Advancing Educational Equity for Children with Hearing Loss: Celebrating the 50^th Anniversary of the Individuals with Disability Education Act (IDEA)

Abstract

The Individuals with Disabilities Education Act has been pivotal in securing necessary accommodations, specialized instruction, and assistive technologies, thereby promoting educational equity. Despite these advances, children with hearing differences continue to face significant barriers in early identification, intervention, and inclusion, necessitating the continuous advocacy and involvement of interdisciplinary professionals in educational and healthcare settings. Nurses are instrumental in bridging healthcare and education, facilitating early detection of hearing differences through newborn screenings and routine school assessments. They have a role in coordinating medical and educational services and advocating for individualized accommodations that enhance learning experiences. However, inconsistent screening policies and lack of awareness among parents, educators, and pediatricians about early indicators of hearing differences persist represent barriers to timely intervention. This article also explores the broader social determinants affecting access to resources and interventions for children with hearing differences, such as socioeconomic disparities and insurance coverage. It advocates for stronger policies and resources to address these inequities and calls for an expanded role of nurses in promoting comprehensive educational access. As IDEA continues to evolve, there is an ongoing need for innovative approaches, including the integration of advanced technologies and interdisciplinary collaboration, to ensure that all children with hearing differences can achieve their full academic potential and quality of life.

Introduction

As the Individuals with Disabilities Education Act (IDEA) (IDEA Regulations, 2004) marks its 50th anniversary, it remains a cornerstone of educational equity, ensuring that children with disabilities receive the support they need to succeed in school. For students with hearing differences, IDEA has secured access to accommodations, specialized instruction, and assistive technologies that enable full classroom participation. However, many students still face challenges in early identification, intervention, and inclusion. Nurses play a vital role in addressing these barriers by bridging the gap between healthcare and education. They assist in early detection, coordinate medical and educational services, and advocate for individualized accommodations that optimize learning. As frontline professionals, nurses educate school staff, support families in navigating complex systems, and help ensure compliance with IDEA’s protections. While nurses are central to bridging healthcare and education, interdisciplinary collaboration is key to comprehensive care. Social workers complement nursing efforts by addressing family needs beyond medical management, thereby helping to navigate accommodations, connect with community resources and services, and address psychosocial challenges. Their role strengthens interdisciplinary care by bridging education and medicine, tackling barriers that might otherwise hinder a child’s success. A variety of patient information resources are available, which can be shared with patients and families to improve understanding of conditions affecting hearing and possible treatments, further supporting access to appropriate interventions (Brender, 2006; Garganta et al., 2021; Goodman et al., 2013; Lawlor, 2021; Thompson, 2015). As we reflect on IDEA’s impact, it is essential to recognize the expanding role of nurses in advancing educational access and advocating for stronger policies and resources for children who are D/deaf or Hard of Hearing (DHH).

Identifying Hearing Differences in Children

Newborn Screening & Early Diagnosis

Universal newborn hearing screening (UNHS) has revolutionized early detection of congenital hearing differences, allowing for timely interventions that are critical for language and cognitive development (Driver & Jiang, 2017). By identifying hearing differences within the first months of life, UNHS provides an opportunity for families and healthcare providers to implement assistive technologies and therapies before delays become significant. Further, since 95% of infants born with hearing differences have parents with typical hearing, families may not initially recognize the signs of hearing difficulties (Kennedy et al., 2006). Additionally, postpartum depression, grief, or the stress of having a newborn can delay follow-up care, making proactive screening and parental education essential. However, late-onset and progressive hearing differences may not be detected through newborn screening alone, highlighting the need for continued monitoring as children grow (Young et al., 2011). Nurses play a key role in educating families about the importance of follow-up testing and advocating for ongoing hearing assessments in at-risk populations.

