By understanding the various types and degrees of hearing loss, along with the more effective ways of interacting with hearing-impaired passengers, school bus drivers and assistants can reduce the probability of miscommunication.

Types of hearing loss

Conductive hearing loss involves the outer and middle ear. It can result from a blockage of wax, a punctured eardrum, birth defects, ear infections or heredity. Usually, conductive hearing loss can be corrected medically or surgically.

Sensorineural or "nerve" hearing loss involves damage to the inner ear. It can be caused by prenatal and birth-related problems, viral and bacterial infections, heredity, trauma (such as a severe blow to the head), exposure to loud noises, the use of certain drugs, fluid buildup in the inner ear or a benign tumor in the inner ear. Only in rare cases can sensorineural hearing loss be medically or surgically corrected. It is the type of hearing loss that is most commonly managed with a hearing aid.

Degrees of hearing loss

Hearing loss can range from mild loss to profoundly deaf. It is measured in decibels (dB) from mild (27-40 dB) to moderate (41-55 dB) to moderate/severe (56-70 dB). Anyone with a hearing loss of 71 dB or more is considered deaf.

Those with mild hearing loss have difficulty in hearing faint speech at a distance and are inconvenienced by school settings and background bus noises. Hearing aids and assigned close-in seating helps.

Students with moderate hearing loss understand average conversational speech at a distance of 3 feet and carry on face-to-face conversation on the bus without difficulty, but they are unable to understand if the other person turns away. They may miss as much as 50 percent of a class discussion and nearly 100 percent of any bus team member's directions.

Students with severe to profound hearing loss can understand loud conversations from 3 to 5 feet away. They generally cannot participate in group discussions or hear conversations face-to-face by the driver or assistant while on the bus. They have serious language deficiencies that make them less able to understand spoken directions and more reliant on gestures and American Sign Language from the bus team.

Students with a "less significant" hearing loss may only need an amplification system to fully participate in conversations.

Only 10 percent of all hearing-impaired adults have learned to read lips. The special-education driver team should not expect most deaf or hearing-impaired students to gain information from lip-reading alone.

{+PAGEBREAK+} Recommendations

Always get the student's attention before speaking. Stay at a comfortable distance with good light and keep your head up toward the student.

Be clear — Speak clearly, perhaps a little louder than usual, but don't shout because it only distorts the lips and makes it difficult to lip read. Speak with the ordinary rhythm and flow of speech. As far as possible, cut out any background noise.

Be concise — Speaking plainly to students helps them more easily understand your meaning, your instructions and the bus rules. Make sure that the listener understands the subject at the beginning of the conversation. It is a good idea to write it down. Don't change the subject without warning.

Be patient — Be prepared to repeat things if necessary. A good tip is if you've tried a couple of times and can't get the message across, rearrange the sentence and present it in a different way, perhaps with the key words at the beginning of the sentence.

When these simple, basic points are followed, it should be easier to communicate with hearing-impaired students, but if all else fails, write it down.

Dr. Ray Turner, owner of White Buffalo Press (www.whitebuffalopress.com), is also special-needs transportation coordinator at Northside Independent School District in San Antonio.