrassed and apologised to Pooja’s mother. Pooja understood this and
insisted that her mother remove the hearing aids. Pooja’s mother smiled at the boy and replied,
“Those are Pooja’s hearing aids. They help Pooja hear well, just as glasses help to see well.” Will
you take care and introduce Pooja to others?” asked Pooja’s mother. Nitish felt elated as he walked
with Pooja to the class and was seen introducing Pooja to other classmates!

Case Study 2: Sheetal was a girl with hearing impairment enrolled in 4th grade of a mainstream
class and was using sign language to communicate. Initially, good in her studies, Sheetal’s
performances started to worsen. She seemed very lonely and had no friends. Sheetal started
expressing that she did not want to continue school any further. She communicated to the school
counsellor that her classmates teased her for using hands and facial expressions. The school
counsellor spoke to the school Principal and introduced Sign Language as an optional language
in school. Sheetal helped other children learn the language. The teacher took help of Sheetal to
model the signs. This was fun! Children not only learned a new language as specified in NCF
(2005), they also now could understand Sheetal well. Sheetal was happy to be a Sign Language
teacher of the school!
Case Study 3: Deepak was a boy with hearing impairment studying in 5th standard of a
mainstream school named Vivekanand Vidyalaya. Once, the class teacher Mrs. Anita announced a
‘talent hunt’, an inter school competition. Since, it was a group event, the organizers needed group
entries only. Mrs. Anita asked all the students to think about an innovative performance. Students
mostly suggested group song, group dance and some other wanted to present a drama. Mrs. Anita
had once noticed Deepak’s miming and acting skills during the free hour time. She suggested that
Deepak teach miming to others. Then Mrs. Anita encouraged one of the class students Rohan to
write a script based on the history textbook titled Evolution of Mankind. Satish was encouraged to
compose play back music. Since the storyline had lots of sequences, almost the whole class got
to participate. The students practised a lot for almost 3 weeks. The hard work and team approach
was quite visible and hence no wonder that they won the 1st prize.
Questions for discussion:

What would have happened had Pooja’s mother not talked to Nitish?
What helped Pooja get a buddy?
What strategy did the school counsellor use to help Sheetal? How did it benefit other
children?
Are there other simple tips to overcome big hurdles like those Sheetal faced?
What was the real innovation in Deepak’s case? Miming or the teamwork? How did
the students use multiple intelligence to foster teamwork?
2.1 Strategies for Overcoming Social Barriers
One effective approach to facilitate socialization of deaf students in mainstream classrooms is to

orient the fellow hearing students, teachers and non-teaching staff about the nature of hearing
loss, amplification devices, sign language and other core issues. Once children know that hearing
aids are devices used to amplify sound, they are likely not to tease a child with hearing loss.
Mainstream students need to be introduced to Indian sign language. It is the mother tongue or
first language of many children with hearing loss. In fact, hearing students and teachers enjoy
learning sign language for the simple reason of keeping secrets of communicating.
Often teachers have a very sympathetic approach towards children with hearing loss in their
mainstream class. They may even overlook poor behavior and treat them preferentially. It is
very important for a teacher to be unbiased and treat all children equally. Avoid being over-
protective to children with hearing impairment.
It is good to encourage peer interaction. A recommended approach is the rotation buddy

system in which each child in the mainstream class gets the opportunity to sit and interact
with the child with hearing impairments. In this way the student communicates with all the
other fellow students in the class. This system tends to avoid group-ism in the class.
Cooperative learning is also known as small group learning. Students are divided into small
groups and task is assigned to each group. The student with hearing loss is also a part of a
small group. The task is such that each member of the group has to participate actively. Thus,
the student with hearing impairments is included in classroom activities and participates.
3. Concessions and Facilities for Children

with Hearing Impairment
Concessions offered by Government for students with hearing loss in a mainstream school
include extra time for SSC examinations and language exemption, meaning that students can
opt for only one language and instead opt for vocational subjects at SSC exam. Concessions
are granted based on producing a disability certificate as per the Persons with Disabilities
Act (PWD Act, 1995). A full list of accommodations/concessions available for children with
hearing impairment is provided in the Annexure 6.
4. Facilitating Collaboration between Different

Stakeholders
Collaboration with different professionals and parents will help teachers understand and better
support children with hearing impairment. Parents can help teachers understand a child’s
communication, while an audiologist and speech specialist can help the teachers understand
the nature and implication of the child’s hearing impairment.
Also see “Collaboration, Convergence and Teamwork” in Unit IV of Module 1: Inclusive Education
for on the importance of collaboration for inclusion.

Unit IV: Curricular
Transactions
and Pedagogic
Strategies
Table 8: Overview of Unit IV
Unit IV: Curricular transactions and pedagogic strategies
1. Curriculum adaptations: Presentation and group Teachers will learn to make

adapting content, instruction, activities accommodations and
assessment practices, and adaptations required for a child
teaching and learning material. with hearing impairment
2. Teaching literacy skills
3. Developing writing skills
4. Teaching mathematics
1. Curriculum Adaptations
This section focuses on the accommodations and adaptations necessary to create enabling
learning environments for students with hearing loss in your class.
Is curricular adaptation and accommodation one and the same?
Different terms are associated with the term curricular adaptation, such as accommodation,
alteration, differentiation, change, revision, enhancement, compacting, integration, and
scaffolding. Comfort (1990) defines curriculum modification as “the adapting or interpreting of
a school’s formal curriculum by teachers into learning objectives and units of learning activities
judged most reasonable for an individual learner or particular group of learners”.
Why is there a need for curricular adaptation for students with hearing loss?
Two standpoints are applicable in the context of adapting teaching learning material. The
first stresses the importance of early identification and intervention of disability to help
prevent impairment of hearing from escalating into disabling conditions in children. The
critical period for language acquisition is 0 to 3 years. And it is within these years, that
it is important for children with hearing loss to build language and communication skills.
Unit IV: Curricular Transactions and Pedagogic Strategies | 37

Systematized efforts can help children acquire age-appropriate literacy skills and eliminate the
need for remediation efforts later in life. Children who have access to early intervention may
be on par with their hearing peers and may not require curricular adaptations. However, many
children with hearing loss are identified much later in life and their language and literacy skills
may lag behind those of their peers. These children are likely to require curricular adaptations
to match their developmental age and stage.
It is important to remember that regardless of when a hearing loss is identified—early or later

in life—each child is unique requiring unique interventions. Each child will have different
instructional needs and as such may require different degrees of curricular adaptation and
accommodation.
According to NCF (2005) the unique characteristics, interests and attitudes of children and
diversity in learning styles demand differential teaching methods to be used by a teacher in
the classroom to facilitate learning. To ensure diversity, an inclusive curriculum is needed.
NCF (2005) also emphasizes the need of inclusive curriculum keeping in view the diversity of
learners. This calls for curricular adaptations. An inclusive adapted curriculum aims to provide
quality education that will enable all children to learn effectively and participate equally in
class. It also affords children the dignity and confidence to learn. As per the NCF (2005), it is
essential to retain all children in school, for which assessment of functional ability of learners
is essential. This calls for broad-based curriculum to accommodate diversity of teaching
approaches and use of teaching and learning materials in a given classroom.
The following NCF (2005) based guidelines will help guide the teacher while developing an
inclusive curriculum for all children. The curriculum must:
Include child-centered pedagogy, keeping in mind the child’s psychological development,
interests and specific learning needs;
Ensure equal access in every possible manner (physical, attitudinal, academic and
social) to maximize learning;
Facilitate learning in an inclusive learning environment with accessible material,
positive attitude and relevant/adaptive teaching strategies;
Incorporate required adaptation in curriculum (learning content, learning approach, learning
aids and evaluation) to address and accommodate individualized learning styles;
Prescribe for use of all available educational/assistive technologies to ensure equal
participation of and effective learning in all children specifically for children with
special needs;
Include all children with and without special needs by providing differential opportunities
to demonstrate learnt skills according to their learning abilities;
Include components of life skills through transitional stages working towards
independent living;
Include locally available conditions/opportunities/situations to develop prevocational
and vocational competencies;
Integrate work pedagogy in education and include broad-based work experiences
taking care of the needs of children with special needs;
Ensure participation of children with special needs in play, games, social and cultural
activities to improve the physical and mental health by developing appropriate
adaptations;
Provide flexibility in school and class time tables to address individual needs of children;
Create opportunities for facilitated social interaction; and,
Construct knowledge by connecting new ideas to existing ideas on the basis of
materials/activities.
When adapting curriculum for children with hearing loss begin by asking yourself three
questions:
What to teach? Adapting the curricular content and teaching learning materials.
How to teach? Adapting the instructional strategies.
When to teach? Adapting the assessment procedures in the classroom.
There is no single recipe for adapting general education curriculum to meet each special
student’s needs. Each teacher, each student, each classroom is unique and adaptations are
specific to each situation. The curriculum does not always need to be modified; by providing
multi-level instruction you will find that adapting a lesson may not always be necessary.
Differentiating instruction and providing multiple ways to assess allows more flexibility for
students to meet the standards and requirements of the class. At other times, the curriculum
can be made more accessible through accommodations. Supports for one student may not
necessarily be the same in all situations. For example, a student who needs full time support
from a paraprofessional for math may only need natural supports from peers for language and
no support for art. Supports should not be determined by the disability label, instead supports
should be used when the instructional or social activity warrants the need for assistance.
For further details see “Creating an Inclusive Learning Environment for Children with Special Needs;
Unit III of Module 1: Inclusive Education.
1.1 Adapting Curricular Content
Issues regarding content for the child with hearing impairment may include difficulty with
language structure which can affect the development of reading and critical thinking skills. Due
to lack of higher order language comprehension skills, structures such as “why”, past tense
verbs, complex sentences, etc. may be difficult. The child may also need additional practice
in using language to explain and make predictions such as, “Why couldn’t the stork drink
the soup?” or “What will happen if you don’t wash your hands?” Adapting curricular content
might involve applications as straightforward as: reducing the number of vocabulary words
assigned in a content; having a learner complete less number of problems on a mathematics
assignment; reducing number of chapters in a particular subject, holding less expectations
than the task demands etc. Individualized adaptations of content can, also, be achieved by
restructured concept-based teaching.
1.2 Adapting Instruction
Most teaching strategies used to instruct children without disability are also appropriate for
children with hearing impairment. Basic strategies for addressing receptive and expressive
language are as follows:
Minimize distractions and background noise.
Use repetitions, routines and multi modal teaching to enhance the memory.

Teach and reteach the concept in variety of context for accuracy.

