Trends Impacting One Public School Program for Students Who Are Deaf or Hard-of-Hearing

Abstract

This article reflects on the author’s experience supervising a public school program for students who are deaf or hard-of-hearing, specifically addressing national, regional, and local trends affecting it. These trends included teacher efficacy, changes in educational service delivery, advances in technology, the selection of the listening and spoken language model, the needs of university teacher education programs, and telepractice. Furthermore, the author describes how the program responded to these trends, which ultimately resulted in positive educational outcomes for the students being served.

Keywords

deaf or hard-of-hearing exceptionalities legal/policy issues vocabulary literacy professional policy/licensure/certification service delivery sign language speech-language pathologists (SLPs)cochlear implants/hearing aids technology

The face of deaf education has changed dramatically in the past thirty years.

—Scheetz (2004)

Public school programs for students who are deaf or hard-of-hearing (DHH) have been in a state of transition almost from the day they were established, which for many was shortly before or after passage of the Education for All Handicapped Children Act in 1975, now known as the Individuals With Disabilities Education Improvement Act (2004). During the 1970s and through the 1980s, many of these programs established self-contained or resource rooms for students who are DHH while also offering itinerant services to students who could be successfully mainstreamed. A significant number of these students during this time period were born during the rubella epidemic of the 1960s, otherwise known as the “rubella bulge” (Moores, 2001).

As the field of education of students who are DHH entered the 1990s, three trends were prominent. First, the “rubella bulge” students began graduating from high school, which resulted in a declining number of students being served by these programs (Dolman, 2010; H. Johnson, 2004). Second, increasing numbers of students were being mainstreamed and were supported either by a resource room teacher or an itinerant teacher for the DHH (Luckner & Miller, 1994). Third, technological advances were having an impact (Solomon, 2012). For example, in 1990, the Federal Drug Administration approved the use of cochlear implants for children with profound hearing losses (Chute & Nevins, 2006). Other technological advances, such as otoacoustic emissions (OAEs) testing, resulted in the earlier identification of infants with a hearing loss, who were provided with amplification and early childhood services sooner, sometimes as early as 3 months of age (White, 2007).

These same national trends were also affecting the services of students who are DHH in the mid-Atlantic state where I supervised a regional education agency program for students who are DHH until I retired in 2012. Although the program I supervised officially began in 1971, the year that regional education agencies were established in this state (McCluan, 2010), services for students who are DHH in the county served by this program actually began in 1969. In the early years, this program was composed primarily of classrooms for students who are DHH that were operating in school districts throughout the county; itinerant services were also provided, but on a smaller scale.

As this program entered the 1990s, it was also affected by graduation of the “rubella bulge” students, by students using cochlear implants, and by students being identified earlier and fitted with amplification sooner. The end result of these trends was that the program steadily shifted from one with a large number of self-contained classrooms to a program that was predominately itinerant (Miller, 2000). As of 2012, this program had three classrooms for students who are DHH: one preschool and two elementary classrooms that served approximately 20 students. In contrast, the itinerant program served approximately 380 students.

Because of universal infant screening and technological advances, such as cochlear implants, there was less of a need for classrooms designed specifically for students who are DHH in this program. However, these classrooms were still essential for students for whom—even though their hearing loss was identified early and they received amplification or cochlear implants relatively soon after identification—the most appropriate placement continued to be a classroom for students who are DHH.

Another trend affecting this program was that the students it served were increasingly using listening and spoken language (LSL). As of 2012, the program served approximately 400 children from as young as 2 months to 21 years of age. Of this number, approximately 3% primarily used sign language, meaning approximately 97% of the students served by this program were primarily using LSL.

To summarize, as of 2012, the program I supervised was composed almost entirely of itinerant teachers, and the students that they served were overwhelmingly using LSL. There were a few students in the program using sign language; however, their numbers were declining due in part to the impact of universal infant hearing screening, early intervention, digital hearing aids, and cochlear implants.

