In the first part of our DHH series, we explored DHH in depth, including signs and symptoms, public benefits, cochlear implants, deaf culture, and more. Now, we’re exploring what it means to support a child across all areas of life, starting with school and home. How do we ask for the right therapies and communication supports in the IEP? And how can we make sure our kids are fully included, understood, and connected not just in the classroom, but in everyday life?
For more insights, we spoke to Janice Myck-Wayne, EdD, special education expert at California State University, Fullerton; Lauren Lamoureux-Brown, CCC-SLP, speech-language pathologist and teacher specialist at the California School for the Deaf (CSD), Fremont; Jeni Jackerson, communications specialist at CSD, Fremont; and Lydia Sussman, retired lead teacher for d/Deaf and hard of hearing infants at LAUSD and adjunct professor at California Lutheran University.
The Rehabilitation Act, established in 1973, is one the earliest laws put into place to protect the rights of individuals with disabilities in programs and activities that receive federal funding from the Department of Education. Specifically, Section 504, was established to provide reasonable accommodations for equal access and opportunity in school. This means your child with a disability, such as hearing loss, must be provided with reasonable accommodations.
In California, additional protections are in place through California Education Code Section 56000.5, often referred to as the Deaf Child’s Bill of Rights. This law recognizes that DHH students have the right to a language-rich educational environment — whether they use spoken language, sign language, or both. It also highlights the importance of early language development, qualified staff, and full communication access in school.
California law also supports:
Together, these laws help to make sure that DHH children in California not only receive services, but receive them in a way that’s meaningful, accessible, and tailored to their communication needs.
If you’re a parent navigating a new diagnosis of hearing loss for your child, you’ve probably heard that early intervention is key (which it is), but knowing where to start can feel like a lot. Luckily, in California, there are laws in place — like the ones mentioned above — that help support d/Deaf and hard of hearing children from the start. Specifically, under the Individuals with Disabilities Education Act (Part C) and California’s Early Intervention Services Act, early intervention services must be provided.
The earlier we can identify a child’s needs, the better. That’s where early intervention comes in. These services are designed to help babies and toddlers with developmental delays or disabilities — such as hearing loss — get what they need as early as possible. In California, this system is often coordinated through your local Special Education Local Plan Area (SELPA), or Regional Center.
As Concoff Kronbeck explains, “SELPAs provide early intervention programming for kids with low-incidence disabilities, and in California, that generally includes people with orthopedic impairment, people with vision and hearing impairments, and people with multiple disabilities.” Services that a SELPA could provide to a child with an eligible low-incidence disability include physical, occupational, speech, and behavioral therapy, as well as assistive technology (AT). If your child qualifies, SELPA services offer a strong foundation in these early years.
Regional Centers
California’s Regional Centers provide vital early intervention services for children 0-3 diagnosed with, or at risk for, developmental delays or disabilities. They can include everything from speech therapy to audiology services and family training, which are crucial for your child’s early development. For a deeper dive into accessing these services, check out our articleWhat Is Early Intervention? - The 4 Ws of Early Intervention.
It’s important to note that if your child with hearing loss does not have a co-occurring developmental disability, early intervention services are typically provided by your local school district (SELPA) through Early Start, not the Regional Center. Both SELPAs and Regional Centers provide Early Start services for children 0–3, which can be somewhat confusing. A child who also has a developmental disability or delay can receive services from both the SELPA and their local Regional Center. But if your child doesn’t qualify for early star school-based services through SELPA, and has a developmental disability, Regional Center can help.
Individualized Family Service Plan
Typically, when your newborn fails their hearing test, a notification is sent to the California Early Hearing Detection and Intervention (EHDI) program or the state Regional Center to initiate services, along with a referral to an audiologist. In the video below, Myck-Wayne explains more on the Individualized Family Service Plan (IFSP) put into place after your newborn fails their hearing test and provides guidance on navigating these early challenges.
Once your child’s eligibility for early intervention has been established by the audiologist, they will be assigned an early intervention professional, most likely a DHH teacher (and possibly additional mentors/specialists, depending on their needs), who will contact you to schedule a formal intake meeting and an assessment to develop your child’s IFSP within 45 days of eligibility being confirmed.