Routine School Hearing Screenings

School-based hearing screenings serve as an essential safety net for children who develop hearing differences after infancy, ensuring that educational barriers are identified and addressed early. These screenings help detect hearing differences that may have gone unnoticed, particularly in children experiencing gradual or unilateral hearing differences. Because hearing differences is invisible, it often remains undiagnosed until it significantly impacts communication and learning. For example, when children have fluid in their ear that goes unrecognized, it can have lifelong implications for speech, language, and educational achievement. This issue is often underrecognized, partly due to the difficulty in tracking longitudinal data, as highlighted in research on otitis media and central auditory processing disorder (Katz et al., 2024). Research has shown that early identification and consistent access to speech and language services significantly improve long-term outcomes for children with hearing differences, with auditory-verbal users often achieving stronger spoken language and literacy outcomes compared to other communication modalities (Thomas & Zwolan, 2019).

However, inconsistencies in screening policies across states and school districts result in gaps in detection, leaving some children without necessary evaluations. For example, in Michigan, these screenings are conducted by local public health departments rather than school nurses, per MI Public Health Code (MCL – 369-1978-9-93). While school nurses do not conduct screenings in Michigan, they play a critical role in ensuring that students who fail screenings receive appropriate follow-up, advocating for referrals to audiologists, and educating families and school staff on the importance of diagnostic evaluations. In many school-based settings, nurses lead efforts to identify hearing concerns and guide families toward interventions. In some models, such as the University of Michigan’s Regional Alliance for Healthy Schools, nurses work closely with social workers to address non-clinical barriers to follow-up, such as transportation, financial concerns, and family hesitancy. This collaboration strengthens nurse-led care by ensuring that recommended interventions are not just identified but effectively implemented.

One of the biggest barriers to early diagnosis remains pediatricians who may dismiss concerns. When a child fails a school screening, families often turn to their pediatrician, who may misattribute delays to late talking or conduct an in-office tympanogram, incorrectly assuming no further testing is necessary. Nurses can advocate for standardized school-based screening protocols and collaborate with educators to ensure that children with potential hearing concerns receive timely referrals for comprehensive assessments.

Parental & Teacher Awareness

Parents and teachers are often the first to notice subtle signs of hearing differences, yet many cases go undiagnosed due to a lack of awareness about its early indicators. Children with hearing differences may struggle with speech development, have difficulty following instructions, or exhibit inattentiveness that is mistakenly attributed to behavioral or learning issues (Le Clercq et al., 2020). Incorporating resources like the American Speech-Language-Hearing Association (ASHA)’s Recognize the Signs campaign can aid in educating families and educators on early warning signs and the importance of timely intervention (American Speech-Language-Hearing Association, n.d.). Training nurses, educators, and caregivers to recognize these warning signs is crucial in facilitating early intervention and preventing academic setbacks. By promoting awareness and encouraging open communication among families, schools, and healthcare providers, nurses help ensure that children with hearing differences receive the support they need to succeed.

Diagnostic Testing & Follow-up

Hearing differences is a neurodevelopmental emergency, and early intervention leads to improved outcomes. Comprehensive audiological assessments, including pure-tone audiometry, tympanometry, speech audiometry, otoacoustic emissions, and auditory brainstem testing, are essential for accurately diagnosing the type and severity of a child’s hearing differences. Early detection alone is not enough—timely follow-up care is necessary to confirm diagnoses and implement appropriate interventions (Fitzpatrick et al., 2015). Further, research indicates that children with cochlear implants exhibit better educational outcomes in reading and writing, as well as improved quality of life, compared to their peers without implants (Cejas et al., 2023). Nurses serve as vital coordinators in this process, ensuring that families understand the importance of follow-up testing and assisting with referrals to audiologists and speech-language pathologists. By facilitating communication between healthcare providers, schools, and parents, nurses help bridge the gap between identification and effective management of hearing differences in children.

