The purpose of this study is to show the changing trends within the population of children who are deaf and hard of hearing in Belgium over the last 12 years. The combination of Universal Newborn Hearing Screening programs, early intervention, and cochlear implants have tremendously influenced the education and support of children who are deaf or hard of hearing in Flanders, Belgium. Today, three times more children with a hearing loss are educated in mainstream settings than 20 years ago. At the same time, the needs of children in special schools for the deaf have become more complex as a significantly greater proportion of these students have additional needs. At a mainstream secondary level, students who are hard of hearing and students who are deaf make different academic choices: More students who are hard of hearing go to vocational training schools, and more students who are deaf attend technical schools. Although all students with hearing loss who attend mainstream secondary schools in Flanders are entitled to an interpreter, significantly fewer students with a cochlear implant choose this option in comparison to students without a cochlear implant. Of the students with cochlear implants who do request an interpreter, approximately half use a notetaker and half use a sign language interpreter. Among students without a cochlear implant, there is a clear preference for a sign language interpreter. (Contains 6 figures and 3 footnotes.)