Spotlight: A Family with Hearing Loss

By Linda L. Daniel and Sheha V. Bharadwaj
December 23, 2019

The following case study is taken from the new book, Video-Based Aural Rehabilitation Guide: Enhancing Listening and Spoken Language in Children and Adults by Linda Daniel and Sneha V. Bharadwaj. Each chapter in the book concludes with a spotlight on a personal story about a child, adult, or family with hearing loss and assimilates key concepts from the chapter. As an example, the spotlight in Chapter 1 depicts a mother, father, and their two children, all of whom have bilateral, profound, sensorineural hearing loss. The videos and narrative highlight the importance of early diagnosis of hearing loss, state of the art hearing technologies, and the listening and spoken language approach to aural rehabilitation.


The spotlighted family includes Rebecca and Bruce Sr., both diagnosed with hearing loss before the age of 18 months, over 45 years ago. Each was fitted with analog, body-worn hearing aids. Rebecca attended Central Institute for the Deaf in Missouri, where she learned to communicate orally and received an education taught by teachers who used spoken language. While in college, Rebecca learned to communicate in sign language to socialize with friends who had hearing loss. She later became a Certified Oncology Nurse and obtained a position as charge nurse in a hospital. Bruce Sr. received speech therapy when he was young and attended St. Mary’s School for the Deaf in New York where students used manual communication. His family moved to Texas, where he attended a typical classroom with assistance from interpreters who used Signed English. Bruce Sr. learned to communicate via speechreading, speech, and sign language. He attended community college before working in a retail business.

Rebecca and Bruce Sr.’s firstborn child, Aliza, passed her newborn hearing screening. By 12 months of age, her family noticed that she had stopped responding to sound. Audiological tests revealed that she had bilateral, profound, sensorineural hearing loss, and she was fitted with behind-the-ear hearing aids. Along with her mother and grandmother, who did not have hearing loss, Aliza began participating in Auditory-Verbal therapy. Aliza’s parents conferred with each other and Aliza’s neurotologist regarding the struggles they encountered as a result of lifelong, profound hearing loss. Rebecca and Bruce Sr. educated themselves about cochlear implants and met with families whose children had been implanted at a young age and taught to use oral language. Seeing the ease with which the children communicated verbally, Rebecca and Bruce Sr. agreed to have Aliza undergo cochlear implantation so she could have the opportunity to integrate into the hearing culture. In order to understand what Aliza would experience with her cochlear implant, Rebecca and Bruce Sr. underwent cochlear implantation. Following activation of their devices, they participated in educational counseling and auditory training with an Auditory-Verbal therapist.

Aliza’s grandmother received coaching to advance Aliza’s listening and spoken language skills during the time she was with her granddaughter. She played a key role in Aliza’s aural rehabilitation. In addition to oral language, Rebecca and Bruce Sr. exposed Aliza to sign language to foster her acquisition of bilingual/bimodal communication. They wanted her to be able to communicate manually with her father and individuals in the Deaf community.

As a result of early implantation, quality access to the speech spectrum, Auditory-Verbal intervention, and family support, Aliza’s receptive and expressive verbal language grew steadily. Upon completion of an auditory-oral preschool for children with hearing loss, she transferred to her neighborhood school. At the age of five, she received a second cochlear implant.  Aliza was eventually placed in the gifted and talented program. When the family’s second child, Bruce Jr., was born, he was referred on the newborn hearing screening, which led to the diagnosis of bilateral, profound, sensorineural hearing loss. He received bilateral cochlear implants at 12 months of age. Bruce Jr.’s journey was similar to that of Aliza. He progressed well in listening and spoken language development and attended an auditory-oral preschool followed by regular education in his neighborhood school.

The persistent advocacy by Rebecca and Bruce Sr. resulted in their children’s competence in verbal communication, integration into the hearing culture, use of sign language, and self-determination to engage in a host of opportunities available to them. In the following video, Rebecca and Bruce Sr. discuss the positive impact that cochlear implants  had on their family. In the next video, Aliza and Bruce Jr. discuss their respective passions and activities made possible with their cochlear implants, extended family involvement, competence in the use of listening and spoken language, and ongoing parental advocacy.

The spotlight presented above exemplifies the clinical focus of this video-based aural rehabilitation textbook. Two hundred captioned videos on a wide range of topics are integrated into the text. The videos illustrate key concepts relevant to fostering listening and spoken language in children and adults with hearing loss. The chapters cover the following topics:

1.      Overview of Aural Rehabilitation

2.      Hearing Aids and Hearing Assistive Technology Systems

3.      Cochlear Implants for Children and Adults with Hearing Loss

4.      Auditory Brainstem Implants for Children and Adults with Hearing Loss

5.      Intervention After Early Identification of Hearing Loss: Listening and Spoken Language Approach

6.      Factors Affecting Intervention and Outcomes of Children with Hearing Loss

7.      Educational Supports for Students with Hearing Loss: Primary Through Post-Secondary Settings

8.      Aural Rehabilitation for Adults with Hearing Loss

9.      Fundamentals of Assessing Communication Skills in Children and Adults with Hearing Loss

10.  Quality of Life, Counseling, and Advocacy for Children and Adults with Hearing Loss

An average of 20 captioned videos are incorporated into each chapter to demonstrate the application of terms in the practice of aural rehabilitation. To exemplify interprofessional collaboration in aural rehabilitation, the videos include physicians, clinical audiologists, Listening and Spoken Language Specialists, speech-language pathologists, administrators, a vocational rehabilitation assistant, teachers of the deaf and hard of hearing, an occupational therapist, and a neuropsychologist. Also included in the videos are parents, extended family members, and other communication partners.

Study questions at the end of each chapter guide students in learning important concepts in aural rehabilitation. Inset boxes throughout the textbook and chapter spotlights assist the reader in understanding how the information directly applies to people with hearing loss. This one-of-a-kind textbook with captioned videos presents current topics in aural rehabilitation for improving communication skills and enhancing quality of life for children and adults with hearing loss and their families.