Equity, Access, and Inclusiveness: Supporting Deaf and Hard-of-Hearing Young Adolescents in the Mainstreamed Middle School Classroom


The numbers of deaf and hard of hearing (D/HH) students mainstreamed in classrooms today is growing (Kelman & Branco, 2009). More than 87% of D/HH students receive instruction in general education classrooms (U.S. Department of Education, 2015). Within the D/HH student population, more than 40% are students with disabilities, also referred to as “Deaf Plus.” Effectively addressing the needs of this unique population can be challenging for educators, but especially for middle school educators, for several reasons:

  • few educators of young adolescents have deep and specific knowledge of how to meet the needs of D/HH middle school students in general education middle school classes (Blanton, Pugach, & Florian, 2011; Florian, 2010);
  • not enough research specific to D/HH middle grades students on instructional and managerial strategies to support D/HH students in general education middle grades classrooms;
  • middle school teachers have to use generic D/HH strategies and research that they locate on their own and try to implement practices and materials “on the fly” (Guardino & Cannon, 2015);
  • little, if any, systematic professional development is offered or available on ways to support D/HH young adolescents in general education middle school classrooms (Benedict, Johnson & Antia, 2011; Lenihan, 2010; Marschark, Shaver, Nagle, & Newman, 2015); and
  • minimal collaboration time for teachers, specialists, and support staff of D/HH students to plan, implement, and evaluate effectiveness of approaches targeting needs of this particular student population (Szymanski, Lutz, Shahan, & Gala, 2013).

Tenets of This We Believe addressed:

  • The school environment is inviting, safe, inclusive, and supportive of all
  • Comprehensive guidance and support services meet the needs of young adolescents
  • Educators use multiple learning and teaching approaches

To support educators who work with D/HH young adolescents, this research summary presents terms and definitions related to D/HH students to offer a common language, an overview of challenges D/HH young adolescent students can face, strategies middle grades teachers can use to support D/HH young adolescents, and annotated resources related to supporting D/HH students. Additional insight and practices are offered by one of the authors who is deaf and was mainstreamed during his middle and high school grades. Based on his experiences and discussions with D/HH friends and colleagues, he provides effective recommendations for teachers of D/HH students.

The goal of this research summary is three-part: (a) provide a review of the literature related to supporting D/HH students in middle grades environments, (b) enhance understanding of the needs of this unique population, and (c) provide specific, low-cost, high-impact research-based practices for middle grades teachers of D/HH students that can be implemented immediately in general education middle school classrooms. While these strategies provide increased educational access for D/HH young adolescents, they are also effective for most middle school students because they are visual strategies that promote learning for all students but especially the 65% of the population that are visual learners (Bradford, 2011; Ha, 2005; Vakos, 2011).

Overview of D/HH Research and Connection to This We Believe

Much of the research on practices to support D/HH students in schools is not specific to young adolescents. For example, there is significant research on D/HH population that addresses instructional and managerial practices and challenges D/HH students face across the K-12 spectrum or aimed at primary or secondary levels (Easterbrooks & Stephenson, 2006; Guardino & Cannon, 2015; Lukomski, 2008; Marschark, Spencer, Adams, & Sapere, 2011; Wiley, 2013). Other studies on D/HH review early childhood with early hearing detection and intervention (Muñoz, Nelson, Goldgewicht, & Odell, 2011; Wiley, 2013). There is also increasing research on meeting the needs of “Deaf Plus” students who are D/HH students with additional disabilities (Borders, Gardiner-Walsh, Herman, & Turner, 2017; Musyoka, Gentry & Meek, 2017). Further, there is research discussing how to develop emerging literacy and math skills for D/HH students (Dirks & Wauters, 2015; Webb, Lederberg, Branum-Martin, & McDonald, 2015). More current research on D/HH students includes issues of equity, access, and inclusiveness (Borders, et al., 2016; Marschark, Sapere, Convertino, & Pelz, 2008), which are issues across the PK-12 continuum in the United States and around the world (Obiakor, 2011; NMSA, 2010; Schleicher, 2014; UNESCO, 2017).

