Infosheet | Supervising students with hearing impairment

“Accessible education is also about better understanding what a student needs to learn.”

Sound plays a big role in education: explanations during class or lectures, group discussions, online meetings, videos and informal moments in between. But what seems obvious is not so for everyone. For students with a hearing impairment, studying can cost extra energy due to difficulty understanding, overstimulation or persistent noise. This infosheet gives you insight into what an auditory disability can mean in educational practice and how you as a professional can contribute to an accessible and supportive learning environment with targeted adaptations. The infosheet was developed in cooperation with Stichting Hoormij NVVS.

What does the infosheet offer?

An auditory disability does not mean the same thing to every student. Some students are deaf or hard of hearing and use sign language, subtitles or other visual forms of communication, for example. Others, on the other hand, experience hypersensitivity to sound, such as with tinnitus or hyperacusis. These differences can affect studying, social interaction and well-being.

This infosheet helps you as an education professional to recognize signs and offers concrete tips to make education and support more accessible. By paying attention to clear communication, structure, predictability, stimulus reduction and flexible support, you create a learning environment in which students with hearing impairments can better utilize their talents.

Who is the infosheet for?

This infosheet is intended for teachers, study guides, SLB’ers, educational developers and other professionals in mbo, hbo and wo who guide students in their learning process. Do you work with students who are hard of hearing or deaf? Or with students dealing with tinnitus, hyperacusis or other forms of noise sensitivity? Then this infosheet offers practical support. Even if an auditory disability has not (yet) been officially diagnosed, but you notice that a student has difficulty with stimuli, communication or lecture situations, you can use these tips to get started right away. The infosheet supports you in providing accessible and inclusive education – not by creating extra work, but by consciously and thoughtfully organizing what is already there.

More about the infosheet

What do we mean by auditory impairment?

Auditory impairment can range from hearing impairment to deafness and includes conditions such as:

  • Tinnitus (tinnitus): the perception of sound without an external source.
  • Hyperacusis (sound sensitivity): normal everyday sounds come in (much) too loud and can cause irritation, overwhelm or pain.
  • Misophonia: strong (often emotional) reaction to specific sounds.
  • Usher’s syndrome (combination of hearing and visual impairments).

Important: hyperacusis (and sometimes tinnitus) is not primarily about “not being able to hear,” but about not being able to hear/bear or process sound. Sound can come in distorted, more intense or painful. You can read more about these conditions under background information in this infosheet.

Impact varies by student

Why customization is necessary

The impact depends on, among other things:

  • Degree and type of hearing loss, deafness or other auditory impairment.
  • Access to communication (sign language, subtitling, written interpretation or other visual forms of information).
  • Use of technology or support (e.g., interpreter, subtitles, assistive devices).
  • Fluctuations (per day/per period) in tinnitus/hyperacusis.
  • Personal factors (coping, energy, stress, fear of unexpected noises).
  • Accessibility of the learning environment (digital, social and physical).
  • Study aspects that carry extra weight (especially with hyperacusis):
    • travel distance and travel incentives.
    • living close by vs. having to travel.
    • scheduling (changes, crowding, multiple campuses).

There may also be combinations: multiple auditory impairments, or auditory and other condition(s).

Strengths and qualities

What students often bring

Students may have strengths such as:

  • Highly developed visual memory.
  • Strong visual perception skills and an eye for body language and facial expressions.
  • Strong nonverbal communication skills.
  • Creative problem-solving skills.
  • Focus and concentration (under the right conditions).
  • Empathy and social awareness.
  • Eye for detail and environment.
  • Adaptability in communication (switching between different forms of communication).
  • Independent and able to plan well.
  • Aware of limits and possibilities.
  • Practically handy, flexible, dedicated and lots of perseverance.

(Note: these are possible qualities, not “musts.”)

Information & communication

  • Speakers not visible (teacher walks around or speaks with back to group).
  • Limited access to spoken information (especially in groups/noise), hearing text but unable to understand or process it.
  • Without captioning/writing/ sign language interpreter: missed details and context.
  • Telephoning is often difficult: need for text/visual alternatives (email, chat, image calling).
  • Figurative language and nonverbal cues can be interpreted differently.
  • Use of video or audio without subtitles or transcript.
  • Lip reading is limited: a large proportion of sounds are visually indistinguishable.
  • Not all information is available visually, for example, spontaneous explanations, comments from the group or verbal changes to assignments.

Hyperacusis/tinnitus (specific)

  • Sound is quickly too much and sounds come in equally intense; microphone/boxes can be painful.
  • Anxiety/tension at unexpected sounds or audio/video.
  • In a class “physically present” but mentally unable to cope (“over the limit”).
  • After teaching moments, the “battery” is often empty, making social moments extra tough.

Social

  • Difficult to catch informal conversations (pauses, jokes) or to be there at all.
  • Risk of loneliness/isolation.
  • Misunderstandings due to pacing, group dynamics, talking through each other.
  • Conversations in larger groups or when people are walking around/talking through each other are difficult to follow.
  • Informal moments often do not have an interpreter present, so interactions may be missed.