Learn more about the IFSP in the video below, as Myck-Wayne shares her experience on what an IFSP is and how it can help support your child and family.
During the initial intake meeting, your child’s early intervention professionals will assess your child’s overall development, not just their hearing loss. According to Myck-Wayne, the law requires that evaluations cover all five of your child’s developmental areas: motor, emotional, communication, social, and physical. Following this assessment, they’ll collaborate to come up with a plan for your child and your family. It’s important to understand that early intervention is not one-size-fits-all — it looks different for every family. For those with no prior experience with hearing loss, the process can feel overwhelming. It’s common for families new to hearing loss to feel a sense of loss and confusion with a new diagnosis. But the IFSP is meant to guide you and your family on this new journey.
IFSP support may include setting up services to help you better understand your child’s type of hearing loss, exploring language and communication options (such as ASL, cued speech, or AAC), connecting you to the Deaf community, providing education for your family and relatives on how to use assistive hearing devices and technology, and coordinating/determining therapy services that best support your child’s communication development.
In this video, Lydia Sussman shares her experience as a DHH teacher involved in supporting families through the IFSP.
Again, early intervention is designed to be personalized! The types of services your family seeks will depend on your priorities, preferences, available resources, concerns, and the results of your child’s assessment.
If you believe your child is not receiving the necessary support and have already discussed your concerns with your IFSP team, you have the right to initiate a formal process known as due process. This allows you to request changes to the level, frequency, or types of services and support offered to make sure your child’s needs are fully met.
Transitioning from the IFSP to an IEP
When your child turns three, early intervention services will shift from Regional Center (if your child was eligible due to a co-occurring developmental disability) to your local school district. If your child has been receiving services through Early Start, the school district will assess them to determine if they qualify for an individualized education plan. To determine eligibility, a current audiological evaluation is required, along with evidence that the hearing loss impacts communication and demonstrates a need for special education support. Following are federal eligibility requirements for obtaining an IEP. Note that your state may have different eligibility criteria.
While the IFSP is about helping your child develop foundational skills, the IEP is about providing access to learning and supporting their success in the classroom. The IEP is more education-focused and outlines the services, goals, placement, and supports your child will receive in a school setting.
This transition process includes a meeting where your child’s development is reviewed and new goals are set based on updated evaluations. This meeting is a valuable opportunity for you to share and consider what’s worked, ask questions, and advocate for the services and environment that will best support your child’s growth.
In the following video, Sussman shares a few tips for what to expect when transitioning from an IFSP to an IEP.
In 1836, a pivotal piece of legislation known as The Deaf Child’s Bill of Rights was signed into law, highlighting the important need for children who are d/Deaf and hard of hearing to receive an education in environments that respect and utilize their preferred communication modes.
This bill set the foundation to allow educational settings to be tailored to the unique needs of each child. Myck-Wayne notes that the support specified in an IEP can vary widely, reflecting the diverse needs of DHH students. The IEP is specifically designed to provide support within the least restrictive environment (LRE) in educational settings, and that includes aligning with the child’s specific communication needs and learning style.
Placement can vary widely, ranging from mainstream public schools with support services to specialized schools for the d/Deaf, such as California School for the Deaf, Riverside or California School for the Deaf in Fremont.
Examples of types of educational placements for d/Deaf or hard of hearing students:
1. Mainstream public school (general education with support)
2. Mainstream public school with specialized Deaf education program
3. Schools for the d/Deaf (e.g., California School for the Deaf, Riverside and California School for the Deaf in Fremont)
4. Private schools with d/Deaf and hard of hearing support
5. Homeschooling
Ultimately, the best placement for a d/Deaf or hard of hearing student depends on the student’s and family’s needs and wants. For some, a school for the d/Deaf provides the most accessible and enriching environment, where they can communicate freely in sign language with peers and educators who share their language and culture. For others, a mainstream public school setting — with the right support services, accommodations, speech therapy, or ASL interpreters — can provide meaningful inclusion while allowing them to learn alongside hearing peers. In the video below, Myck-Wayne shares her insights on determining the placement for your child with a hearing loss.
It is important that the IEP team — including parents, educators, and specialists — works together to determine the most appropriate environment for the child. If a placement doesn’t fully meet their needs, families can advocate for adjustments or explore alternative options to ensure their child receives the support necessary for success in both education and social development.