Cytomegalovirus (CMV) & Hearing Differences

Congenital CMV is a leading cause of non-genetic hearing differences, yet awareness remains low (Centers for Disease Control and Prevention, 2018). It can cause progressive or late-onset hearing loss, making early detection and long-term monitoring essential. Nurses play a key role in CMV prevention, educating expectant mothers on saliva and urine exposure avoidance, hand hygiene, and prenatal screening. For affected infants, regular audiological evaluations, early intervention, and specialist referrals can help mitigate long-term effects. Expanding public and provider awareness is critical for earlier detection and better outcomes.

The Academic Impact of Hearing Differences

Delayed Speech & Language Development

Hearing differences significantly impacts a child’s ability to develop speech and language skills, which are critical for effective communication and learning. Without consistent auditory input, children with hearing differences may experience delays in both expressive and receptive language, affecting their ability to engage in conversations, follow classroom instructions, and develop age-appropriate vocabulary. Early intervention, including speech therapy and assistive listening devices, is essential in minimizing these delays and supporting language acquisition. Nurses can play a pivotal role in recognizing speech and language delays, educating families about intervention options, and ensuring children receive the necessary support services to enhance their communication abilities.

Reading and Literacy Challenges

Phonological awareness—the ability to recognize and manipulate sounds within words—is a foundational skill for reading and writing, yet children with hearing differences often struggle with this critical aspect of literacy development. Because they receive limited auditory exposure to spoken language, they may have difficulty decoding words, recognizing letter-sound relationships, and developing strong reading comprehension skills. These challenges can result in significant academic gaps if not addressed early. Nurses, educators, and speech-language pathologists must work together to implement literacy interventions, such as visual aids, captioning, and structured phonics instruction, to ensure that students with hearing differences have equitable access to reading and writing education.

Vocabulary building is another critical factor in literacy development. A lack of a rich vocabulary contributes to reading comprehension difficulties. For children using spoken language, vocabulary deficits may arise due to a reduced ability to overhear conversations and incidental learning opportunities. For children using American Sign Language (ASL), vocabulary development can be challenging because ASL is a three-dimensional language, and direct equivalents for certain English words may not exist. Addressing these challenges requires targeted interventions, including explicit vocabulary instruction, multimodal teaching strategies, and tailored support from educators and specialists.

Listening Fatigue, Social Development, and Academic Performance

Processing auditory information requires greater cognitive effort for children with hearing differences, often leading to listening fatigue and reduced attention span in the classroom. As a result, these students may struggle to keep up with lectures, miss key details, or disengage from learning activities. The social implications are equally concerning, as difficulty communicating with peers can lead to feelings of frustration, isolation, and lower self-esteem. As illustrated in Figure 1, hearing differences impact multiple domains of life, including social interaction, academic performance, and emotional well-being. Over time, these barriers contribute to a higher risk of academic underachievement if appropriate accommodations are not in place. Nurses can serve as advocates in school settings by promoting awareness of listening fatigue, encouraging peer inclusion programs, and supporting individualized education plans (IEPs) that provide necessary classroom modifications to help students with hearing differences reach their full academic potential. It’s important to note that social workers provide additional counseling and guidance, reinforcing nurses’ roles through addressing broader family dynamics, bullying concerns, and peer relationships. This complementary support ensures that the care initiated by nurses extend beyond the classroom, helping families navigate the broader emotional and psychosocial impact of hearing differences.

Figure 1: Lived Experiences of Individuals with Hearing Loss.

This figure reflects several of aspects of life affected by hearing loss with captions below detailing personal perspectives of individuals with hearing loss. Hearing loss can cause impairments across multiple domains in school, home, and community. The dotted line interconnecting these domains reflected the complex interdependence of these aspects of life experience.

Communication Difficulties

Hearing loss makes communicating much more difficult for both the person with the hearing loss and those around them. Words may have to be repeated, tiring the speaker and frustrating the listener with hearing loss. Such challenges can cause the person with hearing loss to not engage for fear of annoying others, leading to social isolation or poorer performance in school.

Social Isolation

When people cannot hear well, they might stop joining group activities or spending time with friends because it feels too hard to keep up. This isolation can make them feel lonely and left out. Over time, staying away from others can make things worse because of lack of connection. Help for hearing loss can keep people connected, bringing joy and happiness.

