Auditometry
Audiometry involves the use of a sound-treated room in which a child is presented with a variety of sounds from high to low pitches, and from soft to loud intensity. An audiologist will have the child respond to the different sounds and document it. A young child can be taught to turn to a sound (behavioral testing), or to place a toy on a box or a ring on a post (play audiometry).

Auditory Brainstem Response (ABR)
During this test, three small electrodes are placed on the baby’s head, and then clicks or tones are played into little headphones placed over the baby’s ears. The equipment measures the brain’s response to these sounds. This test does not measure what the baby can hear, rather it determines the sounds to which the brain actively responds. This test takes only a few minutes and can be done while the baby is sleeping.

Impedance Testing
These are tests that determine the functioning of the middle ear. It only takes from 3 to 30 seconds per ear. It may also be referred to as Immittance Testing, which includes tests called (a) Tympanometry, and (b) Acoustic Reflexes. In this type of evaluation, eardrum mobility is measured under different pressure conditions to determine if any problems exist in the middle ear.

Otoacoustic Emissions Testing (OAE)
Quick, non-invasive probe measure of cochlear (inner ear) function. During this test, a small probe is place in the baby’s ear and clicks or tones are played and sent from the probe speaker to the ear canal, through the middle ear, and into the cochlea. Outer hair cells in the cochlea become excited and react by generating and emitting an acoustic response. This emitted response then travels in a reverse direction from the cochlea back to the ear canal, where it is detected by the probe microphone. This is not really a test of what the baby hears, it simply tells the doctors whether the hair cells in the ear are functioning within normal limits.

Audiogram
An audiogram is a graph that shows the audible threshold for standardized frequencies as measured by an audiometer. The Y axis represents intensity measured in decibels and the X axis represents frequency measured in hertz.

Audiologist:
healthcare professional with a Master’s or Doctoral degree who is qualified to provide services in prevention, evaluation, and (re)habilitation of hearing and associated communication disorders.

Audiommeter:
a specialized instrument used in the measurement of hearing.

dB (Decibel):
a unit of sound intensity that uses a base 10 logarithmic scale. Usually used in conjunction with some reference level.

dB HL (Decibels Hearing Level):
the notation used on an audiogram where “0 dB HL” represents average or typical hearing in humans.
Feedback:
the squeal/whistle a hearing aid makes when amplified sound from the receiver reaches the microphone and is re-amplified.

Hertz
The hertz (symbol: Hz, definition: 1/s) is a unit derived from time which measures frequency in the International System of Units (SI). Frequency is how often something happens. A frequency of 1 hertz means that something happens once a second.

Huggies:
a flexible plastic tubing and band device to help keep hearing aids on an infant or young child.

Huggie Aid:
a huggie that is attached to a length of flexible tubing and attached to a child’s clothing to reduce the chance of hearing aids being lost.
Speech Reception Threshold:
the quietest sound intensity level where speech can be correctly identified.

Auditory Assistive technologies are available to those who choose to use their residual hearing
Bone Anchored Hearing Systems
Unlike hearing aids, bone-anchored hearing systems are surgically implanted devices. They provide bone conduction of sound vibrations to the inner ear—this is in contrast to regular hearing aids, which amplify acoustic sounds that enter the ear canal. Those who benefit from bone-anchored hearing systems include those who have outer or middle ear malformations.

Cochlear Implants
A cochlear implant is a surgically implanted neuroprosthetic device to provide a person with moderate to profound sensorineural hearing levels a modified sense of sound. An implant bypasses the normal acoustic hearing process to replace it with electric signals which directly stimulate the auditory nerve.

FM Systems
A personal frequency modulation (FM) system uses radio waves to send speech and other signals to hearing aids and cochlear implants. FM is the same type of signal as your FM radio, only it’s tuned to a frequency band designated for personal use.
There are two basic components of a personal FM system: a transmitter microphone and a receiver. The receiver may be integrated into a pair of hearing aids or a set of headphones.

