Understanding Hearing Loss

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Assistive Listening Devices

Best practice guidelines for early intervention with deaf children state that ‘Providers must be skilled in the tools, assistive devices, and mechanisms necessary to optimally support the child’s language and communication development,’ (Moeller et al, 2013: 438). The introduction of the Newborn Hearing Screening Programme has resulted in the diagnosis of hearing loss in the first few weeks of life (Public Health England, 2016). Despite significant progress in early identification and amplification, families often find themselves in challenging listening situations when their child is at a distance with background noise. There is no legislation in place to control the listening environment in pre-schools and nurseries. 

The first quality standard from the UK Children’s Radio Aid Working Group states that, ‘Every deaf child should be considered as a potential candidate for provision with a personal radio aid as part of their amplification package, at first hearing aid fitting,’ (NDCS, 2017:11). In the introduction to this document, McCracken (NDCS 2017: 4) refers to the ‘hostile acoustic environments’ that deaf children face in everyday life.

A study by Klatte et al, (2010) showed that background noise had a greater impact on children’s speech perception and listening comprehension than adults, with high levels of classroom noise adversely impacting attainment. Children are not able to make sense of words they have missed, as their auditory neurological network is not fully developed (Cole and Flexer 2011). Nursery classrooms have noise levels ranging from 34 to 73dBA (Schafer and Thibodeau 2006) and a radio aid can help to overcome distance and improve signal-to-noise ratios. 

A study by the Ear Foundation and NDCS (2017) showed that the majority of parents (84%) considered there to be benefits of using the radio aid in certain situations on a daily basis. Parents identified times of the day when the radio aid was of significant benefit to aid communication such as in the car (89%), shopping (91%), outside (85%) and 100% of the parents reported the benefits of using a radio aid when their child was in a buggy.

In addition to parent perception, the study used the LENA technology (Warren, 2015) to monitor the child’s vocalisations throughout the day. The results were conclusive in highlighting the benefits of radio aid use to increase language input with adult words, child vocalisations and conversational turns all showing a significant increase. Language opportunities and the quality of parent child interaction were shown to increase.

The study (Ear Foundation 2017:37) recommended that ‘All parents of a young deaf child should be informed of the significant potential benefits of radio aids and have the opportunity and support to use the technology at home.’ The report also states that the provision of radio aids to young deaf children should be equitable around the country with funding being provided. There is now a legal requirement for ‘auxiliary aids’ to be provided as part of reasonable adjustments as outlined in the Equality Act (2010). 


The Radio Aids MESHGuide provides detailed information about what a radio aid is and why it is used. Information is provided about using radio aid in everyday life and in educational settings. There is a column about setting up a radio aid with cochlear implants, hearing aids, bone conduction aids and use with soundfield systems.



This Quality Standards for the use of personal radio aids written by the NDCS provides information about the fitting, setting up and management of personal radio aids.





Roger for Education is a guide produced by Phonak outlining their portfolio of devices for different learning scenarios in education.

Roger Reference Sheets have been created by Phonak, providing advice for a daily listening check and information on using the Multimedia Hub, Pass-around mic, Roger Touchscreen, Roger Inspiro, Roger Pen, Roger Digimaster and how to create a small group network or a Roger Multitalker Network.



  Oticon EduMic is a wireless remote microphone system that provides direct access to the teacher's voice.


Auditory Processing Disorder (APD)
Children with Auditory Processing Disorder have difficulty understanding speech and this is particularly challenging in background noise. 'Roger Focus for Auditory Processing Disorder' by Phonak explains how this technology can be used and the benefits. A MESHGuide on Auditory Processing Disorder provides further information.


Connevans have collated an information booklet about a range of equipment including loops, solutions for home and leisure, listening to music and much more.






Soundfield Systems

A soundfield systems uses a speaker, or combination of speakers to enable children and students to hear better in classrooms regardless of where they are seated in the room. Soundfield systems can monitor the level of background noise in the room and automatically increase the level of the speakers' voice when background noise increases, providing a better signal to noise ratio and improved access to speech.

Speech recognition results achieved with traditional and dynamic soundfield are presented in the article, 'The Dynamic Soundfield System' by Phonak as explained in this booklet.

RG Sound Solutions provide information about soundfield systems for education.



Roberts Audio Solutions provide information about a number of soundfield systems suitable for use in education.



Frontrow Juno is bluetooth classroom soundfield system.

 Frontrow Pro Digital can be connected to two microphones and connected to existing speakers to improve access to sound in the classroom. This animation explains the challenges of distance and noise in schools.


Redcat Access is a flat pannel speaker, which can improve speech intelligibility in a classroom.




Connevans provide advice and information on a wide range of School Soundfield systems. 



The British Association of Teachers of the Deaf has collated a list of Assistive Listening Technology Working Groups useful links.




Cole, E. B., Flexer, C. (2011) Children with hearing loss, developing listening and talking. San Diego, CA: Plural Publishing. 

Equality and Human Rights Commission. Equality Act 2010 [Online]. Available at:  https://www.gov.uk/guidance/equality-act-2010-guidance   [Accessed:12 February, 2021].

Klatte, M., Lachmann, T. and Meis, M. (2010) ‘Effects of noise and reverberation on speech perception and listening comprehension of children and adults in a classroom- like setting.’ Speech Perception and Understanding 12. pp. 270-82. 

Moeller, M., Carr, G., Seaver, L., Stredler-Brown, A., & Holzinger, D. (2013). ‘Best practices in family-centered early intervention for children who are deaf or hard of hearing: An international consensus statement.’ The Journal of Deaf Studies and Deaf Education18(4), pp. 429-445. 

NDCS (2017) Quality Standards for the use of personal radio aids. [Online]. Available at: https://www.ndcs.org.uk/documents-and-resources/quality-standards-for-the-use-of-personal-radio-aids-promoting-easier-listening-for-deaf-children/  [AccesIsed:12 February, 2021].

Phonak (2011) Dynamic Soundfield: A new era in classroom amplification. [Online]. Available at: https://www.phonak.com/uk/en/hearing-aids/accessories/roger-dynamic-soundfield.html [Accessed: 15 February, 2021].

Phonak (2011) Field Study News: Traditional or Dynamic Soundfield. [Online]. Available at: https://www.phonak.com/content/dam/phonak/HQ/en/solution/accessories/roger_dynamic_soundfield/documents/fsn_DNS-Traditional_or_Dynamic.pdf [Accessed: 15 February, 2021].

Public Health England (2016) Newborn hearing screening: programme overview. [Online]. Available at: https://www.gov.uk/guidance/newborn-hearing-screening-programme-overview#evidence-and-recommendations [Accessed: 12 February, 2021].

Schafer, E. C. and Thibodeau, L. M. (2006) ‘Speech recognition in noise in children with cochlear implants while listening in bilateral, bimodal, and FM-system arrangements’. American Journal of Audiology, (15). pp. 114-126. 

The Ear Foundation & NDCS (2017) Using radio aids with pre-school children Available at: https://www.ndcs.org.uk/media/1822/ear_foundation_using_radio_aids_with_preschool_deaf_children.pdf  [Accessed: 12 February 2021].

Warren, S (2015) Right from Birth: Eliminating the talk gap in young children. [Online]. Available at: https://www.lena.org/research/ [Accessed: 12 February, 2021].