Anxiety or Depression

Anxiety or depression often accompany hearing loss because of it can be difficult to converse with others, leading to social isolation and reduced learning. Challenges with mental health can make life much more difficult for not only the one suffering from hearing loss, but also those around them.

Impaired Learning

When people have hearing differences, it increases the effort required for communication. This can make it harder to learn, remember or think clearly; it can also be an impediment to social interaction. Less social interaction with others can result in less ongoing learning, so treatment for hearing loss can promote healthier brains and healthier living.

Risk of Injury

People with hearing difference are more likely to fall or may not be aware of dangers in the environment, such as an approaching motor vehicle. Therefore, even basic activities can be more dangerous for someone with significant hearing loss, since there are fewer cues about the environment. Feeling less safe in the environment or sustaining an injury can contribute to decrements in any of the other domains.

Decreased Quality of Life

When someone can’t hear well, it can affect everything in their life—talking to friends, happiness, and overall health. They might feel disconnected from the world. With the support from an interdisciplinary team, individuals help them enjoy life more. This team may include school nurses, audiologists, teachers, psychologists, and parents. Although these experiences are often conceptualized as discrete or linear, they interact in real life.

Accommodations in Schools: The Critical Role of Nurses

Nurses play a crucial role in ensuring that students with hearing differences receive appropriate accommodations to support their academic success. As healthcare professionals embedded in school systems, they serve as advocates, educators, and coordinators, helping students, families, and teachers navigate the complexities of individualized learning needs. By promoting awareness, ensuring compliance with legal mandates, and facilitating communication between medical and educational teams, nurses help bridge the gap between healthcare and education, ensuring that students with hearing differences have equitable access to learning opportunities.

IEPs and 504 Plans

Students with hearing differences are entitled to support under the Individuals with Disabilities Education Act (IDEA) through Individualized Education Plans (IEPs) or accommodations under Section 504 of the Rehabilitation Act. IEPs provide specialized instruction and related services tailored to a student's unique needs, while 504 Plans ensure that students receive necessary classroom modifications to access the curriculum effectively. Nurses play a key role in identifying students who may benefit from these plans, advocating for comprehensive hearing-related accommodations, and ensuring that schools comply with IDEA mandates. By collaborating with educators, audiologists, and families, nurses help develop and implement individualized strategies that allow students with hearing differences to thrive.

Classroom Accommodations

A well-structured classroom environment is essential for students with hearing differences to fully engage in learning. Preferential seating arrangements, such as placing students closer to the teacher and away from background noise, can significantly improve auditory access. Additionally, real-time captioning services, FM/DM systems, notetaking assistance, and visual learning tools—such as qualified sign-language interpreters and written instructions—enhance comprehension and participation. Nurses play a vital role in advocating for these accommodations, educating school personnel about their importance, and ensuring that students have access to the assistive technologies they need to succeed.

Teacher Training & Awareness

Effective communication strategies in the classroom are essential for supporting students with hearing differences, yet many teachers lack the training necessary to implement them. Simple adjustments, such as using clear speech, facing the student while speaking, and repeating key information, can make a significant difference in comprehension. Nurses can facilitate professional development sessions for teachers, providing guidance on best practices for communicating with students with hearing differences. By fostering an inclusive and informed learning environment, nurses empower educators to meet the needs of all students effectively.

Practical classroom modifications can also enhance auditory access. Small environmental changes—such as closing a classroom door to reduce background noise—can significantly improve a student's ability to hear and engage. Teachers should also consider reducing competing noise sources, incorporating visual cues, and ensuring that students with hearing differences have access to preferential seating for optimal listening conditions.