Rehearse and practice in the context of daily living routine activities.
Make sure to catch student’s attention before speaking. While teaching, it is very
important to make eye contact with all children, so that everyone feels that they are
being looked at. Besides talking, it is also good to use nonverbal communications such
as gestures and animations to make teaching effective for all children and more so for
children with hearing loss.
Use short, concise, simple sentences and avoid idiomatic language. Classroom
instructions must be given crisply and step by step. After every step, it is good to check
whether students understood the instructions/concept; they may require more practice
or explanation to avoid communication breakdown.
Use visual or tactile cues wherever possible. For example, for a child with hearing
impairment, the teacher could use graphics, images and other visual learning aids to
supplement an oral explanation.
Use student’s name while giving instructions.
Use positive rather than negative language.
If possible, provide transcripts of audio information.
Be flexible in allowing longer duration for handling teaching aids like flash cards
Allow students to indicate answers by drawing, sketching, writing, signing or enacting.
Use real objects, pictures, photographs so that children could point to answers.
After explaining content gently check if the child understood what is being taught. This
can be done by asking a clear question and asking the child to point to the correct
answer. This will facilitate communication in class.
Planning classroom teaching
At the beginning of the school year, teachers are advised to study the assessment reports
of children with hearing loss, and discuss with the resource teachers and parents the
children’s learning goals. (For more on auditory assessment see Annexure 7.) An observation
and interaction with the student will help the teacher establish further rapport and clearly
understand the needs of the student in the classroom. Teachers in inclusive classrooms are not
expected to provide totally different programs to students with hearing impairment; rather, the
differences can be managed using a variety of approaches such as a Learning Pyramid and/or
differentiated instructions.
Learning Pyramid helps the teacher plan the content of his/her lessons. The teacher first
identifies the key concepts or skills in the topic or content and then categorizes the content in
terms of three degrees of learning:
What some students will learn – top of the Pyramid
What most, but not all, students will learn – middle of the Pyramid
What all students will learn – base of the Pyramid
In an inclusive classroom, the teacher will have to first identify the essentials of desirable
content and then plan his/her strategy accordingly.
Differentiated instruction addresses diversity and helps teachers in accommodating students
with a wide range of abilities, interests, and learning styles. Teachers can differentiate curriculum
in three broad areas: content (matter to be taught), process (the way it is taught), and product
(expected learning outcomes). Because students with hearing impairment experience difficulty
with receptive and expressive language, with remembering, and with understanding abstract
ideas, techniques of teaching need to be chosen with care.
Classroom organisation
An inclusive classroom should provide a good acoustic environment. A classroom away from
noise or one that is acoustically treated will create a good listening environment. According
to Graham and Faser (1993) good acoustic listening conditions are vital for students with
hearing loss and other students to enable them to make the maximum use of their aided
residual hearing. This helps children with hearing loss to understand classroom instructions.
See Module 1: Inclusive Education; Unit III on creating an inclusive environment for more
suggestions on classroom organization.
Children with hearing loss could also be provided with a preferential seat, which will help them
speech read the teacher (i.e. read the teacher’s lips). Paying attention to lighting arrangements
is also important; sufficient light should fall on the teacher’s face to help the child with hearing
loss to read the teacher’s lips. Many children with hearing loss are visual learners, so reducing
visual distractions such as chewing or moving while talking is also helpful. Additionally, a
teacher may need to signal a speaker in case a child with hearing loss fails to localize who is
speaking.
Other instructional strategies
Some instructional strategies that you can undertake in an inclusive class.
Advance notice of topics to be taught in class allows parents to prepare their children
with some background information.
An outline or sketch of the topic that reflects the general flow of content is also useful,
as are glossaries and summaries.
Taped lectures are particularly useful for a child with hearing loss, who has difficulty
understand a lecture and needs to hear it more than once.

Tailored materials and use of assistive technology such as computer assisted

instructions, and Powerpoint presentation are other ways to adapt instructions.
Grouping for instructions, role playing and cooperative learning are good techniques
that benefit the entire inclusive class.
Use of variations in teaching styles or stimulus variations creates interest and enhances
learning. For example, students can walk along a route of colored tape on the floor to
learn the path of blood flow to/from the heart.
Activity-based instruction are particularly useful in an inclusive classroom environment

and benefits all children—with and without disabilities. Students who are hearing
impaired often prefer activities that involve concrete learning through visual, tactile or
kinaesthetic teaching styles.
Graphic organizers (also known as mind maps, webs, clusters, and think sheets) are visual
diagrams that represent abstract ideas and concepts in a concrete form.
An Example: sorting organizer for solid and liquids from a given list
Sr. no
Things we eat Things we drink
1.
2.
Lesson frames are used to present an overview of a lesson or concept

to help students organize their thoughts around a lesson. They are
presented in writing but may also include pictures or graphics, and
are usually placed on overheads, photocopies, chalkboards, or
posters. Lesson frames typically indicate the course, topic, date,
lesson outline, lesson outcomes, assignment, and notes. The example
below shows a lesson on sources of water.
1.3 Adapting Assessment Practices
Assessment is a vital component of instruction, undertaken by a teacher at various stages

of classroom instruction. When judging a student’s prior knowledge of a specific topic,
assessment can be done quickly at the beginning of the instruction. Mid-course assessment is
done periodically to check whether or not the children are following the instruction, and unit
end assessment is undertaken after a lesson/unit is completed. Assessment can be mostly
done orally or by way of pointing or writing.
The scheme of Continuous Comprehensive Evaluation (CCE) is being followed in mainstream
schools, since no detention policy has been adopted till grade 8 under the Right of Children
to Free and Compulsory Education Act, 2009 (RTE Act, 2009). The primary purpose of
assessment and evaluation is to improve children’s learning to help them progress leading
to their overall development. Assessment during teaching-learning process (i.e., continuous
assessment) gives clues about children, which the teacher can act upon to enhance holistic
learning, especially where children are facing difficulties and special help is needed. The same
CCE is applicable to the students with hearing loss too.
Effective assessment of children with hearing impairment is challenging as many have significant
language and communication difficulties. Adapting the style of assessment to meet a child’s
specific needs is therefore critical. While assessing the child with hearing loss, the assessor/
teacher should face the child as he/she speaks and should speak slowly and clearly. Instructions
should be simple and repeated, if required by the child. To the extent possible, the assessor/
teacher should first demonstrate the expected response, and then ask the child to perform.
Oral and written tests are typical evaluation tools. However, oral recitations or answers and
written assessment material such as a question paper may present barriers of language and
communication, especially for children with disabilities. A child may indeed know the answer,
but may not be able to respond correctly. Oral tests such as evaluating through reciting a poem,
narrating a story, elocution, and viva are challenging for children with hearing impairment as they
face difficulties in comprehending the oral questions, framing answers in correct grammatical
structures, speaking intelligibility and answering within the given time span. Hence, the manner
and content of assessment needs careful planning. Oral tests could be modified using parallel
techniques such as action songs, role playing or enacting stories, and distributing written text
of the speech to the child with hearing loss. Designed to evaluate performance/knowledge in
subjects like science, language, and maths, written tests generally consists of an objective, and
short answer and essay type questions. Achievement is measured in terms of students’ abilities
in expressing the knowledge gained through correct written language.
Helpful tips
Performance tests rather than paper-pencil tests help to overcome the innate language and
communication barrier experienced by majority of children with hearing impairment.
Individual rather than group tests are beneficial.
Extra allocation of time and assistance through instructions is also helpful.
Sometimes teachers feel that writing essay type questions are difficult, so they give
students short or objective type questions with multiple choices. However, even
these might have some aspects of language twists, making the questions difficult to
understand and answer correctly. (see example in box next page)
While students write reports, classroom assessments for children with hearing
impairment could be supplemented by teacher observation.
Modern assessment techniques such as the portfolio, open book exams and
presentations could also be used as a part of summative evaluations.
For formative evaluations various Classroom Assessment Techniques (CAT) such
as Course Knowledge and Skills (see below) could be undertaken, and benefit all
students:

Sample written test question

Double-negatives are unnecessarily confusing to a test-taker with hearing impairment.
Which one of the following choices is not a correct option and is not used as an astronomical
tool?
zz Bow and arrow
zz Seat and needle
zz Type of compass
zz Scissors
The question could be reframed more clearly as:
Many devices were used to make astronomical calculations in ancient India. Select one choice
below that was not an astronomical device:
zz Bow and arrow
zz Seat and needle
zz Type of compass
zz Scissors
The use of idiomatic expressions such as “who was baking up the wrong tree?” in test questions
may confuse children as they may understand the literal meaning only.
Sometimes the structure of the question itself is not understood due to the incorrect word order.
The Vedanga Jyotisha was an example of which kind of calendars? The more appropriate frame
could be: What type of calendar was Vedanga Jyotisha?
The teacher should also be cautious about using words with multiple meanings and embedded
clauses with the same meaning or with a stem question.
yyOne-Minute Paper: Asking the students to write the most important thing they
learned today and what they understood least on a paper.
yyChain Notes: A key question on the content is pasted on a large envelope and passed
around the class. Each student writes or tick marks and puts it in the envelope.
yyGroup questions: Students are divided into small groups and each group asks
questions to the other group on the content that the teacher has taught.
Other strategies of formative assessment include:
Seminar: Working in groups of eight to ten students, comprising students with hearing loss, a
given topic is researched/studied and ‘presented’ to all students. In this group activity, students
with hearing loss may be given the responsibility of data entry, preparing the material, and/or
presenting to the class using sign language. The areas of assessment are: ability to research
a specific topic; acquisition of content knowledge; public speaking/signing with interpreter
services; ICT skills and leadership quality.
Symposium: Students can be asked to ‘present’ papers on the topic of their choice. Students
with hearing loss may be permitted to present in sign language with support of interpreter
services. The areas of assessment are: depth of the content; presentation of the content; use
of audio visual aids; expression and comprehension of the topic.
Group discussion: Groups of ten students can be given specific topics to discuss. Students
choose a group leader, moderator and recorder. Roles have to be clarified before throwing the
topic open for discussion. The group leader ensures that all students including those with
hearing loss participate in the discussion. The moderator ensures that there is no cross talk,
and no two students speak together and everyone listens to each other patiently. The moderator
also ensures that students with hearing loss are not teased, bullied, isolated, ignored, and/or
ridiculed by other students. The recorder records all students’ observations, including those
of students with hearing loss. The areas of assessment are: courage to put forth one’s view;
teamwork; respect for peers; knowledge of content; appropriate body language; communication
and listening skills.
Group activities: While planning group activities, teachers should ensure that students with
hearing loss are not left out and instead are able to participate in each and every activity.
This requires teachers to use alternative strategies for evaluating students with hearing loss
and entrusting them with roles and responsibilities to be performed in the group activity. The
teacher can plan a wide variety of group activities for facilitating the participation of students
with hearing loss in the mainstream set up such as projects, action plans and surveys.
Rubrics: Rubrics is an assessment tool that clearly indicates marking criteria. It can be used
for marking assignments, class participation, or overall grades. A rubric is a coherent set
of criteria for students’ work that includes descriptions of levels of performance quality on
the criteria. The genius of rubrics is that they are descriptive and not evaluative. Of course,
rubrics can be used to evaluate, but the operating principle is to match the performance to the
description rather than “judge” it. Effective rubrics have appropriate criteria and well-written
descriptions of performance.
Subject specific assessment strategies

Languages
For students with hearing loss, teachers may use performance-based assessment measures
wherein the students are required to perform a range of activities starting from simple pointing,
signing, writing, sketching for indicating their response. Some students with hearing loss may
have issues with language and reading comprehension.
Performance-based assessment: As stated earlier performance-based measures can prove to

be the best source for deducing true picture of a student’s performance. Hence, it is also known
as authentic or alternate assessment. Teachers may use a variety of alternate assessment
techniques like using role play and dramatization while assessing languages of students with
hearing loss.
Communication boards: Communication boards usually have a picture corresponding to every
word or sentence. A child with hearing impairment needs visual clues and simply points out
the correct item on the communication board to indicate his/her response. (See Unit III of this
module for more detailed discussion of AAC.)
Marking: Considering the reading difficulties students with hearing loss may face, teachers
may mark the passage of the textbook for these students. Marking a specific passage can
help overcome to a great extent the difficulties associated with taking dictation. They are
constantly kept within the loop of classroom activities. Marking can also act as a visual clue
to the students during assessment. It reduces the content or distracters and the students with
hearing loss can arrive at the correct response more quickly.
Sign language: During oral quizzes, storytelling, story development, and presentations involving
conversations with peers and teachers, the students with hearing loss may be allowed to
communicate using sign language, provided that there is a sign language interpreter in the
class. The interpreter will translate the student’s response into speech and the teacher’s oral
question into sign language.

Open book tests: Students with hearing loss

may find it difficult to answer questions that
involve answering in brief, giving reasons,
making short notes, and writing essays due
to difficulty in framing sentences and under-
developed grammar structures. Allowing
them to keep the textbook open while writing
descriptive answers for the exam could be
especially beneficial.
Multiple choice questions: To overcome the

challenge that the students with hearing
loss face while writing descriptive answers,
teachers may use multiple choice questions.
The aim of such tests is to purely assess the
knowledge of the students. They are asked to place a tick mark against one correct answer
from among the given alternatives.
Computer-based assessment: Computer-Based Assessment (CBA) offers an alternative to

local assessment. Students have to respond to questions on the computer, clicking the correct
option from the given alternatives. Questions could be made attractive for students with hearing
loss by inserting graphics, images, and signing avatars. A computer-based approach provides
much needed flexibility to learners, as they can learn at their own pace. Computer provides
instant feedback to the students with hearing loss in a visual way.
Mathematics
Mathematics involves many abstract concepts. Language issues faced by students with hearing
loss make math a bit more complex for them. A possible approach is to divide the class into
groups, allowing students with hearing loss to solve math problems in a collaborative way.
While students use paper/pencil worksheets for solving math problems, students with hearing
loss may be asked to solve the same math problems using visual teaching aids such as objects
for arithmetic calculations, play act the role of buyer and seller for teaching concept of profit
and loss, etc. Field activities, reporting, assignments (class work and homework) can remain
the same for students with and without hearing loss.
Environmental activities
There are various instructional techniques that can be used to support teaching learning
process for Environmental Science e.g. reading with a purpose(making notes), oral quizzes,
presentation on current topics, group discussion, use of charts and models, map reading, field
trips and reports.
1.4 Adapting Teaching and Learning Material
Students with hearing impairments are able to see and manipulate printed instructional
material; thus, they are not commonly considered to have a print disability. Hence, both audio
and video assisted materials are helpful:
For students with moderate or moderately severe hearing loss the use of audio and/
or digital text could improve access to curricular materials. These students may
not hear all speech sounds (background noises could be particularly distracting to
them, resulting not understanding, fatigue, and poor concentration). Technology with
adjustable controls and noise-cancelling earphones could be used while listening to
audio tapes.
For those with higher degrees of hearing loss, use of videos with captioning is very
helpful. For this the classrooms have to be digitised. If such digitised facilities are not
available, the traditional approaches could be used such as charts, colour coding for
key words and flashcards. Pictures should have labels and charts should have titles.
Adapting Instructional Materials

Instructional material (such as textbooks and reference books) in most classrooms are
language heavy. They are primarily developed for children without disabilities, often making
them difficult to understand by children with hearing loss and/or other disabilities. Adapting
such instructional material is necessary to make it more accessible to all children.
Adapting teaching materials involves making changes to the text or curricular material to
which a student has access during the course of instruction. This may involve changing the
formats (both language and presentation) through which information is represented to better
meet the needs of the learner. As seen in the example below, presenting material graphically
or with a diagram could greatly enhance the accessibility of the material.5
Direct introduction of Maxim of concrete

abstract concepts to abstract
Original text Adapted text
2- dkyekiu 2- dkGekiu
lw;kZpk çdk'k i`Fohoj iMrks- i`Foh xksy vlY;keqGs lw;Zçdk'k
fuEe;k Hkkxkoj iMrks- R;keqGs rks Hkkx mtsMkr vlrks o fuEe;k
Hkkxkoj vaèkkj vlrks-
fnol% i`FohP;k Lor% Hkksorh fQj.;keqGs frpk vaèkkjkrhy
Hkkx gGwgGw lw;kZleksj ;srks- i`Fohpk vaèkkjkrhy Hkkx ifgY;kank
mtsMkr ;srks] R;k osGh rsFks lw;ksZn; gksrks- i`Fohpk tks Hkkx osG] dkG] HkkstU;klkBh] fp=krhG nLrwaok mi;ksx gksrks- dkG Eg.kts nSG vkf.k
mtsMkrwu ifgY;kank vaèkkjkr tkrks rsFks lw;kZLr gksrks- lw;ksZn;kiklwu ekiu Eguts Hkkstus dWGsaMjoj&vki.k o"kZ] efgus] vkBoMs] fnol ¼rkjZl½ cèkrks-
lw;kZLrki;Zrpk dky ^fnu* gks;- lw;kZLrkiklwu lw;ksZn;ki;Zrpk dky fnol] vkBoMs] efgus] o"kZ dls Bjotkr\
^jk=* vlrs- fnu o jk= feGwu ,d ^iw.kZ fnol* gksrks-
rqEgh Hkksojk fQjrkuk ikfgGk vkgs uk\
fnu rks tksjkr Lor% Hkksorh xksG xksG fQjrks-

jkr
i`Foh lw;Z
d#u igk& ,d Nkslklk VscGVsfulpk ckSG gkrkus fLiu djk ¼tkxè;k tkxh xksG
fQjok½- rks gGdk vlR;kus tksjkr fQjsG- HkksoU;kçek.ks osaMq lq)k Lora\ Hkksorh
fnu o jkr xjxj fQjrks-
efguk% loZlkèkkj.ki.ks rhl fnolkapk feGwu ,d efguk gksrks- vkiGh i`Foh xksG vkgs- rh nslhG v'khp Lor*Hkksorh fQjrs- i`Foh xksG
vlY;keqGs lw;Zçdk'k i`FohF;k fuEE;k Hkkxkoj iMrks- fr;s mtsM vlrks- nqlU;k
lIrkg% jfookj] lkseokj] eaxGokj] cqèkokj] xq#okj] 'kqØokj fuEE;k Hkkxkoj vaèkkj vlrks-
vkf.k 'kfuokj ;k lkr fnolkapk ,d ^lIrkg* fdaok ,d ^vkBoMk*
gksrks-
o"kZ% i`Fohyk lw;kZHkksorh ,d Qsjh iw.kZ dj.;kl tks dkG ykxrks
R;kyk ,d ^o"kZ* Eg.krkr- ckjk efgU;kaps ,d o"kZ vlrs- pS=]
fnu o jkr
oS'kk[k] T;s"B] vk"kk<] Jko.k] Hkkæin] vkf'ou] dkfrZd]
3 3
Source: Gathoo and More (1990)
5 http://mhrd.gov.in/sites/upload_files/mhrd/files/upload_document/specialneeds.pdf

Multiple modality materials can be designed that appeal to different learning styles; material
for kinesthetic and tactile learners may be different than material for visual or auditory learners.
This can be done by altering the presentation of the text through the use of bullets instead of
big paragraphs, and use of flowcharts, tables and illustrations. Alternate instructional material
such as speech to text and text to speech software programs or universally designed textbooks
may also be useful.
For a discussion on diverse learning and teaching styles, see Making Inclusion Work: Module
for Inclusive Education; Unit III on Creating an Inclusive Learning Environment for Children with
Special Needs.
Strategies for adapting textbooks
As the diagram below indicates, there are five areas—language, knowledge, presentation,
illustration and evaluation—that need to be considered when adapting textbooks to better
meet the needs of children with hearing impairment.
Language
Break up long sentences: rewrite as two or more short sentences and use simple
conjunctions.
Refrain from too much difficult vocabulary; retain essential technical vocabulary; and
use simple synonyms.
Original text Adapted text – step by step
ù- pkdkpk 'kksèk ù- pkdkpk 'kksèk

osxosxGh okgus vki.k ikgrks- pkdkaeqGs okgus tksjkr èkkow 'kdrkr- QDr jLR;ko:u tk.kkjh] #Gko#u iG.kkjh fdaok vkdk'kkr mM.kkjh v'kh osxosxGh
okgukaeè;sp pkd vlrs vls ukgh- pj[kk igk- jgkV igk- t=srhy fQjR;k okgus vki.k igkrks- lxO;k ogkukauk okds vlrkr vkf.k okdkeqGs okgus tksjkr èkkow
ikG.;kpk [ksG igk- ;k lokZeè;s vkiY;kyk pkdkapk mi;ksx dsysyk fnlrks- 'kdrkr- Qä ogkukaeè;s; okd vlrs vls ukgh- pjlk] jgkV] t=srhG fQjrk ikG.kk
osxosxGok ;a=kaeè;s pkds vlrkr- ?kMÓkGkrlqn~èkk ,desdkauk tksMysyh pkds ;k lok±eè;s vkiY;kyk pkdkpk mi;ksx dsGsGk fnlrks- osxosxY;k ;a=kaeè;s pkds vlrkr]
vlrkr- ?kMîkGkrlq)k ,desdkauk tksMGsGh pkds vlrkr-
pkdkpk 'kksèk v'e;qxkP;k 'ksoVh ykxyk- dqaHkkjdke dj.kkU;k ek.klkus
pkdkpk çFke okij dsyk vlkok-
vksY;k ekrhP;k xksG;kyk gkrkus vkdkj nsÅu ek.kwl HkkaMh r;kj djr
vls- gs dke vfèkd pkaxY;k jhrhus dj.;klkBh ek.klkus vkMO;k fQj.kkU;k
pkdkpk okij lq: dsyk- pkdkeqGs R;kyk lqcd vkdkjkph ekrhph HkkaMh
r;kj dj.ks 'kD; >kys- rks vfèkd HkjkHkj
HkkaMh cuow ykxyk-
pkdkpk 'kksèk ykxR;koj xkMÓkauk ykdMkph
pkds tksM.;kl lq#okr >kyh- lq#okrhph pkdkpk 'kksèk% pkdkpk 'kksèk v"e;qxkP;k 'ksoVh Gkxyk- dqaHkkjdke dj.kkU;k ek.klkus
pkds Hkjho gksrh- dkgh osGk ykdMh pkdkpk çFke okij dsGk vlkok-
QG;k ,desdkauk tksMwu pkds r;kj dsyh
Hkjho pkd tkr vlr- iw.khZ ek.kwl vksY;k ekrhP;k xksG;kyk gkrkus vkdkj nsÅu HkkaMh r;kj djr vls-
uarj vkMO;k fQj.kkU;k pkdkpk okij lq# dsGk- pkdkeqGs R;kGk lqcd vkdkjkph
Hkjho pkds Qkj tM gksrh- v'kk ekrhph HkkaMh r;kj dj.k 'kD; >kkGs- rks vfèkd HkjkHkj HkkaMh cuow GkxGk-
pkdkaph xkMh vks<.ks =klkps gksrs- Eg.kwu
deh otukph pkds r;kj dj.ks vko';d
>kys- R;keqGs ek.klkus vkjs vlysys pkd
vkU;kaps pkd r;kj dsys- Hkjho pkdk,soth ek.kwl
vkU;kaph
36
Source: Gathoo & More, 1990
Use guiding questions about facts, application of prior experience, linking next aspect.
Present cause and result expressions in a simple form.
Aspects like passive sentences, positive and negative sentences, colloquial and
idiomatic expressions should be made clear.
Limit the use of rhetorical language.
Knowledge
Reduce the density of concepts in a chapter and break up concepts into various units
Present knowledge step-by-step
Give direct information first, indirect next and general last
Do not cut down the content
Presentation
Include flowcharts and tables.
Present information in bulleted form instead of paragraphs.
Include footnotes or explanations in the margins.
Highlight important words, definitions by putting them in boxes or using different print.
Include a word bank that gives meanings of different words in a box at the end and
underline or highlight all these words in the text.
Ape like creature appeared: This creature was the

early man of thousands of years ago.
How did the early man look?
zz The early man looked like an ape.
zz He had no tail.
zz His head was bigger than that of an ape.
zz His nose was flat.
zz His jaw was broad.
zz He had lots of hair on his body.
zz His eyebrows were thick.
zz He walked on two legs, but could not stand or
walk erect.
zz His arms were long, reaching up to his knees.
Source: Gathoo & More, 1990
Illustration
Include illustrations such as pictures, sketches, and graphs.
Use simple and clear illustrations.
Place illustrations near the relevant text.
Pictures should be expressive.
Pictures should refer not only to nouns but to the overall meaning of the text.

