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The Hearing Impaired
Transcript of The Hearing Impaired
The amount of the time we use our ears every single day.
The information taken in through your ears and all that you would miss you
if you could not hear.
How the loss of sound would affect you ability to form relationships and communicate with others.
*For individuals who are hard of hearing, the world is limited. Famous People
Hearing Impairments There has been a growing acceptance of
individuals with hearing impairment within the
hearing society, partly due to several persons who
are deaf or hard of hearing that have recieved recognition
in their fields. Phyllis Frelich- Broadway Actress
Won a Tony Award
Marlee Matlin- First Deaf Actress
Won Academy Awards
First Deaf Miss America
Kenny Walker- Pro Football Player
Coached for Iowa School for the Deaf
Helen Keller- Deaf /Blind Writer
Lecturer and Actress
Shoshannah Stern- Actress
Performed in "Jericho" and "Weeds"
First Deaf Person to Play in the NBA
Juliette Gordon Low-
Founder of Girl Scouts of America
Ludwig Van Beethoven-
Famous German Composer
History of Education Aside from the acceptance of more prominent individuals with hearing loss, there are many professions where people who are deaf or hard of hearing are employed. This has not always been the case.
The acceptance of individuals who are deaf has been assisted by government mandates, regulations and advocacy for the rights of all people.
Commissions established by Congress in 1986 and 1988 led to the National Information Center on Deafness, and the Helen Keller National Center for Technical Assistance.
In the 1990s, telephone relaying systems were required to ensure phone access to people with hearing impairments; televisions with screens thirteen inches or larger were required to have captioned broadcasts.
Laws and regulations that were passed that raised public awareness include the Individuals with Disabilities Education Act (IDEA; PL 101-476) and the Americans with Disabilities Act (PL 101-336). Some states have even passed bills to ensure deaf children receive the education they need.
Despite all of these gains, our speech language-oriented society has not accepted American Sign Language (ASL) as a true language.
Because of the dominance of speech in our society, some educators of the hearing impaired suggest the use of oral speech language.
Others suggest sign language, or a combination of both.
This debate on how to teach communication to a child with hearing loss goes back to Europe- Samuel Heinicke stressed oralism (speech), while Abbé de l'Épée stressed manualism (gestures).
A conference in 1880 favored oralism, claiming sign language impeded language development.
In the United States, sign language was encouraged by Thomas Hopkins Gallaudet and Laurent Clerc, who founded the first School for the Deaf (1817).
Gallaudet College was later founded in 1884.
Between 1817 and 1917, schools for the deaf were founded in most states.
In the 1970s, Bob Holcomb (a college graduate with severe hearing loss) advocated the use of both systems (oral and manual), and coined the term total communication method (some type of manual communication is used simultaneously with speech).
No matter which way a person prefers to teach communication skills, it is critical for the student to be taught a communication system that they can master. Characteristics and Risk Factors Definitions of Deafness
15-20 dB: slight hearing loss. Causes: otitis media; fluid buildup in middle of ear; damage to ear through injury, illness and/or noise exposure...the child hears vowel sounds clearly; may miss unvoiced consonant sounds (F, S, Sh)
20-40 dB: mild hearing loss. Causes: otitis media; prenatal exposure to infections; damage to ear through illness, injury and/or noise exposure...the child hears only some louder-voiced speech sounds
40-60 dB: moderate hearing loss. Causes: chronic otitis media; middle ear anomalies; sensorineural damage; prenatal exposure to infections; genetic factors; damage to the ear through illness, injury and/or noise exposure...the child misses most speech sounds at normal conversational level
60-80 dB: severe hearing loss. Causes: middle ear anomalies; sensorineural damage; prenatal exposure to infections; genetic factor and damage through illness, injury and/or noise exposure...the child hears no speech sounds at normal conversational level
more than 80 dB: profound hearing loss. Causes are the same as severe hearing loss...the child hears no speech or other sounds levels of hearing loss Prevalance Causes Assessment Impact Cognitive Development Social and Personal Adjustment The Deaf Culture or Community Educational Responses Family and Lifespan Issues Students with hearing impairments have partial or full hearing loss in one or both ears. The characteristics of the student depend on the factors of hearing loss (degree, type and extent). With proper support, most hearing-impaired children can and do succeed in school.