In 2013, the Laurent Clerk National Deaf Education Center published an in-depth summary of obstacles that D/HH children and their families encounter throughout their academic journey. Five barriers identified were:

  1. knowledge and education of caregivers, professionals, and the public;
  2. collaborative efforts;
  3. qualified professionals and services;
  4. meeting the needs of the student within the school system; and
  5. the child’s self-development (Szymanski et al., 2013).

These barriers are addressed as goals in This We Believe: Keys to Educating Young Adolescents (NMSA, 2010), which states that educational programs in the middle grades must be developmentally appropriate, challenging, empowering, and equitable in order to provide effective educational experiences for middle school students. Middle grades teachers must purposefully plan and implement curriculum and create a learning environment specific to young adolescents so every student can flourish, and where cognitive, psychomotor, and socio-emotional needs are met. This includes knowing how to use and adapt information on practices to support D/HH young adolescents so they can more effectively meet the developmental and academic needs of this population. If middle school educators know how to help their D/HH students overcome the barriers, students with hearing disabilities (and their families) can experience greater success during the middle grades, which likely will have a positive impact on their high school and post-secondary success (ACT, 2008; Balfanz, 2009; Balfanz, Herzog, & Mac Iver, 2007).

Operational Definitions of Essential Concepts and Terminology

To effectively teach D/HH students, educators must familiarize themselves with the appropriate terminologies used for this specific group. When discussing children who are deaf, we focus on the medical terminology, meaning the child has hearing loss. When we use the capitalized version of the word Deaf, we are focusing on the child who is a member of the community (Christiansen & Leigh, 2002). When a person identifies as hard of hearing, it usually means that they have a range of hearing and use spoken communication as a mode of communication (Israelite, Ower, & Goldstein, 2002). The term hearing impaired is a term that is not accepted by deaf or hard of hearing people anymore. It used to be a term that was politically correct but has decreased in use over time (National Association of the Deaf, 2018). Finally, children who are deaf plus, also identified as DWD, are deaf children with additional disabilities (Wiley, Parnell & Bellhorn, 2016). DWD students are hard of hearing and have a learning disability, Autism, attention deficit/hyperactivity disorder, cerebral palsy, an intellectual disability, or a combination of these challenges (Gallaudet Research Institute, 2013; Guardino & Cannon, 2015). If a child is both deaf and blind, they may fall in the deaf-blind category (Kyzar, Brady, Summers, Haines, & Turnbull, 2016).

Children who are D/HH communicate differently. They may communicate using sign language or using a spoken language. Today, worldwide, there are approximately 271 sign languages used (Harrington, 2018). In the United States, American Sign Language (ASL) is the third most used language (Mitchell, Young, Bachleda, & Karchmer, 2006) and has been recognized as a full language (Valli & Lucas, 2000). It is not the first method of communication parents choose for their deaf child. General education teachers may see students with different types of manually coded English sign systems, such as Signing Exact English or Pidgin Signed English, which are signs that follow the English word order and use extensive lip-reading movements to support spoken English (Scheetz, 2012).

Challenges for D/H Young Adolescents

While middle grades teachers are aware that their students experience rapid changes, they may not fully realize the complications of navigating middle school with a hearing disability. Nor, might middle grades teachers understand the challenges faced by D/HH students who require different modes of communication and must deal with additional barriers related to forming identity and having positive peer interactions. D/HH students may have difficulty with their academics outside of the “typical” young adolescent challenges due to:

  1. not understanding the interpreters, teachers, support staff, or peers, (Schick, Williams & Kupermintz, 2005; Szymanski et al., 2013);
  2. a curriculum that may be too fast paced causing inability to take notes or follow along because D/HH students need to use their eyes for visual input (Stinson, Elliot, Kelly, & Liu, 2009);
  3. class discussions that occur too quickly because by the time the D/HH student recognizes who is speaking, the interaction has already passed. Students may experience language delays, which may affect their understanding of the English language (Antia, Sabers, & Stinson, 2006);
  4. class discussions that prevent participation or accessibility of information (e.g., turning around and facing the board while talking, mumbling words, looking down or around, brushing hair away from one’s face, pacing back and forth, multiple people talking at once) (Lane, Pillard, Hedberg, 2011);
  5. social development and interaction challenges common to D/HH students (Batten, Oakes, & Alexander, 2014; Szymanski et al., 2013), especially during the middle school experience (Stinson & Whitmire, 2000);
  6. lack of collaboration between teachers and support staff (e.g., instructional assistants, interpreters), which can lead to miscommunication and impact the educational access of D/HH students (Salter, Swanwick, & Pearson, 2017);
  7. language delays due to communication barriers (e.g., lip-reading multiple people, experiencing different teaching styles, transitioning multiple times, and understanding how the academic content can be applicable), which can affect the ability to interact with their peers, understand the rules of social interaction, and effect the ability to regulate their thoughts and feelings (Batten et al., 2014; Cawthon, 2001; Nikolaraizi & Hadjikakou, 2006; Rieffe, 2012); and
  8. identity formation due to communication barriers and non-acceptance from peers (Batten et al., 2014).