Illustrations restricted to nouns Illustration based on content
Evaluation
Add simple questions within the text.
Add inferential questions to recall from previous knowledge.
Include attractive/innovative assessments like crosswords and puzzles.
See that assessments cover both language and knowledge.
2. Teaching Literacy Skills
“What disables deaf people is not that they cannot hear,

but that they cannot read and write.” (Enns, 2006)
Literacy is fundamental to a child’s educational progress. Students without well-developed

literacy skills find it difficult to participate in the classroom learning. Besides the language
reading textbooks, the content knowledge of school subjects such as science or social science is
also acquired and expressed through reading and writing. Consequently, students who struggle
to read and write are much more likely than their better performing peers to experience failures
in school.
Why is reading difficult for some children? Reading is a language based activity that requires a
good understanding of language. As discussed earlier in this module, hearing impairment at a
young age severely affects language development; children with severe and profound hearing
loss may find reading difficult. Luckner et. al. (2005) compares reading problems of hearing
children to those with hearing impairments:
“Hearing children learn to map the spoken language they already know to the printed
words, but this is difficult to those with hearing loss as they do not have an easy
access to the phonological code.”
“Unlike their hearing peers, who learn to read and write in a language they already
know, many students who are hearing impaired learn to read and write while
simultaneously learning their first language”.
Additionally, if they are sign language users, the signs have their own vocabularies,
morphologies, and syntax, which do not parallel those of spoken or printed English (Marschark
and Harris, 1996). Thus, a vicious circle is created: impoverished vocabularies limit reading
comprehension, and poor reading strategies and skills limit students’ ability to acquire adequate
vocabulary knowledge from context (deVilliers and Pomerantz, 1992).
To be an effective reader, individuals need to be active, self-regulated, and need to be armed
with a variety of strategies to help them understand what they are reading (Snow, 2002).
Regrettably, many students who are deaf at a young age continue to struggle with lower-level
skills, such as recognition of words, syntactic parsing, and understanding vocabulary.
Hence, students with hearing loss do not always develop the independent reading strategies
such as, self-questioning, activating prior knowledge, summarizing the main idea, constructing
representational images, predicting what text will follow, or drawing inferences (Andrews and
Mason, 1991; Strassman, 1992).
Reading could be developed, and needs to be taught to the children who are hearing impaired.
“I would introduce into the very youngest classes the practice of reading regardless
of the fact that children may not understand meaning of the words on the printed
page before them... I would have a deaf child read books in order to learn language...
I believe that in the acquisition of language by the deaf, reading will perform the
function that hearing does for the ordinary child”
...Alexander Graham Bell
Clarifications regarding reading instructions in a mainstream class

Q: Should reading for children with hearing loss be conducted in a separate session?
A: N
ot required in most cases. In fact, reading strategies need to be embedded in all classroom
instructions, but more so in language subjects. However, if a child has specific difficulty in
any one area (e.g. fluency), then individual sessions with the help of resource teachers would
be helpful.
Q: Would mainstream school teachers be in a position to teach or enhance the reading levels
of children with hearing loss?
A: Y
es. The basic strategies of reading remain the same. However, there are certain techniques
like modelling imitation, acoustic highlighting, are necessary for teaching reading to a child
Q: W
ill the performance of other children be hampered if reading strategies for children with
hearing loss are used?
A: N
o. In fact the techniques and strategies used to enhance reading of a deaf child would be
helpful to all children. It would especially help other typical children who are poor readers.
2.1 Strategies and Techniques for Developing Reading and Writing
Reading is the process of constructing meaning from the text. It involves five basic core
abilities: phonics, phonological awareness, fluency, vocabulary and comprehension.
Table 9: Five Basic Core Abilities
Components Activities Description Add-on

of reading techniques
Phonics: The Alphabet matching e.g. Activities for young children that Hand cuing AVK
relationship look and say sound help them to learn sounds and (Auditory, Visual,
between written symbol relation associate letters to sounds Kinesthetic)
and spoken letters Modelling
and sounds. imitation


Phonological Blending and segmenting Activities conducted to create Acoustic

awareness: The sounds awareness about consonant highlighting
knowledge and vowel/consonant combinations
manipulation of
sounds in spoken Auditory feedback
words.
Word games Students match spoken

words to written words while
reading.
Rhyming games Children group words by a

common sounds
Syllable games Students divide words into parts

or chunks i.e. syllables
Fluency: The Audio assisted reading Children read along with the Pausing and
ability to read audio recording or audio tape waiting
with accuracy and by moving their finger along
with appropriate each line
rate, expression
and phrasing Choral reading Children undertake loud reading
together in a group
Paired reading Students read aloud to each

other mostly in pairs
Shared reading The teacher supports or guides

students who share the reading
of a book or other text
Vocabulary: Labels and categorisation Helps children group words Pre-teaching

The knowledge according to some common vocabulary
of words, their characteristics (e.g. living, food
definition and habits, etc.)
context Repeated
Word hunts Students focus on spelling and exposure to words
hunt for other words.
Word maps Helps develop definitions,

synonyms, antonyms, word or
concepts
Word walls A collection of words displayed

in large visible letters on a
wall, bulletin board, or other
display surface (e.g. soft
boards)
Root analysis Teaches essential word

strategies that enable students
to unlock the meaning of
vocabulary words e.g. prefix
and suffix
Comprehension: Predicting Students use information from Keyword method

The overall graphics, text and experiences Making
understanding i.e. to anticipate what will be read/ connections
the meaning of viewed/heard and to actively
the text adjust comprehension while Questioning
reading/viewing/listening.
Concept map A visual/graphic organizer

that enriches students’
understanding of a new
concept. Students think about
the concept in several ways.
Story maps Graphic organisers are provided

to students which help them
learn/identify story characters,
central idea, setting etc.
Visual imagery Students are encouraged to use

prior knowledge and background
experiences to create mental
images as they read.
Listen-Read and Discuss Students listen to the teacher

then read a text. After reading,
they discuss about the topic.
During the discussion, students
compare and contrast the
information which they heard
and read.
Summarising Students identify and

accumulate the most important
ideas and restate them in their
own words.
2.2 Add-on Techniques
Hand cues are mostly used by teachers to alert children with hearing loss to the fact that
someone is talking to them, and that they need to pay attention and listen. Teachers use
hand cues to slightly cover the mouth, but take care that acoustic information is not adversely
affected by the hand cues. Hand cues are also used to prompt the child to respond, either
through imitation or spontaneous speech.
Acoustic highlighting is the speech used when talking with young children with hearing loss
to make the speech more audible. This helps them in learning language and contextually
understand the language. Teachers highlight the sounds in a word or words in a sentence,
and while doing so change the rhythm; stress certain components in a sentence i.e. the supra
segmental aspects in a spoken language.
Modelling imitation is a technique that could be used for speech or language teaching to
children with hearing loss. For those children who do not utter or sign a grammatically
correct sentence, the teacher can model the sentence in whole or in parts. Peers could also
participate.

Auditory feedback is used to encourage children to imitate or use spontaneous speech by

matching their voice production with the speech patterns of others thus monitoring their own
speech production. Besides this direct auditory feedback, children receive indirect feedback
from the listener’s reactions to their vocalisations and speech, which further reinforces the
quality of their production.
Pausing and waiting: Children with hearing impairment may take longer to process auditory
information, so the technique of pausing and waiting with anticipation encourages a child
to listen and follow through with a task rather than waiting for the speaker to repeat. To
emphasise listening, pause and then ask, “What did you hear?”
Auditory, Visual, Kinesthetic (AVK): Auditory path is considered to be best for learning to learn
new words and phonics. So speech/language is first presented through hearing, then visually
and finally, kinesthetically (in tactile mode). This sequence is called AVK.
Enhancing reading skills of children with hearing impairment

Mr. Cross swats a fly!
Mr. Cross was always angry. He was always angry with his family and friends. He lost his temper
now and then. He shouted at his wife and children. He shouted at his friends too. So they all
stayed away from him, as far as possible. This made him angrier.
When teaching the above text, the teacher can begin by drawing the student’s attention to the title
by asking “who do you think is the story about?” Children may say “Mr. Cross or Fly.” The teacher
should next ask to guess the meaning of the word ‘swat’. For children with hearing impairment,
the teacher could use the hand cue to indicate that it is a new word. She may additionally write
the word ‘swat’ on the board and draw one single line beneath the word to indicate that it has one
syllable. The teacher could later inform the students that the word ‘swat’ is also an acronym, related
to the army, Special Weapons and Tactics (Swat). She could give examples of various acronyms.
Next, the teacher could reference the word swat and the name Mr Cross. Depending upon
the level of the children, the teacher could undertake loud or silent reading. For children with
hearing loss she could assist by reading aloud to him/her. She could further discuss the term
‘stayed away’ by using it in a known context. For example, “Rohan had got measles so all
stayed away from him.” Next the teacher could discuss why all stayed away from Mr. Cross.
For a child with hearing loss it would be good to ask who ‘all’ are. Similar strategies could be
used for teaching the phrase ‘lost his temper’ ‘every now and then’ ‘and as far as possible’.
See entire Story of Mr. Cross in Annexure 8.

Source: Balbharti English Textbook, 2013.
Auditory training
Voice inflection: The teacher can cover her lips and say a sentence and ask the child with
hearing impairment to guess whether what she said was a statement, command, request or
question.
Discrimination of environmental sounds: The teacher can play audio sound and ask the child
to guess: Is the sound that of breaking a jar or crashing cups, saucers, plates, bowls? Is the
sound a soft buzz of a fly or a loud buzz or even a louder buzz?
Speech teaching: Read with proper intonation i.e. pause, rhythm, stress and inflections. May
require modelling imitation of high frequency sounds like /sh/ in shoo.
Creative writing: Write a letter to the Mayor or write an essay on ‘If I was a fly’.
3. Developing Writing Skills
The act of writing is a cognitive process that involves comprehension of ideas, expressive
language, and mechanical skills (Dorn, Soffos, 2001). Writing incorporates both cognitive
and motor capabilities occurring simultaneously. According to Gunning (2008), writing
evolves from pre-speech gestures children make and from the language they hear and later
use. According to Giddens (2009) using Gunning’s idea that writing develops from language
children hear and use, it would make sense that children who have incomplete access to a
language would therefore have problems in the development of written language. Children who
have hearing loss have differing access to sound, which depends on many different factors.
Since the access to sound is some way impaired, then access to spoken language would also
be affected to some degree. As access to spoken language is impeded so the development of
written language is also impacted in some way. Most children with hearing impairment would
have the basic mechanical skills of writing skills that include scribbling and drawing. Tracing
and copying would also not be an issue; however activities such as dictation or creative and
independent writing always poses a challenge to them.
Early writing skills include writing letters through listening or writing the beginning, middle or
ending phoneme of words. Children in kindergarten are also required to spell words with or
without writing prompts. The following tips would be helpful to teachers who have a young
child with hearing loss in their classrooms:
For ruling out any visio-perceptual issues, provide figures, colours, letters, words,
phrases and short sentences for the child to copy.
Check for the finger-thumb opposition.
Check if the child is aware that writing is from left to right.
Make sure that the student has strong letter recognition skills, knowledge of syllables
and is able to construct “consonant vowel consonant” combinations.
For developing and assessing writing skills, the following could be used:
Completing the word with prompts and gradually reducing prompts with pictures
alongside.
Creating a word wall with common sight words that children need to use in writing.
Integrate writing activities with all other subjects including drawing or painting.
Have students draw anything they want and write a sentence or words describing the
picture. Do not focus on capitalization or punctuation or grammar until later in the year.
Use guided writing strategies such as experienced based words, lines and paragraphs
for e.g. after a birthday celebration in the class prepare worksheets based on it and
ask the students to write missing letters, words, sentences for pictures based on the
celebration.
Challenges and strategies for creative/independent writing

Generally, creative, independent writing processes include stages such as pre-writing or
planning phase, composing, revising for clarity and organization, editing, and publishing.
Brokop and Persall (2009) have suggested the following strategies to address challenges faced
by deaf children at various stages of writing: pre-writing, vocabulary for writing, composing,
revising, and editing.

