Paediatric deafness 

The number of children with permanent hearing loss in the UK under the age of five years has been estimated to be 7,2001,2 and around 90% of deaf* children are born to hearing parents3,4. All children have the right to develop language and communication so that they can achieve their potential in life. Access to their language and communication environment is key to this development. For children who are born deaf, especially into hearing families with no experience of hearing loss, skilled and sensitive early support is vital if they are to develop the language and communication skills they need to thrive. This early support is vital whether a family wishes to use sign language, spoken language or both.


There are around 7,200 deaf children under 5 in the UK, with around 90% born to hearing parents


Parents** of deaf children should always be presented with clear information about the range of communication approaches so they are able to make an informed decision about which communication approach they would like for their child.


For families who want their deaf child to learn to listen and speak, Auditory Verbal therapy is a robust, evidence-based, family-centred, coaching programme which equips parents and caregivers with the tools to support the development of their deaf child’s speech through listening. But it is not currently widely available for families through publicly funded services in the UK. This needs to change so every family who wants their deaf child to learn to listen and speak has access to Auditory Verbal therapy through publicly funded services in their local area.

Early support


The first three years of life are critical for developing spoken language


Early and effective support is vital whether a family wish to use spoken language, sign language or both. Children’s earliest experiences in life are foundational to brain development5. Research shows that language development before two years can predict educational outcomes6,7. By the age of three and a half, the human brain has completed 85% of its physical growth, meaning the first three years of life are critical for developing spoken language through listening8,9. For families wanting their children to communicate using spoken language, this represents a neurological emergency to access meaningful sound. It is essential to provide intervention as early in the child’s development as possible following the child’s identification, while also considering the preferences of the family10.


Early identification


In the UK there has been substantial investment in the Newborn Hearing Screening Programme (NHSP), with millions of babies having been assessed for hearing loss at birth since 2006. There have also been, and continues to be, significant advances in assistive hearing technologies (e.g., digital hearing aids, auditory implants and all other digital ancilliary aids). However, amplification alone does not allow for optimal spoken language development11, nor does amplification alone support growth in other developmental areas such as social competence12.


The NHSP was introduced in the UK on the premise that outcomes for deaf children could be improved by early identification of hearing loss and effective early intervention13,14. Effective early intervention is crucial if we are to benefit from this investment and technology. We now know that excellent outcomes for spoken language can be achieved if children with hearing loss are fitted expertly with the most appropriate technology and if their families are provided with effective early intervention15.


Educational attainment 


Deafness is not a learning disability. Most children with hearing loss have the potential to reach the same educational outcomes as hearing children if they have appropriate support. However, if there is a language delay, this can affect both children’s literacy and numeracy. A study in 2017 funded by the Nuffield Foundation reported that 48% of oral children aged between 10 and 11 years were reading below age level16. Analysis of 2022’s GCSE results by the National Deaf Children’s Society shows that deaf pupils in England have now achieved an entire GCSE grade less than hearing peers for at least seven years in a row. Just 37.7% of deaf children gained a grade 5 in key subjects English and Maths, compared to 49.8% of hearing children17. Similar analysis for Key Stage 2 results showed that only 40% of deaf children achieved the expected standard for reading, writing and mathematics at Key Stage 2 compared to 59% of all children 17.


Deaf pupils in England have now achieved an entire GCSE grade less than hearing peers for at least seven years in a row17



However, a population study of the emergent literacy skills of pre-schoolers found that children enrolled in Early Intervention before age 6 months had consistently higher scores in emergent literacy components over time compared with children enrolled at or after age 6 months18, highlighting the importance of effective early intervention.


Figures show that deaf children are not ‘catching up’ from their lower starting points as they move through secondary school19. Furthermore, an early language delay can continue to jeopardise future educational outcomes for deaf children.




Children who have hearing loss are also at greater risk of experiencing social isolation, loneliness and difficulty with peer relationships19,20. This influences later adult relationships and social emotional development. Early access to language is the decisive factor that drives development forward and provides good social-emotional functioning21. With over 40% of children with permanent hearing loss estimated to have mental health difficulties in childhood/early adulthood22, there is a vital place for effective, family centred, early intervention.