It is necessary for teachers to be proactive in addressing these challenges to ensure that barriers are removed and addressed so D/HH young adolescents have positive and productive learning experiences. Having a tool belt with effective, varied, research-based practices aimed at supporting young adolescents with hearing disabilities is necessary to enable teachers to help cultivate independent, strategic, confident learners. The strategies described below can benefit all students, regardless of their abilities, as they help ensure increased access to the education experience in the middle grades classroom.

Strategies to Support D/HH Young Adolescents

For D/HH students, many of the more common and traditional approaches to curriculum and the learning environment for young adolescents are effective (Knoors & Marschark, 2014; Scheetz, 2012). Yet, this is often not enough and requires teachers to consider classroom layout, curricular materials, class requirements, performance-based learning and assessments, teaching style, and learning opportunities outside of the regular classroom (e.g., field trips, recess, speakers, plays, assemblies in the auditorium, sporting events) in light of D/HH young adolescents’ unique needs (Knoors & Marschark, 2014; Martins & Gaudiot, 2012). Teachers need to create an educational environment that is visually accessible and welcoming for D/HH students.

Esera (2008) explains in her study of students ages 13-18 that “for education to be successful for deaf students, the learning environment and curriculum is required to be genuinely reflective of, and responsive to, a student’s specific cultural background” (p. 36). As students need to hear or understand what is being said in a classroom to maximize learning opportunities, teachers must use strategies that enable all students access to learning. Limited access to curriculum and fewer opportunities to learn content are two main reasons why there is greater underachievement of D/HH students as compared to their hearing peers (Qi & Mitchell, 2011).

When considering the needs of D/HH students, teachers must be mindful that many of students’ needs require visual learning strategies. Visual learning is “the assimilation of information from visual formats” (Raiyn, 2016, p. 115). Through visual learning opportunities, students’ understanding of information gained through classroom learning experiences is deepened and enhanced (Raiyn, 2016). Visual formats can include: pictures, charts, graphic organizers, videos/movies, simulations, graphs, cartoons, coloring books, slideshows/PowerPoint presentations, posters, games, and manipulatives (Rodger et al., 2009). Teachers of D/HH students need to ensure that their pedagogical practice is visual based and includes consideration of their bodies, environments, and approaches and in doing so can increase D/HH students’ access to curriculum, provide equitable learning opportunities, and support learning needs (Easterbrooks, 2008).

Visual Bodies

Mrs. Wenzel is planning a new unit on the Oregon Trail for the 26 students in her class, two of whom use a sign language interpreter. She is mindful of the different communication access in her classroom, and she wants to make sure all the students are successful in learning about life on the trail. She knows that she needs to prepare a list of vocabulary words for the interpreter and does so. On the day of the lesson, Mrs. Wenzel, with her back to the class, writes on the board details about the journey and explains while writing the route from Independence, Missouri to The Dalles, Oregon. She turns around to the class and notices that Megan, a student relying on the interpreter, seems confused. What can Mrs. Wenzel do to increase Megan’s opportunities for success?

We recommend that Mrs. Wenzel makes sure all communication is clear by repeating the statements while facing the class, asking a student to repeat what was just said, or asking a clarification question. Also, provide the student with teacher notes before the class to help the student stay on task as much as possible. Providing notes to all students will allow students to refer to notes during a lecture, see what is coming up next, and allow students to add additional comments on the teacher-created notes to help increase or extend their understanding of the current topic.