Current and Future Trends

As the field of education of students who are DHH and this program enter a new century and a new decade, it is worthwhile to examine the continued impact of established trends as well as the impact of more recent trends whose long-term implications remain unknown. The following trends, old and new, are likely to influence the education of students who are DHH in the mid-Atlantic state in which I worked and throughout the country as well. The trends are clustered under the categories of teacher efficacy, sign language interpreting, listening skills, educational audiology, service delivery, cost of services, generic supervision, teacher training programs, recruiting future teachers of the DHH, and telepractice.

Teacher Efficacy

Over the years, the teachers and staff of this program developed good relationships with the school personnel in the various districts that they served, and the feedback from these districts indicated that they were satisfied with their services. However, some administrators asked whether the services of a teacher of students who are DHH (TSDHH) could be just as effectively provided by another educator, for example, a special education teacher or a speech-language pathologist. This questioning of the efficacy of teachers of students who are DHH was also occurring in other states (Lenihan, 2010).

Because a typical student who is DHH and is served by this program uses LSL, it is not surprising that an administrator may question whether a student needs the specialized services of a TSDHH. A student who uses LSL may have intelligible speech, possibly causing an administrator without a background in education of students with hearing loss to not recognize the scope of language learning issues challenging these students on a daily basis. The administrator thus concludes that this student’s needs are minimal, and therefore, the student does not need a teacher with specific expertise. However, it would be unlikely for this same administrator to question the need for a TSDHH for a student who uses sign language, because signing is a unique skill that a special education teacher or a speech-language pathologist is unlikely to have or is unlikely to be proficient at using (Seal, 2000).

Administrators are not the only ones who may not realize the depth of the language learning problems experienced by a student who is DHH. Special or general education teachers also may not recognize the unique language learning problems of these students (Foster & Cue, 2008–2009; L. R. Goldberg & Richburg, 2004; H. Johnson, 2004; Luckner & Howell, 2002; S. Reed, Antia, & Kreimeyer, 2008).

Thus, a major challenge for TSDHH is educating special and general education administrators and teachers about the language and learning problems confronting a student who is DHH, whether in a general or special education classroom. Furthermore, the TSDHH can inform the other educators how their expertise can help the Individualized Education Program (IEP) team to more effectively and efficiently meet the needs of this student (Bullard & Luckner, 2013; Easterbrooks, 2008). This expertise can be delivered by directly teaching the student who is DHH (Luckner & Muir, 2001; Miller, 2008), or it can be delivered indirectly via consultation/collaboration. The latter allows the TSDHH to provide advice or model best practices for a general or special education teacher to use with a student who is DHH (American Speech-Language-Hearing Association [ASHA], 2010; Compton, Tucker, & Flynn, 2009; Kluwin, Morris, & Clifford, 2004; Luckner, 1991; Nevins & Garber, 2006).

A skill that is often overlooked by special and general education administrators and teachers is that of previewing and reviewing of vocabulary, concepts, and idioms (Berndsen & Luckner, 2012; Foster & Cue, 2008–2009; H. Johnson, 2013; Luckner & Muir, 2001; Yarger & Luckner, 1999). Although a TSDHH is uniquely qualified to work on these skills and potentially will devote a significant amount of time to them, these are skills that can be modeled via consultation for another educator, such as a special education teacher. It may take weeks, months, or even years for another educator to develop this same expertise for knowing which vocabulary, concepts, or idioms will be problematic for a student who is DHH. However, these skills can be developed and refined over shorter time frames with regular meetings between the TSDHH and a special educator, general educator, or speech-language pathologist.

Sign Language and Interpreting

The number of students who used sign language in this program was relatively few. Nevertheless, I still encouraged teachers to pursue certifications or take sign language evaluations, such as the American Sign Language Proficiency Interview (2011), the Educational Interpreters Performance Assessment (Classroom Interpreting, 2011), or even the National Interpreter Certification examination (Registry of Interpreters for the Deaf, 2011). Although this state did not require a TSDHH to demonstrate proficiency with sign language, it was important to me that teachers working with students using sign language be proficient. In addition, earning a certification in sign language was a way for a TSDHH to differentiate himself or herself from other special educators and demonstrate the efficacy of his or her services with students who are DHH.