Hearing Aids
A hearing aid is an electronic device designed to improve residual hearing of Deaf/hard of hearing people by making sound more audible. A hearing aid can be analog or digital and is worn behind the ear. A hearing aid can help people hear more in both quiet and noisy situations.

Sound Field Systems
A sound field system is an amplification system that provides an even spread of sound around a room. This is beneficial for deaf students, as they can hear the teacher’s voice clearly from wherever they are seated, even if the teacher is facing away from them.

Telephone Amplifiers
These are small devices that plug into a phone to amplify sound.

The outer ear is made up of…
the part we see on the sides of our heads, known as (1) the pinna, (2) the ear canal, and (3) the eardrum, sometimes called the tympanic membrane, which separates the outer and middle ear

Pinna: the external cartilaginous portion of the ear that holds hearing aids or earrings.

The middle ear is made up of…
Eardrum/ Tympanic membrane: a membrane forming part of the organ of hearing, which vibrates in response to sound waves. In humans and other higher vertebrates it forms the eardrum, between the outer and middle ear.

Ossicles: the three small bones of the middle ear (malleus, incus, and stapes) that transmit sound from the eardrum to the inner ear.

The inner ear is made up of the…

Auditory Nerve -The auditory nerve is a bundle of nerve fibers that carries hearing information between the cochlea the brain.
Cochlea -the inner ear, consisting of bony and membrane chambers containing fluids and the sensory cells (hair cells) that send sound from the middle ear to the auditory nerve. Damage to the sensory cells in the inner ear is the most common cause of permanent hearing loss. The inner ear is physically connected to the balance mechanism.

Semicircular canals: each ear contains three semicircular canals: anterior, posterior, and horizontal canals. Each of these canals provides a separate sense of directional balance, and each canal on the left is always paired with a canal on the right for normal function. The anterior canal detects forward and back head movement, like nodding. The posterior canal detects head tilt like tipping the head toward the shoulders. The horizontal canal detects horizontal movement of the head, such as swiveling the head side to side.

American Sign Language/English Bilingual Approach
The ASL/English Bilingual approach uses both English and American Sign Language through the ready use of children’s eyes and hands. The focus is on full communication access in American Sign Language and written English with the primary goal of being bilingual with mastery of ASL and written English. This is an “inclusive” approach that benefits Deaf and hard of hearing children with varying degrees of hearing levels through fully accessible and natural pedagogies.

Listening and Spoken Language Approach (Oral Deaf Education)
The Listening and Spoken Language approach teaches infants and young children to use hearing and speech to develop spoken language for communication and learning. Signs are not used in this approach; however, natural gestures that are used in typical conversations are included. The goal is for children to enter the mainstream after they have time to strengthen their language, social, and cognitive development in a Listening and Spoken Language program.

Total Communication Approach
Total Communication (TC) includes the use of all modes of communication at the same time (i.e., speech, signing, auditory training, speech reading, lip-reading, and fingerspelling). Children are provided with information in both auditory and visual formats. This allows the child to use the information that best suits his or her needs.

Assessment
The way in which service providers document a child’s progress and determine his or her developmental level. In California, the tools used are the DRDP and the Ski-Hi.

Critical Mass
Deaf children require settings that utilize a critical mass of language peers to ensure age-appropriate development of learning, emotional and social skills. Deaf children require interaction with deaf adult role models to internalize their self worth and visualize their potential.

Early Start
Early Start is California’s name for the Part C is the section of federal Public Law 105-17 (IDEA) that refers to early intervention services available to eligible children from birth through 2 years of age and their families.

Home Visits
Weekly visits provided to your family to share resources and information about your child’s hearing levels, language opportunities, and developmental milestones. Your Early Start teacher, from your local school district, will help you explore opportunities, and support you in your journey with your Deaf/hard of hearing child.

