Kids are back to school – Help your students with unilateral hearing loss succeed!

Learn how expert guidance, Roger Focus II and Phonak CROS technology can help your kids in the classroom this new academic year.

For the estimated 3 in 100 children who develop UHL by the time they reach school age2, research has shown that:

  • They are 10 times more likely to need to repeat a year of school than children with normal hearing.3
  • They are 5 times more likely to need support services.4
  • UHL can negatively impact their speech and language development.5
  • They perform poorer on tests of verbal working memory and phonological processing compared to normal-hearing siblings.6

Fortunately, in the last half a decade, we’ve made strides in understanding the challenges and needs of children with UHL. This culminated in the 2019 Consensus practice parameter: audiological assessment and management of unilateral hearing loss in children1 developed by a group of pediatric audiologists, researchers and clinicians.

Based on this publication, here are 3 recommendations when assessing and managing a student with UHL:

Ensure effective communication with families

Just like in all areas of pediatric goal setting, partnering with parents is the gold standard of care. According to the expert guidelines, collaborating with parents can drive the best combination of:

  • Amplification
  • Academic accommodations
  • Follow-up monitoring

Provide support and resources to families

Parents need education and support so they know what considerations to make for their school-aged child. According to the expert guidelines, audiologists have an important role in providing this support to families.

The new Phonak Parent Guide for understanding best practice recommendations for children with UHL is now available to do just that. Written by Janet DesGeorges, Executive Director of Hands & Voices, this guide will help support families of children with UHL throughout their journey and will help foster effective communication with you and other professionals. This resource may be shared freely with the caretakers and teachers of your students.

Consider a variety of hearing technologies

Did you know that research has shown that children with UHL show a significant decrease in speech understanding in both quiet (at a distance of 3 m or more), and in noise (at 1.5 m or more), when no interventional technology is used?7 For students with UHL, technologies that improve speech understanding are important for their academic success.

According to the expert guidelines, a variety of hearing technologies should be considered. Of course, every child with UHL is unique so there is not just one solution. Below are several options available depending on whether the hearing loss is aidable or not.

Hearing technology for aidable UHL

For students with aidable UHL, we recommend a Sky Marvel hearing aid (worn on the child’s ear with loss). This hearing aid features the world’s first and only operating system designed for children.

It is able to detect the environment the student is in and can adjust the hearing aid accordingly. It comes in multiple models to suit different hearing losses, and even comes in a rechargeable option.

If you have a student on your caseload with UHL, they could be considered for a trial with amplification to determine the benefits.

Hearing technology for unaidable UHL

The new Roger Focus II is the latest ear-level Roger receiver. It consists of two parts:

  • The Roger Focus II receiver worn on a student’s normal hearing ear which receives the signal streamed from any Roger microphone.
  • A Roger microphone which picks up voices and sends them directly to the Roger Focus II and into the student’s ear.

In a recent study, when Roger Focus ll was used in a simulated noisy classroom, children with UHL understood distant speech, such as a teacher’s, significantly better than their normal hearing peers.7 Even in a quiet environment, using Roger Focus II provided significantly better speech understanding for children with UHL compared to no technology.7

Roger Focus II is compatible with all Roger microphones and is now offered in a rechargeable or 312 battery model with tamperproof battery door options, color options and access to the full range of SlimTube sizes.

Phonak CROS B is a microphone built in a small behind-the-ear housing that picks up sound from the impaired side and sends the sound to the normal hearing ear wearing a small Sky B BTE. With advanced processing, this system is great when a child needs to hear someone who is talking on the side of the ear with hearing loss.

For older kids, the latest generation Phonak CROS P can be worn with a Phonak Audéo P hearing aid.

Recent research has shown that adults and children with UHL who use a CROS system, have improved speech recognition scores in noise when speech is presented to the ‘deaf’ side.8-13

More expert recommendations a click away

Below are 2 documents filled with best practice recommendations that can help you ensure children with UHL are ready for success.

  • The peer-reviewed Consensus practice parameter provides recommendations for the management of children with UHL so you can fully support their unique needs.
  • The Quick Practice Guideline provides a shortened summary of the full practice parameter, making it a quick and convenient to review best practice recommendations.

To learn about the comprehensive portfolio of hearing solutions designed to meet the unique needs of children with UHL, we invite you to visit


  1. Bagatto, M., DesGeorges, J., King, A., Kitterick, P., Laurnagaray, D., Lewis, D., Roush, P., Sladen, D. P., & Tharpe, A. M. (2019). Consensus practice parameter: audiological assessment and management of unilateral hearing loss in children. International Journal of Audiology, retrieved from, accessed March 3, 2021.
  2. Bess, F. H., Dodd-Murphy, J., & Parker, R. A. (1998). Children with minimal sensorineural hearing loss: prevalence, educational performance, and functional status. Ear and Hearing, 19(5), 339–354.
  3. Bess, F.H., Tharpe, A.M. (2008). Case history data on unilaterally hearing-impaired children. Ear and Hearing, 7, 14-19.
  4. Oyler, R.F., Oyler, A.L, & Matkin, N.D (1988). Unilateral hearing loss: demographics and educational impact. Language, Speech, and Hearing Services in Schools, 19, 201-210.
  5. Bagatto, M., DesGeorges, J., King, A., Kitterick, P., Laumagarary, D., Lewis, S., … Tharpe, A.M. (2018) Quick Practice Guideline – Tools and considerations for assessing and managing unilateral hearing loss in children. Retrieved from, accessed March 3, 2021.
  6. Ead, B., Hale, S., DeAlwis, D., & Lieu, J.E.C. (2013) Pilot study of cognition in children with unilateral hearing loss. International Journal of Pediatric Otorhinolaryngology, 77 (1), 1856 – 1860.
  7. Nelson, J. & Dunn, A., (2021). Roger Focus II in children with unilateral hearing loss. Phonak Field Study News, accessed May 2021.
  8. Snapp, H. (2019a). Nonsurgical management of single-sided deafness: Contralateral routing of signal. Journal of Neurological Surgery Part B: Skull Base; 80(2): 132-138.
  9. Snapp, H., Hoffer, M., Spahr, A., Rajguru S. (2019b). Application of wireless contralateral routing of signal technology in unilateral cochlear implant users with bilateral profound hearing loss. Journal of the American Academy of Audiology; 30(7): 579-589.
  10. Kuk, F., Seper, E., Lau, C., Crose, B., Korhonen, P. (2015). Effects of training on the use of a manual microphone shutoff on a BiCROS device. Journal of the American Academy of Audiology; 26(5): 478-493.
  11. Picou, E.M., Davis, H., Tharpe, A.M. (2020). Considerations for choosing microphone technologies for students with limited useable hearing unilaterally. Language Speech and Hearing Services in Schools; 51(1): 74‐
  12. Williams, V.A., McArdle, R.A., Chisolm, T.H. (2012). Subjective and objective outcomes from new BiCROS technology in a veteran sample. Journal of the American Academy of Audiology; 23(10): 789‐806.

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