During my tenure, this program employed several educational interpreters. The number of educational interpreters remained stable for years, but this gradually changed. As was mentioned earlier, the impact of universal infant hearing screening, early intervention services, and technology (i.e., digital hearing aids and cochlear implants) resulted in students with severe and profound hearing losses who were increasingly using LSL. Previously, these students would likely have used sign language, but technology was providing them with auditory access sufficient to develop strong LSL skills (Cole & Flexor, 2007; Lartz & Litchfield, 2005–2006).

Parental desire favoring a spoken language option was another factor affecting interpreting. In North Carolina, the Early Hearing Detection and Intervention (EHDI) Program found in 1995 that approximately 60% of parents favored a sign language option when their child was diagnosed with a hearing loss. Ten years later, Brown (2006) found that approximately 85% of parents were selecting a spoken language option. The parents served by my mid-Atlantic regional agency’s educational program were reflecting a trend similar to that in North Carolina.

For all of these reasons, it is conceivable that fewer students in the future may need sign language or an educational interpreter. This trend appears to be happening not only locally but also regionally, nationally, and internationally (H. Johnson, 2004; Johnston, 2004).

Listening Skills

A TSDHH must possess expertise in developing listening skills. When the majority of the students in a program are using LSL, it is imperative that a TSDHH is knowledgeable about developing listening skills. Recently, the Alexander Graham Bell Association for the Deaf developed the Listening and Spoken Language Specialist (LSLS) certification (D. Goldberg, Dickson, & Flexor, 2010). It involves (a) observing a certified auditory–verbal therapist (AVT) or auditory–verbal educator (AVEd) who is working on listening skills with a child, (b) taking coursework, and (c) accumulating direct therapy hours under the supervision of an AVT or AVEd. In addition, the person must take a 3-hr evaluation on the principles underlying the development of listening skills.

During my tenure supervising the regional education agency’s program for children with hearing loss, one TSDHH had earned her AVT certification, with a few others expressing a desire to pursue the LSLS certification. However, it appeared that most of the program’s TSDHHs found the requirements needed to earn the AVT or AVEd certifications to be daunting. Still, as with sign language certification, the AVEd or AVT certifications indicate expertise with listening skills and are tangible ways to differentiate a TSDHH from other special educators.

Another professional who has the expertise to address listening skills is the speech-language pathologist (ASHA, 2010). Although speech-language pathologists may have the training and background to work effectively on listening, they typically do not express confidence working on this skill with students who are DHH, especially students with cochlear implants (Compton et al., 2009; Houston & Caraway, 2010; Luckhurst, 2008). That being the case, this provides an opportunity for a TSDHH to work collaboratively with a speech-language pathologist to help this person gain the confidence needed to work on listening skills.

Educational Audiology

The program I supervised employed two full-time and one part-time educational audiologists. The employment of educational audiologists by other regional education agencies in this state varied from zero to three. Overall, this regional education agency was supportive of educational audiology services, as can be seen not only by the number of educational audiologists employed but also by its support of a hearing aid loaner bank—a rare service in this state. Furthermore, this regional education agency provided generous support for procuring up-to-date amplification and other audiological equipment. In addition, a local Sertoma club provided funding for audiological equipment to support this program. Even with this relatively high level of support, one could make the case that this audiology program was understaffed. The county this regional education agency served had approximately 100,000 students, which worked out to a ratio of a 1:40,000 (full-time audiologist to students). In comparison, ASHA (2002) recommended a ratio of 1:10,000. It should be emphasized that this ratio is an ASHA guideline, not an ASHA standard. Furthermore, it needs to be acknowledged that there were several private audiologists serving students from this county, which would likely make this ratio of audiologist to students smaller. Finally, the educational audiologists for this regional education agency developed close working relationships with many of these private audiologists and collaborated extensively with them when they had a student in common.

