DHH Language and Literacy Law: Important Terms

A non-invasive test that measures the hearing potential of the auditory nerve from the cochlea through the brainstem; responses are evoked from an auditory stimulus and are measured in five to seven waveform peaks. The automated version is used for infant hearing screening.

A sleep state or sedation is required for infants and toddlers. This test may also be referred to as BAER (Brainstem Auditory Evoked Response) and BSER (Brainstem Evoked Response).

Pertaining to sound, the sense of hearing or the science of sound. Often used to refer to the quality (noise and reverberation levels) of the sound environment such as classroom acoustics.

Hearing loss which develops after birth. Sometimes referred to as adventitious loss.

The role parents or guardians play in developing and monitoring their child's educational program. Advocating for your child means knowing what rights are assured you by the law and actively participating in the decision-making process to ensure that the services are delivered in line with your goals for your child's development and education.

The background noise in an environment which usually competes with the primary speech signal.

The use of hearing aids and other electronic devices to increase the loudness of a sound so that it may be more easily received and understood.

Devices and systems which are available to help deaf and hard of hearing people improve communication, adapt to their environment, and function more effectively. These include personal hearing instruments, frequency modulation (FM) systems, infrared, special connectivity devices for telephone, television, computer use, and amplified or visual alarms and signals. These devices may also be referred to as hearing assistance technology (HAT).

Refers to voice quality that lacks traditional musical tonality or harmonics.

Like the ABR, the ASSR is a measure of the brainstem’s responses to particular auditory stimuli. This noninvasive, test is usually administered while the child is sleeping. ASSR technology offers the audiologist an additional method to determine your child’s hearing across different frequencies. The equipment has higher upper limits than traditional ABR equipment, thus allowing the audiologist to more accurately differentiate between severe and profound hearing loss in infants.

A graph on which a person's ability to hear different pitches (frequencies) at different volumes (intensities) of sound is recorded.

An evaluation of hearing ability that is minimally comprised of pure-tone thresholds and speech and word recognition measurements to determine the type and degree of hearing loss. Additional measures such as acoustic immittance, acoustic reflex, otoacoustic emissions, speech-in-noise, and procedures to identify the need for amplification or verify the fitting of amplification are included as needed.

A person who holds a degree in audiology and is a specialist in the assessment of hearing ability and providing habilitation services to persons with hearing loss. Audiologists who specialize with children and youth in school placements are identified as educational audiologists. Audiologists may be certified by either The American Speech-Language-Hearing Association or the American Board of Audiology. Most states require audiologists to be licensed in the state they practice.

An auditory disorder that disrupts the synchronous activity of the hearing system. There is high variability in individual effects with most common complaint of hearing sounds but not comprehending what is heard; hearing ranges from normal to severe hearing loss and some improve over time. Treatment also varies.

Hearing acuity is normal but the ability to process and understand what is heard is affected; listening in background noise is a common symptom. There is significant variability from mild listening problems to auditory processing disorders. Some improve with age. Treatment may be similar to those with hearing loss. Most problems are diagnosed at about seven to eight years of age.

The process of training a person's residual hearing and listening skills to recognize, identify, and interpret sound. Training is usually provided by a speech language therapist or audiologist.

Treatment designed to help persons with hearing loss make productive use of their residual hearing. Sometimes includes training in speech reading and communication strategies.

An audiologist assesses a young child's behavioral response to sound by observation. This method must be accompanied by physiological measures (e.g., ABR, OAE) to diagnose hearing loss.

Belonging to both a hearing/English language culture and Deaf Community/ASL culture.

A hearing loss in both ears.

Hearing aids worn on both ears.

Sound is delivered through the bones of the skull.

Chronological is how old the infant or child is based on his/her date of birth. It is referred to when comparing him or her to other children born at that same time. If a baby was born prematurely, however, his/her development may be measured at his/her adjusted age. Adjusted age takes into account the time between premature birth and the actual due date of a full term pregnancy. Doing this gives a truer reflection of what the baby's developmental progress should be.

