By: Heather Motter, Sarah Urchuck, Megan Daley, Lindsay Kimes, and Amanda Vogler

Hearing

Impairment

Background Hearing Impairment- the full or partial decrease in the ability to

detect or understand sounds

Can happen to any organism that perceives sound

Caused by a range of biological and environmental factors

Trauma to the ear, genetic factors, diseases like meningitis Categories of hearing loss: neural/sensorineural, conductive,

combination

Hearing impairment can lead to social isolation and someone who deals with this must use many adaptations to live independently

Otologist and audiologist will primarily treat those with hearing impairments.

Some of the speech problems that will be dealt with include omitting speech sounds, distortion of consonants, and substitution of sounds.

Background Some of the speech problems that will be dealt with include omitting

speech sounds, distortion of consonants, and substitution of sounds.

More specifically there are four major ways in which hearing loss affects children:

It causes delay in the development of receptive and expressive communication skills (speech and language).

The language deficit causes learning problems that result in reduced academic achievement.

Communication difficulties often lead to social isolation and poor self-concept.

It may have an impact on vocational choices. Treatment includes cochlear implants and possible gene therapy

Statistics

2006- 37 Million adults in the U.S. had trouble with hearing (full range)

Males are more likely to be hearing impaired than females.

Respiratory & Phonatory Production because the primary basis for learning language is

hearing

It (if you can’t hear it, it will be hard to produce it)

Voice problems that result from improper use of the respiratory system:

Breathiness, roughness, diplophonia, poor pitch, inability to control intensity

Speech problems in the phonatory system include:

Poor articulation, poor vowel discrimination, improper placement of articulator

It is important to notice signs of hearing impairment early. The “critical period” of cognitive development in children ranges from birth to 6 years of age. The earlier the diagnosis, the earlier the treatment, and therefore the child can stay on track developmentally. They can lead a closer to normal life.

Respiratory & Phonatory Ways to foster communication with a hearing impaired child:

Spoken Language Approaches:

1)Auditory/Oral: makes use of residual hearing through hearing aids or cochlear implants and lip reading to maximize input

2) Auditory/Verbal: believes that children with hearing loss can be taught to use any residual hearing they have. Encourages listening without visual cues such as sign language or lip reading.

3)Cued Speech: a visual system to demonstrate phonetic info with hand signals along with natural speech movements. Therapists will also use tactile cues to increase input.

A video online that shows a therapist working with a deaf child on pitch and intensity:

http://www.teachertube.com/viewVideo.php?video_id=116192&title=No_8_intensity_pitch_deaf_spech

Articulatory Voice quality may be harsh,

breathy, nasal, and/or monotone

Sounds may be distorted and/or omitted from words

Example: “I caught a fish” may be spoken or written as “I cau_ fi_”

-May drop plural and possessive endings

Example: “The boy hat” for “The boy’s hat.”

Pitch, rhythm, stress, inflection and/or volume are inappropriate

Difficulty following oral and written directions people with a hearing impairment also have a limited vocabulary

A child with such a loss as difficulty learning the speech sounds

Child tends to distort, substitute, and omit many speech sounds

Childs voice will lack normal intonation and rhythm; the voice may also be of higher pitch

Children with hearing loss comprehend and produce shorter and simpler sentences than children with normal hearing.

Children with hearing loss may not hear their own voices when they speak. They may speak too loudly or not loud enough. They may have a speaking pitch that is too high. They may sound like they are mumbling because of poor stress, poor inflection, or poor rate of speaking

Anatomy of the Auditory System

Outer Ear

Pinna

ear canal

ear drum

Middle Ear

Ossiclesmalleus, incus, stapes

eustachian tube

Inner Ear

vestibular system

Cochlea

auditory nerve

Types of Hearing Loss

Conductive

damage to outer/middle ear air conduction

Sensorineural

damage to inner ear/auditory nerve bone conduction

Mixed

Effects of Hearing Impairmentdelay in development of receptive and expressive

language

Articulationfinal consonant deletion

volume of voicesocialization may be limited

Treatment and solutions Udiologist

hearing tests hearing aids

Speech-Language Pathologist

pure tone hearing screenings assist in language/speech problems

Other

face the other person speak clearly

Sound waves vary in amplitude and in frequency. Amplitude is the

sound wave's peak pressure variation. Frequency is the number of

cycles per second of a sinusoidal component of a sound wave. Loss

of the ability to detect some frequencies, or to detect low-amplitude

sounds that an organism naturally detects, is a hearing impairment.

Speech Variables

The hearing loss usually affects the highest frequencies (18 to 20 kHz) early on and gradually affects the

lower frequencies; it usually becomes clinically significant when it affects the critical 2- to 4-kHz range

around age 55 to 65 (sometimes sooner). The loss of high-frequency hearing significantly affects speech

comprehension. Although the loudness of speech seems normal,

certain consonant sounds (eg, C, D, K, P, S,T) become heard to hear.

Deaf children have limited control over their voice loudness. Pitch of a

considerable number of deaf children is on the high side with inappropriate rise

and fall variations.

Clinical Application Cochlear Implants

An electronic device that directly stimulates the auditory nerve by bypassing a person’s damaged cochlea.

Implants are able to detect and transmit a wide range of frequencies.

Parts: microphone, signal processor, transmitter and receiver/stimulator, and electrode array

This is used with sensorineural hearing loss.

When speech has more contextual cues and linguistic structure, then fewer electrodes in the implant need stimulated.

Hearing with the implants is very different and actually needs to be learned.

Clinical Application

Hearing Aids

Hearing aids amplify sounds, they only make them louder.

They are limited in the high frequency range.

Styles: in-the-canal, in-the-ear, and behind-the-ear aids

Parts: microphone, amplifier, and speaker

If there is greater damage to the hair cells in the inner ear, then greater amplification is needed.

Other options include American Sign Language or Speech Reading