Pre-Writing
Challenges: Limited language proficiency and vocabulary to express length and breadth
of ideas. Spelling is another challenge as it requires combination of phonemic awareness,
morphemic awareness, and visual memory.
Brainstorming: By undertaking a group brainstorming in the form of recording all ideas

generated by the group a teacher puts all that is expressed on a whiteboard or flip chart
paper. It becomes effective as this not only helps to generate ideas, but also gives the child
with hearing loss an opportunity to build on the vocabulary and labels connected in to the
topic. It also gives an occasion for modelling and exposure to the grammatical structures and
communicative language.
In another variation groups can be formed. One student of the group writes an idea, another
reads it and adds feedback and his or her own idea, and then passes it on to another. If
computer labs are available discussion boards could also be arranged by pairing a child with
hearing impairment with a typical child.
Vocabulary for writing
Challenge: Significantly limited vocabulary knowledge; they learn new vocabulary at a slower
rate than their peers.
Knowledge model: While teaching a new target word, the teacher may discuss additional
meanings of the word. This strategy entails always connecting the “unknown” or “new” with
existing knowledge.
Vocabulary web: It includes synonyms, antonyms, and derivations of the new word. The
teacher can add categories, including phrases that incorporate the target word, idiomatic
expressions, or related grammatical forms.
Composing
Challenge: Lack of understanding of difference between different types of texts like narrative,
descriptive, direct, expository and argumentative.
Strategies: Use of Mnemonics for composing. For example:

C-SPACE – Generating content for story writing (MacArthur and Graham, 1993)
C = characters, S = setting, P = problem or purpose, A = action, C = conclusion
E = emotion
PLEASE Strategy – Paragraph writing (Vaughn, Bos, and Schumm, 2003)
P = Pick the topic, audience, and paragraph type. L = List information about the topic
E = Evaluate whether the list is complete and determine how to order the items in the
list. A = Activate your writing by starting with a topic sentence. S = Supply supporting
details in sentences, using items from list. E = End with strong concluding sentence
and evaluate the paragraph by revising and editing.
TREE Strategy – Essay writing (Vaughn, Bos, and Schumm, 2003)
T = Write a topic sentence. R = Think of reasons o support the topic.
E = Examine your reasons. E = Think of ending, or conclusion:
Revising
Challenge: Inner voice for detail or explanation or clarify their thoughts where students expand,
combine, rework, or eliminate phrases and sentences to make the text clearer.
Strategy:
Collaborative approaches where students with hearing impairment are grouped with
hearing students.
Specific feedback on a regular basis from teachers and peers.
Editing
Challenge:
Difficulty with grammar as students with hearing impairment do sequential
transmission of language.
Grammar of spoken and sign language is different.
Strategies:
Grammar practice workshop supplemented with concept explanation in writing.
Practice with sentence structure strips like jumbling up words and asking students to
put in correct word order.
An editing checklist for error and rules (see Table 10) could be made on charts.
Table 10: Sample Editing Checklist
Error Rule Example
I played with ball red Adjective comes before the noun I played with a red ball
I wondering Double-check words that end with “ing.” If they I was wondering
are acting as verbs (action) they need to include a
helping word in front. I need to decide if the verb
is present, past, or future, and then pick the right
form of the verb “to be.”
4. Teaching Mathematics
Mathematical concepts can be learned by children who are deaf or hard of hearing in the same
sequence and manner as by their hearing peers (Meadow, 1980). However, various factors
may prevent them from successfully constructing mathematical knowledge. Students may lack
general vocabulary and the basic mathematical vocabulary needed to be able to understand
math concepts/processes. Incidental learning, of mathematical concepts such as “in front
of/behind” or “heavy/light” is sometimes missed out by them due to hearing loss and if not
formally taught. If the child with hearing impairment and others in his or her environment do
not communicate with each other effectively, they will not be able to engage in mathematical
processes such as problem-solving, developing logic and reasoning, and communicating
mathematical ideas. Cognitive development also gets delayed in case of children with hearing
loss as they are not introduced to a diversity of mathematical experiences along with a rich
language base (Ray, 2001).

Strategies for mathematical instructions

Provide meaningful situations and enriched experiences with opportunities for
exploration and problem-solving.
Provide effective vocabulary, label objects and also pre-teach mathematical concepts
and ideas.
Consider parents as equal partners as home situations provide limitless opportunities
to explore and discuss math concepts during daily routines.
For teaching concepts such as fractions, etc. manipulative, verbal, pictorial, and symbolic
modes so also integrating it with drawing and craft activities will be effective.
Word problems could be introduced with informal stories or dramatization and then
translating into the math problem.
ACTIVITY
Inclusive Teaching
Materials Required: Grade 3 and 4 NCERT Books in Social Science as well as Math; waste
material for creating TLM (leaves, paper rolls, empty boxes, socks, buttons, wool, etc.) scissors,
six paint boxes, medium paint brushes, whistle, glue, fevikol, colored paper, and chart paper.
Instructions
Divide participants into four small groups
Provide the teachers with the NCERT books (any preferred subject).
Request them to plan an inclusive lesson plan for a class with a child with hearing
impairment. Half the groups should plan with Rupa in mind and the other with Rohit—
two eight year olds we met at the beginning of this module.
Let’s meet Rupa and Rohit

Eight year old Rupa and Rohit study in different sections of 3rd grade in the same
school. Both wear hearing aids behind their ears. While teachers are happy to have
them in their class, Rohit’s class teacher has many concerns. Rohit’s speech is not
‘understood’ by other children. Rohit struggles to communicate even in his mother
tongue and uses lots of signs and gestures. His reading and writing skills are not age
and grade appropriate. Rupa on the other hand has no problems in communicating
with others. She speaks fluently in English, Hindi and in her mother tongue, and reads
and writes well.
Ask the teachers to choose a topic of their choice and develop an inclusive lesson,
keeping learning needs of Rupa or Rohit in mind. Each group will also develop
Teaching Learning Materials (TLM) using waste material available
Each group to transact the lesson in front of others in a mock classroom situation
Collect feedback on each lesson from other teachers and discuss
Since every child with hearing loss has a different learning profile, it is the teacher’s role to use
a range of strategies to make the curriculum more engaging and meaningful, “personalising”
learning for each and every student, and creating communities of learners who support and share
in each other’s learning. This includes methods of assessing what the child has learned, which in
turn will inform future teaching strategies.
Annexures
Annexure 1: Ten Common Myths on Hearing

Impairment
Myth 1: A child’s hearing loss cannot be identified unless the child is three years old.
Fact: Hearing loss can be identified even in newborn babies.
India is yet to have a mandatory Universal New Born Screening. Hence, awareness about
deafness needs to be created. Those with a family history of deafness, mothers with
complications during pregnancy and babies who have complications like infantile jaundice,
and/or high fever immediately after birth should be screened for hearing and other disabilities.
Remember early identification can do a lot to avert disabling conditions.
Myth 2: The child will outgrow hearing loss.

Fact: Most children who have damage in the inner ear have permanent hearing loss; it cannot
be outgrown.
If hearing loss is due to a physical obstruction such as wax, then hearing can be restored by
removal the wax. If it is due to an infection in the middle ear it can be treated with antibiotics
and hearing can be restored. However, many children have hearing loss due to damaged hair
cells in the inner ear. These hair cells cannot be regenerated; hence, in these cases, hearing
loss is permanent and cannot be restored. Using hearing aids will help the child to minimise
the disabling effects of hearing loss.
Myth 3: Hearing aids/cochlear implants should be fitted when the child grows old enough
to handle it.
Fact: There should be no gap between identification of hearing loss, fitting of hearing aids,
and language intervention.
Early identification and support holds the key to successful development of spoken language
and communication skills. Hearing aids can be fitted even in infants and they often begin
to enjoy hearing from them. While cochlear implants can assist communication needs
early-on, many deaf people have also raised ethical concerns about their surgical implantation
in young children, for example in relation to fully informed consent and the use of sign-
language as the first language.
Annexures | 59
Myth 4: A child with hearing loss should attend special school.

Fact: Many children with hearing impairment are successfully studying in mainstream
schools.
RTE (2009) mandates neighbourhood schools and suggests making schools inclusive and
responsive to the needs of all children. A child with hearing loss also has the right to education
in a mainstream school for which the school has to make accommodations, modifications and
adaptations. This allows the child with hearing impairment to participate in school like any
other child in the class.
Myth 5: Children with hearing loss are a homogeneous group; all of them exhibit similarities
in terms of educational challenges.
Fact: No two children are alike and hence no two children with hearing loss can be alike.
Children differ in their degree and type of hearing loss, cognitive abilities, socio cultural
backgrounds, learning styles and their strengths and weaknesses. Children who receive support
early after identification of their hearing loss will exhibit different levels of performance then
children who may have not received such support.
Myth 6: Hearing impairment can be ‘cured’ by using a hearing aid.

Fact: Hearing impairment is not a ‘disease’ to be cured.
Hearing impairment is a result of difficulties in the auditory pathway of the ear, which can
be restored or compensated to some extent by using a hearing aid or undergoing a cochlear
implant surgery. These devices do not correct hearing loss in the way glasses correct vision.
They amplify sound to varying degrees. However, hearing difficulties may still be experienced
by the person with hearing aids or a cochlear implant.
Myth 7: Teachers should speak loudly while talking to a child with hearing impairment.
Fact: Speaking loudly to a child using an amplification device such as a hearing aid or a
cochlear implant can cause pain to the child’s ears, distort the sounds and also damage the
speaker’s voice.
Hearing aids amplify the speech, so speaking at a normal tone and level is beneficial to a child
with hearing impairment. The rate of speech needs to be kept normal avoiding exaggerations
such as jaw dropping or getting very close to the child. Talking in simple direct speech is
always recommended.
Myth 8: Children with hearing impairment have ‘lower’ cognitive abilities.

Fact: Many children with hearing impairment perform very well in school.
Language—the gateway to knowledge—may be affected in deaf children. This may in turn

create language difficulties which may impact reading and writing. However, with adequate
support these difficulties could be overcome, and children could be guided to read and write.
Myth 9: Many people think everyone who is hearing impaired or deaf uses only sign language
to communicate.
Fact: Not all people who have hearing impairment use Sign language to communicate.
Some may use sign language, some may prefer to be oral i.e. may speak, while some others
may use a combination of speaking and signing called ‘Total Communication’. People with
hearing impairment use modes of communication that are different from those used by the
majority population.
Myth 10: Children with hearing impairment cannot go to college.

Fact: Many children with hearing impairment succeed academically.
Students with hearing impairment have full potential to achieve great heights if the right
supports are provided to them at the right time. The Government of India has also made
provisions of 3% reservations and schemes such as HEPSEN has been initiated to promote
higher education of persons with disabilities.
Annexures | 61
Annexure 2: Classification of Hearing Loss