An electronic device that is surgically implanted in the cochlea of the inner ear. It transmits auditory information directly to the brain, by-passing damaged or absent auditory nerves. Technically, it synthesizes hearing of all sounds, but the wearer requires training to attach meaning to the sounds. This is called auditory "habilitation", or "rehabilitation". Typically, cochlear implant users have severe to profound hearing losses and do not get much benefit from hearing aids. Successful CI users gain useful hearing and improved communication abilities. The FDA has approved CIs for qualified candidate adults and children starting at age 12 months.

Refers to the ability to think, learn and remember.

In play audiometry the audiologist helps the child understand the rules for playing a game. For example, when the child is presented with a sound he or she is to drop a block into a container, indicating that the sound was heard. Play audiometry is generally used from 18 months to 48 months of age.

Impairment of hearing due to failure of sound to reach the inner ear through the normal air conduction of the outer and middle ear. In children, conductive loss is typically medically correctable, and is most often associated with Otitis Media. Some children will have permanent conductive hearing loss due to structural abnormalities of the ear such as an absent canal opening (atresia) or as a result of chronic middle ear disease.

Hearing loss present at birth or associated with the birth process.

A mode of communication using the mouth and hand to visually distinguish the phonemes of English spoken language. There are 8 handshapes (cues) indicating groups of consonants and 4 positions around the face indicating vowel sounds.

Medically and clinically speaking, a hearing loss which is so severe that the child is unable to process linguistic information through hearing alone. Socially, when used with a capital letter "D," Deaf refers to the cultural heritage and community of deaf individuals, i.e., the Deaf culture or community. In this context, Deaf applies to those whose primary receptive channel of communication is visual.

Hearing loss and visual impairments of any degree occurring together.

A group of people who share common interests and a common heritage. Their mode of communication is American Sign Language (ASL). The Deaf community is comprised of individuals, both deaf and hearing, who respond with varying intensity to particular community goals which derive from Deaf cultural influences. The Deaf community in the United States may have a wide range of perspectives on issues, but emphasis remains on Deafness as a positive state of being.

A view of life manifested by the mores, beliefs, artistic expression, understanding and language (ASL) particular to Deaf people. A capital "D" is often used in the word Deaf when it refers to community or cultural aspects of Deafness.

The unit of measurement for the loudness of a sound. The higher the dB, the louder the sound and the worse the hearing loss.

A custom made plastic or vinyl piece which fits into the outer ear to connect with a hearing aid.

A professional member of the educational team who is fluent in the languages used by deaf and hard of hearing children; most states require special certification to work in schools.

A child must be determined eligible for special education services based on specific disabling conditions and an exhibited delay (see Part B & Part C) as a result of that condition.

A medical doctor, who specializes in the treatment of problems of the ears, nose and throat. Sometimes referred to as an otolaryngologist, otologist. (See otologist.)

Finger spelling is a standardized series of handshapes for each letter of the alphabet that are used to form words. Fingerspelling is often used when there is no sign for a particular word.

A hearing assistance device that transmits the speaker's voice via a frequency modulated signal to an electronic receiver worn by the listener. The receiver may be in a hearing aid, earphones or earbuds, or a speaker. The device reduces the problem of background noise interference and the problem of distance from the speaker.

The number of vibrations per second of a sound. Frequency, expressed in Hertz (Hz), determines the pitch of the sound.

The decibel difference between unaided and aided hearing sensitivity thresholds. For example, a child with unaided hearing at 70 dB who, when amplified, hears at 30dB, is experiencing a gain of 40 dB. Functional gain measures should only be used with speech tests due to hearing aid signal processing circuitry.

Provides genetic diagnosis and guidance for individuals with birth defect/genetic disorders including recurrence risk information for individuals with hearing loss and their families.

A hearing loss that is mild to severe. This term is preferred over "hearing impaired" by the Deaf and hard of hearing community when referring to individuals who have hearing loss, but also have and use residual hearing.

An electronic device that amplifies and delivers sound to the ear. The purpose of a hearing aid is to improve speech reception and intelligibility.

An audiometric procedure to identify the ability to hear selected frequencies at an intensity above normal hearing. The purpose is to identify individuals with potential hearing loss, with minimal time expenditure, and to refer them for further testing.

