One of the parents in my practice, the mother of a bright, early-identified, early-amplified, thriving AV toddler, was discussing her son’s preschool options. Should he enroll in a local class for children with hearing loss, or attend the neighborhood preschool with his hearing peers. “I wonder,” the mother asked, “is it ever “too early” to mainstream?”
Auditory Verbal Therapy 
You say the mainstream is generally the best option “if a child’s communication skills are within one year of their hearing peers.” I assume you mean their language age is within 1 year of their chronologically aged peers. What if the linguistic gap is greater than 3 years; what would you recommend? Is mainstream going to be beneficial or will it just be a huge frustration and put them behind academically since they won’t understand much of the language? Not that being in a DHH or language-intensive classroom will necessarily keep them on par academically either…, but still, can they learn if the language being used will be that far above them?
Great question, Roman! I think we always need to look for the situation where the child can be most successful — a “just right challenge.” In the case you describe, it seems as if that child would find more frustration than success in trying to keep up with his or her age-matched peers. Specialized instruction for academic subjects, particularly language, may be needed. At the same time, we learn language best from those who speak better than us, so some partial mainstreaming, whether it’s for PE class or an after-school activity like scouting, can really benefit this type of child. With support and accommodations, successful participation is possible.
My child is multi-sensory impaired (Charge syndrome). She copes well with her visual impairment, but her hearing impairment and balance problems have a greater impact on her overall development. She has been aided from 8 weeks old with good access to hearing. She is just about to turn 4 and has around 1 year speech delay. She is very social, confident and cognitively not delayed. She started nursery at 2 1/2 at a really good local mainstream nursery. But the nursery was in a church hall and the noise levels were challenging for a MSI child. We moved her to mainstream nursery school with a hearing impairment unit, where she spends half the day with the mainstream kids and the other with the unit kids. Despite having the most complex needs in the unit, she has by far the best communication, social and language skills. The plan was for her to do the reception year at the unit school. We would then move to our local mainstream school, where her brothers go, to repeat the reception year to give her extra time to catch up with her hearing peers. I am a little worried that at the unit school she may not be pushed forward enough because being in a class where she has the most developed language. Repeating reception at the mainstream school, would get that extra year to catch up, both with speech and mobility, and start at the very beginning with all the other kids. I am doing the right thing? She has been doing AV for 2 years now.
I agree wholeheartedly. You don’t want the academics to fall behind because of language, but it is essential that socialization with peers of higher language levels occur. Related arts and extra curricular activities are great opportunities.
Thank you for your question. Not knowing your daughter in person, I can only offer a general opinion, but I think that being in a class with peers who are good language models (more advanced than the child with hearing loss) is a great thing, and repeating the first year of formal schooling is a great thing (for almost all children with hearing loss, and many with typical hearing!). It sounds like doing two reception years at the mainstream school offers both of these advantages. It sounds as if your daughter is doing quite well. Congratulations! Behind every successful child is a hard-working parent!