Just as with TSDHH, some administrators question the necessity of educational audiology services. They believe that a school district fulfills its obligation for hearing testing following a model in which the school nurse screens for hearing loss at specific grades and notifies parents if their child has failed the screening. With such notification, it is the parents’ responsibility to have their child seen privately. Some parents immediately take their child for further evaluation by the child’s health care provider. However, some parents never do so, for a variety of reasons. The child not followed may experience a delayed diagnosis of hearing loss, culminating in poor performance in school (L. R. Goldberg & Richburg, 2004; Shargorodsky, Curhan, Curhan, & Eavey, 2010). Interestingly, general education teachers in Missouri expressed a lack of confidence in school-based hearing screening (i.e., screening done by someone other than an educational audiologist), especially for identifying children with minimal hearing loss (McCormick Richburg & Goldberg, 2005). Having educational audiology services readily available makes it more likely that a child’s hearing loss can be efficiently diagnosed and managed, including properly fitted and functioning hearing aids and assistive listening devices. Such service delivery offers the child more effective access to the general education classroom and curriculum (Bullard & Luckner, 2013; L. R. Goldberg & Richburg, 2004; C. Johnson & Seaton, 2012). Furthermore, educational audiologists know the schools and staff within a specific school district, whereas audiologists practicing elsewhere may not. Such knowledge by the educational audiologist can be a distinct advantage to appropriately managing a student’s hearing loss in an educational setting, such as evaluating how the amplification equipment used by students who are DHH functions in different environments (i.e., general education classroom, lunchroom, multi-purpose room, and playground).

Finally, it appears that the importance of educational audiology will only increase in the years ahead. Results of a study by Shargorodsky et al. (2010) revealed that hearing loss has increased 30% in the last 12 years for teenagers from 12 to 19 years of age. Furthermore, it appears general educators may have noticed this trend, especially at the middle and high school levels, because they are expressing a need for their students to learn about hearing conservation (McCormick Richburg & Goldberg, 2005). The mid-Atlantic regional education agency’s audiologists are a reflection of this trend in that they have been receiving an increasing number of requests to provide hearing conservation presentations to schools.

Service Delivery

Traditionally, itinerant TSDHH pull out students to work with them (Hyde & Power, 2004; Luckner & Miller, 1994). However, the emphasis on inclusion has increasingly resulted in services being provided in the classroom (Foster & Cue, 2008–2009; C. Reed, 2010). Advantages of push-in services include being able to observe how a student functions in a classroom, thus minimizing a student missing classroom content. Such service delivery also provides for immediate feedback to a general or special educator as well as the opportunity to model strategies for them. There are times, however, when pull-out services are necessary for a student who is DHH, especially when he or she needs a quieter setting than the classroom to work on specific skills, such as listening (L. R. Goldberg & Richburg, 2004).

Although a TSDHH utilizes a pull-out or push-in type of service delivery approximately 60% of the time (Yarger & Luckner, 1999), consultation/collaboration is increasing in use and importance (Berndsen & Luckner, 2012; Bullard & Luckner, 2013; Nevins & Garber, 2006; C. Reed, 2010). For my program’s teachers, a typical progression in terms of service delivery is to directly see a student utilizing a mix of pull-out and push-in services. Then depending on a student’s progress, a TSDHH reduces the amount of time seeing a student and increases the time consulting/collaborating with a classroom teacher and related service providers. It makes sense to engage in consultation/collaboration when feasible, because a TSDHH has service delivery time constraints. Devoting 1 hr a week to consulting with a general educator who is with this student all day may be more effective than providing direct service an hour a week to the student (Yarger & Luckner, 1999). If the student continues to do well, then he or she will likely be dismissed from the TSDHH’s caseload.

Engaging in consultation or collaboration may not come naturally to a TSDHH. Most such teachers receive minimal exposure to consultation/collaboration in their training programs (Luckner & Howell, 2002). Furthermore, teachers, especially those just out of school, may be uncomfortable consulting with general or special educators who are older and who have more years of teaching experience. Finally, most TSDHHs desire to teach children, not to consult or collaborate with adults (Dinnebeil, Pretti-Frontczak, & McInerney, 2009). It is understandable that some TSDHHs may hesitate to embrace a consultation/collaboration model because they believe that it is more beneficial to work directly with the student rather than trying to work through someone else who likely has little or no background educating a student who is DHH.

