Hearing and Vision
Chapter 6 in The Exceptional Child: Inclusion in Early Childhood
Education; Allen, K. Eileen and Cowdery, Glynnis E.; 2012
• Most all early learning occurs through the senses
• Vision and hearing impairments are the most common and most
serious of the sensory impairments, with hearing having the greater
potential for interfering with development.
• Hearing impacts language development negatively; in turn, language
delays impact cognitive development negatively.
• Hearing also interferes more with social development.
• Specialists for children with hearing and with vision impairments are
essential in the early years.
Deafness and Hearing Loss
• Deafness – even with hearing aids, a person with deafness cannot
process spoken language
• Hard of hearing – a lesser hearing loss, but still has an impact on
development in other domains (social, language, cognitive)
• Pre-lingual hearing loss – happens prior to the child developing
language; generally speaking, this is the more likely to negatively
impact development in other domains.
• Post-lingual hearing loss – happens after the child has developed
Types of Hearing Loss
• Conductive hearing loss – occurs in the outer or middle ear and can
be corrected with hearing aids (amplification devices); there is no
interference with the brain processing the messages
• Sensorineural hearing loss – loss is in the inner ear, either the cochlea
or auditory nerve; may cause sounds to be intelligible; cochlear
implant may help, but child is generally 12 months or more before
this can be done.
• Higher auditory cortex – causes central deafness
Signs of Hearing Loss
• Infants who do not exhibit behaviors associated with startle
responses or localization of sounds (turning head towards sounds or
mother’s voice) may have a hearing loss
• Some people have residual hearing – intermittent hearing due to
allergies, ear infections, or other problems that interfere with
hearing; this may be harder to recognize.
• Signs such as tugging at the ears, discharge from the ears, ear
infections, or delays in language development may all be signs of
• The text provides many symptoms on pp. 125 & 126.
Problems Caused by Hearing Loss
• Hearing loss has a cumulative effect on a child’s social, language, and
• Children with “moderate to severe hearing loss are educationally
delayed by as much as three to five years”
• They may exhibit social and behavioral problems
• They may fall even further behind as school becomes more difficult
Language and Cognitive Development
• Hearing loss may prevent early language acquisition, particularly
during critical periods
• Hearing loss may also result in lack of responsiveness from others
which, in turn, creates more problems.
• Cognitive skills and language skills are interdependent; while these
children are rarely intellectually impaired, lack of informational input
impacts cognitive development.
Social Development Problems
• Children with a hearing loss are often left out of social experiences
and stimulation because of a lack of responsiveness.
• Evidence of negative social behaviors during preschool years for
children with hearing loss
• Give and take skills associated with making friends and interacting
with others may be lacking.
• These children miss out on many of the nuances of natural social
development that interactions with others and language facilitate.
• The more severe the hearing loss, the more challenging the problems
are likely to be
• Parents may have a hard time imposing limits, from the child
understanding to the time required to fully help a child with these
• Many approaches are necessary, including language for the child and
the family and behavior intervention.
• Many means of communication are describe on p. 128 in your text
What to Use?
• Generally speaking, a total approach to communication is preferred.
• Children with hearing loss face further discrimination if their language
is a language that no one around them speaks (i.e. only American Sign
• Signing has been shown to be effective even with typically developing
children who are acquiring spoken language or intellectually disabled
children with little or no oral language.
• No matter what is chosen, children must receive language stimulation
and adults must become trained in best communicating with a child
with hearing loss.
Suggestions for Teachers
• The text provides a list of several suggestions for supporting and
communicating with a child with a hearing loss.
• Many of these suggestions are relevant for any young children
• Finally, the text describes a teacher’s responsibilities for helping a
child maintain his or her amplification devices.
Blindness and Vision Impairments
• Blind – severe vision loss that does not allow for reading print and
requiring Braille or some other materials using touch and sound.
• Low vision – enough residual vision to allow reading of large print or
regular print under certain conditions
• Total blindness – cannot distinguish light and dark
• Residual vision is at risk for total loss if it is not used
Types of Vision Problems
• Most vision problems are caused by physical abnormalities
• Cataracts and glaucoma
• Retinopathy of prematurity – less occurrence of this now that oxygen levels
are controlled better for premature babies
• Cortical blindness – visual impairments associated with the brain
• Visual acuity, astigmatism, myopia, and hyperopia – generally corrected with
• Other vision problems are caused by muscle abnormalities
• Strabismus, amblyopia, and nystagmus
Identifying Vision Problems
• Blindness is identified relatively early
• Partial losses may not be detected until a child is in school, especially
once print gets smaller.
• Children do not know what they are supposed to be seeing, so they
do not realize they have vision problems.
• Warning signs of vision problems are on pp. 135 – 136 in your text.
Vision Problems and Development
• Learning comes from seeing, watching others, and observing.
• Vision problems impact development in all of the developmental
• Children with severe vision impairments may not be able to interact
with the environment safely and freely
• Children with severe vision problems may engage in blindisms, which
are atypical behaviors that children with severe vision loss may have.
• Language acquisition happens when children learn to identify objects;
visually impaired children must rely on other senses to interact with
Vision Problems and Development
• Children with vision problems generally fall behind their typically
developing peers the first few years of life, but are often able to catch
up by five or six with appropriate interventions.
• Motor development is impacted because children with vision
problems cannot judge where things are in relation to them.
• Social development and play skills may develop more slowly with a
child with visual impairments. Adults need to use language as they
describe events and promote socialization.
Families and Early Intervention
• Parents can be encouraged to interact; visually impaired children can
sense smiles and other social cues.
• Early programs focus on family interactions
• Toddlers and preschoolers may attend center-based care
• Children learn adaptive behaviors for getting around
• Orientation and mobility specialists help classroom teachers provide safe and
appropriate environments for children with visual impairments.
• Adults may need to learn appropriate responses to mishaps involving children
with visual impairments.
• Guidelines for teachers are on pp. 140 – 142 in your text.