Deaf students who primarily use ASL to communicate and prefer to be in mainstream classrooms typically need interpreters to fully access the curriculum. A qualified interpreter is certified, is fluent in both English and your child’s preferred signed language, and understands how to keep up with fast-paced conversation or instruction. They also need to understand what’s being taught so that they can effectively communicate that to your child, all while making sure your child is engaged and included.
However, it’s important to note that students must constantly shift their attention — from the teacher’s materials on the board to the interpreter signing, and then to their own note-taking (if they do not have a note taker). This requires practice and can be quite challenging.
It’s important to also address that having an interpreter solely in the classroom can create social barriers between d/Deaf students and hearing peers. For example, imagine being a teenager with an adult constantly by your side, interpreting your signed conversations to your friends and theirs back to you. This dynamic can be uncomfortable and can limit privacy for your child and affect the natural flow of a conversation. All that said, though, there are children who find using an interpreter in mainstream classrooms to be amazing. In the following video, Sussman shares a story of a student who found success with an interpreter.
Lamoureux-Brown notes that one key objective of programs that teach in ASL is to connect d/Deaf students with d/Deaf peers and adult role models, including teachers, counselors, and school leaders. Seeing d/Deaf professionals succeed gives students powerful examples of what they can achieve. These role models can not only inspire but also empower d/Deaf students, helping them navigate their educational journey with confidence.
In ASL-based programs or schools, students are immersed in visual language throughout the day. This natural exposure — through interactions with teachers, staff, and peers who are fluent in ASL — helps children acquire language in much the same way as hearing children pick up spoken language. It creates a rich environment for natural language development.
For d/Deaf and hard of hearing students, the services and accommodations included in the IEP depend on their individual needs — including the degree of hearing loss, communication style (spoken language, ASL, or both), and any co-occurring diagnoses. Support can look very different from one student to the next and often includes a combination of therapies, assistive technology, and specialized staff.
Some examples of supports and services might include:
Sign language interpreters. For students who use ASL or other sign systems, interpreters help them fully participate in class, group activities, and school events.
Modified educational materials. Visual schedules, captioned videos, tactile learning tools, and language-rich curricula support DHH students in understanding and engaging with content.
Acoustic Accommodations. Schools can use speaker systems, carpeted floors, paneled ceilings or sound-softening tiles, and curtains to reduce echo and background noise. These modifications help students using hearing aids or cochlear implants hear more clearly and reduce listening fatigue throughout the day.
For your child with a hearing loss, there are typically a number of specialists that are involved in the IEP to help support your child at school. Some of these specialists will work directly with your child or as a consultant on the team.
Here are a few related services providers and specialists:
Deaf and hard of hearing teacher (DHH Teacher): a specialized teacher that works specifically with d/Deaf or hard of hearing students to support language development, access to the curriculum, and overall communication supports.
Educational audiologist: licensed audiologists who assess, diagnose, recommend supports and services; help with hearing aids and cochlear implants; and help to train school staff on what the child needs and how to work assistive hearing devices.
Itinerant support teachers or DHH specialists: students may receive support from a teacher of the d/Deaf and hard of hearing (also called a DHH specialist or itinerant teacher). This is a specialist that typically works across several different schools that offers training on specialized supports like (assistive technology), monitors a students progress, and can be a part of the IEP team. Sussman shares more about the role of an itinerant teacher in the video below.
Notetakers: a designated person (typically a student) that writes or types out their notes from class so that the DHH student does not miss important information.
Captioning services/real-time transcribers
Classroom aides or paraeducators
These supports and accommodations are chosen based on what will help your child best access learning in the least restrictive environment, and they’re determined by you and your child’s IEP team.
Potential goals to add in my child's IEP?
Your child’s IEP team should set clear goals in the IEP that supports your child’s success in the classroom. In speaking with our experts, here’s a list of a few goals that are commonly included in an IEP for students who are d/Deaf or hard of hearing. Depending on the area of need, age, and level of hearing loss these goals can look different for every child.