One of the hallmarks of a successful TSDHH in the future will be the ability to engage in inter-professional collaboration (Prelock, 2013). Such a teacher will need to strike a balance between devoting sufficient time to increasing one’s expertise in education of children with hearing loss, as well as time to cultivating professional relationships to share this expertise with others for the benefit of the student.

Cost of Services

Through the present time, most school districts served by the regional education agency (within which I supervised the program for children with hearing loss) relied on the agency to provide staff support and TSDHH. However, some school districts hired their own TSDHH. In the future, this may increase as more school districts decide it is more economical to hire their own teachers rather than contracting with a regional educational agency.

Generic Supervision

A strength of regional education agencies that provide services for students with a hearing loss is that supervision of teachers and staff is typically provided by someone with a background in the education of students who are DHH or a closely related field, such as speech-language pathology. However, it appears that approximately half of the supervisors of TSDHH in the state within which the regional education agency is located do not have a background in education of students with hearing loss. Results of an unpublished survey TSDHH in this state was conducted in 2011 and revealed that 50% had a supervisor with a background in education of students who are DHH. The other 50% had a supervisor from another discipline, such as speech-language pathology, audiology, early childhood, blind and visually impaired, special education, or general education.

With regard to discipline-specific supervision, Clouse (1993) found that special educators in Pennsylvania preferred a supervisor with a background in their field. These teachers stated that this resulted in greater ease of communication with their supervisor, which may not be the case with a supervisor with a more generic background. They also indicated that it helped develop continuity in the program across schools and, as a result, reduced teacher isolation.

It must be pointed out that having a background in education of students who are DHH does not automatically make an administrator an effective supervisor of TSDHH. There are aspects of supervising a program for students who are DHH that transcend knowledge about deafness, such as the ability to manage a budget or conduct staff meetings. However, there are aspects of supervising a TSDHH that could be challenging if one does not have in-depth knowledge of education of students who are DHH. For example, teacher observation is gaining in importance (Danielson, 2007). It may be difficult for an administrator to critique and provide feedback to a teacher when he or she does not know the unique needs of students who are DHH. This difficulty will be especially apparent if the mode of communication being used is sign language and the administrator has limited knowledge of this modality. In general education, subject matter knowledge by the administrator is necessary if improvement in instruction is to occur (DaFour & Mattos, 2013; Goldring, Huff, Spillane, & Barnes, 2009). Similarly, it would seem that administrative knowledge of a disability area would also be necessary to foster improvement of instruction.

In the unpublished survey mentioned earlier, some of the TSDHH provided additional opinions on their being supervised by someone with a background in education of students who are DHH. Most of the comments stressed the importance of having a supervisor with a background in education of students with hearing loss. For example, one teacher said,

Having a supervisor with a degree in deaf education makes a difference. My supervisor is able to collaborate, brainstorm, support with facts and more. He is a very valuable asset to our program, because he knows about hearing loss and the impact it has on learning language. He also has experience working with the deaf.

A few teachers in the survey, however, mentioned advantages of having a supervisor without a background in education of students with hearing loss. For example, one teacher said,

While most of my supervisors in the past 25 years have not had any or much training in deaf education, many still provided a lot of support and gave me much helpful advice in the realm of special education and teaching in general.

The belief that a TSDHH should be supervised by a person with a background in educating students with hearing loss appears to have face validity. However, current and foreseeable educational workforce circumstances suggest that educators or other professionals in school systems without this background will continue to be among those providing such supervision, for several reasons. First, the DHH disability category has a low incidence. Thus, the number of TSDHH in any given program is going to be small. Therefore, to make economic sense administratively, it is likely that TSDHH will be supervised by an administrator who is also responsible for teachers and staff working with students with other disabilities or supervised by a general education administrator. This administrator may have a background in education of students who are DHH, but most likely not. Second, it is common for teachers to earn administrative certification with no intention of ever becoming an administrator. In the Commonwealth of Pennsylvania, for example, only 27% of those who have administrative certification are working as administrators (Joint State Government Commission, 2003). Reasons that teachers give for not pursuing administrative openings include inadequate compensation for the increased responsibilities of administrative positions, decreased job security, increased time commitments, and stresses of the job.

