Meeting the educational needs of children with hearing loss

Paediatric hearing loss is a growing public health issue that is currently a significant barrier to achieving sustainable development goal 4 (SDG 4), that is, quality education for all. When children with hearing loss do not receive treatment, they might have difficulty accessing mainstream schooling and therefore obtain worse educational outcomes. The severity of these implications is correlated with level of hearing loss and earlier age of onset. Children with any degree of hearing impairment have been shown to exhibit poor language development, leading to lower literacy rates, diminished social skills and impaired executive function capacity. Different severities of hearing loss must be considered, as a child's ability to access schooling and participate in integrated education is highly dependent on level of hearing loss. A child's educational ability can be affected at a milder severity of hearing loss than what was considered as disabling. Consequently, the global burden of educationally disabling hearing loss is larger than previously estimated by the World Health Organization (WHO). Mild hearing loss, that is, a hearing level threshold between 26-40 decibel (dB) in the better ear, affects almost 50 million children worldwide, yet is frequently overlooked and undertreated. A 2016 review concluded that children with mild hearing loss, overall, tend to have compromised speech recognition and poorer language skills. Therefore, these children are over 2.5 times more likely to have academic difficulties and they more commonly experience grade retention. One study indicated that 37% (24/66) of children in a cohort with mild hearing loss had failed at least one grade. With respect to children affected by moderate hearing loss (41-60 dB), educational impairments mirror the deficits of those with mild losses, yet are more common and impactful. A study from France reported nearly half of children with moderate hearing loss had experienced one or more years of grade retention. Standardized academic test scores for children at all levels of hearing impairment are significantly lower than those of children with normal hearing, and notably demonstrate a strong correlation with the severity of hearing loss.