Inclusion
Deaf or hard of hearing students in inclusion programs attend classes with hearing students. A variety of additional services and resources may be involved in inclusion – interpreters, note takers, teacher aides, teachers of students who are deaf, and consultants. Disadvantages of inclusion include limited opportunities for direct instruction and communication, since the student interacts with teachers and peers primarily through an interpreter. (https://www.theclassroom.com/)
Individualized Family Service Plan (IFSP)

An IFSP is a written plan developed by parents or guardians and a multidisciplinary team. The IFSP will do the following:
a. Address the family’s strengths, needs, concerns, and priorities.
b. Identify support services available to meet these needs.
c. Empower the family to meet the developmental needs of their child.

Language Milestones
Expected developmental steps linked with your child’s age for signed and/or spoken language.

Language Rich Environment
A language rich environment is about providing an accessible language such as a visual language like ASL with Deaf and hard of hearing children. Building a language rich environment is about using every opportunity to use language, to interact, to play to share a focus, and to take turns.

Local Education Agency (LEA)
LEA stands for Local Education Agency. Basically it’s a fancy way of saying ‘school district’.” In an IEP* meeting, the LEA is the representative of the school district that referred the student to special education services, and pays for them.

Low-Incidence Disability
Individuals with disabilities that make up a small percentage of the population. Some examples of these might be having a visual impairment, Deaf and hard of hearing, deaf–blind or significant cognitive impairment. The definition of low-incidence disability varies from state to state.

Mainstreaming
Mainstreamed students spend most of their school day in classes with hearing students, however, their home classroom is a special education class. Mainstreamed students are often expected to keep up in classes with hearing students without additional resources. Often an interpreter is offered to the student (https://www.theclassroom.com/)

Modality
The sensory channels (that is, vision, touch, or hearing, or a combination of these) through which the family will communicate.

Part C of the Individuals with Disabilities Education Act (IDEA)
Part C is the section of federal Public Law 105-17 (IDEA) that refers to early intervention services available to eligible children from birth through 2 years of age and their families. In California the Part C program is called Early Start.

SELPA
The acronym “SELPA” stands for Special Education Local Plan Area. School districts and County Offices of Education (referred to as Local Educational Agencies, or LEAs) join together in geographical regions in order to develop a regional special education service delivery system.

Speech Therapy
Speech therapy focuses on the development of listening and articulation skills for the development of spoken language skills which contribute to the overall development of literacy and learning.

Hearing levels can range from mild to profound. Residual hearing can be affected by the frequency of the hearing level.
Mild Hearing

A person with a mild hearing level may hear some speech sounds but soft sounds are hard to hear.

Moderate Hearing Level
A person with a moderate hearing level may hear almost no speech when another person is talking at a normal level.
Severe Hearing Level

A person with severe hearing level will hear no speech when a person is talking at a normal level and only some loud sounds.

Profound Hearing Level
A person with a profound hearing level will not hear any speech and only very loud sounds.

(adapted from the Center for Disease Control)

Hearing levels can range from mild to profound. Residual hearing can be affected by the frequency of the hearing level.

Mild Hearing
A person with a mild hearing level may hear some speech sounds but soft sounds are hard to hear. Will have trouble hearing faint or distant speech and understanding speech in a noisy environment. Many children with undiagnosed mild hearing loss experience language delays and read at grade level equivalencies below those of their normal hearing peers.

Moderate Hearing Level
A person with a moderate hearing level may understand only loud speech., may have difficulty in group discussions. Their own speech may have errors. Vocabulary limitations and deficiencies in language comprehension and usage are common.

Severe Hearing Level
A person with severe hearing level will hear no speech when a person is talking at a normal level and only some loud sounds. Will not be able to discriminate words without visual cues. If hearing loss is present during first year of life, understanding of spoken language and use of speech will not develop spontaneously. Own speech is mostly unintelligible.

Profound Hearing Level
A person with a profound hearing level will not hear any speech and only very loud sounds. Will rely on vision rather than hearing as primary sensory channel for communication. Own speech is unintelligible.