Teacher Training Programs

Currently, there are two teacher training programs in education of students who are DHH in the state of the regional education agency cited in this article. However, one program is slated to close soon. The reasons for closing the program include responding to budget cuts affecting all universities in this state, professors retiring or resigning from the program, and costs associated with providing a college major with less than 50 students (Stonecypher, 2012). These reasons are also factors in the closing of teacher training programs for education of students who are DHH in other states (H. Johnson, 2013; Lenihan, 2010).

Closing such teacher training programs will make it difficult for administrators in any system to replace teachers who have retired, will soon retire, have moved elsewhere, or have entered other work environments. These circumstances will make it necessary for administrators to seek out-of-state candidates to fill teaching positions, which could be a challenging endeavor.

Recruiting Future Teachers of the DHH

College students are attracted to majoring in education of students who are DHH for a variety of reasons, but chief among them is learning sign language (Dolman, 2010; Lenihan, 2010) and having a classroom. However, as was stated earlier, the number of students using sign language is declining, as is the number of classrooms devoted specifically to students who are DHH. Furthermore, TSDHH will be doing more consulting and collaborating and less direct teaching with students. In other words, future TSDHH will be working directly more with adults and less so with students. Such changes in service delivery may make the education of students who are DHH a less attractive major, resulting in fewer future TSDHH.

Telepractice

Telepractice is being used increasingly to provide early childhood services for students who are DHH (Houston & Stredler-Brown, 2012). As experience in other fields (e.g., health care) demonstrates, telepractice’s disruptive innovations (Christensen, Johnson, & Horn, 2010) are expected to have positive impacts on the education of preschool children who are DHH. Telepractice is utilized also in K through 12 settings, although to a lesser degree at this time (Hopkins, Keefe, & Bruno, 2012). By using video conferencing technology, a TSDHH is able to provide services in the home of a preschool child or in a facility convenient to where the child resides. Such locales require Internet connectivity, of course. Instead of traveling great distances to be served by a TSDHH, such as one possessing LSLS certification, the child with a hearing loss can receive services at or close to home. Such service delivery is ideal, for example, for children living in rural areas or at great distances from TSDHH resources (McCarthy, Duncan, & Leigh, 2012).

Education of students who are DHH is not alone in embracing telepractice. Audiology, speech-language pathology, early childhood education, and sign language interpreting are also utilizing this form of service delivery (Edwards, Stredler-Brown, & Houston, 2012; Kiernan, 2006).

The itinerant service delivery model proved disruptive in its ascendancy, consequent to the decline of the self-contained classroom model for educating students with hearing loss. In a similar fashion, telepractice (as a disruptive innovation) has the potential of changing the itinerant service delivery format used by TSDHH. These educators of children with hearing loss will become less itinerant in the sense of traveling less between student locations. Distance, travel time, weather factors, road and traffic conditions, travel expenses, and scheduling problems will be significantly less intrusive to educational service delivery. From an overview perspective, telepractice’s disruptive innovations portend improvements in utilizing the expertise of TSDHH; conserving fiscal resources of educational systems; increasing the number of students served; and improving understanding by other teachers, co-professionals, and parents about educating children with hearing loss.

Summary of Trends

By the early 1990s, a significant number of children who were DHH as a result of the rubella epidemic of the mid-late 1960s had graduated from public high schools. Many, if not most, of these children were educated in self-contained public school classrooms, coupled with general classroom education when possible. The significant decline in the number of children who were placed in classrooms for DHH in the public schools in the 1990s occurred as the trend for increased inclusion in general education classrooms took place. This inclusive education model for children who were DHH was supported by the trend of using TSDHH as itinerant service providers and resource room teachers.

