According to the National Resource Center for Early Hearing Detection and Intervention (2012), Early Hearing Detection and Intervention (EHDI) is a program funded in most states that makes it mandatory for hospitals to screen newborns to identify any hearing changes that may not be part of the norm. If the infant is identified as having such a change, he or she typically will go through evaluations at the one-month, three-month and six-month mark. Infants who do not pass the first evaluation should have a diagnostic audiologic evaluation in their third month. Before six months, the infant has the right to receive early intervention services. It is part of EHDI's goal to maximize linguistic and communicative competency as well as literacy development for all children who are deaf or hard of hearing. 

All infants and toddlers (ages 0-3) identified as deaf or hard of hearing are eligible for educational services under Part C of the Individual with Disabilities Education Act (IDEA). They have the right to be provided services by a local educational agency (LEA) or the local department of developmental services regional center, or both. The focus of these services should be aimed at the development of language skills, which requires skilled, trained, and certified teachers who are familiar with communicative and linguistic needs of deaf and hard of hearing infants and toddlers. At home visits, the teacher coaches the family about using strategies to support the child's development. They are also models of language and play activities that families can learn from.  Furthermore, studies show that early intervention prior to 12 months old makes a difference in the outcomes of language, social-emotional, and speech development (Calderon, 2000; Moeller, 2000; Yoshinaga-Itano, 2003).


Kushalnagar et al. (2010) stated, "The success of early hearing detection and intervention (EHDI) programs depends on families working in partnership with professionals as a well-coordinated team. The recommendation throughout is that families receive unbiased information so they can make an informed decision, and then primary care providers (PCPs) are to act in accordance with that decision" (p. 2). In other words, infants, toddlers, and their families have a variety of needs that demand collaboration from the early intervention (EI) team, which consists of people who are educators in Deaf education or special education, audiologists, psychologists, linguists, social workers, counselors, and/or speech-language pathologists. A meaningful collaboration from these people would reflect mutual respect, cultural understanding and sensitivity, and cultural mediation between families, hearing professionals, and the Deaf community.

Steele & Riggins (n.d.) stated that families are the ultimate decision-makers of the team. According to Buysse & Wesley (2006), when families and professional go through the process of making a decision, they integrate the best available research evidence along with family and professional wisdom and values. Due to a gap between research and practice in Deaf education and EI services for deaf and hard of hearing children, families often do not have the opportunity to know what may work for their children when it comes to language development and needs. This highlights the importance of families receiving services from an interdisciplinary team providing them with evidence-based and balanced information about early language acquisition and EI services.


Increasing richness of diversity in the United States has made it important for professionals to acknowledge the newer definition of what it means to be a family. As they work with families, they need to know that the family is a constant part of the child's life, as people who are and will always be with the child. This is why the family's background, values, views, expectations, and their power in making decisions need to be respected by these professionals (Benedict & Sass-Lehrer, 2007; Steele & Riggins, n.d.). 

Trivette & Dunst's (2005, as cited in Steele & Riggins) definition of family-centered is a philosophy or way of thinking that leads to a set of practices in which families or parents are considered central and the most important decision maker in a child's life. More specifically, it recognizes that the family is the constant in a child's life and that service systems and personnel must support, respect, encourage, and enhance the strengths and competence of the family.

Hansel & Lynch (2004, as cited in Steele & Riggins) and Steele & Riggins (n.d.) have created a guideline for professionals in utilizing the family-centered approach. Families can use this as a checklist to ensure that they are working with the right service provider who is responsive to their culture, values, and education.

  •  Respect family values, beliefs, and practices
  • Trust that the family knows best
  • Be sensitive to diverse backgrounds
  • Acknowledge family members as decision makers
  • Treat the family members as people first
  • Recognize that you are a guest in the family's home and life
  • Maintain appropriate boundaries
  • Be flexible
  • Enjoy the children and families
  • Communicate clearly and respectfully


Position statements are documents developed by a group of experts in the field after a comprehensive literature review. They are only recommendations and are not required by law or regulation. Professionals are expected to know about their association or organization’s position statement that offers an explanation about their role(s). These documents are useful manuscripts for parents and professionals, especially if and when there is a conflict of views, practice, or decisions that can happen during the child’s education.


© Video used with permission of ASLized! (http://aslized.org/ei


Benedict, B. S., & Sass-Lehrer, M. (2007). Deaf and hearing partnerships: Ethical and communication considerations. American Annals of the Deaf, 152(3), 275-282.

Buysse, V., & Wesley, P.  W. (2006). Evidence-based practice: How did it emerge and what does it really mean for the early childhood education field? In V. Buysse & P.W. Wesley (Eds.), Evidence-based practice in the early childhood field (pp. 1-34). Washington, DC: Zero to Three Press.

Calderon, R. (2000). Parental involvement in deaf children’s education programs as a predictor of child’s language, early reading, and social-emotional development. Journal of Deaf Studies and Deaf Education 5(2), 140-155.

Concept paper: Responsiveness to Family, Culture, Values and Education (2004). Retrieved from www.dec-sped.org.

Early hearing detection and intervention: Website resource guide (2012). Retrieved from http://www.infanthearing.org/webguide

Kushalnagar, P., Mathur, G., Moreland, C. J., Napoli, D. J., Osterling, W., Padden, C., & Rathmann, C. (2010). Infants and children with hearing loss need early language access. The Journal of Clinical Ethics, 21(1), 1-13.

Moeller, M. P. (2000). Early intervention and language development in children who are deaf and hard of hearing. Pediatrics, 106, E43.

National Center for Hearing Assessment and Management Resource Guide for EDHI (2012). Retrieved from http://www.infanthearing.org/index.html.

Steele, S., & Riggins, R. (n.d.). Ask PFI: Reflection on Family-Centeredness. Retrieved from http://projects.fpg.unc.edu/~pfi/pdfs/AskPFI_FamCen_01_2011.pdf.  

The MacArthur-Bates Communicative Development Inventories (2003). Retrieved from http://www.sci.sdsu.edu/cdi/cdiwelcome.htm

Turnbull, A., Turnbull, R., Erwin, E., & Soodak, L. (2006). Communicating and collaborating among partners. (pp. 185-208). IN FAMILIES, PROFESSIONALS AND EXCEPTIONALITY: POSITIVE OUTCOMES THROUGH PARTNERSHIPS AND TRUST. Upper Saddle River, NJ: Pearson.

Yoshinaga-Itano, C. (2003). From screening to early identification and intervention: Discovering predictors to successful outcomes for children with significant hearing loss. Journal of Deaf Studies and Deaf Education, 8(1), 11-30.


    © Jaclyn Vincent 2015. All rights reserved.