Coordinating Care and Implementation

Nurses act as a central point of coordination between educators, parents, and healthcare providers to ensure that accommodations are effectively implemented and maintained. They help facilitate access to audiological assessments, provide guidance on hearing aid and cochlear implant management, and ensure that students receive the necessary support services. By staying engaged in a child's educational journey, nurses advocate for ongoing adjustments as needed, ensuring that students with hearing differences receive continuous, personalized support throughout their academic careers.

Adherence to cochlear implant use, speech therapy, and school-based accommodations is essential for maximizing outcomes, yet many children face barriers that limit consistent engagement. Challenges include inconsistent device use, missed therapy appointments, limited family follow-through on recommended communication strategies, and difficulties navigating school-based accommodations. Nurses play a key role in identifying these adherence concerns early and coordinating support to ensure interventions are sustained. Because adherence is often influenced by psychosocial stressors, family dynamics, and broader systemic barriers, collaboration with social work is critical in addressing these factors. By integrating medical education, and social support, nurses help bridge the gap between recommended interventions and meaningful sustained outcomes in collaboration with social work for children with hearing differences.

Special Education Considerations for Students with Hearing Differences

Nurses play a vital role in ensuring students with hearing differences receive appropriate special education services. As advocates and care coordinators, they help families navigate the system, provide guidance on communication strategies, and connect students to necessary resources. By collaborating with educators, audiologists, and mental health professionals, nurses support an inclusive learning environment that fosters academic and social success.

Deaf & Hard of Hearing (DHH) Programs

Specialized programs for deaf and hard-of-hearing (DHH) students offer tailored instruction, accommodations, and peer support. These range from fully immersive environments to integrated settings within mainstream schools. Nurses help families evaluate options and advocate for necessary adjustments to ensure students receive appropriate support.

Language & Communication Plans

Effective communication is key to learning, but needs vary. Some students rely on American Sign Language (ASL), while others benefit from spoken language, bilingual models, or total communication strategies. Nurses collaborate with educators and speech-language pathologists to ensure students receive appropriate language support and educate staff on effective communication strategies.

Audiological and Speech-Language Services

Access to audiologists and speech-language pathologists (SLPs) is essential for students with hearing differences. These professionals provide services such as speech therapy, auditory training, and hearing aid management. Nurses assist with referrals, monitor hearing device use, and ensure students receive ongoing audiological care.

Social & Emotional Support and Environment

Hearing differences affects not only academics but also social interactions and emotional well-being. Students may struggle with peer relationships and communication barriers, leading to frustration or isolation. Nurses help identify students in need of counseling or peer support programs to foster confidence and resilience. In addition, deciding between a mainstream or specialized school involves weighing factors like communication access and social integration. Nurses help families assess options to ensure the best fit for each student’s needs.

Assistive Technologies and Interventions: The Vital Role of Nurses

Nurses are pivotal in ensuring that students with hearing differences receive appropriate assistive technologies and interventions. Beyond facilitating access, they educate school staff, troubleshoot device issues, and advocate for accommodations that maximize learning outcomes. Their interdisciplinary role—collaborating with audiologists, speech therapists, and educators—ensures students with hearing differences receive the individualized support they need.

Table 1 provides a structured overview of key assistive technologies, outlining their function and the corresponding responsibilities of nurses in supporting and translating these technologies. These devices range from personal amplification systems (such as hearing aids and cochlear implants) to classroom-wide tools (such as FM/DM systems). Nurses help bridge the gap between medical recommendations and educational implementation by ensuring that students receive appropriate devices, proper training, and consistent support.