1. Degree of hearing loss
Source: Eisner (2012) University of Illinois at Urbana-Champaign
The figure above will help to understand how range of hearing measured by decibels (dB)
determines the degree of hearing loss.
Degree of Range of Characteristics

hearing loss hearing (dB)
Mild 26- 40 This degree of hearing loss may often go unnoticed. Children
with mild hearing loss may be a bit un-attentive in class.
Teachers may feel they are poor in academics. Some amount
of language delays is expected. Missing of parts of words is
also common. If left unattended, children may have speech
errors like difficulty in articulating /a/ for /k/. Less severe loss
is more harmful as it goes unnoticed; such children may
unnecessarily be labelled a slow learners.
Moderate 41-55 Moderate hearing loss may also go unnoticed, especially for
those at the lower end of the range of hearing. Apart from
being un-attentive, children with this degree of hearing loss
may have difficulty communicating. If the loss is undetected,
and if children are not wearing aids, they could also have
misarticulated speech and a limited vocabulary. Children
will find it difficult to follow oral instructions and may make
mistakes in class dictations.
Moderately 56-70 As the degrees of hearing loss increases, access to oral

severe information decreases. Without the use of hearing aids,
children will find it extremely difficult to understand others.
Apart from speech and language difficulties, children may also
have a different voice quality i.e. they may talk in high pitch or
nasality.
Degree of Range of Characteristics
hearing loss hearing (dB)
Severe 71-90 Children with severe hearing loss, who have received any
support in early years of development may have no speech. If
using hearing aids, it is likely that they make speech errors.
Difficulty in understanding others may lead to avoidance of
communication with others. Reading and writing difficulties
frequently result in academic failures.
Profound 90 and above Speech and language delays are likely for children with
profound hearing loss. Children may ‘read lips’, or use sign
language.
2. Site of lesion
a. Conductive hearing loss
Why does it happen? The outer ear and middle ear conducts sounds to the inner ear. Defect
or dysfunctioning in the outer or middle ear hampers the conduction or transmission of sound
and hence is called conductive hearing loss.
Sometimes small children may put cotton balls or chalk, paper bits or beads/beans etc. in the
ear canal. This may also block or plug the hearing. Remember, wax is essential to protect ears
so one should not unnecessarily remove it. In some children there may be infection resulting
in inflammation or ear discharge also causing perforation of ear drums. These may cause
blockage or obstacle in the path of sound propagation. The child should be referred to an
Ears, Nose and Throat (ENT) doctor, who will properly guide in respect of wax and infection
or perforation.
Implications, characteristics and management: Blockage due to obstruction as mentioned

above could result in mild hearing loss. Such children may miss out in some classroom
instructions and be temporarily inattentive. Once the obstacle-causing object is removed and
attended, their hearing will be restored.
Annexures | 63
b. Sensori-neural hearing loss
Why does it happen: The inner ear is made up of a very tiny but important sensory organ called
cochlea. The cochlea is snail shaped and is filled with fluid. It also has very tiny hair cells, which
transmit information to the auditory nerve which in turn carries it to brain for interpretation.
Defects or damage to the sensory organs or nerve causes sensori-neural hearing loss.
Implications, characteristics and management: Damage or defective inner ear results into
severe or profound hearing loss. This is a permanent loss to the hearing and can only be
managed by use of an appropriate hearing aid and intensive language intervention. Cochlear
implant are a surgical insertion of electrodes into cochlea and is proving to be very effective in
improving hearing reception. Children with sensori-neural hearing loss are commonly found to
have profound hearing loss and hence require good support services in mainstream inclusive
classrooms in terms of preferential seating, room acoustics, audio visual teaching aids,
adaptation of curricula and teacher sensitivity for differentiated instructions. It is generally a
good practice to face the child while speaking in order to optimize the speech reading.
c. Mixed hearing loss

Why does it happen? When both sensori-neural hearing loss and conductive hearing loss are
present the result is a mixed hearing loss. This is also a kind of permanent hearing loss due
to the inner ear damage.
Implications, characteristics and management: This will be the same as stated for sensori-
neural hearing loss.
d. Central Auditory Dysfunctioning
Why does it happen? This type of impairment is not necessarily accompanied by a decrease
in hearing sensitivity but children will have problems of auditory comprehension. It can simply
be explained as if the brain doesn’t hear what the ears hear. That means both the ears
and brain aren’t fully coordinated with each other. It is frequently associated with learning
disability. Hence, it has become common audiological practice to perform a central auditory
test battery on children who have been diagnosed as having a learning disability.
The cause is not really known. However, head trauma, tumors, degenerative disorders,
childhood viruses, recurring ear infections, oxygen deprivation, lead poisoning could cause
this disorder.
Implications, characteristics and management: Children may have difficulty with noise, may
ask frequent repetitions, make mistakes in spellings, and reading. Their language may not be
age appropriate too. Understanding children communication mode, computer assisted learning
and individualized attention are some of the strategies that help.
3. Age of Onset
a. Congenital Hearing Loss
Hearing loss occurring prior to birth of a baby is termed as congenital hearing loss.
Why does it happen? This loss could be due to hereditary factors or could have happened due
to complications arising out of pregnancy of the mother or at the time of delivery.
Implications, characteristics and management: Babies born with hearing loss of any degree
will surely miss out on the sound world. Babies learn to understand the language of the family
due to small routine interactions and the mother’s routine ‘talk’ during the activity of feeding,
bathing etc. Slowly babies start using the language of the family meaningful i.e. they speak.
Children with congenital hearing loss can hence be expected to have delayed language. When
they come to schools they may not have age appropriate language and speech. Management
will be intensive language training, use of appropriate communication options and emphasis
on visual learning material.
b. Acquired Hearing Loss
Why does it happen? Acquired means hearing loss has occurred any time after birth of a child.
This could be due to injuries or infections of the ear.
Implications, characteristics and management: The impact and management varies according
to the degree or type of loss. The silver lining here is that the children would have had some
time after the birth or childhood, where he/she may have got a chance to develop language
and speech. These children would be mostly oral speaking kids. They may have developed
speech already. However may rely on lip reading skills. Noise will be distracting to them as it is
amplified by their hearing aids. Teachers may have to take care of their listening environments.
Use speech to text and text to speech material
c. Pre-Lingual Hearing Loss
The term pre-lingual suggests that the hearing loss has occurred prior to the completion of the
basic language acquisition process. The language acquisition age is 0 to 5 years of age. So
any loss occurring between this age group is termed as Pre-Lingual hearing loss. The reasons,
implications, characteristics and management will be the same as congenital hearing loss.
Annexures | 65
d. Post-Lingual Hearing Loss
The term post-lingual suggests that the hearing loss has occurred after the completion of
the basic language acquisition process. So any hearing loss occurring after the age of 5
years is referred to as Post-lingual hearing loss. The reasons, implications, characteristics and
management will be the same as acquired hearing loss.
4. Causal factors
a. Pre-natal hearing loss
Natal means birth and so pre-natal refers to before birth. So hearing loss happening in the
womb of the mother is called pre-natal hearing loss.
Why does it happen? The vital organs of hearing and brain are formed of the embryo in
the mothers’ womb during the first trimester (first 3 months of pregnancy). Hence mothers
contracting infection such as German measles (Rubella), tuberculosis, meningitis etc. or use
of drugs or medicines which are ototoxic may lead to pre-natal hearing loss in the babies.
Implications, characteristics and management: Children having pre-natal hearing loss will be
congenitally born deaf. They will not hear spoken language naturally, hence all those efforts
taken for a congenital or pre-lingual hearing loss will be applicable to these children also.
b. Post-natal hearing loss
Post-natal means after birth, hence hearing loss occurring after birth is termed as post-natal
hearing loss.
Why does it happen? The vital organs of hearing and brain if damaged or injured after the
birth causes post-natal hearing loss. This may be caused due to infantile jaundice or fever etc.
It is also caused sometimes due to fire crackers bursting aloud near the babies or may also
result due to fall or accidents.
Implications, characteristics and management: Children having post-natal hearing loss are
also termed as acquired hearing loss children. If they acquire a severe or profound degree of
loss before language acquisition, it becomes detrimental to language development impacting
academics. So depending upon the severity of degree and type of post-natal hearing loss
appropriate measures mentioned above could be undertaken.
c. Noise induced hearing loss
Noise has become a part and parcel of our daily leaving. So much so that people living near
airports or railway tracts do not even notice it.
Why is it caused? Very loud sound of 4000 Hertz or more from an explosion may cause
temporary loss of hearing. However, constant exposure such noise could make it permanent.
People living near airports, industries, looms where cloth is woven are known to cause hearing
loss to children and adults. Excessive use of mobile phones, loud music for more than 85 to
90 dB is injurious to hearing health.
Implications, characteristics and management: Temporary hearing loss will be disappears

after proper rest and avoiding excessive exposure noise, so that is the only thing that teachers
could do. If loss is of a permanent nature, then depending upon the degree and site of lesion
as specified above, appropriate measures as could be undertaken.
5. Nature
a. Sudden hearing loss
It is a type of hearing loss in which the child’s hearing was normal and suddenly the child
stops hearing or responding.
Why does it happen? Shock, falls of severe nature, accidents or war affected areas having loud
explosions may cause a sudden hearing loss.
b. Gradual hearing loss
A child who had normal hearing but slowly losing it is termed as gradual hearing loss.
Why does it happen? Children with prolonged infections or constant exposure to noise will
eventually develop a gradual hearing loss.
Implications, characteristics and management: Gradual hearing loss can be difficult to detect,
but the first signs usually include difficulty following conversations amid background noise,
trouble understanding higher-pitched voices and needing to turn up the volume on the TV.
Academically teachers may notice such children facing isolation and children themselves
avoiding conversations with others. Understanding oral communications and directions slowly
starts affecting and they may start losing interest in participation. Referral to an audiologist
will be helpful and other measures specified for seating arrangements, noise free atmosphere
etc. will be will be beneficial.
Annexures | 67
Annexure 3: Strategies for Overcoming Likely

Barriers
Classroom Likely barriers Overcoming barriers
interactions
and activities
Permission for Teacher may not understand the A general classroom rule could be made
entering class or child’s speech seeking permission to knock on the classroom door to catch
Principals room to enter the class. The child may the teacher’s attention. Teachers can
also miss out on the teacher also signal/gesture for student to ‘come
instructing him/her to enter the in’.
classroom.
Attendance/Roll Students with hearing Don’t change the order of names too
call impairment may miss out his/ often. If name order is kept the same,
her name while teachers call out students with hearing impairment will
numbers. This is because many find it easier to identify his/her name.
names have phonemes which are
in audible (e.g./she/ in Shashi),
some sound the same (e.g.
Mohan and Rohan), and others
sound the same due to a similar
starting phoneme: /p/b/m/.
Announcements Student with hearing impairment Providing ‘buddy’ or peer assistance

may not only miss out on the is a most effective strategy. Classroom
content of an announcement, but instructions could be written on the
may also not realize that there board.
are common announcements A displaying panel showing the
from the principal’s office about matter announced; a glowing lamp
change in timings or visitors in like an alarm located near the black
school or dress code of a board so that the child knows when
special day. announcements are being made.
Prayers time Students with hearing National Anthem and prayers could also
impairment may not be able be sung in Sign Language. Student with
to sing the national anthem or hearing impairment could be given a
school prayers at the same pace place facing the row monitor to make
as others. it easier to lip read and maintain the
pace. Row monitors could be changed
so that all children get a chance to be
the ‘buddy’!
Assembly School assemblies have speeches For Sign language users an interpreter
and lectures, which students with would be useful.
hearing impairment may find In the absence of an interpreter the
difficult to hear and comprehend. content matter of the speech could be
provided in printed form to the student.
Subject classes Subject teachers are different for Teachers could be trained to lower
each subject. Each teacher has a their rate of speech, face children while
different teaching style. Adjusting explaining and using more of audio
to speech reading of different visuals.
teachers becomes difficult for a Digitized classrooms benefit all
student with hearing impairment children as teachers can make use of
if teachers change too frequently. PPTs, videos, etc. to supplement oral
explanations.
interactions
and activities
Art and craft Students with hearing impairment A clock in the art room will be helpful.
classes are very creative; they work with The art teacher could keep checking
concentration and perfection the work and reminding the child of
and hence are less distracted. the remaining time. Making a small
However, they may lose out if
an activity is time bound. Many demonstration of steps to be undertaken
art and craft teachers give oral for a craft activity or showing a sample
instructions, which may not be of the finished product will be beneficial
‘understood’ by the student. to all students in the class.
Physical Students with hearing Drums are audible due to low

Education and impairment enjoy and excel in frequency and hence could be used
sports physical activities; however, oral instead of whistle.
instructions are often a barrier. Physical instructors could be sensitized
Many sports teachers blow a to use colored cards or hand signaling
whistle to signal the start/end of along with whistles.
a game or an activity. A whistle
Score boards could be used for
has a very high frequency and
displays like stadiums which will
are not audible to students with benefit the whole school.
hearing impairment.
Sensitization about care of person using
hearing devices is especially important
as the devices are very expensive.
Tiffin time/ Students with disabilities Sensitization to peers about importance