(adapted from the Center for Disease Control & Sound Beginnings; A Kansas Resource Guide)

Many people perceive being Deaf or hard of hearing as a disability or a medical condition. As a parent of a Deaf/hh child, you will learn which terms are appropriate to use. Below are many terms you may encounter whether they be at an audiology appointment or with a neighbor. Many Deaf people view themselves as members of a distinct cultural community with its own language, values, and social norms. There are no specific hearing levels or personal characteristics that determine how a person identifies themselves. For example, a person with profound hearing level and has the ability to engage in spoken conversation may identify themselves as hard of hearing, while another person with moderate hearing level identify as Deaf. How an individual chooses to identify is based on a variety of factors that include hearing level, communication preference, cultural orientation, and use of technology.

deaf (lowercase ”d”) – Generally, this refers to the audiological condition and includes all individuals of varying hearing levels.
Deaf (uppercase ”D”) – Individuals who identify themselves as Deaf use ASL as their primary language and mode of communication and may have any hearing level from mild to profound. Deaf people share common language, values, social norms, traditions, and beliefs that characterize Deaf culture.

DeafBlind – a DeafBlind (DB) or deafblind (db) person has a combination of differing hearing and vision levels. There are varying levels of vision issues, such as reduced peripheral vision or close vision. Depending on their vision and hearing levels, many DB/db individuals use tactile ASL to communicate; others may use modified versions of sign language.

hard of hearing – A Hard of Hearing HH/ hh person typically has some residual hearing which may enable them to use spoken language for everyday communication. Many hard of hearing people use ASL to communicate, or other forms of sign language in addition to spoken language.

hearing – Someone who has typical hearing levels
late-deafened – This indicates a change in hearing level that occurred after spoken language is fully developed (during childhood).

Terms to AVOID
Hearing Impaired – this term implies the person is impaired or broken

Hearing Loss – this is also a clinical term that means something is lacking however many deaf people are born deaf and never “lost” anything Levels

deaf and dumb – this is an older offensive term that referred to people who were deaf and could not talk. We do not recommend this term to be used AT ALL.

American Sign Language is a visual natural language that serves as the predominant sign language of Deaf communities in the United States and most of Anglophone Canada. With sign language, the brain processes linguistic information through the eyes. The shape, placement, and movement of the hands, as well as facial expressions and body movements, all play important parts in conveying information.

Language is the systematic and rule-governed, conventional method of communicating. More sophisticated than “just” communication. Language inspires cognition and cognition inspires language. They are intricately intertwined. Languages most often referred to on this website include American Sign Language, English and Spanish.

Language Acquisition: a natural progression or development in the use of language, typified by infants and young children learning their first language

Language Milestones
Expected developmental steps linked with your child’s age for signed and/or spoken language.

Language Rich Environment
A language rich environment is about providing an accessible language such as a visual language like ASL with Deaf and hard of hearing children. Building a language rich environment is about using every opportunity to use language, to interact, to play to share a focus, and to take turns.

Language model: Anyone who provides a good demonstration of the family’s chosen language(s) to communicate with a child.

Spoken Language:
Naturally acquired language expressed in speech. Children often easily acquire home spoken languages whether they be in English, Spanish, Cantonese, etc.

Audiologist
healthcare professional with a Master’s or Doctoral degree who is qualified to provide services in prevention, evaluation, and (re)habilitation of hearing and associated communication disorders.

Deaf Coach
Deaf coaches provide insight into your child’s experience of growing up Deaf/hard of hearing. A Deaf Coach is trained to work with families and to support the language goals of your child and family.

Early Start Coordinator
Oversee the service provision and assessment of the needs of infants and toddlers (0 to age 3) who are eligible for Early Start services.

Early Start Teacher
An Early Start Teacher is responsible for overseeing and providing developmentally appropriate activities and instruction to children who have disabilities. Early Start teachers working with Deaf/hard of hearing children are certified teachers of the deaf, audiologists or speech language pathologists.

