Building Listening and Communication in Children with Hearing Loss who have Additional Disabilities

Abstract: Up to 40% of children with hearing loss also present with additional educationally relevant disabilities, requiring highly individualized intervention. This session explores assessment strategies and therapeutic modifications to support auditory skill development—detection, discrimination, identification, and comprehension—in children with complex needs. Presenters will highlight evidence-based practices, case-based strategies, and family-centered approaches to improve communication outcomes. Topics include tailoring therapy for children with autism, motor impairments, cognitive delays, or craniofacial differences, as well as the critical role of parent involvement and interdisciplinary collaboration. Attendees will gain practical tools to adapt traditional listening and spoken language practices to serve this underserved and diverse population more effectively.
Description: Children with hearing loss who have additional disabilities—often referred to as “Deaf Plus”—represent approximately 40% of the pediatric hearing loss population. These children present with a wide range of cognitive, physical, neurological, and sensory challenges that impact communication development and outcomes. This session will provide clinicians, educators, and related service providers with evidence-based strategies and practical tools for assessing and treating this diverse and underserved group.

Drawing on clinical expertise and current research, the presenters will first provide an overview of the prevalence and types of co-occurring conditions, such as autism spectrum disorder, global developmental delay, cerebral palsy, visual impairments, and congenital syndromes. Attendees will learn how these diagnoses influence access to sound, language development, and therapy planning. Emphasis will be placed on recognizing red flags, understanding prognostic factors, and setting realistic, functional goals in collaboration with families.

The session will outline modifications to the traditional auditory skill hierarchy—detection, discrimination, identification, and comprehension—to support children with complex profiles. Participants will explore how to adapt listening tasks, use alternative response modalities (e.g., eye gaze, motor actions), and select motivating and accessible therapy materials. Strategies will also address children with limited mobility, those who are nonverbal, and children with sensory integration needs.

Additional focus will be given to the importance of dynamic assessment and the integration of criterion-referenced tools that capture a child’s true communicative intent beyond standardized measures. Presenters will highlight the significance of parent engagement, modeling, and carryover into daily routines, reinforcing that the family is the most powerful change agent in a child’s communication journey.

By the end of the session, participants will be equipped to evaluate each child holistically and deliver therapy that is developmentally appropriate, responsive to coexisting challenges, and grounded in the family's vision and priorities. Through case examples, practical demonstrations, and collaborative discussion, this session empowers professionals to more confidently serve children who fall outside the traditional cochlear implant or hearing aid user profile.

This session is ideal for speech-language pathologists, auditory-verbal therapists, early interventionists, audiologists, educators of the deaf, and any professionals working in pediatric hearing healthcare or inclusive settings.

Supporting Research: Reference 1: Glaubitz, C., Liebscher, T., & Hoppe, U. (2022). Children with cochlear implant and additional disabilities benefit from consistent device use. International Journal of Pediatric Otorhinolaryngology, 162, 111301. https://doi.org/10.1016/j.ijporl.2022.111301

Supporting Research: Reference 2: Herrmannova, D., Lenarz, T., Phillips, R., O’Donoghue, G., Twomey, T., Ramsden, R., Henderson, L., & Bertram, B. (2009). Champions profile for evaluation of paediatric cochlear implant users with complex needs – European retrospective study. 8th ICCES Proceedings.

Supporting Research: Reference 3: Cruz, I., et al. (2012). Language and behavioral outcomes in children with developmental disabilities using cochlear implants. Otology & Neurotology, 33(5), 751–760.

Supporting Research: Reference 4: Cejas, I., Hoffman, M., & Quittner, A. (2015). Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: A review and report of family influences on outcomes. Pediatric Health, Medicine and Therapeutics, 6, 45–63. https://doi.org/10.2147/phmt.s65797

Supporting Research: Reference 5: