1 Deafness / Hearing Impairment can have a profound impact on the development, education, employment opportunities and social life of the individual and their families. The risk of experiencing abuse is 3.4 times higher for a deaf child., 40% will experience mental health problems in childhood 2 There are specialist skills required for Speech and Language Therapists (SLTs) working with children and adults who are Deaf or Hard of Hearing. These specialist SLTs can directly manage individual cases or support local speech and language therapists in the continuing care of this client group 3 There is consensus that good practice demands that speech and language therapists are an integral part of the specialist team. 4 SLTs have key skills in promoting the development of speech, language and communication. They should play a central role in the support of children who are Deaf or Hard of Hearing and their families. 5 SLTs are experts in the differential diagnosis of speech, language and communication disorders and differentiate these from speech, language and communication difficulties associated with hearing loss / Deafness. 6 SLTs can facilitate families in making informed choices in the management of an infant, child, young person or adult with a hearing loss for example in decisions relating to communication by oral and/ or signed language. 7 SLTs develop listening and attention skills in individuals. This is of particular importance in babies diagnosed with significant hearing impairment, very young children and before and after Cochlear Implant if effective listening and spoken language skills are to be developed. 8 Research has indicated that the speech and language therapy interventions that have been studied are beneficial.