Recess time encounter barriers in of inclusion and having ‘best buddy
understanding jokes and take award’ may help to create incentives to
time to understand rules of involve students with disabilities.
games of other students during
Tiffin or recess times. This may
lead to social isolation.
Library time A library has rules around Rules of book issue and return could be
book issue and return. They displayed on a board in the library. The
are noise free and require librarian could make use of a simple
silence. Whispering is a difficult calendar to indicate how many days a
skill for students with hearing student can keep a book.
impairment. Good light in the library will not only
help readability but will also help
speech reading personals.
Posters of silence if displayed will help
students with hearing impairment to
understand that they need to be quiet.
Laboratory work Laboratory technicians Signage for use of laboratory apparatus

sometimes give only oral and procedures written step by step
instructions for use of equipment if displayed will be beneficial to all
or carrying out an experiment. students including students with
A student with hearing hearing impairment.
impairment not fully understand It is beneficial to all students if a small
oral instructions. Laboratory demonstration is given by the laboratory
technicians might also speak and technician.
manipulate objects or perform Posters of dos and don’ts in a laboratory
a task simultaneously. Students will also be of a general help to all
with hearing impairment may students.
not completely understand the Doing one step at a time, then speaking
process due to split attention. about it or vice a versa will help.
Annexures | 69

interactions
and activities
Functions and As part of co-curricular activities, Students with hearing impairment can
festivals in schools organize competitions, be motivated to say dialogues through
school festivals and other functions that peer tutoring or by drilling and practices
include performing arts such to say dialogues.
as dance and dramas. Due to
communication barriers, students
with disabilities are often not
given a role—or at best, given
a very insignificant one such as
becoming a tree in a stage act or
a servant who does not have to
speak.
Outreach and Community activities, such as Pamphlets could be designed for

extension awareness about cleanliness or such activities which the students
activities water and energy conservation will distribute and this would be
are fun for all children and also supplementary or supportive to their
broaden their social horizon and communication. This will help to avoid
commitment. Outreach activities communication issues.
are also some times undertaken
by schools for fund raising. These
may require communication with
the general public, which may
create embarrassments due to
misinterpretations for the student
School Communication barriers of Social workers and school counselors

administration students with hearing impairment may specially be assigned the work
including paying may lead to misinterpretations of assisting students with hearing
fees, filling and cause delays in payments impairment and their families.
scholarship of fees. Reading comprehension
forms etc. may also cause a barrier in
filling up of forms etc. for higher
class students or those who are
children of deaf parents.
Annexure 4: Communication Options
Oralism
The philosophy which desires to develop verbal language in the deaf children through aural-
oral mode is referred to as Oralism.
Emphasis on Speaking: Children who come from an Oralism background use auditory
(listening) modalities. They are also called verbal or oral kids as they speak and some also
speech/lip read. Hearing loss in such children would have been identified early and they would
have been fitted with good quality hearing aids or cochlear implants at an early age. Their
parents would have taken efforts to teach them to speak and read at a young age. There are
two prominent methods under this approach:
Auditory/Oral method emphasises listening through the use of hearing aids, and use
of techniques that support the development of audition and spoken language. Some
auditory/oral education therapy programs also have a strong visual component. In
other words, there is an emphasis on using visual techniques to teach speech. In
some cases, speech (lip) reading skills are used as a supplement to hearing.
Auditory-Verbal method is similar to the auditory/oral approach in that there is a
strong emphasis on maximizing a child’s residual hearing and his/her ability to use
it. The primary goal is to provide adequate support to the child’s development and
integration of listening and spoken language into everyday life. The Auditory-Verbal
approach also supports a child’s participation in regular classroom placements as
soon as possible. Certified Auditory-Verbal Therapists (AVT) provide individual therapy
sessions in their centers and also coach their parents or caregivers to teach their child
how to communicate using spoken language.
Total Communication
The philosophy which incorporates all means of communication including speaking, speech
reading, signing, use of writing is referred to as Total Communication.
Emphasis on communication: Unlike Oralism, Total Communication (TC) follows an eclectic

approach i.e. doing whatever works best for the child and emphasizes communication in
any form. It supports the use of all modes of communication and language as needed in
differing contexts. The intention of this philosophy is to provide a deaf child with any and
all strategies necessary to support his/her development of communication and language. It
does not intend to incorporate equally or used at the same time all the strategies.
Fingerspelling is a method spelling each letter alphabet using hand and finger movements.
Fingerspelling is used to spell out names of people and places for which there is no sign,
for words for which signer does not know the sign for, and/or to clarify a sign that is not
known by the person reading the signer. Given below are Fingerspellings as per Indian Sign
Language (ISL).
Signed system is based on a verbal language wherein every word is signed separately. It is
used along with speech. Hence, it is Also Called Simultaneous Communication (SIMCOM).
One has to speak while signing. In signed system, each morpheme has a manual sign.
Annexures | 71
Example: “The boys played cricket.” In this sentence, there will be total 6 signs for (the, boy,
s, play, ed, cricket). Here is another visual example.
Children Like Going to School
Educational Bilingualism
The philosophy which desires to develop both –a manual language i.e. Sign Language and
one or more oral i.e. spoken language for e.g. Hindi. Marathi, English etc. in deaf children is
referred to as Educational Bilingualism.
Bilingualism is similar to TC, in the sense that both involve the use of signs and sign language.
However, bilingualism makes use of sign language to substitute speech. TC advocates sign
system along with speech and Bilingualism advocates sign language instead of speech.
“Bi” meaning two, so bilingual education is a combination of proficiency in both a Sign

Language (Indian Sign Language (ISL)/American Sign Language (ASL) and any other spoken
language such as Hindi/English/Marathi/Gujrathi). These languages could be addressed
through both print and spoken medium with the assistance of an interpreter. Advocates of
Bilingual education believe that for deaf children sign language is only the first language. On
the basis of sign language, they can learn any other verbal language as second language
Indian Sign Language (ISL) is used by Indian deaf individuals. There are some variations in
vocabulary in different parts of the country. (Work Book- A Level, AYJNIHH).
This House My
Other sign languages: Like ISL in India, other countries of the world have their own
independent sign languages e.g. United States has American Sign Language (ASL), and the
United Kingdom has British Sign Language (BSL), etc. Sign languages do not encourage
speech and is considered an independent language.
Annexures | 73
Annexure 5: Software for Teaching Speech for

Children with Hearing Impairment
1. Speech Therapy
There is different software available for speech therapy. Software is used for evaluation
of speech sounds and voice as well as fluency. During intervention, speech exercises are
taken with the help of an animated programme. Details about some software are given
below.
VAGMI professional, a window-version programme, helps in Voice, Articulation and

Fluency therapy. It provides visual feedback of the voice production process. It includes
very interesting games with visual clues, which stimulate the speaker to complete a given
task. The performance is scored and a goal can be set to help the child to learn with
interest. The software is quite effective and also time saving.
Dr. Speech is developed for speech/voice assessment and training purpose. For
assessment, Dr. Speech clinicians can assess different aspects of speech such as acoustic,
electroglottographic (EGG) and perceptual measures. And for speech therapy, Dr. Speech
includes various colourful interactive games. With the help of these games, the child will
learn different aspect of speech such as pitch, loudness, voiced and unvoiced phonation,
voicing onset, phonation etc.
Screenshot Examples from Dr. Speech
Sound Awareness: Phonation Time Skill Building:

A seesaw moves when there is sound over silence setting Keeping phonation moves the strawberry from left to right
Speech Articulation: Speech Articulation:

Vowel production (vowel/i/) Consonant production (vowel/p/)
Pitch Skill Builder: Loudness Skill Builder:
Pitch controls how the boat moves around the rocks Loudness controls how high the fireman climbs
Voicing Skill Building: Voicing Onset Skill Building:

Voicing mode determines which mice will run Voicing onset mode controls how the flower opens around the tree
My Word is very useful software for children with different communication difficulties. This
software is used for speech and language therapy. Its key features include:
Colourful animated videos and an IPA for each word are used for speech therapy
It covers different aspects of language such as noun, verb, adjective, numerals etc.
Speech production, auditory comprehension, auditory and visual attention memory

can be done using this software.
Speech/voice therapy software is used for changes in pitch, loudness, voicing, voicing
onset, maximum phonation time, sound, vowel tracking and phonetic exercise. Key
features are:
Colourful interactive video games for speech therapy
Biofeedback
Statistical report
Clinical goal settings.
2. Communication
Tools such as internet, email, video calling, fax, text message, chat room, video conference
can be useful for facilitating communication. With help of these tools children with
hearing impairment can communicate with others using preferable communication
options (Oralism, TC. and Educational Bilingualism). Some examples of softwareused for
communication are:
Annexures | 75
Skype
iVisit
ooVoo
Eyeball Chat
Ekiga
3. Emergent literacy
Various software is available for developing emergent literacy skills, such as phonetic, linguistic,
and physical skills, etc. The software could be used for developing emergent literacy skills in
children with hearing impairment. It is particularly helpful for drill work.
Azimpremji foundation educational software (http://www.azimpremjifoundation.org/
E-learning_Resources)
KIDWARE (http://www.kidware.com/mobius/17grops.htm)
4. Sign language
Online sign language dictionaries are available on internet. Particularly useful, is the dictionary
prepared by Ram Krishna Mission Vivekanad University, Coimbatore and can be accessed on
http://indiansignlanguage.org/dictionary/The website includes a downloadable video of a huge
number of signs. Users simply click on word and the video of the sign plays automatically.
5. Subject based software
Content-based subject material is available in the form of e-books. These cover almost all
topics of all subjects up to 12th standard and are available for state board, CBSE board and
ICSE board curriculum. Educational software publishers include:
Navneet publication’s digital classroom
Morya Marketing
Topper PVT LTD
Annexure 6: Concessions
Item Scheme Details
Financial Children’s Educational Reimbursement of Rs 40/- p.m. from class I-X

Allowance (for income slab and Rs 85 from class XI-XII for day scholars
below Rs 2000 p.m.) and Rs 140 for hostellers
Financial Class IX-XII Hosteller Day scholar
B.A./B.Com./B.Sc. Rs 140/- Rs 85/-
National scholarships for B.A./
Rs 180/- Rs 125/-
B.Com./B.Sc.
Professional courses B.E./ Rs 240/- Rs 170/-
B.Tech/Ph.D/M.Phil/ Rs 1000/- Rs 700/-
Engineering/Agriculture/
Vetenary/Management. Rs 700/- Rs 400/-
Financial UPSC/SSC Exams Exempted from payment of application and

exam fee
Scheme of integrated education Books and stationary allowance of Rs 400/-
for the disabled children per annum
Uniform allowance of Rs 200 per annum
Transport allowance Rs 50 p.m.
Reader allowance Rs 50 p.m. for blind children
For hostellers boarding and lodging charges
max of Rs 200 per month
Maintenance Rs 75 p.m.
Financial Scheme of assistance to Diagnosis and fitting of aids and appliance at
disabled persons for purchase/ free of cost up to income slab Rs 6,5000/- Pls
fitting of aids/appliances refer to AYJNIHH website
Financial Birth Right Insurance Scheme New India Insurance Co
Financial On purchase of hearing aids for Reimbursement of the cost of aids
the disabled child
Travel Road/rail/air 50% concession for travel in bus
50% concession for disabled and his escort
in rail
Telecommuni- STD/PCO booths Preference is given to the disabled
cation
Income tax For disabled employees under Exemption of Rs 50,000/-
concession 80 U
Professional tax Disabled employees/spouse/ Exempted from professional tax
parents of disabled
Employment Reservation of jobs 3% for all disabled (1% each for OH, VH, HI)
in group A,B,C and D posts
Age relaxation Relaxation in upper age limit up to 10 years for
for employment appointment to any post
Reservation PMRY and SJSY of ministry of 3% of the allocation are ear marked for PWDs
in self- rural development and poverty
employment alleviation schemes
loans
Reservation in 3% reservation
admission
Annexures | 77
Annexure 7: Auditory Assessment

Auditory assessment is the main area of assessment of listening levels of students with hearing
loss, who use hearing devices and who follow an oral communications approach. Students are
assessed at four stages:
1. Detection: At this stage, the teacher checks to see if student is able to distinguish
between presence and absence of sound in his/her environment. Ability to detect
phonemes, words, phrases or sentences through listening alone is assessed.
2. Discrimination: The second stage assesses the student’s ability to discriminate between
different sounds. Again the student needs to be assessed at level of phonological
awareness, word, phrases and sentences.
3. Identification: This means checking if the student is able to identify the particular
sound, phoneme, word, phrase or sentence.
4. Comprehension: This is the highest stage of achievement. Once the child is able to
identify, the child’s ability to understand the meaning of the message heard needs to
be assessed.
Record the details of the students with hearing loss in the Auditory Assessment chart given
below:
Stages of Phonological Word level Phrase level Sentence

Assessment awareness level
Detection
Discrimination
Identification
Comprehension
PRESENT SPEECH STATUS
Instruction: Spoken language or speech is assessed for improving the speech intelligibility.
Record the vowel/syllable and put a tick mark in the corresponding columns as per quality of
the student’s production. This may be indicated as present, absent or emerging. The teacher
is expected to work on the areas where the pronunciation is absent or emerging.
Vowels/syllables Present Absent Emerging
Annexures | 79
Annexure 8: Story of Mr. Cross
Source: Balbharti English Textbook-Standard Two (2013). Chapter 3- Mr. Cross Swats a fly!. Maharashtra State Bureau of
Textbook production & curriculum research: Pune.
Suggested lessons using the Story of Mr. Cross
The story can be used to teach:
Language/Grammar
Annexures | 81
Degree of comparison: Angry, angrier, and angriest
Type of sentences: Exclamatory, assertive, imperative, interrogative
Contextual use of the word: ‘cross’ (Mr. Cross, cross with the fly)
Questioning: Frame questions for the sentences: He found a large and heavy frying pan
(Who? What?)
Cause and effect: Why did it happen? What happened?