Our bodies occupy the visual space (Crossley, 1995). This means that when students are learning from teachers, their bodies are listening, sometimes rapt with attention, sometimes not, but always visible. Teachers’ bodies are the same way. A teacher’s positionality can have an impact on students’ learning. For example, leaning too closely to students may cause students to feel uncomfortable and could encourage students to stop an undesirable behavior, which can be effective in classroom management. However, if a teacher positions themselves too far from students, some students make take advantage of the teacher’s lack of proximity to disengage from learning or interrupt the learning of others. Intentional use of one’s body can increase learning opportunities for all students though some specific practices aimed to support D/HH students include:

  1. Mindful communication access. (Knoors & Marschark, 2014). Pause speaking when writing on the whiteboard or smartboard and until facing the audience. While lip-reading may not be effective for some D/HH students, facial expressions can fill in clues.
  2. Pre-plan presentations. Having PowerPoint or multimedia presentations prepared, or using a document camera, allows teachers to face the class when discussing presented information. Avoid writing on a board, which can put a teacher’s back to the class, force a student to have to watch an interpreter, and potentially miss information, which may hinder their ability to focus and learn.
  3. Look at students when making a point. Eye contact is imperative for visual learners. Have students raise hands and engage in eye contact before speaking. Teachers should point at the student who is speaking to help the D/HH students find the speaker in time before interactions begin.
  4. Ensure clarity of communication before moving forward in a lesson. (Steinbrenner & Watson, 2015). Asking a student, “What did I just say?” requires the student to reiterate what was explained to show their level of understanding. This approach provides feedback to the teacher so they know if the student grasps what was presented. If correct and complete, repeat or paraphrase what the student said so the D/HH student (and other students) can receive reinforcement that their understanding is accurate (Bird, 2015). If additional or different information needs to be shared, the teacher can do so at this time. Repeating what students say is particularly useful if the original speaker speaks softly, mumbles their words, or doesn’t accurately or completely capture the original information presented by the teacher.
  5. Think before you react. Non-verbal expressions, including facial responses, can benefit and hinder lessons or learning experiences and can be implicit, especially when emphasizing a point. Many non-verbal responses do not match what one hopes to relay. Take time to think about how non-verbal responses may be perceived by someone observing. This may increase accuracy of what one hopes to portray (Johnson, 2017).

Visual Environments

Mr. Ellis has a classroom of 35 students. He teaches six periods a day and knows that each period has different students with different needs. His health class meets during fourth period and he has one deaf student in the classroom. He wants to be able to interact with all of his students, so he is reconsidering the best way to arrange seating in the classroom. He previously had the class sit two-by-two at tables, but noticed that this is not effective for Haley, as she is unable to turn her head fast enough to lip-read whomever is speaking. Haley does not use an interpreter and depends on the minimal hearing she has with a hearing aid. What can Mr. Ellis do to better support Haley and other students?

We suggest that since the classroom is large, Mr. Ellis should put tables together in a U-shape, where students can see each other, and use this set-up for all of his classes. He should encourage students to raise their hands and wait to be called on, stating that “we are a classroom community and must work together to maintain understanding.” These practices do not single out any students and the U-shape seating increases visual access for all students.

The environment is often known as the third teacher (Carter, 2007; Strong-Wilson & Ellis, 2007). The classroom space should be arranged to maximize visual access. There are benefits to learning when teachers plan for the environment and consider students’ varied needs (Martins & Gaudiot, 2012). Guardino & Antia (2012) note, “[t]he physical arrangement and features of the classroom environment, such as seating arrangement, lighting, and organization can influence student behavior and attention to academic tasks” (p. 518). Tsymbal (2010) adds that “total visual access/connectivity in buildings therefore is a key Deaf Space idea” (p. 22). It is important for students to be able to see each other, the teacher, and support staff for language and visual understanding. Strategies to maximize learning for D/HH young adolescents include:

  1. Consider sight lines. Arrange the classroom in a U-shape, if possible, so D/HH students can have access to as many faces as possible. If seating in clusters, position D/HH students in a corner of the classroom to maximize their vantage point (Dye, Hauser, & Bavelier, 2009, Guardino & Antia, 2012). Talk to D/HH students about their seating preferences and needs.
  2. Unobstructed views. Maintain open visual space; avoid placing tall bookcases in the middle of the classroom as partitions or having equipment, like a document camera, block a speaker’s face. Create clean visual lines in the entire classroom. This is important for all classrooms but more so for D/HH students due to their visual needs (Duncanson, 2014; Tsymbal, 2010).
  3. Appropriate lighting. Provide ample lighting for visual clarity. Avoid standing in front of windows when speaking and do not stand too close to the smartboard as this causes a shadow making it difficult to “read” the speaker (Guardino & Antia, 2012).
  4. Maintain appropriate noise levels. Noisy environments can impact students who use their residual hearing; thus, minimize noise. Signal the class for quiet before providing instructions and speak clearly (Crandell & Smaldino, 2000; Guardino & Antia, 2012).
  5. Organize materials and make all materials accessible. Pre-planning how materials will be introduced, distributed, collected, and made available in the room will help D/HH students predict what they need to do, reduce confusion and wasted time, and increase opportunities to access material (Guardino & Antia, 2012).

Visual Approaches

Mr. Graham is teaching a seventh grade health class, which has 32 students, three of whom are deaf and communicate using spoken English and lip-reading. The class is having a heated discussion and the noise level increases. Mr. Graham wants to gain the class’ attention to redirect the conversation and address misunderstandings. He considers raising his voice over the din and sternly tell the students to quiet down or raising his hand at the same time he is using his voice, but he realizes neither approach will be effective for all students. What should he do?

We suggest that Mr. Graham flicker the lights to gain attention and quiet down the room, and wait before speaking so the students can turn their faces in his direction and await further instructions. This would not single out any student, instead, will gain attention from all students.

Teachers must recognize that every child, including D/HH students, is different and may require varied instructional approaches to succeed (Luckner, Bowen, & Carter, 2001). Thus, differentiating instructional strategies to meet the needs of all students, regardless of their hearing ability is essential to ensure equal access and increase educational opportunities. However, as many D/HH students have different degrees of hearing loss and their language use varies based on their backgrounds and circumstances (Scheetz, 2012), planning for, and creating visually rich learning environments, can increase learning opportunities (Luckner, Bowen, & Carter, 2001). “Visual approaches” strategies include:

  1. Using visual classroom management strategies. Look students in the eye when explaining. Use visual timers and non-verbal cueing, and provide visual images for schedules, posters with rules, procedures, expectations, and consequences (Luckner, Bowen & Carter, 2001).
  2. Providing breaks for eye rest. Many students utilize their hearing, which requires fewer muscles than eyes do for seeing. Eyes can be sensitive to straining, and overuse can lead to concentration fatigue. Allow D/HH students to focus on something other than the teacher for a few minutes and to reorient themselves for better vision stamina (Bess & Hornsby, 2014; Hornsby, Werfel, Camarata, & Bess, 2014; Nagane, 2004).
  3. Providing copies of instructional notes to students. Requiring D/HH students to write notes causes them to take their eyes off the interpreter or the teacher, which can affect the access to, and input of, information. It is easier for D/HH students to read prepared notes and then watch the teacher during the lesson instead of trying to watch the teacher and take notes simultaneously. When students understand the content, they can follow along better (Owen, Bussien & Callahan-Ferris, 2016).
  4. Ensuring understanding of assignments, activities, and assessments. Meet with D/HH students when assigning work or an assessment to ensure understanding of the task. Encourage students to repeat back directions or information for clearer understanding. Provide students opportunities to ask questions as they may not know that they can ask questions. Some students may not have developed the awareness or the advocacy skills to ask for what they need, or due to trying to fit in or be “invisible,” students may not ask for clarification (Dostal, Gabriel, & Weir, 2017).
  5. Providing transcripts or closed captioning (CC) with videos. Even with an interpreter, D/HH students will not get word-for-word access that transcripts can provide as ASL does not translate fully to English, nor vice versa. Providing complete transcripts allows students to access accurate and thorough information presented, if CC is not possible. CC are particularly beneficial for persons watching videos in their non-native language, for children and adults learning to read, and for persons who are D/HH (Gernsbacher, 2015; Stinson et al., 2009).
  6. Modeling desired behavioral expectations. Explain expectations in visual ways, repeat expectations frequently, and offer students time to practice desired behaviors to increase opportunities to understand and meet expectations. Students respond more positively and consistently if they understand the reasoning behind each expectation.
  7. Using visual representations during oral explanations. Use whiteboards, chalkboards, PowerPoints, chart paper, or allow students to refer to tablet or computer screens. This multimodal practice can increase opportunities for understanding and remembering presented information (Dostal, Gabriel, & Weir, 2017).


