The Second Critical Period

Most healthcare professionals are aware of the critical period of child development, characterized by rapid development across realms from birth to 3 years. Much attention has been placed on the importance of language input, both conversational and literary, socialization experiences, including imaginative play, and music activities, to reinforce language development and sensorimotor coordination with a rhythmic structure. This early critical period forms the foundation for increased learning throughout childhood.

We propose that adolescence reflects a “second critical period” that lays the foundation for adulthood. As highlighted by many authors in this issue, the rapid changes in physical, emotional, and social skills are tempered by unpredictable hormonal changes. As if successful navigation of this potentially tumultuous phase is not difficult enough, teenagers with communication challenges related to hearing loss often need additional support. This support can range from subtle oversight regarding personal assistive technology and accommodations that allow full participation in extracurricular activities, to more intensive consultations when teenagers reject technology, grades decline, or social withdrawal begins. We propose that audiologists are in a unique position to initiate and expand a support system for the teenagers they serve, as well as their families.

This issue, Living with Hearing Loss as an Adolescent, provides an overview of essential needs during this “second critical period,” along with an array of resources to share with teachers of the deaf or hard of hearing, parents, medical professionals, and the community. To set the stage for understanding the scope of the challenges these adolescents face, we invited adults and teens to write about their high school experiences. We discuss the resulting major themes in the paper “Then and Now.” Many of the issues raised by the teens could be addressed with technology and counseling to promote self-advocacy and self-acceptance. Many options exist to network across devices and utilize apps on the smartphone to enhance communication as we learn about the value of “Streaming Audio Signals” by Gross et al and accessing nonauditory apps, such as those described by Childress in “Power in your Pocket.” Unfortunately, the use of smartphones has become so all-consuming that most states have enacted legislation that restricts access to smartphones during school hours. Straight and Thibodeau review the implications of these restrictions for students and provide possible solutions in their paper on “Smartphone Bans.”

Socialization experiences represent an important conduit to quality of life during adolescence as teens engage in more group events that may not have direct oversight, as discussed in the paper by Keywork et al on “Extracurricular Activities.” This period of new social experiences is complicated by potential deficits in emotion recognition, pointed out by Warner-Czyz et al, such that teens may experience peer rejection related to social perception and pragmatic issues. The self-confidence and knowledge that teens bring to these situations, known as social capital, can be strengthened by audiologists, as we learn from Punch and Duncan. Johnson highlights the role of the educational system in navigating challenges and provides a platform for teens to apply their confidence and knowledge to advocate for themselves, request accommodations, and provide feedback when something is not working. Attending transition and educational planning meetings provides adolescents with practice for the next phases of college, job interviews, and health care management. The “Post-Secondary Transition Planning Paper” provides guidance and resources for identifying goals.

In the final paper, we encourage audiologists to think of this “second critical period” as a time when we need to think outside the booth. Clinicians should continue to consider educational and vocational aspects of transition planning, but also the expected adolescent experiences outside of education. These may include learning to drive, establishing a vibration/light/auditory alarm system, and using technology in unique ways (e.g., using a remote microphone to converse with friends at a concert or to hear a coach during a team huddle).

Helping today's teenagers progress through the transitions with confidence and the knowledge to seek resources when needed will provide a strong foundation for moving into adulthood. We are grateful for the expertise shared by the authors of this issue and hope that each reader will relate to a technique or idea in some way that will result in making a difference in the quality of life of an adolescent with hearing loss. This issue of Seminars in Hearing is focused on those adolescents who experience some impact on communication relative to some differences in the auditory system relative to those with typical auditory systems. All authors have agreed that the acronym DHH encompasses the following terminology used to represent these populations: Deaf, deaf, hard of hearing, adventitiously-deafened, Deaf-Blind, and Deaf-Disabled. The specific terminology used in each manuscript may differ but the intent is to represent all of those adolescents with atypical hearing abilities regardless of their mode of communication.

Publication History

Article published online:
13 February 2026