Language and communication goals:
Social communication goals:
Self-advocacy goals:
Receptive and expressive sign language goals:
Again, each of these goals will look different depending on your child’s needs, strengths, and communication preferences. That’s why it’s so important to work closely with your IEP team to make sure the goals truly reflect what supports and services your child needs. For more information on creating strong IEP goals, check out our article A Parent's Guide to IEP Goals.
When we spoke with Lauren Lamoureux-Brown, CCC-SLP, she highlighted the importance of learning language in the early years in a child’s life — often referred to as a critical period for language learning. During this time, your child is primed to absorb and develop language naturally with relative ease. That’s why early exposure and consistent daily interaction with a chosen form of communication is so important.
For children who are d/Deaf or hard of hearing, accessing language might look different depending on what works best for them. This could be sign language, spoken language supported by hearing aids or cochlear implants, or a more structured approach like oral communication through Auditory-Verbal Therapy (AVT). Regardless, without access to communication, some kids experience what’s called language deprivation.
Lamoureux-Brown explains that this happens when the brain doesn’t get the language exposure it needs during those early critical years of development. If the brain’s language pathways don’t form early on, it can make it much harder for a child to develop and use language later in life. This can affect how they learn, express themselves, build relationships, and read and write.
When deciding on the right communication method for your child, there are several factors to consider: the language your family uses at home, your child’s level of hearing loss, where you live (and what resources are available), and whether your family includes other d/Deaf individuals. All of these are important to think about when establishing your child’s preferred language, so you can give them early exposure to a strong language foundation, meaningful communication, and connection with others.
Sign language is a widely used form of communication for people with different levels of hearing loss. It’s a visual language that relies on hand movements, facial expressions, and body language to convey meaning. Just like spoken languages, sign languages aren’t the same everywhere — each country (and even some regions) has its own version.
For example, British Sign Language (BSL) is used in the UK, French Sign Language (LSF) in France, and American Sign Language (ASL) in the U.S. While all of them use visual signs to communicate, each has its own unique grammar, vocabulary, and cultural context, so they’re not interchangeable. Sign language is a rich, expressive way to communicate that reflects the diversity of the Deaf community worldwide.
In the U.S., for example, ASL follows a different grammatical structure than English. In English, you might ask, “What’s your name?” However, in ASL, you would sign, “Your-Name-What?” The syntax and sentence structure are different from spoken English.
How do you learn sign language?
You can learn sign language at any age. It is easier for children to pick up sign language if they are taught it early on (their brains are like sponges). Adults or older kids can learn sign language from local sign language groups or classes. The best way to learn sign language is by immersing yourself in the language. Facebook, for example, has many sign language learning groups where people meet up or go to Deaf events to get used to signing.
Online classes, YouTube videos, printables, and apps are great ways to reinforce or learn from the comfort of your own home. Here are a few recommendations for learning ASL:
Apple apps:
Android apps:
Online sign language classes:
YouTube channels:
Sign language free printables:
HandSpeak and Signing Savvy are also great (and free) platforms that act as ASL dictionaries — they allow you to type in words and then show you videos on how to sign them. For our Southern California families, the CSUN Northridge Deaf Project offers free sign language classes for eligible families.
Other forms of signing
Sign language comes in multiple forms. While ASL is the most commonly used in the U.S., there are other signing systems that families can explore — especially if they’re supporting spoken language or adapting to their child’s preferred form of language.
One type of sign language, called Signing Exact English (SEE), signs exactly what and how you would say something in English. For example, in SEE, the sentence “I’m going to the store” would be signed with every word and contraction clearly shown. This includes adding signs for suffixes like -ing, -ed, or -s. SEE is often, but not always, used by families with hearing parents who want to stick closely to English grammar while introducing visual communication.
Another form of sign language is Pidgin Signed English (PSE), sometimes called contact signing. This is a blend of ASL and SEE, using signs from ASL while sometimes following English word order.
For individuals with both vision and hearing loss, tactile signing is a form of communication that relies on touch. You might hear it referred to as “hand-under-hand,” “hands-on signing,” or “tracking.” In this form of sign language, the person who is DeafBlind places their hands on top of the signer’s hands to feel the movements, shapes, and gestures being made. This allows them to interpret and communicate the message/response through touch, making communication more accessible when vision and hearing aren’t available.