Applies to individuals with any degree of hearing loss, including deafness. This term is not acceptable to deaf and hard of hearing persons because it implies that the person is “impaired”.

Types of hearing loss are described individually throughout this glossary. (See acquired hearing loss, auditory neuropathy/dysynchrony, auditory processing disorder, bilateral hearing loss, conductive hearing loss, congenital hearing loss, deaf, hard of hearing, mixed hearing loss, sensorineural, unilateral hearing loss.)

Hearing levels are typically characterized as follows:

Normal Hearing: 0 dB to 15 dB

Minimal Loss: 16 dB to 25dB

Mild Loss: 26 dB to 40 dB

Moderate: 41 dB to 55 dB

Moderate/Severe: 56 dB to 70 dB

Severe Loss: 71 dB to 90 dB

Profound: 91 dB or mor

The brand name of a plastic-ringed device designed to "hug" the hearing aid to the ear. Popular for infants and toddlers whose ears may be too small to hold the hearing aid snugly in place.

The Individuals with Disabilities Education Act, Public Law 108-446; formerly known as Public Law PL 10517; 101-476, PL 94-142 and PL 99- 457. Part C (see Part C) provides services to children birth to three years of age with disabilities. Part B (see Part B)of IDEA provides educational mandates for students three years of age through high school graduation or who age-out of the system at 21 years. The 2004 Reauthorization of this law is also known as the Individuals with Disabilities Education Improvement Act.

Often used synonymously with the term "mainstreaming," this term refers to the concept that students with disabilities should be integrated and included to the maximum extent possible with their (typically developing) peers in the educational setting. Inclusion is meant to assure that children with disabilities are equal members of the general education classroom and provided services in separate settings only as determined by the IEP. (See mainstreaming).

The IFSP addresses 1) The family's strengths, needs, concerns and priorities; 2) identifies support services available to meet those needs; and 3) empowers the family to meet the developmental needs of their infant or toddler with a disability. The IFSP is a written plan developed by parents or guardians with input from a multidisciplinary team.

The loudness of a sound, measured in decibels (dB).

A person who facilitates communication between hearing and deaf or hard of hearing persons through interpretation into a signed language, or transliteration of a language into a visual and/or phonemic code by an oral interpreter, a signed language interpreter or cued speech transliterator.

The aspect of speech made up of changes in stress and pitch in the voice.

A basic principle of IDEA which requires public schools and agencies to establish procedures to ensure that, to the maximum extent appropriate, children with disabilities, including children in public or private institutions or other care facilities, are educated with children who are not disabled, and that special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only when the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.

Educational placement of students with disabilities into selected general education classrooms, for some parts of the school day, based on the student’s IEP. This placement decision was rooted in the philosophy that children with “disabilities” should be integrated with their non-disabled peers when appropriate to the needs of the child with a disability. The term differs from inclusion in that inclusion implies that the child is a member of the general education classroom and removed for services only when necessary as determined by the IEP.

A combination of conductive and sensorineural components that make up the hearing loss.

The use of one hearing aid instead of two.

A linguistic unit of relatively stable meaning that cannot be divided into smaller meaningful parts.

Qualified persons representing two or more disciplines or professions, e.g., a speech-language therapist and an audiologist, conduct this assessment and evaluation of the child. The child's development is evaluated to determine if there are any delays or conditions that would indicate the need for special services.

The language of the home, e.g., the native language of children who are deaf with deaf parents is often American Sign Language.

An unspecific term that is sometimes used when referring to individuals with hearing loss and deafness who talk but don't necessarily use sign language. Emphasis is placed on use of residual hearing, lip reading and contextual cues to communicate using spoken language.

A middle ear infection. Children with recurring episodes may experience fluctuating hearing loss and may be at risk for speech/ language delays. Fluid can be present with or without infection and may cause temporary hearing loss, which can permanent loss.