Table for students to complete
CAUSE EFFECT
Why did it happen? What happened?
Mr. Cross hit the ruler at the fly. There was an The inkpot fell and all the splashed. Over the
inkpot on the table. letter.
Storyboard/chain of events graphic organizer: This organizer can be used for helping students
understand how events are sequenced in a story. Students can also describe some of the
details that are associated with each event.
References
Andrews and Mason. 1991. A Review of Evidence-Based Literacy Research with Students
Who are Deaf or Hard of Hearing. Retrieved online on 2nd April, 2015. Available from
http://www.unco.edu/ncssd/research/DHHliteracyreport.pdf
Anderson-Inman, L. and Horney, M. A. 1998. “Transforming Text for at-risk Readers.” In D.
In D. Reinking, M. McKenna, L. Labbo, & R. Kieffer (eds.), Literacy for the 21st Century:
Technological Transformations in a Post-typographical World, 15-43. Mahwah, NJ: Erlbaum.
________________. 2007. Supported e-Text: Assistive Technology through Text Transformations.
Reading Research Quarterly, 42(1), 153-160.
Balbharti English Textbook. 2013. Chapter 3- Mr. Cross Swats a fly! Maharashtra State Bureau
of Textbook production & curriculum research: Pune.
Brokop, F. and Persall, B. 2009. Writing Strategies for Learners who are Deaf. Retrieved
online on 3rd April, 2015. Available from https://www.norquest.ca/NorquestCollege/media/pdf/
centres/learning/CELS-Writing-Strategies.pdf
Comfort, R. 1990. “On the Idea of Curriculum Modification by Teachers”. Academic Therapy,
25(4), 397-405.
deVilliers and Pomerantz. 1992. A Review of Evidence-Based Literacy Research with
Students who are Deaf or Hard of Hearing. Retrieved online on 2nd April, 2015. Available from
Dorn, L. J. and Soffos, C. 2001. Scaffolding Young Writers: A Writers’ Workshop Approach.
Portland, Maine: Stenhouse Publishers.
Dowaliby, F. and Lang, H. G. 1990. Adjunct Aids in Instructional Prose: A Multimedia Study
with Deaf College Students. Journal of Deaf Studies and Deaf Education, 4(4), 270-282.
Gentry, M. M., Chinn, K. M., and Moulton, R. D. 2004/2005. Effectiveness of Multimedia
Reading Materials when used with Children who are Deaf. American Annals of the Deaf,
149(5), 394-403.
Gathoo. V. G. & More. R. (1990). An Adapted Textbook of Geography for Children with
Hearing Impairment. Unpublished book. Education Department, AYJNIHH, Mumbai.
Giddens, E. 2009. Teaching Written Language to Students who are Deaf or Hard of Hearing.
(Masters Thesis). Retrieved online on 2nd April, 2015. Available from http://digitalcommons.
wustl.edu/cgi/viewcontent.cgi?article=1185andcontext=pacs_capstones
References | 83
Graham, J. and Fraser, B. 1993. “Does the Acoustic Environment Make a Difference to Children
with Multi-sensory Impairments?” British Journal of Special Education, 19, 3, 2-3, 114-115.
Gunning, T.G. 2008. Creating Literacy Instruction for All Students. Boston: Pearson
Education, Inc.
Lederberg, A. and Spencer, P. E. 2001. “Vocabulary development of deaf and hard-of-hearing
children” in M. D. Clark, M. Marschark, and M. Karchmer (Eds.), Cognition, Context, and
Deafness. Washington DC: Gallaudet University Press.
Luckner, J. L., Sebald, A. M., Cooney, J., Young, J., and Muir, S. G. 2005/2006. “An
examination of the evidence-based literacy research in deaf education”. American Annals of
the Deaf, 150, 443–456.
Marschark, M. and Harris. M. 1996. Success and Failure in Learning to Read: The special case
(?) of deaf children. In C. Cornoldi and J. Oakhill (Eds.).Reading comprehension difficulties.
Processes and Intervention (pp 279-300). Mahwah, N. J.: Lawrence Erlbaum Associates.
Dye, M.W.G. Hauser, P.C. Bavelier, D. (2009) Is Visual Selective Attention in Deaf Individuals
Enhanced or Deficient? The Case of the Useful Field of View. PLoS ONE 4(5): e5640.
doi:10.1371/journal.pone.0005640
Meadow, K. 1980. Differentiated instructional strategies for mathematics for students who are
deaf of hard of hearing. Downloaded on 1/1/2015. Available from http://www.doe.virginia.gov/
special_ed/disabilities/sensory_disabilities/hearing_impairment/strategies_teaching_math.pdf
National Curricular Framework. 2005. School and classroom environment. Retrieved on
1st October, 2015. Available from http://www.ncert.nic.in/rightside/links/pdf/framework/
School%20and%20Classroom%20environment.pdf
________________. 2005. In Development of exemplar material on curricular adaptation
from the perspective of inclusive education. Report of proceedings. 2013. Downloaded
online on 24th March, 20115 from http://www.ncert.nic.in/departments/nie/degsn/pdf_files/
ReportB%27loreworkshop.pdf
Nelson, K. E. and Camarata, S.M. 1996. Improving English Literacy and Speech-Acquisition
Learning Conditions for Children with Severe to Profound Hearing Impairments. Volta Review,
98(2), 17-41.
Nixon, M. 2002. Assessing The Acoustics In Your Child’s Classroom: A Guide for Parents,
Accessed from: http://www.hdhearing.com/learning/mikenixonarticle.htm
Parton, B. S. 2006. Snapshots of Interactive Multimedia at Work across the Curriculum in
Deaf Education: Implications for Public Address Training. Journal of Educational Multimedia
and Hypermedia, 15(2): 159-173.
Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act,
1995. National Policy for Persons with Disabilities, 2006. Retrieved on 2nd March, 2015.
Right to Education. 2009. In Right of Children to Free and Compulsory Education Act- World
Health Organization. 2001. International Classification of Functioning, Disability and Health.
Wikipedia-the free encyclopaedia. Retrieved on 4th July, 2014. Available from:
http://en.wikipedia.org/wiki/Right_of_Children_to_Free_and_Compulsory_Education_Act
Snow, C.E. 2002. Reading for Understanding: Toward a Research and Development Program
in Reading Comprehension. Arlington, VA: RAND.
Strassman. 1992. A Review of Evidence-Based Literacy Research with Students
who are Deaf or Hard of Hearing. Retrieved online on 2nd April, 2015. Available from
Online
Resources
http://www.classroomhearing.org/acoustics.html
Signed English dictionary

http://sign.com.au/
This website includes a Signed English dictionary of almost 3,000 words. Each word is
illustrated and has a description.
Sign 4 Me
This is a Signed English Translator that can readily be installed on school computers.
More details can be found on https://itunes.apple.com/in/app/sign-4-me-for-ipad-signed/
id383462870?mt=8
Indian Sign Language (ISL)

If interested in learning ISL, Ali Yavar Jung National Institute for the Hearing
Handicapped (AYJNIHH) in Mumbai has a basic level course. For details see:
http://ayjnihh.nic.in/advertisement.asp
Study material of the basic level course (A level in ISL) in video- CDs can be purchased from
Material Development Department (MDD), AYJNIHH, Reclamation, Bandra (W), Mumbai 50.
Online Resources | 85
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Table of Contents | iii

3. Concessions and Facilities for Children with Hearing Impairment 35

In 2000, the Government of India embarked on a massive endeavor to universalize elementary

Director: Amit Dar

Table 1: Overview of the module

CONTENT METHODOLOGY EXPECTED OUTCOMES

Unit I: Understanding Students with Hearing Impairment

1. Definition and Presentation, group work, Teachers will be able to:

1. Communication barriers Group activity, Teachers will be able to describe

CONTENT METHODOLOGY EXPECTED OUTCOMES

3. Interactions and activities zz Interactions, activities

Unit III: Creating Enabling Environments

Unit IV: Curricular transactions and pedagogic strategies

1. Curriculum adaptations: Presentation and group Teachers will learn to make

Table 2: Overview of Unit I

CONTENT METHODOLOGY EXPECTED OUTCOMES

Unit I: Understanding Students with Hearing Impairment

1. Definition and Presentation, group work, Teachers will be able to:

Unit I: Understanding Students with Hearing Impairment | 3

PAUSE and THINK

1. Definition and Understanding Hearing

1.1 Importance of Hearing

Question for discussion:

1.2 The Process of Hearing

Unit I: Understanding Students with Hearing Impairment | 5

1.3 What is Hearing Impairment?

Three aspects emerge from this definition:

Hearing loss is never the same in any two individuals

1.4 Relevant Terms

Audiogram is a graphical representation of what the person is able—and unable—to hear. It

Unit I: Understanding Students with Hearing Impairment | 7

Figure 2: Normal hearing

Loudness (Hearing Level) in Decibels (dB) 0

Figure 3: Hearing loss in both ears

2. Classification of Hearing Loss,

Let’s meet Rupa and Rohit

Table 3: Five Factors of Classification of Hearing Impairment

FACTORS EXPLANATION CLASSIFICATION

Unit I: Understanding Students with Hearing Impairment | 9

FACTORS EXPLANATION CLASSIFICATION

3. Myths about Hearing Impairment

Ten Common Myths on Hearing Impairment

6. Hearing impairment can be ‘cured’ by Hearing impairment is not a ‘disease’ to be

Unit I: Understanding Students with Hearing Impairment | 11

Table 5: Overview of Unit II

CONTENT METHODOLOGY EXPECTED OUTCOMES

1. Communication barriers Group activity, Teachers will be able to describe the

Figure 2: The Communication Process

Checking previous knowledge and introducing a topic

2.1 Listening Environment

2.2 Visual Environment

Tips for enhancing classroom acoustics and visual learning

2.3 Classroom Seating Arrangements

3. Interactions and Activities in the Classroom

 Ask teachers to visualize a typical day in a mainstream school.

Interactions and activities Likely barriers

3. Concessions and Facilities for Children with Hearing Impairment 35

Ask teachers to visualize a typical day in a mainstream school.

Teach and reteach the concept in variety of context for accuracy.

Tailored materials and use of assistive technology such as computer assisted

Activity-based instruction are particularly useful in an inclusive classroom environment