Safeguarding deaf children in healthcare

It can be concerning when a family doesn't attend appointments, but it's important to take all reasonable steps to understand and support the family before considering it a safeguarding issue.

Explore possible barriers

• Timing: Could the appointment be moved to a more convenient time for the family?
• Travel: Is the location too far? Could the family be seen in a more local setting, or could some assessments be done at home?
• Support needs: Do parents need mental health or emotional support?

Improve communication

• Call instead of write: Families may not respond to letters. Phone calls often lead to better engagement.
• Involve other professionals: Teachers of the Deaf and health visitors can help encourage attendance. Health visitors may also send helpful phone or text reminders.

Be transparent and supportive

• Have open conversations: Talk honestly with families about the risks of missing appointments.
• Before escalating: Ensure all reasonable steps have been taken to remove barriers and support the family.

You may be concerned if a child is not using their hearing device, fearing it could indicate a lack of language input or a potential safeguarding issue. However, it’s important to take a balanced approach.

Key considerations

• Alternative communication: Not using a hearing device does not always mean language deprivation. Many families use sign language or other communication methods that meet the child’s needs.
• Adjustment period: Young children may take time to adapt to hearing technology. Families may be struggling to maintain consistent use. Some families allow breaks or follow the child’s lead.

Safeguarding concerns should only arise if the child is consistently not using the device and is not receiving language input of any kind (spoken or signed).

Communicate with the family

• Ask why the child is not using their hearing device.
• Does the child remove it often? Explore possible reasons and offer strategies to encourage consistent use.
• Share resources, such as our advice on keeping hearing aids and implants on babies and toddlers.

Counsel the family

• Discuss the importance of early language development and the potential impact of hearing loss.
• Use hearing simulations to help families understand what their child experiences.

Understand family beliefs

• Explore personal, cultural or societal beliefs about deafness and hearing technology.
• Does the family have any stigmas that could affect the child’s access to support?
• Ask the child's Teacher of the Deaf about connecting the family with others from similar backgrounds or with deaf role models.
• Share stories of deaf people achieving great things.

Share information on communication options

• Provide balanced information on the benefits and limitations of hearing aids and implants.
• Offer guidance on other communication options, such as sign language.

Collaborate with other professionals

• Discuss your concerns with Teachers of the Deaf, health visitors or others involved in the child's care.
• Work as a team to assess the child’s needs and agree on next steps.

Set realistic goals

• Work with the family to set achievable goals, such as starting with short periods of device use.
• Use play-based strategies, like roleplay, to build comfort and familiarity. Try to incorporate the child's interests, such as using Barbies if that is their favourite toy.

Review your local trust's safeguarding policies to understand the steps to take if you have a concern. These guidelines should help you decide whether a situation needs further action.

If, after exploring all options and consulting with professionals, the family continues to not engage and the child is not receiving appropriate language support (spoken or signed), escalate your concern following local safeguarding procedures.

If you believe a child is at risk, it is your responsibility to contact social care services. Your safeguarding team can support you, but you must make the referral.

Some hearing aids and implants have location tracking features. While useful for recovering lost devices, this feature should be used with caution, especially for children and young people in care.

Depending on the situation, you may need to turn this feature off to keep the child safe.

Consider adding specific guidance on the use of location tracking to your safeguarding policy.