Lip reading-- according to Ball State University, even the most skilled lip readers are only able to decipher 20-30% of spoken English. Lip readers may appear to understand everything that happens in the classroom, but may misinterpret information or miss the verbal interaction of their peers, causing them to fall behind.
American Sign Language-- Depending on the severity of the hearing loss and views of the parents and community, many hearing impaired students learn to use American Sign Language as a primary source of communication. A child may require an interpreter to communicate effectively with others, and could become dependent on the interpreter. This could interfere with the child's ability to acquire age-appropriate social and negotiation skills with peers.Grammar and Syntax-- ASL does not translate word for word into English, but instead functions much as a form of shorthand. As such, the child may not learn the subtle nuances of a language and may struggle with grammar and syntax. speech delay
frequent or recurrent ear infections
a family history of hearing loss
syndromes known to be associated with hearing loss (Down syndrome, the Alport syndrome, Crouzon syndrome)
infectious diseases that cause hearing loss (meningitis, measles, cytomegalovirus [CMV] infection)
medical treatments that may have hearing loss as a side effect (some antibiotics and chemotherapy agents)
poor school performance
diagnosis of a learning disability or other disorder, such as autism or pervasive developmental disorder (PDD).
low birth weight (less than 2 pounds) and/or prematurity
severe jaundice after birth
maternal illness during pregnancy (for example, German measles [rubella])
hydrocephalus A hearing loss is defined by the degree of loss, the type of loss, and the age at which the loss occurred.
IDEA defines deafness as a hearing impairment that is severe enough that the child cannot process linguistic information through hearing, even when using amplification or hearing aids.
Being hard of hearing is defined as an impairment in hearing that may be permanent or fluctuating.
Both can adversely affect the child’s education and they need special educational adaptations to support them. Degree of Hearing Loss the severity of hearing losses determined by the individual’s reception of sound as measured in decibels (dB): *loss of 15-20 dBs, considered slight*20-40 dBs, considered mild*40-60 dBs, considered moderate*60-80 dBs, considered severe*more than 80 dBs, considered profound (deafness) Types of Hearing Loss Structure of the Ear Hearing loss is classified into four categories:
1. Conductive loss
2. Sensorineural loss
3. Mixed Hearing loss
4. Central Auditory Processing loss conductive hearing loss sensorineural hearing loss mixed hearing loss central auditory processing -when something blocks the sound passing through the outer or middle ear
-caused by wax, ear infections, and any malfunction of the ear canal
-makes hearing faint sounds more difficult
-usually temporary, corrected by medication or surgery
-children will need educational supports to help them with language development
-also the child may need speech-language support to overcome articulation problems -damage to the inner ear (cochlea) or to the auditory nerve
-affects ability to hear faint sounds
-makes specific sounds difficult to comprehend
-caused by genetic syndromes, diseases, injuries, exposure to loud noise
-hearing aids are useful for a majority of individuals with sensorineural hearing loss
-cochlear implants can be considered for people with profound hearing loss in both ears who cannot benefit from hearing aids
-educational support and related speech services will be needed to help the child be able to achieve successfully -result from problems with outer, middle, and inner ear
-resembles many of the difficulties from conductive and sensorinueral hearing loss
-may hear distorted sounds and have difficulties with sound levels
-combination of medical treatment and amplification with hearing aids can be used to try to increase hearing
-some people may benefit from cochlear implants
-students will need educational and related service supports -central auditory processing disorder (CAPD)
-people may have difficulties with sound localization, auditory discrimination, understanding speech sounds against a noisy background, auditory sequencing, memory and pattern recognition, sounds of words, and reading comprehension
-students will need support of multidisciplinary team to provide support and services Age of Onset Hearing loss can be congenial (present at birth) or acquired (occurred in childhood or adulthood). The time of an acquired hearing loss is very important and can determine a child’s language/speech abilities.
