Do You Hear What I Hear?

Living and Learning

with Conductive Hearing Loss/Otitis Media Kit

WA Department of Education

CONDUCTIVEHEARING LOSS

• Age at which the child experienced the first

incidence of OM

• Number of incidences under the age of 12

months

• Access to good medical intervention

• Access to certain types of interactions within

the family

• Access to audiology and speech pathology

• Child’s general health

Impact of Otitis Media is Multi-Factorial

Speaking and listening provide the foundation

for all language learning and underpin the

successful development of reading and writing

skills.

Proficiency in speaking and listening contributes

to children’s abilities to learn effectively in all

learning areas.

First Steps: Oral Language Developmental Continuum

Oral Language is fundamental …

• Language is the repository of the speakers’

cultural knowledge and reflects their world view.

When we devalue a language we devalue

everything contained within and reflected by it.

• The Western school system is set up to reflect a

literate tradition. It assumes all children come to

school knowing how to work with language in a

de-contextualised manner. We need to be aware

that children may come to school with rich

language experiences from predominately oral

traditions and cultures.

Cultural Considerations

Impact of CHL on Speechand Language Development

• Hearing children learn the basics of language passively, by hearing it. This avenue is not open to children with hearing losses.

• Creates a barrier for normal speech development and phonological processing

• Causes delays in the development of a child’s first language and any additional language, particularly when the hearing loss begins at a very young age:

Poor vocabulary and semantic organisation

Expressive and receptive language difficulties – language structure, word endings, grammar, word order etc.

• For Aboriginal children, diminished auditory experiences can affect opportunities for learning about culture, law, relationships, etc. (Clarke, 1992)

‘Oral comprehension’ relates to the ability to understand the meaning of what is spoken. Comprehension is dependent upon context, previous knowledge and experience, sentence length, concepts and attention. (adapted from Health Department of WA Teacher Modules, 2000)A child with CHL or a history of CHL probably has:

• Difficulty with lengthy or complex instructions

• An underdeveloped vocabulary including concepts and descriptive terms (e.g. in Preprimary will not understand concepts such as location [over/under…] or size, and descriptive terms [colour, shape])

• Difficulty with some questions (e.g. in Preprimary can’t understand ‘wh’ questions [who, what, when, where])

Impact of CHL on Comprehension

Semantics refers to the link between our thoughts and ideas and the vocabulary and concepts we use to express these thoughts. Semantic organisation describes how we organise incoming information in order to make sense of and later retrieve it.(adapted from Health Department of WA Teacher Modules, 2000 ; Holt & Spitz, 2000)In Preprimary, a child with CHL or a history of CHL

probably:

• Has a vocabulary of less than 1500 words

• Speaks in sentences of < 3 to 5 words

• Doesn’t use language socially

• Is slow to learn words and concepts (due to ‘fuzzy’ representations)

Impact of CHL on Semantics

Impact of CHL on Semantics

Other indicators may be :

• Difficulty integrating new information with existing

• Limited conceptual understanding

• Under-developed receptive and expressive vocabulary

• Difficulty retrieving words

• Difficulty generating ideas related to a topic

• Conversational difficulties

Syntax or grammar refers to the way we organise words into sentences. Grammatical rules tell us which words should come before or after others, the word endings we should use and the way words combine to form sentences.(adapted from Health Department of WA Teacher Modules, 2000 ; Holt & Spitz, 2000 ; Owens 1992)

• Problems with forming linguistic categories such as plurals and tenses

• Grammatical errors and unusual word order

• Incomplete sentences

• Restricted use of describing words (adjectives/adverbs) and connectors (but, then, because, so …)

Impact of CHL on Syntax

Narratives/Oral texts encompass such genres as stories, reports, procedures, explanations, recounts and news telling. The common feature of these genres is the linguistic structures that are used to tell and retell a series of events in time order. (Adapted from Health Department of Western Australia Teacher Modules, 2000 ; Holt & Spitz, 2000)The Western-style narrative structure tends to be linear in nature and uses a distinct model that may be difficult to understand for Aboriginal and other CALD students. If a child has hearing problems they are likely to have additional problems with story grammar and descriptive vocabulary.

Impact of CHL on Narrative(Oral Texts) Skills

Phonological processing relates to the ability to use the sounds of a language to process oral and written language, which allows us to form phonological codes and access a word stored in our brain’s lexicon. Phonological awareness skills (explicit awareness of sound structure and ability to manipulate structure of words) are dependent on phonological processing skills.

• Need to hear words to learn words – to ‘map’ words to objects

car? ar? bar? tar? …

• Absence of second sound in two-letter blend (eg frog, block)

• Absence of unstressed syllable(s) (banana, dinosaur, balloon)

• Poor discrimination and identification of sounds

Impact of CHL on Phonological Processing

Australian English speech sounds with which ESL/ESD speakers frequently are not familiar:

Consider the similarities between these sounds (voice, placement of lips and tongue). If a child can’t hear a sound correctly he/she will have considerable difficulty learning to say it correctly, particularly if he/she is reliant on visual differentiation.

t, d, th a, e, ir, ai

f, v, b, p, k, g o, o-e, oo/u, u-e

s, z, sh, ch, j u, i-e, oi, ai

ee, i, e, a o, oar, ar, oi, ir

a, ar, u, ow (Adapted from Making the Jump, Catholic Education, Kimberley, 1997)

Impact of CHL on Phonological Processing

• Don’t know how to play with sounds and words,

eg rhyming

• Don’t know what a ‘word’ is so have difficulty

understanding word boundaries and segmenting

sentences into words: “Ontheweekend”,

“smorning”

Metalinguistics refers to the ability to use language to think, talk about, reflecton and manipulate units of language.

Impact of CHL on Metalinguistic Skills

Impact of CHL on Metalinguistic Skills

• Difficulty manipulating words within words (eg

take ‘sun’ from sunshine); syllables in words (eg

take ‘ing’ from doing); sounds in words (eg boat

has 3 sounds: b / oa / t; take ‘c’ from coat); and

blending sounds to make words (eg s – t – o – p)

• Poor understanding that words are arbitrary

symbols of a language system – words usually

don’t contain any hint of their meaning

• Problems working out how communication

breaks down

Pragmatics relates to the use and functions of language for communication. Pragmatic awareness is the knowledge of conversational rules and includes both verbal and non-verbal aspects.(adapted from Holt & Spitz, 2000 ; Owens 1992)

Children with a hearing difficulties may have problems with:

• Entering into a group, requesting, responding and taking turns

• Initiating conversations

• Understanding subtle social rules

• Accepting others points of view and others’ feelings

• Monitoring the listener

Impact of CHL on Pragmatics

Children with hearing difficulties, however, are also likely to present with social and emotional challenges due to:• Their own frustration and/or the frustration of

their peers

• Avoidance

• Just not “getting it” i.e. the subtleties and

unwritten rules of social exchanges

Impact of Hearing Loss on Socialisation

Summary of Educational Impact of CHL

• More than three infections under the age of 12 months is a

significant risk factor

• Even without a current ear infection children can still suffer the

effects of a history of conductive hearing loss

• Poor ability to discriminate sounds in words and to hear words

in words; difficulty chunking words into individual parts; and

relationship between own sound repertoire and written

alphabet is tenuous

• Language learning difficult; frequently have restricted content,

vocabulary, language and confidence; prediction as a reading

strategy is not functional except with simple or familiar texts

• Poor foundation for literacy and without help will fall further

behind every year

• Socialisation difficulties and behaviour problems are likely

• The most debilitating aspects of deafness are secondary

to the hearing impairment itself