The OAE is a soft sound that is produced by the normal functioning cochlea. The OAE test verifies cochlear function without participation of the child. The procedure is quick and a routine part of assessment for infants and young children suspected of having hearing loss; automated versions are used for infant screening. The test consists of a probe placed in the ear canal that emits an auditory signal and measures the resulting response of the auditory nerve. There are 2 types of OAE tests: transient (TEOAE) and distortion product (DPOAE). OAEs are primarily used to diagnose sensorineural hearing loss but also provide information about the conductivity of the middle ear system.

A physician who specializes in medical problems of the ear. (See ENT.)

Refers to how much sound is being put out by a hearing aid or amplification system.

A program of family-centered education and infant intervention which stresses early exposure to language and attention to developmental processes which enhance the learning language.

Part C is the section of IDEA that refers to diagnostic and early intervention services available to eligible children from birth through two years of age and their families.

Part B is the section of IDEA that refers to special education and support services available to eligible children aged three through twenty-one in the public schools.

Refers to hearing loss acquired while learning a first language.

Refers to hearing loss acquired after learning a first language.

Refers to hearing loss, which is congenital or acquired before acquisition of language.

A series of measurements that address the actual output of the hearing aid in the ear canal. These measurements are obtained using a probe-microphone that is placed into the ear canal along with the hearing aid and ear mold fitted in place. They assess how effectively sound is actually being amplified by the hearing aids in the ear. Real ear measurements are considered a very important aspect of hearing aid fitting and verification because everyone's ear canals are shaped differently which effects how a hearing aid functions.

Relay Telephone Service/Relay Network. A service which involves an operator “relaying” conversation  between a video phone (via sign language) or TDD/TTY (via text) user (generally a person with a hearing loss and/or speech impairment) and a hearing/speaking individual using an ordinary, non-adapted phone.

The amount of usable hearing of a person with hearing loss.

The use of language in meaningful referents, both in word and sentence structures.

A type of hearing impairment caused by a disorder of the inner ear (cochlea) and/ or hearing nerve. Sensorineural hearing loss is usually irreversible.

A visual representation of language that is based on the grammatical structure of English or American Sign Language which has its own grammatical rules.

Hearing assistance technology that disperses the speaker’s voice to the audience, usually a classroom. The system includes a microphone worn by the speaker and strategically placed speakers. These systems are beneficial to all listeners.

The lowest (softest) level at which an individual correctly identifies 50% of spondaic spoken words.

A professional who works with individuals who have speech and language disorders.

This is the lowest (softest) level at which speech is audible to an individual.

The ability to be understood when using speech.

The area on the audiogram where most conversational sounds of spoken language occur. Sometimes called the "speech banana" because of the shape this area depicts on the graph. One purpose of hearing aids is to amplify sound into this zone.

The interpretation of lip and mouth movements, facial expressions, gestures, prosodic and melodic aspects of speech, structural characteristics of language, and topical and contextual clues.

Defines the word classes of language, i.e., nouns, verbs, etc., and the rules for their combination, i.e., which words can be combined and in what order.

A type of hearing instrument that produces a vibration or "tactile" signal to indicate the presence of sound(s). It is worn on the body and triggers the sense of touch or feeling to draw attention to information that cannot be heard by the individual with hearing loss.

Originally and often still called TTY’s, these electronic devices allow deaf and hard of hearing persons to communicate via a text telephone system. This term appears in ADA regulations and legislation.

A graph of middle ear immittance based on varying air pressure. A test of acoustic immittance tells how the ear canal, eardrum, Eustachian tube, and middle ear bones are working. It is not a hearing test.

A hearing loss in one ear.

A multisensory technique for teaching phonics to deaf and hard of hearing children using tactile, kinesthetic, visual and auditory feedback. The system consists of hand cues and written symbols that help children make the connections between written and spoken language.

Video Relay Service (VRS) is a communication technology where the deaf and hearing consumers are in different locations and are linked through an interpreter provided through a relay center. Users of VRS must have equipment that allows them to send their image to the Relay Center. Once connected, a deaf caller can simply sign a message to the sign language interpreter, who conveys it to the person called. That person, in turn, can reply and the interpreter will transmit the message in sign language back to the deaf caller.

A method of assessment in which the child is conditioned to respond to sound using a toy that lights each time he or she hears the sound as reinforcement; used with young children.