Energy & well-being

  • Fatigue due to lip reading, exertion, sensory filtering or camouflaging (masking), active exclusion of non-important auditory cues.
  • Fatigue due to continuous visual tracking (interpreter, speaker, slides, classmates).
  • Additional cognitive load due to simultaneous processing of multiple sources of information.
  • Over-stimulation, energy restriction, concentration and processing problems.
  • Stigma anxiety, underestimation, prejudice.

What almost always helps (in various combinations)

  • Accessible information in multiple forms (written, visual and/or oral).
  • Structure, predictability and repetition.
  • Extra processing time and clear expectations.
  • Limit noise and triggers (noise, crowds and/or unexpected audio).
  • Flexibility and customization in participation, assignments, deadlines.
  • Patience and space for the student to indicate what works.
  • Make sure speakers and information are highly visible.
  • Use subtitles, transcripts or interpreters as needed.

Important nuance (tinnitus/hyperacusis)

Subtitles/transcripts often help, but facilities such as written language interpreters or specialized software are not always available or reimbursed for this group. So think creatively.

Practical tips by educational situation

  • Offer standard alternatives to telephone contact, such as e-mail, chat, video calling, or an on-site appointment.
  • Agree which channel will be used for what (for example, schedule changes always through the same channel).
  • Share important information also in writing (summaries, announcements, changes).
  • Make sure the speaker’s face is clearly visible (important for lip reading).
  • In conversations:
    • talk calmly and clearly, not too fast.
    • Have one person speak at a time and repeat questions or comments from the group.
    • When using a (writing) interpreter: address the student, not the interpreter.
    • Allow short pauses between speakers so the student can follow (via interpreter or lip reading).
  • Check your understanding of each other (e.g., “Is it true that…?”) without being patronizing.
  • For hyperacusis: recognize that a student may withdraw because the sound may be painful or overwhelming. Withdrawal in auditory overstimulation can occur more broadly. Respect this and see it as a way to regulate overexcitement.

Structure & predictability

  • Share teaching materials in advance.
  • Make instructions always findable and read back.
  • Inform timely about assignments, required preparation for contact hours, deadlines and changes.
  • Discuss lesson agreements and expectations.
  • Explain why you are asking/doing something.

Information & instruction

  • Use easy-to-read visual aids (slides, diagrams, summaries).
  • Consistent formatting and language.
  • Keep speaking pace steady and plan short breaks (processing information, being able to follow interpreter).
  • Note key points or decisions visibly.
  • Offer information in writing, orally and visually.
  • Use live subtitles or transcripts whenever possible.
  • Avoid figurative language or explain it.
  • Keep background noise low; avoid loud/sudden noises.
  • Alert before audio/video (so student can choose to leave).

Flexibility & freedom of choice

  • Choice in assignment format: written/visual/ oral.
  • Allow alternatives for oral contributions.
  • Allow students to use tools.
  • Offer physical as well as online participation options (especially with hyperacusis); for online environment, allow subtitles by default in settings.
  • Avoid “on-the-spot” assignments; give thinking time and option to come back later.
  • Offer (temporary) recordings with subtitles.
  • Allow moments of rest: short breaks (e.g., after 45 min max), moments of silence.
  • Make sure information can be read or looked back at a later date.
  • Ear plugs/noise cancelling:
    • Can be helpful in specific situations; allow use.
    • but not as the first/standard solution in hyperacusis (risk of exacerbation/dependence). The balance is individual.
  • Good lighting (for speech vision/gesture).
  • Allow a student to change seats.
  • Good sight lines: instructor, fellow students, board/slides.
  • Improve acoustics: minimize reverberation, close windows/doors during noise.
  • Room layout: distance between tables, less sliding/dragging of furniture.
  • Allow the student to leave the room for a moment.
  • Make sure a quiet place is really available.

(Teams/Zoom/Canvas e.d.)

  • Provide:
    • subtitles and where possible transcript accompanying audio/video.
    • For live sessions: allow closed captions by default.
    • clear, consistent structure and uncluttered formatting in the online environment.
  • Preferably also make audio/video available asynchronously (at home in your own stimulus control).
  • Ask participants to turn on their cameras (for lip reading and visual communication).
  • Use the chat feature for questions, comments or additions.
  • Highlight or point out important items on the screen.
  • Agree: don’t talk through audio/video; pause audio when someone speaks.
  • Preferably make materials such as (draft) presentations available prior to class.
  • A preliminary schedule of assignments and “homework” is helpful for good personal planning.

Preparation

  • Inform about possible facilities and methods of operation.
  • Have student explore the test room beforehand.
  • Consider a written or hybrid test format.

Flexibility & choice

  • Choice in test format (where appropriate).
  • Allow oral/written explanation.
  • Extra time where needed.
  • Flexible deadlines/test times whenever possible.

Physical environment & rest

  • Low incentive test space.
  • Good lighting.
  • Avoid interfering light or bright light, be able to adjust settings of monitor.
  • Make sure the student can see the invigilator or examiner clearly (for instructions or questions).
  • Schedule breaks during review.
  • Allow use of writing/sign language interpreter (where applicable).
  • Practical cushioning (e.g., mouse pad under computer mouse, soft surface).