In a recent study, researchers found that about 70% of deaf or hard of hearing individuals use speech as their primary mode of communication. This is where auditory/oral communication comes in. This communication approach focuses on helping children use spoken language by making the most of the hearing they have — often with the help of hearing aids or cochlear implants. It doesn’t involve the use of sign language, so kids don’t need to know or learn a signed language to use this method. Through listening practice and speech development, kids can learn to understand and use spoken language as a main form of communication. Auditory Verbal Therapy, or AVT, is a form of therapy that helps facilitate this type of communication method (more on this later). It’s also important to note that this type of communication greatly depends on the level of hearing loss and personal preference.
Creating inclusive classrooms for kids using auditory/verbal communication
Instead of using sign language or interpreters, children who use auditory/verbal communication rely on their residual hearing — often supported by hearing aids or cochlear implants — to access spoken language. These students are typically supported by speech-language pathologists (SLPs), auditory-verbal therapists, and teachers trained to help build strong spoken language and listening skills.
To help make classrooms more hearing-friendly, schools can provide:
With these strategies in place, an inclusive classroom is formed to help make sure that students that use auditory/verbal communication can thrive and feel confident in participating and engaging with their peers. If spoken language is your child’s primary mode of communication, talk with your IEP team about what supports are needed to help make their classroom feel more accessible and inclusive!
Total communication
Total communication (TC) is an approach that combines multiple modes of communication and language — such as sign language, spoken language, body language, visual cues, and assistive technology — to support children with hearing loss. Instead of relying on just one mode of communication, TC allows each child to use the tools that work best for them. This flexible approach recognizes that children are all different and encourages the use of all available methods of communication.
Note: while it is encouraged for both verbal and visual language to be used in conjunction with one another, the ability to use both languages at the same time is called simultaneous communication (SimCom), and it can be challenging for even the most skilled signers.
Cued speech
Cued speech is a communication system that uses hand cues along with spoken language. These hand shapes and placements represent different phonemes (individual speech sounds) and help clarify words that might look the same when lip-reading, such as “fan” and “man.” Adding visual cues to spoken words helps to make spoken language sounds more distinguishable for people who are d/Deaf or hard of hearing.
Cued speech therapy can support your child in learning how to use this communication system by teaching hand cues, practicing visual tracking, and building confidence in using cued language in everyday communication.
Augmentative and alternative communication
For individuals who may struggle with signing, augmentative and alternative communication (AAC) is a great alternative form of communication. Examples of AAC tools include speech-generating devices, picture boards, and apps that vocalize text. In the video below, SLP and AAC specialist Ali Steers explains more about the basics of AAC and how these tools can help individuals communicate more effectively.
It’s important to recognize that the environment also plays an important role in supporting total communication. Your child’s ability to develop strong communication skills is heavily influenced by their surroundings and exposure to language.
Dr. Myck-Wayne mentions that creating a language-rich environment means offering consistent, meaningful, and diverse language exposure in multiple forms, ensuring a child is immersed in communication throughout their daily experiences. This includes spoken language, sign language, visual cues, printed words, gestures, and assistive technologies — all naturally incorporated into interactions. Also, it’s not just about following the child’s lead; caregivers, educators, and family members should actively model, introduce, and reinforce language in various ways to encourage continuous learning. A language-rich environment encourages natural communication by ensuring that kids with hearing loss are constantly exposed to language in ways that are accessible, engaging, and interactive.
For example, in a language-rich home or classroom, parents, teachers, and caregivers might:
Dr. Myck-Wayne shares more on the importance of a language-rich environment in the following video.
Before starting therapy, Lamoureux-Brown suggests carefully considering several key factors to best support each student.
Sometimes when parents hear “speech therapy,” they immediately think of helping a child say certain sounds correctly — but for children who are d/Deaf or hard of hearing, speech therapy can look very different, depending on the child’s unique needs and communication style.
Speech-language pathologists (SLPs) play an important role in determining and supporting the communication for children who are d/Deaf or hard of hearing. They provide targeted speech and language therapy to help children develop a range of skills, including:
The ultimate goal of an SLP isn’t necessarily to get your child to speak — it’s to support the communication method that works best for them, whether that’s spoken language, sign language, or AAC. They’re there to help you and your child find what works consistently for them, both at home and in the classroom.