Table 1:

Assistive Technologies and the Role of Nurses in Supporting Students with Hearing Differences

Assistive Technology	Purpose	Role for Nursing
Hearing Aids	Amplify sound for mild-to-moderate hearing differences	Ensure proper use, educate teachers, assist in technology troubleshooting
Cochlear Implants	Provide auditory stimulation for severe-profound hearing differences	Support follow-up care, explain limitations, advocate for accommodations
BAHA (Bone-Anchored Hearing Aids)	Transmit sound via bone conduction for conductive or mixed hearing differences	Assist with maintenance, coordinate FM/DM system use
FM/DM Systems	Reduce background noise and enhance speech clarity	Train teachers on microphone use, ensure proper setup
Speech-Language Therapy	Develop auditory processing and communication skills	Facilitate referrals, monitor therapy progress, reinforce communication strategies
Sign Language & Bilingual Education	Support ASL users and bilingual learning approaches	Advocate for inclusive classrooms, educate staff on total communication strategies

Legal and Policy Frameworks Supporting Students with Hearing Differences:

Nurses play a crucial role in ensuring that legal protections for students with hearing differences translate into meaningful educational support. They help enforce compliance with federal, state, and local policies, assist families in navigating the system, and advocate for necessary improvements. Beyond individual support, nurses drive systemic change by working with administrators, policymakers, and professional organizations to promote inclusion, expand resources, and enhance access to essential services.

IDEA and its Protections

The Individuals with Disabilities Education Act (IDEA) ensures that students with hearing differences receive specialized educational services through an Individualized Education Plan (IEP). This federal law mandates that schools provide tailored support, such as speech-language therapy, assistive technology, and classroom modifications. Nurses play a crucial role in ensuring IDEA compliance by identifying students who need services, educating families about their rights, and working with educators to implement appropriate interventions.

ADA & Section 504 of the Rehabilitation Act

In addition to IDEA, the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act require schools to provide equal access to education for students with disabilities, including those with hearing differences. Table 2 provides a comparison of the ADA and IDEA. Section 504 accommodations—such as preferential seating, captioning, and FM/DM systems—ensure that students can fully participate in the classroom. Nurses help enforce these protections by advocating for necessary accommodations, assisting with medical documentation, and ensuring that students’ needs are met in compliance with the law.

Table 2:

Comparison of ADA and IDEA

Aspect	Americans with Disabilities Act (ADA)	Individuals with Disabilities Education Act (IDEA)
Full Name	Americans with Disabilities Act	Individuals with Disabilities Education Act
Primary Purpose	Prohibits discrimination against individuals with disabilities in public life	Ensures free appropriate public education (FAPE) in the least restrictive environment (LRE)
Scope	Broad civil rights law covering public accommodations, employment, transportation, and more	Education-specific law for students in K-12 public schools
Who is Covered	All individuals with disabilities	Children and youth (ages 3-21) with eligible disabilities
Applies To	Public and private entities, including workplaces, businesses, schools, and government institutions	Public schools and federally funded private schools
Services Provided	Reasonable accommodations in employment, education, and public spaces	Individualized education programs (IEPs) with special education services
Accommodations	Mandates accessibility but does not provide individualized services	Requires schools to provide specialized instruction and support services
Funding	No direct funding; requires compliance from institutions	Provides federal funding for special education services
Post-High School	Continues to provide protections in college, employment, and public accommodations	Ends after high school; does not apply to post-secondary education or employment

State and Local Education Policies

While federal laws provide broad protections, state and local policies influence how services are implemented. Some districts have robust programs for students with hearing differences, while others lack consistent resources. Nurses bridge these gaps by staying informed on local regulations, connecting families with community resources, and advocating for improvements in school-based hearing services.

Challenges and Barriers to Implementing IDEA for Students with Hearing Differences

Despite IDEA’s protections, significant barriers remain in ensuring equitable education for students with hearing differences. Gaps in early identification and intervention, especially in underserved communities, delay critical support, while shortages of school-based audiologists, speech-language pathologists, and specialized educators limit access to essential services. Nurses frequently encounter families facing barriers to follow-up care, whether due to financial constraints, transportation issues or uncertainty about next steps. In such cases, social workers assist by coordinating resources and troubleshooting challenges, reinforcing efforts to ensure children receive necessary interventions. This partnership helps translate screening and diagnosis into actionable, sustainable care.

Funding disparities further hinder schools’ ability to provide accommodations, assistive technology, and staff training. Beyond school-based resources, broader social determinants of health, such as insurance coverage, healthcare accessibility, and socioeconomic disparities, significantly impact whether children with hearing differences receive timely intervention and ongoing support (Schuh & Bush, 2021). Research indicates that factors like public insurance, non-white race/ethnicity, and non-English primary language are associated with delays in accessing pediatric hearing aids, underscoring the need for targeted interventions to address these disparities (Zhang et al., 2020). Compounding these challenges, stigma and misconceptions about hearing differences can lead to exclusion, lower academic expectations, and decreased school engagement (Khalsa & Chan, 2023). Nurses can address these issues by advocating for stronger screening programs, connecting students to specialized care, promoting inclusive policies, and educating school staff to create a more accessible and supportive learning environment.

The Future of IDEA: Innovations and Opportunities

Nurses will continue to play a pivotal role in shaping the future of IDEA by integrating new technologies, fostering interdisciplinary collaboration, and advocating for more inclusive policies. As frontline healthcare professionals in school settings, they are uniquely positioned to bridge the gap between medical advancements and educational access, ensuring that students with hearing differences benefit from emerging innovations and systemic improvements.

Technology’s Expanding Role

Advancements in artificial intelligence (AI) and telehealth are transforming how students with hearing differences access education. AI-driven speech recognition software and real-time captioning tools enhance classroom learning, while remote audiological and virtual speech-language therapy with listening and spoken language specialists supports and expands access to hearing specialists, particularly in rural and underserved areas. Nurses can help implement these technologies by training educators on their use, ensuring students receive proper accommodations, and advocating for school-wide adoption of assistive learning tools that improve accessibility.

Interdisciplinary Collaboration

Strengthening communication between nurses, educators, audiologists, social workers, and policymakers is essential to improving services for students with hearing differences. By fostering interdisciplinary collaboration, nurses help create comprehensive support systems that address both medical and educational needs. They serve as liaisons between families and school staff, ensuring that audiological recommendations are integrated into classroom accommodations and that students receive continuous, coordinated care. Further, collaboration with social workers is critical to support children with hearing loss. Their expertise in addressing social determinants of health ensures that children and families receive wraparound support, from navigating IEPs to providing counseling for adjustment difficulties.

Advocating for More Inclusive Policies

As IDEA evolves, healthcare professionals, including nurses, will play a key role in shaping policies that prioritize equity and accessibility. By advocating for increased funding, updated screening protocols, and expanded access to assistive technologies, nurses can help drive systemic change. Their direct involvement in student care gives them unique insights into the challenges students face, making them powerful voices in policy discussions. Ensuring that IDEA’s next phase fully supports students with hearing differences requires ongoing advocacy and innovation, with nurses at the forefront of these efforts.

Conclusion

Over the past 50 years, the Individuals with Disabilities Education Act (IDEA) has transformed education for students with hearing differences, ensuring access to specialized support and legal protections. However, continued vigilance is necessary to address gaps in early identification, accommodations, and resource availability. Nurses play a crucial role in advocating for these students, bridging healthcare and education, and ensuring policies evolve to meet their needs. As IDEA moves forward, nurses must remain at the forefront of efforts to promote accessibility, inclusion, and equity, helping every student with hearing differences reach their full potential.

A Note on Language: Embracing Inclusive Terminology.

The term hearing difference is increasingly preferred over “hearing loss” or “hearing impairment” because it acknowledges variations in hearing without framing them as deficiencies. Traditional terms like “loss” or “impairment” suggest a deviation from normal that needs to be fixed, whereas difference aligns with a more inclusive perspective that respects diverse auditory experiences.

This shift is particularly evident in educational settings and is beginning to gain traction in medical contexts. Similarly, the term “Deaf or Hard of Hearing (DHH)” is preferable to “hearing impaired” when referring to individuals with hearing differences, as DHH affirms identity and avoids labeling or deficit-based language. By embracing terminology that reflects diversity rather than deficiency, we foster a more inclusive and respectful dialogue about hearing and communication.