Specific tinnitus/hyperacusis (examples)

  • Testing in low-stimulus room.
  • Being able to choose place in space.
  • Possibly allow for non-audible sound diversion.
  • Hearing protection allowed.

At home or at the educational institution

Structure & overview
  • One central place for materials.
  • Examples/templates for assignments.
  • Clear planning/checklists/step-by-step plans.
  • Divide/help delineate large assignments.
  • Using visual aids.
Communication & guidance
  • Fixed touch points (online or physical).
  • Provide explanations of assignments and important information also in writing.
  • Feedback also in writing.
  • Instructions short and clear.
  • Ask regularly what is working/not working.
  • Encourage study buddy.
  • Offer meeting/support of like-minded people (threshold lowering).

Prior

  • Announce period well in advance.
  • Enable alternative period or part-time without study delays.
  • Help find internship placement.
  • Discuss workplace adjustments.
  • Create a guidance plan together with specific expectations/roles/goals.
  • Explain assessment criteria.
  • Give examples of assignment/structure.
  • Make sure career/study activities are accessible.

During

  • Fixed point of contact.
  • Flexible rhythm/deadlines (in consultation with internship company).
  • Clear, accessible communication in the workplace.
  • Make sure colleagues know how to communicate clearly (face visible, speak one person at a time).
  • Support in social situations.
  • Spread workload.
  • Visual aids (weekly schedule, checklists, visual deadlines).
  • Allow use of tools.
  • Monitor regularly and make timely adjustments.

Afterwards

  • Evaluate: what worked/not worked.
  • Feedback on process and result.

Often underestimated, big impact

  • Schedule in quieter buildings/spaces whenever possible (not near busy hospitality/walking routes).
  • Sufficient space between teaching blocks: rest breaks possible.
  • Limit building changes: avoid multiple campuses in one day.
  • Accessible (quieter) routes, clear wayfinding information (in advance) and signage. Also consider use of quieter entrances or those for visitors with disabilities, quieter elevator group.
  • Timely schedules and changes.
  • Barrier-free rest/still room (preferably without reservations).
  • Quiet place during breaks (a library is not necessarily “quiet” in hyperacusis).
  • Damping measures at study areas/computer rooms (mouse pads, soft surface, reduced laptop/walking noise).
  • Deployment of buddy/tutor.
  • Clear procedure for applications/appointments and periodic review.
  • Free tutoring/course if there is direct link to the disability (studyability/study success).

General

  • Point students to relevant contacts and support platforms within the institution.
  • Inform about resources, facilities and benefits (e.g., through UWV/unimpededstudying.com) where applicable.
  • For tinnitus/hyperacusis, facilities are often limited. Creative thinking is extra important.
  • Refer to information about studying with an auditory disability and peer/advocacy organizations (such as your own referral lines and platforms).
  • Ask how someone names themselves (deaf/hard of hearing/person with…).
  • Avoid generalizations and trivializing (“Noise is just there…”, “never mind”).
  • Assume individual differences; tune out what really helps.
  • Involve students’ experiential knowledge; share do’s and don’ts with colleagues.
  • Use the social model as a starting point: barriers are often in environment, organization and communication.

Tinnitus: key features

  • Noise with no external source; may be continuous or fluctuating; varies by day/per period.
  • Possible consequences:
    • restlessness, tension, sleep problems, anxiety.
    • problems with understanding.
    • faster distracted, slower, cognitive load.
    • more quickly overstimulated/overwhelmed, fatigue, energy restriction.
    • stress/environmental factors can increase symptoms; complete silence or (too much) hearing protection can also backfire.

Hyperacusis: key features

  • Hypersensitive to normal everyday sounds: irritation, overwhelm or pain.
  • Triggers can be loud, repetitive, soft or just “many at once”; peak moments possible.
  • Possible consequences:
    • earache/headache, sleep problems, tension, sometimes anxiety.
    • “on,” continuously scanning for sound.
    • problems with understanding, delayed processing.
    • anger/irritability/irritability, gloom/depression.
    • overstimulation (broader sensory), fatigue, energy impairment.
    • balanced use hearing protection may help, but it is not a solution.

Deafness/serious hearing impairment: key features

  • (Almost) no or very limited functional hearing; information is processed primarily visually or through assistive devices.
  • Communication may be through sign language, written language, lip reading, captioning, written interpreter or sign language interpreter (this varies by student).
  • Lip reading is possible but only partially reliable; a large proportion of sounds are visually indistinguishable.
  • Spoken information may be partially or completely missed, especially with multiple speakers, background noise or high speaking rate.
  • Possible consequences:
    • extra effort to follow conversations and information.
    • missing information or nuances (e.g., humor, comments from the group, spontaneous explanations).
    • fatigue due to constant visual attention (teacher, interpreter, slides, fellow students).
    • delay in interaction because information must be processed first (e.g., via interpreter).
    • social barriers in group discussions or informal moments.
    • dependence on visual accessibility (view of speaker, clear structure, visual support).

Get started right away!

Download the infosheet here