Hearing Hearing ImpairmentsImpairments

Background InformationBackground Information

Intensity (loud versus quiet) is Intensity (loud versus quiet) is measured in decibels (dB)measured in decibels (dB)

Frequency of sound (high versus Frequency of sound (high versus low) is measured in hertzlow) is measured in hertz

Assessment is conducted by an Assessment is conducted by an AudiologistAudiologist

Results are scored on audiogramResults are scored on audiogram

Normal HearingNormal Hearing

0 – 15 dB0 – 15 dB0 indicates no loss0 indicates no lossNumbers > 0 indicate the Numbers > 0 indicate the

degree or amount of lossdegree or amount of loss

DefinitionsDefinitions

The inability or limited ability to receive The inability or limited ability to receive auditory signals…a hearing lossauditory signals…a hearing loss

Degrees of hearing lossesDegrees of hearing lossesMild-loss of 25-40 dB. Difficulty with Mild-loss of 25-40 dB. Difficulty with conversations.conversations.

Moderate-loss of 40-70 dB. Difficult Moderate-loss of 40-70 dB. Difficult keeping up with conversations when keeping up with conversations when not using a hearing aid.not using a hearing aid.

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Severe-loss of 70-95 dB. Severe-loss of 70-95 dB. Benefits with a powerful Benefits with a powerful hearing aid; yet still relies on hearing aid; yet still relies on lip reading. Some sign lip reading. Some sign language is used.language is used.

Profound-loss of 95 or more dB. Profound-loss of 95 or more dB. Hard of hearing. Relies on lip Hard of hearing. Relies on lip reading and or sign language.reading and or sign language.

CharacteristicsCharacteristics

Person has trouble Person has trouble hearing others.hearing others.

Person appears to be not Person appears to be not “paying attention.”“paying attention.”

Speech ImpairmentsSpeech Impairments

Warning SignsWarning Signs

DaydreamingDaydreaming InattentionInattentionBehavior IssuesBehavior IssuesNot following simple Not following simple

verbal directionsverbal directions““huh?”huh?” “I don’t know”“I don’t know”

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Limited speech or vocabularyLimited speech or vocabulary Inappropriate responses to Inappropriate responses to

questionsquestions Difficulty with phonicsDifficulty with phonics Unusual voice quality (soft, nasal, Unusual voice quality (soft, nasal,

monotone)monotone) Watching others for instructional Watching others for instructional

cuescues

ChallengesChallenges

Learning language – greatest Learning language – greatest challengechallenge

Low expectations by teachersLow expectations by teachers Lower than expected reading levels Lower than expected reading levels

(4(4thth-5-5thth level as graduates) level as graduates) No difference in self-esteemNo difference in self-esteem Not hearing “social cues”Not hearing “social cues” Social/emotional growth and needsSocial/emotional growth and needs

Types of LossesTypes of Losses

ConductiveConductiveOuter or middle ear blockageOuter or middle ear blockageMay be temporaryMay be temporaryUsually mild to moderateUsually mild to moderateImproved through Improved through amplificationamplification

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Sensorineural – Inner earSensorineural – Inner earSound not delivered to brainSound not delivered to brainPrelingual or post lingualPrelingual or post lingualCongenital – present at birthCongenital – present at birthAdventitious – later in lifeAdventitious – later in life

Some causesSome causes

Premature birth/birth complicationsPremature birth/birth complications Heredity (10% have parent who is Heredity (10% have parent who is

hard of hearing)hard of hearing) Maternal rubella (vaccine in 1969)Maternal rubella (vaccine in 1969) Other viruses contracted by fetusOther viruses contracted by fetus Meningitis (after birth) viral Meningitis (after birth) viral

infectioninfection Otis media (after birth) Otis media (after birth)

inflammation of middle earinflammation of middle ear

Assessment ProceduresAssessment Procedures Infant ScreeningInfant Screening

Performed at the hospital, days after birth.Performed at the hospital, days after birth. Tests performed:Tests performed:

Automated auditory brainstem Automated auditory brainstem response (AABR).response (AABR).

Conventional auditory brainstem Conventional auditory brainstem response (ABR).-Electrodes are response (ABR).-Electrodes are placed on baby’s head. Sound is placed on baby’s head. Sound is introduced to baby’s ear through tiny introduced to baby’s ear through tiny earphones, while child sleeps. earphones, while child sleeps. Electrodes pick up sound that reaches Electrodes pick up sound that reaches brain. Painless. 5 min.brain. Painless. 5 min.

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Transient evoked otoacoustic Transient evoked otoacoustic response (TEOAE).-A tiny, flexible response (TEOAE).-A tiny, flexible plug is inserted into the baby’s ear. plug is inserted into the baby’s ear. Sound is projected through this Sound is projected through this plug. A microphone inside the plug plug. A microphone inside the plug detects any OAE (faint sounds detects any OAE (faint sounds produced in the inner ear) and sends produced in the inner ear) and sends them to a computer for recording. them to a computer for recording. Emissions will not be detected if the Emissions will not be detected if the baby cannot hear. Painless and baby cannot hear. Painless and performed while baby is sleeping.performed while baby is sleeping.

Assessment Procedures, Assessment Procedures, cont.cont.

School Aged ScreeningSchool Aged ScreeningIf a teacher suspects a student has If a teacher suspects a student has trouble hearing, the teacher will notify trouble hearing, the teacher will notify the school nurse.the school nurse.

The school nurse or school audiologist The school nurse or school audiologist can perform a hearing test on the child, can perform a hearing test on the child, with parent’s permission.with parent’s permission.