As students with low incidence disabilities, like D/HH students, are appearing more in general education classrooms, teachers of D/HH students need materials and approaches that can be implemented easily to increase student (and teacher) success. While D/HH students face many challenges in school, particularly as they navigate adolescence and the middle school years (Caskey & Anfara, 2014), teachers can support this unique population by: (a) determining in advance the appropriateness of selected instructional and managerial materials for the classroom, (b) ensuring that students have the skills to take advantage of them, and (c) verifying that they are being used correctly by students (Marschark & Knoors, 2012). While these strategies are effective for D/HH young adolescent students, they promote learning for many young adolescents because they are thoughtful, responsive, visual practices. In collaboration with families and support staff, teachers of D/HH students can create and support learning experiences in mainstream classrooms that encourage and enable all students to be successful.


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Annotated Resources

Make a Difference Handbook. This handbook is designed for teachers and includes recommendations on how to support D/HH students including communication issues, using an interpreter, and set up of classrooms. While primarily geared for university faculty, there are tips and strategies beneficial for D/HH middle school students. https://www.umaryland.edu/media/umb/oaa/campus-life/

Gallaudet University’s Laurent Clerc Center. This website offers a variety of resources to support the needs of D/HH students including publications, tips for shared reading, webinars, workshops, and an online network. One example includes a video outlining the 15 principles to guide parents and teachers in promoting literacy development for children who are D/HH. http://www3.gallaudet.edu/clerc-center/our-resources.html

The IRIS Center. While not geared specifically to D/HH education, it is a valuable resource for working with students with unique needs. Topics include accommodations, differentiated instruction, learning strategies, transition, and collaboration, and include evidence-based practice summaries, films, and advice on how to implement specific strategies. https://iris.peabody.vanderbilt.edu/iris-resource-locator/

Canadian Hearing Society. This guide offers ideas for classroom accessibility for students who are deaf and hard of hearing. It includes a description of the D/HH student population as well as the five building block framework for language accessibility to help those supporting D/HH students in a school setting. Included are strategies for (1) building the environment, (2) access to information, (3) language access, (4) technology, (5) education and training. https://www.chs.ca/sites/default/files/mhg_images

University of Minnesota’s Deaf Education Resources. This resource for working with D/HH students provides information language, reading, assessment, transition, technology and progress monitoring to support classroom teachers. There are webinars, articles, manuals, and videos that can support D/HH teachers. The website constantly changes and adds the most updated resources possible. http://www.cehd.umn.edu/DHH-Resources/


Alicia Wenzel is an associate professor of education specializing in curriculum, instruction, and assessment at Western Oregon University. Her research focuses on curriculum, assessment, and middle level education as well as supporting in-service novice teachers across the PK-12 continuum.

Patrick Graham is an assistant professor in D/HH education at Western Oregon University. His interests focus on educational equity, sociocultural contexts in education, and sociological perspectives of schooling. He is also interested in the impact of language deprivation in D/HH children.


Wenzel, A. & Graham, P. (2019). Research summary: Equity, access, and inclusiveness: Supporting deaf and hard-of-hearing young adolescents in the mainstreamed middle school classroom. Retrieved from http://www.amle.org/Publications/ResearchSummary/TabId/622/

Published November 2019.


  1. This summary offers invaluable insights into the challenges faced by deaf and hard of hearing (D/HH) young adolescents in middle school classrooms, shedding light on the complexities of meeting their educational needs. What makes it particularly impactful is its use of practical strategies to address challenges effectively. As a teacher, understanding the diverse needs of students is paramount, and resources like this provide valuable guidance on how to create inclusive learning environments. By incorporating visual learning strategies and optimizing classroom arrangements, educators can ensure that D/HH students have equitable access to education alongside their peers.