Hearing loss can be developed before a child’s language skills have evolved.
the stronger a child’s speech and language foundation before hearing loss, the more they can use it to help with communication. In 2004, about 31.4 million people in the US, or 10% of the general population, were reported to have some degree of hearing loss; Less than 1% are likely to be deaf
Hearing loss is estimated to occur in the following:
- three in ten people over age 60
- one in six people ages 41-59
- one in fourteen people ages 29-40
- about 1.4 million children and youths under the age of 18
About three in one thousand infants are born with serious to profound hearing losses
In 2001, 70,767 students were listed as deaf or hard hearing
- 43% were served in regular classes (spending over 80% of their time in general education classrooms)
- 24% received services primarily in special education classes
- 14% attended separate environments or residential school
it is estimated that factors are 1/3 genetic, 1/3 environmental or aquired, and 1/3 unknown. genetic causes environmental causes seventy documented syndromes exist
inherited from one or both parents, if the parent is hard of hearing or not
children with genetically-related disabilities may also have hearing problems (for examply, children with Down syndrome often have narrow ear canals and are prone to middle ear infections) exposure to bacteria, viruses, toxins, trauma, infection during pregnancy
group infections affecting mother can cause hearing loss in child (labeled TORCHS):
- TO: toxoplasmosis (parasitic)
- R: rubella (can also cause blindness)
- C: cytomegalovirus (CMV)
- HS: herpes simplex (can cause death)
other causes include asphyxia (lack of oxygen), meningitis and otitis media (ear infection)
Accommodations can be detected at birth-- many states require screening newborns
octoacoustic emissions-- to determine if brain picks up sound
bone-conductor test-- measures movement of sound
play audiometry-- assesses child's ability to hear
pure-tone audiometry-- for hearing acuity Importance of early intervention--
the child will not have experiences needed with spoken language if not given amplification/cochlear implants/early intervention supports Communication Needs--
if child does not have any stimulation, they will not be able to communicate well, if at all.
children that are not hard of hearing have a constat flow of language stimulation during their early years...for children with severe hearing loss, early, consistent and concious use of visible communication modes (sign language, finger spelling, cued speech) and/or amplification and oral training can help reduce long delay most children who are deaf or hard of hearing have normal intelligence, some are gifted intellectually
hearing loss will not affect overall cognitive abilities, but children may experience developmental delays
children will need special instruction to reach the same cognitive abilities as children who can hear Academic Development in Reading--
reading levels tend to be lower for kids who are hearing impaired because they will not be able to decode print if they are taught the usual method of matching speech sounds to print
if children are taught reading visually or manually, they will be able to learn to read, write and use appropriate language forms (past tense, questions, logical propositions)with the increase in children (with disabilities) receiving cochlear implants and hearing aids, more of them are gaining access to speech sounds, helping them learn to read Several factors help improve the social adjustment:early identification and interventionfamily support/acceptance participation in extracurricular activitiesskilled professionals that work with child and family Promoting Alternative Thinking Strategies (PATHS)- curriculum designed to improve social competence and to reduce behavioral problems for children who are deaf.
curriculum focuses on problem solving techniques to resolve social problems and overcome frustrations
PATHS is used from late preschool to 6th grade
90% of parents who are deaf or hard of hearing are not able to communicate fully with their children through speech being able to communicate allows a person with hearing loss to be involved fully with their environment
communication is central to full participation with others the Deaf community exists as a separate cultural group within our society, and has a status of a minority groupIt is a very diverse group; members composed of many different religious, social, and ethnic backgrounds
share values and traditions, a common language (ASL) and specific behavior protocols
they have state and local networks, hold world games for the deaf, and publish newspapers
provides a sense of belonging and pride for members, helping them overcome isolation Children who are deaf will need their own IEP and services provided within all three tiers of the RTI modelMultidisciplinary team is key in planning for children with hearing losses. This team consists of: audiologists, speech-language pathologists, sign language interpreters, general education teachers, special education teachers and parents. audiologist: assesses the degree, type and extent of loss and monitors the use of implant supports
speech-language pathologist: support for speech development and communication skills
sign language interpreter: meet communication needs in classroom
general education teacher: responsible for general education content; responsible for recognizing signs of hearing loss
special education teacher: works with child on special needs
parents: can help the others understand the child’s needs and work at home to support development Examples of RTI Tier Supports Tier I Supports Tier II Supports Tier III Supports Teacher works to make sure child is included in daily activities and checks to make sure child understands key information
More explicit instruction in vocabulary; additional hands on materials for math and science; and word processing support for writing More intensive instruction in the academic areas and can also address special learning strategies or study skills Varies depending on child’s specific needs
Often support includes use of hearing aids or cochlear implants
Instruction in speech reading and speech production
Specific instruction on communication skills and language development
Manual communication approaches: ASL, Pidgin Sign English, Signing Exact English, Finger Spelling, etc. (of these, only ASL is an actual “language” with its own grammar and syntax)
Continued lessons in ASL and speech reading (with visual prompts and reading comprehension strategies) **the COMBINED services help to ensure students have supports they need to succeed. General Education Teacher’s Role in Recognizing Hearing Problems The general education teacher can help identify a child with a possible hearing loss by observation: Warning signs indicating a hearing loss:
Does the child appear to have physical problems associated with ears?