4 myths of speech therapy
Some common misconceptions about speech and language development according to Lamoureux-Brown include the following:
SLPs using ASL
Some SLPs are fluent in ASL, which allows them to incorporate both signed and spoken communication strategies to best meet each child’s needs.
In these cases, they may support spoken language with signed language to help with full comprehension. One technique, as Lamoureux-Brown describes, is called “sandwiching,” in which SLPs provide a target word or phrase in spoken English and then in ASL and then again in spoken English to bridge the two languages and help students understand fully. They may also use a variety of visual and tactile supports.
As always, your child’s environment and communication preferences are important to consider when choosing an SLP. For example, an SLP who knows sign language might be a great fit if your child attends a school for the Deaf or is naturally leaning toward signing over verbal communication. It really comes down to what works best for your child. Many SLPs are trained to tailor their approach to your child’s needs — especially if they have experience with different communication methods.
Auditory-verbal therapy
About 95% of children born with hearing loss have hearing parents — and the majority of these families (around 85%) initially choose spoken language as the primary mode of communication for their child. For children with residual hearing and hearing technology — such as hearing aids or cochlear implants — auditory-verbal therapy (AVT) is a specialized form of early intervention designed to help them develop spoken language. For example, in some AVT settings, visual cues such as lip reading may be limited or intentionally removed (for example, by covering the mouth), so that children can focus on processing sound through their hearing devices.
AVT focuses on strengthening listening and auditory processing skills, with the goal of teaching children how to interpret sounds through their devices and use spoken language. Therapists providing AVT are certified as listening and spoken language specialists (LSLS).
This type of therapy isn’t just for the child, but the whole family. In fact, parent coaching is a core part of the process. During sessions, parents learn practical strategies they can use at home to help their child grow stronger listening and speaking skills. This might include practicing certain sounds, encouraging listening during everyday routines, or creating an environment that supports spoken language. The goal is to help parents feel confident and equipped to support their child’s progress beyond therapy.
This type of therapy isn’t just for the child, but the whole family. In fact, parent coaching is a core part of the process. During sessions, parents learn practical strategies they can use at home to help their child grow stronger listening and speaking skills. This might include practicing certain sounds, encouraging listening during everyday routines, or creating an environment that supports spoken language. The goal is to help parents feel confident and equipped to support their child’s progress beyond therapy.
If you're looking for fun ways to support your child's AVT practice at home beyond what their therapist has assigned, there are some great apps to try! Articulation Station and Sound Matching are both kid-friendly and make practicing speech and listening skills feel like play. Want even more ideas? Check out our Top Communication Tools article for a full list of helpful apps and resources to explore together!
Aural habilitation therapy (child audiologic/hearing habilitation)
Unlike rehabilitation, which focuses on recovering skills that were lost, habilitation is all about helping kids develop new skills from the start. Aural habilitation therapy for children with hearing loss is conducted by a certified auditory-verbal therapist or an SLP, and it is aimed at developing communication skills and improving speech and language abilities. This therapy focuses on helping children gain or improve skills they might not have developed naturally due to hearing loss, such as teaching listening skills and sound awareness, practicing use of hearing devices, and helping working on social languages.
First off, if you’re here, you’re already taking important steps to support your child who is d/Deaf or hard of hearing — and that matters more than anything. One of the best ways to continue that support is by encouraging early language development. Whether that means learning and using sign language, making sure your face and body are always visible when talking, improving the listening environment by eliminating background noise, or creating a language-rich environment, every bit of language exposure helps. Here’s some helpful tips to support your child at home:
At the end of the day, the most powerful thing you can do is create a home environment where your child feels understood, supported, and encouraged to communicate in the ways that work best for them. Whether you’re learning a new language, making small changes to your routine, or connecting with others in the Deaf community, every effort you make adds up.
Remember, you’re not in this alone. With the right tools, community, and support, your child can grow up confident in who they are and fully connected to the world around them. For additional information on DHH as a low-incidence disability, be sure to check out our article Low Incidence 101 to learn more!
And for more information on DHH, head to our article d/Deaf or Hard of Hearing (DHH)101
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