A Team Approach to Hearing Assistive Technology

HAT Definition

Hearing Assistive Technology (also referred to as Assistive Listening Devices/ALDs) enhances audibility by prioritizing a speaker's voice over distance and in noise. It is typically used in conjunction with personal hearing devices such as hearing aids (HAs) and cochlear implants (CIs). It can also be used as stand-alone technology, specifically sound fields/classroom audio distribution systems (CADS).

Examples & Selection

Examples include Individual Digital Modulation (DM)/Remote microphone systems, Sound field/CADs, Hearing Loop Systems, and Auracast. These must be selected and fit by an audiologist.

The selection of HAT is based on team considerations, communication environments, and a child's individual needs. Only an audiologist is qualified to select and fit HAT.

Assessment & Verification

Assessment: Team members assess child's performance across communication environments. Observations, standardized assessments, and audiological assessments are collected and shared.

Verification: Audiologist completes an evaluation and works with child and team to ensure the HAT is working so equitable access is provided across all communication environments.

Considerations & Validation

Considerations: Team members consider the different communication environments and partners throughout the day. Distance, noise, and access to information and social connection are considered.

Validation: As part of IDEA (§300.113), the team is responsible for ensuring that the device is providing the child with equitable access across all communication environments, monitoring the use of HAT, and troubleshooting the devices.

Team Roles

Team: Self-determination (teach and empower self-advocacy); Validation (collaborate to ensure optimal device use); Accessibility Tools (monitor captioning, alerting systems, and accommodations); Daily Listening Checks (assign and track); Personnel Support (provide in-services to extended and general education team).

Audiologist: Assessment (identify hearing type and degree, evaluate functional listening); Device Selection (recommend appropriate HAT); Fitting and Configuration (select, fit, evaluate, and verify devices); Training (teach individuals how to use HAT effectively across settings).

SLP: Audibility — assess and provide feedback when access impacts understanding/production across communication domains.

TODHH: Integration — ensure child has access to general education curriculum, specialized instruction, and social engagement throughout the school day.

Red Flags

Listening fatigue such as reduced sustained attention; Reliance on peers for following directions; Difficulty with peer engagement, particularly in noise and less structured settings; Slowed rate of progress or regression of previously developed skills; Avoidance or decreased use of HAT (e.g. social anxieties of being different).

Presence of a red flag means the team (including an audiologist) needs to take action to understand and address the cause.

*Team members should include the speech-language pathologist (SLP), teacher of the Deaf/hard of hearing (TODHH), general education teacher, special education teacher, etc.

Families and students should be included as part of the team and team members should all have experience working with children who are DHH.