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Know Your Rights

Knowing your legal rights and being able to advocate for yourself are important skills for everyone but especially for people with hearing loss. Here is a brief overview of the two major U.S. laws designed to ensure equal access to education and opportunities.

Americans with Disabilities Act

The Americans with Disabilities Act (ADA) protects individuals against discrimination in many areas of their lives. The ADA outlines five areas (“titles”) in which people with disabilities have legal rights: employment, public services, public accommodations, telecommunications and other miscellaneous provisions.

ADA Title I: Employment

Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others.

ADA Title II: State and Local Government Activities

Title II requires that state and local governments give people with disabilities an equal opportunity to benefit from all of their programs, services and activities (e.g., public education, employment, transportation, recreation, health care, social services, courts, voting and town meetings).The transportation provisions of Title II cover public transportation services, such as city buses and public rail transit (e.g., subways, commuter rails, Amtrak).

ADA Title III: Public Accommodations

“Public accommodations” include facilities such as restaurants, hotels, grocery stores, retail stores, etc., as well as privately-owned transportation systems.

Title III requires that all new construction and modifications must be accessible to individuals with disabilities. For existing facilities, barriers to services must be removed if readily achievable.

ADA Title IV: Telecommunications Relay Services

Title IV addresses telephone and television access for people with hearing and speech disabilities. It requires common carriers (telephone companies) to establish interstate and intrastate telecommunications relay services (TRS) 24 hours a day, 7 days a week.

ADA Title V: Miscellaneous Provisions

Title V contains multiple additional laws and acts adopted through the years to further strengthen ADA.

For more information about ADA, visit https://www.ada.gov/

IDEA

The Individuals with Disabilities Education Act (IDEA) guarantees the right to a free and appropriate public education to infants, children and teens with disabilities (ages birth to 21 or until achieving a high school diploma) in the least restrictive environment appropriate. The law specifies how schools must provide or deny services and how parents can approach school districts, as well as challenge school district recommendations. IDEA includes three parts: Part A, which outlines general provisions; Part B, which outlines provisions for school-aged children (ages 3 to 21), including the Individualized Education Program (IEP); and Part C, which provides for early intervention services for children ages birth to 3.

For more information about IDEA, visit http://idea.ed.gov/.

Education Advocacy

Knowing your educational rights are a vital part of ensuring your child has access to the learning environment he or she needs to succeed. However, this process can be difficult even for people who have experience with education law. Check out these helpful tools:

IEP Checklist Preparation for the IEP Meeting FAQs about Special Education Advocacy D.D. vs. Foothills Selpa E.N. vs. St Johns County

Position Statements

The Alexander Graham Bell Association for the Deaf and Hard of Hearing has taken an official position on many issues related to the success and quality of life of individuals with hearing loss. Here are our views. Click on each to learn more.

Spoken Language

Cochlear Implants in Children American Sign Language Delivery of Services by Listening and Spoken Language Specialists Early Hearing Detection and Intervention Reauthorization Act of 2008 Full Funding of Individuals with Disabilities Education Act

Insurance Coverage and Medicare Reimbursement for Hearing Aids, Cochlear Implants and Other Hearing Assistive Devices Communications Access/Captioning Reauthorization of the Individuals with Disabilities Education Act Recommended Protocol for Audiological Assessment, Hearing Aid and Cochlear Implant Evaluation, and Follow-up

Statement References

Young Children

More than 90% of children who are DHH are born to hearing parents.[1]

Children require robust language models as they learn language through interaction with their parents and other family members.

It is natural for parents to extend their language(s) to their children, however important steps must be taken to make spoken language fully available if the child is deaf or hard of hearing. Research shows the primary language of the home significantly impacts a child's language development.[2]

Children who are deaf or hard of hearing are a diverse population, thus one story is only one story.

We cannot assume that what works best for one works best for all. For example, there is variability in the degree of hearing loss across children. U.S. data indicates that many more children are “hard of hearing” vs. “deaf.” Also, important to note, a large percentage of children (about 40%) identified through newborn hearing screening have unilateral hearing loss—hearing loss in one ear and normal hearing in the other ear.[3] Some of these children will develop bilateral hearing loss later, although the percentage is unknown.

Early intervention is key to helping a child develop the important language and literacy skills needed to succeed in school and life

Children who are found to be deaf or hard of hearing usually need specific attention on learning language. Most children, regardless of the type and degree of hearing loss, can learn to listen and talk if provided with early access to spoken language.[4] Babies can be fitted with hearing technology that is set especially for them (by their pediatric audiologist) in the early weeks and months of life. Some families will choose to teach their child one language (usually the spoken language used at home), and some families will choose to have their child work on more than one language. Either way, it is important that the family find and work with qualified professionals who can guide them through the process of helping their child develop strong language and literacy skills. AG Bell’s Parent Consultant is available to assist families of children of all ages and stages: (https://www.agbell.org/Families/Listen-Learn-Link-Parent-Support-Line).