Other trends occurring from 1990 to the present influenced the delivery of educational services to children who are DHH. Technological advances in screening the hearing of newborns enabled earlier detection of hearing loss. Early intervention starting as young as 3 months of age ensued and involved public education’s programs for children with hearing loss. In addition, during this time, the technology of cochlear implants became accessible to infants with severe to profound hearing losses, and advances in hearing aid technology benefited children with mild to severe hearing losses as well. The consequences of these technological trends included (a) the need for TSDHH with early childhood experiences to facilitate parental stimulation of infants and toddlers and (b) an increased interest by parents in LSL education for their children with severe to profound hearing losses. Both of these consequences of technology resulted in additional service delivery options within public education programs concerning TSDHH specialization areas. In turn, university programs needed to address these trends in the education of future TSDHH.

Additional trends intrinsically related to those cited above and that involve public education programs are as follows:

Inclusive education of children who are DHH has increased greatly the use of a consultation–collaboration model of service delivery by TSDHH, with the consequence that TSDHH must be familiar with and comfortable in providing their expertise this way.

Interest by parents in LSL learning methods has increased requests for it from TSDHH; a request that public education programs need to address depending on their professional staff’s capabilities.

University teacher training programs for TSDHH are declining in the United States, resulting in fewer teachers having American Sign Language (ASL) proficiency. Public schools may be challenged to find such talent to meet parental choice of ASL for their child.

Fewer university training programs result in fewer TSDHH overall to meet public school recruiting needs in the future. This trend may lead public schools to seek staffing solutions by asking general or special education teachers, or others on staff (e.g., speech-language pathologists), whether they can teach children who are DHH.

The trends related to school staffing issues address the need for TSDHH to periodically inform general and special education administrative personnel about the knowledge required in language and speech learning to effectively educate children who are DHH, as well as supervise TSDHH who provide such education.

There is a recent trend of increasing numbers of speech-language pathologists gaining expertise in LSL education through training and certification as LSLS. This trend could add future service providers for children who are DHH in public education systems.

Educational audiologists do provide services in school programs for children with hearing loss. Many school districts recognize the value of these services for their students who are DHH. However, some school districts may question the cost of providing audiology services due to the relatively small number of children with hearing loss within their system. The latter circumstance reflects the need to inform school personnel periodically of the benefits to students and families of such services.

Telepractice offers an exciting innovation in the delivery of early childhood and preschool services for children who are DHH, and potentially for those in the K through 12 grades. It offers an alternative way for how itinerant services are delivered by TSDHH to children, their families, and other educational personnel serving these children.

Conclusion

During my tenure as a supervisor of the program for children who are DHH in a regional education agency, I experienced the impact of many trends that affected this agency as well as other programs throughout the country. Some of these trends resulted in dramatic changes in the way this program educated students who are DHH, including an increasing reliance upon the itinerant model of service delivery, an increasing emphasis upon consultation/collaboration, and an increasing ability of students with hearing loss to access sound due to technological advances, such as cochlear implants.

Although these trends were challenging, the program that I supervised always found a way to adapt. I attribute this flexibility to three factors: First, the teachers and staff were good at handling change. Some if not many of the aforementioned trends created disequilibrium for them. However, in true Piagetian fashion, when teachers and staff were confronted with one of these trends, they soon determined how to accommodate and assimilate these changes. They developed new schema to embrace a trend and make it work for students. Second, teachers and staff always placed the needs of the student who is DHH above their own needs. I would tell teachers and staff that our job was to “put ourselves out of a job.” In other words, our goal was to provide students who are DHH with the skills they need to be successful in school so that they would no longer need us. Third, teachers and staff were excellent at building relationships and developing trust, especially with students, parents, teachers, and administrators.

If a program for children who are DHH in a regional education agency—or any other school program serving students who are DHH—can focus on what is best for students, develop relationships, and build trust, then regardless of the trend, that program will adapt and thrive under the most challenging of circumstances. Because of this ability to adapt, a program with teachers and staff who demonstrate these qualities will ultimately provide their students with an education that will prepare them for success in school and in adult life.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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