Does the child articulate sounds poorly and particularly omit consonant sounds?
When listening to radio, TV., or records does the student turn the volume up so high that others complain?
Does the student cock his or her head of turn toward the speaker in an apparent effort to hear better?
Does the student frequently request that what has just been said be repeated?
Is the student unresponsive or inattentive when spoken to in a normal voice?
Is the student reluctant to participate in oral activities? Instructional Strategies to Enhance Participation:
speak louder and clearer
speak at eye level and face the child…gain their attention first
minimize background noise and reduce distractions
promote language learning
increase the child’s attention to language Assistive and Instructional Technologies:
assistive technology: any equipment or product that assists the learner with special need
alerting devices and alarm systems: show flashing lights and vibrate (alarm clocks, fire alerts, doorbell signals, phone signals)
speech-to-print systems: reproduce classroom dialogue on a computer screen
telecommunications and media access: captioned telephone relay services are available in 42 states Accommodations are intended to "level the playing field". They in no way guarantee success nor should they compromise the integrity of the course. Please remember that the following are only suggestions. Faculty/Staff are not required or expected to provide all of these accommodations. *Students with hearing impairments will benefit from front row seating. An unobstructed line of vision is necessary for students who use interpreters and for those who rely on lip-reading and visual cues. If an interpreter is used, the student's view should include the interpreter and the lecturer. Do not speak facing the blackboard. *Whenever possible, utilize circular seating arrangements as they offer deaf or hard of hearing students the best opportunity to see all class participants. *Be aware of the fact that hands, books or microphones in front of your face can add to the difficulties of lip readers. *Keep your face within view of the student and speak in a natural tone.
*When an interpreter is being used, speak directly to the student, not to the interpreter. *Recognize the brief amount of extra processing time that it takes for the interpreter to translate a message from its original language into another language, because this will cause a delay in the student's receiving information, asking questions and/or offering comments. *Repeat the questions or remarks of others in the room-- acknowledge who has made the comment so that the hard of hearing student can focus on the speaker. *Use visual aids to reinforce spoken presentations whenever possible
*Whenever possible, provide the student with class outlines, lecture notes, lists of new technical terms and printed transcripts of audio and audio-visual materials *Do not hesitate to communicate with the student in writing when conveying important information such as assignments, scheduling and deadlines.
*Whenever possible, try not to speak when the person is writing.
*Do not shout!! *If there is a break in the class, be sure to get the hard-of-hearing student's attention before resuming the lecture. *Be flexible: allow a deaf student to work with audio-visual material independently and for a longer period of time.
*Allow the student the same anonymity as other students (i.e. avoid pointing out the student or their accommodations to the rest of the class). Family provides essential support for the child who is deaf/hard of hearing
Family helps shape the educational program for the child and reinforces the intervention in the home
Family involvement leads to better communication skills It is important to recognize a family’s strengths and respect their values and beliefs.
Child’s development is facilitated when family members adopt interactive strategies and encourage the child to request, respond, and take initiative Encouraging Academic Achievement at Home Parent involvement is key. Strategies for parents:
develop perception that is accepting of deafness
learn sign language
use short utterances
exaggerate, repeat, and prolong signs
learn an oral or an aural approach Transitions Transition planning should begin in high school and address the following:
Students who are hearing impaired face the same question as hearing students: What do I want to do when I grow up? The high school counselor should help the students explore options and help families plan ahead. Students will look at vocational schools, job training and college.
most colleges have support systems for students with needs.
Questions for students to ask include
Am eligible for support services?
What academic supports are available?
What kinds of counseling supports are available?
What lifestyle modification can be made?
More and more students with hearing loss are attending college than ever before, and more colleges are accommodating these students. Katalin Somerville