North Carolina nonprofit, BEGINNINGS For Parents of Children Who are Deaf or Hard of Hearing has collected data for the past 22 years about parent choice for communication at time of diagnosis. It is the only known database of its kind and represents families from all 100 NC counties All socio-economic, ethnic, and geographical settings are represented. This database contains family data from more than 5,000 families. Since 2018, more than 90% of parents chose spoken language as the primary mode of communication (1,632 families).[5]

In addition to the North Carolina data, smaller studies have reported data on communication or language choice(s) with similar findings.

A survey of 458 families of children 0 to 6 year, from 41 states and territories, found 92% of parents used English, 4% American Sign Language and 4% used another language as their primary home language.[6]
A survey of 321 families of 2- to 6-year-old children residing in 10 states revealed 92% of families used listening and spoken language, either alone or with additional supports, as the primary mode of communication.[7]

Older Children

15% of school-age children have a hearing loss

(Niskar, A. S., Kieszak, S. M., Holmes, A., Esteban, E., Rubin, C., & Brody, D. J. (1998). Prevalence of hearing loss among children 6 to 19 years of age. Journal of the American Medical Association, 279 (14), 1071-1075.

An estimated 12.5% of children and adolescents aged 6–19 years have suffered permanent damage to their hearing from excessive exposure to noise

According to the CDC (Niskar AS, Kieszak SM, Holmes AE, Esteban E, Rubin C, Brody DJ. Estimated prevalence of noise induced hearing threshold shifts among children 6 to 19 years of age: The third national health and nutritional examination survey. 1988-1994, United States. Pediatrics 2001;108:40–43 and National Institute on Deafness and Other Communication Disorders. Quick Statistics. Bethesda, MD: U.S. Department of Health and Human Services; August 2008.

One in eight people in the United States (13 percent, or 30 million) aged 12 years or older has hearing loss in both ears

Based on standard hearing examinations (Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. [Letter] Arch Intern Med. 2011 Nov 14; 171(20): 1851-1852.)

Adults

About 2 percent of adults aged 45 to 54 have disabling hearing loss. The rate increases to 8.5 percent for adults aged 55 to 64. Nearly 25 percent of those aged 65 to 74 and 50 percent of those who are 75 and older have disabling hearing loss.[8]

Approximately 15% of American adults (37.5 million) aged 18 and over report some trouble hearing.[9]

About 28.8 million U.S. adults could benefit from using hearing aids.[10]

As of December 2019, approximately 736,900 cochlear implants have been implanted worldwide. In the United States, roughly 118,100 devices have been implanted in adults and 65,000 in children.[11]

Citations

[1] Mitchell, R. E., & Karchmer, M. A. (2004). Chasing the Mythical Ten Percent: Parental Hearing Status of Deaf and Hard of Hearing Students in the United States. Sign Language Studies, 4(2), 138–163.

[2] Gilkerson, J., Richards, J.A., Warren, S. R., Oller, D. K., Russo, R., and Vohr, B. (2018) Language experience in the second year of life predicts language outcomes in late childhood. Pediatrics, 142(40). doi: 10.1542/peds.2017-4276

[3] (https://www.cdc.gov/ncbddd/hearingloss/2020-data/documents/12_2020-HSFS_Type-and-Severity-Table.pdf)

[4] Rufsvold, R., Wang, Y., Hartman, M. C., Arora, S. B., & Smolen, E. R. (2018). The impact of language input on deaf and hard of hearing preschool children who use listening and spoken language. American Annals of the Deaf, 163(1), 35–60

[5] BEGINNINGS for Parents of Children Who Are Deaf or Hard of Hearing, Inc., Raleigh, NC, data report (2022). www.ncbegin.org

[6] Ward, A. C. Hunting, V. & Behl, D. D. (2019). Supporting Families of a Deaf or Hard of Hearing Child: Key Findings from a National Needs Assessment. Journal of Early Hearing Detection and Intervention, 4(3). DOI: https://doi.org/10.26077/5f99-5346

[7] Behl, D., Mariger, H., Doutre, S.M., Plucinik, J., and White, K.R. (2017). National Center for Hearing Assessment and Management. Final Report. < a style="color:#f47b6a;" href="https://www.infanthearing.org/ei-snapshot/docs/2021%20EI%20Snapshot%20double(3_29).pdf">https://www.infanthearing.org/ei-snapshot/docs/2021%20EI%20Snapshot%20double(3_29).pdf

[8] Based on calculations performed by NIDCD Epidemiology and Statistics Program staff: (1) using data from the 1999-2010 National Health and Nutrition Examination Survey (NHANES)

[9] Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: National Health Interview Survey, 2012 (PDF). National Center for Health Statistics. Vital Health Stat 10(260). 2014).

[10] Based on calculations by NIDCD Epidemiology and Statistics Program staff

[11] (Estimates based on manufacturers’ voluntary reports of registered devices to the U.S. Food and Drug Administration, December 2019)