Parent Mentors
Parents who have experience raising a child who is Deaf/hard of hearing and are trained to work with other families. They can share what they have learned and support your family as you navigate the possibilities and challenges in raising your child.

Pediatrician
Pediatricians are doctors who manage the health of your child, including physical, behavior, and mental health issues. They’re trained to diagnose and treat childhood illnesses, from minor health problems to serious diseases.

Pediatric Audiologist
An audiologist who has special training and certification to work with babies and children. Pediatric audiologists provide regular hearing testing to assess your child’s hearing levels and current functional hearing. Hearing levels and conditions such as microtia, atresia, and auditory neuropathy are explained. Hearing technology such as hearing aids and cochlear implants are also explained and discussed.

Otolaryngologist (ENT)
an ear, nose, and throat physician.

Sign Language Interpreter
Sign language interpreters are often used to facilitate communication between a signing Deaf person and a non-signing person. It is important to know that interpreters are certified professionals who adhere to a strict professional code of ethics and code of conduct in which confidentiality and neutrality is maintained in all situations. The interpreter mediates between two language users and cultures, but is not a participant in the interaction.

Speech/Language Pathologist:
A healthcare professional who has a Master’s or Doctoral degree with expertise in providing services in prevention, evaluation, and rehabilitation of speech and language disorders. Speech-Language Pathologists (SLPs) address the complex interplay of the areas of listening, speaking, signing, and reading.

A system of making English visible to Deaf /HH children.

Signing Exact English (SEE): Signing Exact English is a visual representation of spoken English. It is an invented sign system that represents literal English. To make visible everything that is not heard, SEE supplements what a child can get from hearing and speechreading. Since American Sign Language (ASL) has a different vocabulary, idioms and syntax from English, SEE modifies and supplements the vocabulary of ASL so children can see clearly what is said in English.

(www.seecenter.org)

Conceptually Accurate Signed English (CASE): Conceptually Accurate Signed English (CASE) uses the grammatical structure of English, but uses the conceptually accurate signs of American Sign Language.

Cued Speech: Cued Speech is a mode of communication based on the phonemes (sounds) and properties of traditionally spoken languages. Cueing allows users who are Deaf or Hard of Hearing or who have language/communication disorders to access the basic, fundamental properties of spoken languages through the use of vision.(www.cuedspeech.org)

Simultaneous-Communication (Sim-Com) or Signed Supported Speech (SSS): Sim-Com or SSS is the use of parts of ASL or SEE signs while speaking English at the same time.

Alerting Devices
Alerting devices can Deaf/hard of hearing help people stay connected and safe every day and in emergency situations. They use one or more of these types of signals: visual – a flashing light, vibrotactile – a vibrating component and auditory – increased amplification and use of lower frequency sounds. Devices include light flashing and/or vibrating alarm clocks, doorbells, baby crying signals and smoke detectors.

Computer Aided Real-time Transcription (CART)
CART refers to the instant translation of the spoken word into English text using a stenotype machine, notebook computer and real-time software. The text produced by the CART service can be displayed on an individual’s computer monitor, projected onto a screen, combined with a video presentation to appear as captions, or otherwise made available using other transmission and display systems.

Closed Captioning on TV
Closed captioning displays the audio portion of a television program as text on the TV screen, providing a critical link to news, entertainment and information for individuals who are Deaf or hard-of-hearing.

Phone Apps
There are many apps on cell phones that serve as video phones as well as video messaging such as Face Time, Google Hangouts, Glide, Marco Polo and many more.

Videophones (VP)
Video phones are specialty phones that allow callers to see each other on a screen. Video phones are provided free to Deaf individuals including families with Deaf/hh children.

Video Relay Services (VRS)
The United States funds a service called ‘Video Relay Services’ (VRS) to provide interpreters to Deaf people to make telephone calls to hearing people. The video phone, often called a VP, can be used to talk to others via a sign language interpreter, who connects with a person who can hear through a regular phone.