The child’s parents can also take the The child’s parents can also take the child to the child’s regular doctor and child to the child’s regular doctor and have the doctor perform a hearing test.have the doctor perform a hearing test.

Prevalence and CausesPrevalence and Causes

CausesCausesAgeingAgeingExposure to frequent loud noiseExposure to frequent loud noiseResult of disease or infectionResult of disease or infectionInheritedInheritedResult of physical damage to Result of physical damage to ears or serious injury to the ears or serious injury to the headhead

Prevalence and Causes, Prevalence and Causes, cont.cont.

PrevalencePrevalenceGet testedGet testedUse a hearing aidUse a hearing aidLearn sign language or how to lip Learn sign language or how to lip readread

Avoid noisy situations as much as Avoid noisy situations as much as possible…cover your earspossible…cover your ears

Treat diseases and infections as Treat diseases and infections as soon as possiblesoon as possible

Accommodating Accommodating Students with Some Students with Some

Residual HearingResidual HearingPosition yourself to child’s Position yourself to child’s

better earbetter earLip reading considerationsLip reading considerationsWatch glare and shadowWatch glare and shadow

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Remain in one place as much as Remain in one place as much as possible. possible.

Speak slowly but naturally.Speak slowly but naturally. Be careful not to drop your voice at the Be careful not to drop your voice at the

end of a sentence.end of a sentence. Try to use shorter sentences and pause Try to use shorter sentences and pause

between phrases.between phrases. When possible, repeat the questions or When possible, repeat the questions or

responses of other students in the responses of other students in the classroom.classroom.

Speaking Individually Speaking Individually with Students Who are with Students Who are

DeafDeaf Get the student’s attention with a Get the student’s attention with a touch or a visual sign.touch or a visual sign.

Use gestures, body language, and Use gestures, body language, and facial expressions to support facial expressions to support communication.communication.

Use paper and pencil if necessary. Use paper and pencil if necessary. If a computer is available, typing If a computer is available, typing may be faster than writing.may be faster than writing.

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Face the student directly and Face the student directly and maintain eye contact.maintain eye contact.

Avoid asking, “Do you Avoid asking, “Do you understand?” Instead, use open-understand?” Instead, use open-ended questions to check ended questions to check comprehension. This prevents comprehension. This prevents students from nodding without students from nodding without really understanding.really understanding.

Adapting the Classroom Adapting the Classroom for Students Who Are for Students Who Are

DeafDeaf Incorporate as many visuals as possibleIncorporate as many visuals as possible Non-verbal communication is crucialNon-verbal communication is crucial Put an outline of the class agendaPut an outline of the class agenda Provide the student with vocabulary Provide the student with vocabulary

lists and definitions of new terms and lists and definitions of new terms and concepts.concepts.

Additional timeAdditional time Grade writing on content, not grammarGrade writing on content, not grammar Encourage social interactionEncourage social interaction

Encourage the student to use on-line and Encourage the student to use on-line and other computer sources to increase their other computer sources to increase their exposure to course specific terminology.exposure to course specific terminology.

Try to incorporate “hands-on” assignments Try to incorporate “hands-on” assignments When reading to the class, provide the When reading to the class, provide the

student with a copy of the text.student with a copy of the text. If possible, copy the in-class notes of If possible, copy the in-class notes of

another student for the student who is deaf.another student for the student who is deaf. You might ask other students to help you You might ask other students to help you

monitor the pace and clarity of lessons. monitor the pace and clarity of lessons.

Working with Working with InterpretersInterpreters

Control the pace of the class. Control the pace of the class. Speak slowly and pause more Speak slowly and pause more often.often.

Speak to the student, not to Speak to the student, not to the interpreter.the interpreter.

Speak clearly so the Speak clearly so the interpreter can understand.interpreter can understand.

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When asking a question to the class, When asking a question to the class, wait until the interpreter has finished wait until the interpreter has finished signing before calling on a student. signing before calling on a student. This allows the student with the This allows the student with the hearing impairment the opportunity hearing impairment the opportunity to participate.to participate.

Interpreting is a physically demanding Interpreting is a physically demanding job. Build breaks into your lesson to job. Build breaks into your lesson to allow the interpreter time to rest.allow the interpreter time to rest.

Reading is often much faster than Reading is often much faster than extemporaneous speech. When reading to extemporaneous speech. When reading to the class, pause often. If possible, provide the class, pause often. If possible, provide the interpreter with a copy of the text.the interpreter with a copy of the text.

Only one person should speak at a time in Only one person should speak at a time in the classroom. Multiple conversations the classroom. Multiple conversations cannot be interpreted.cannot be interpreted.

The student who is hearing impaired must The student who is hearing impaired must be able to see the teacher, the interpreter, be able to see the teacher, the interpreter, and the board or overhead projector. Keep and the board or overhead projector. Keep this visual line open.this visual line open.

Allow the interpreter time to Allow the interpreter time to reposition whenever necessary.reposition whenever necessary.

Interpreters avoid sitting in front of Interpreters avoid sitting in front of a bright window because the bright a bright window because the bright light can be tiring to a student’s light can be tiring to a student’s eyes.eyes.

Teach other students how to better Teach other students how to better accommodate the student who is accommodate the student who is hearing impaired.hearing impaired.

Interpreters are not content experts. Interpreters are not content experts. Consider giving the interpreter a copy of Consider giving the interpreter a copy of

your lecture notes before class. your lecture notes before class. Read out loud any thing you write on the Read out loud any thing you write on the

board or overhead. board or overhead. Many words (including technical terms and Many words (including technical terms and

proper names) must be “fingerspelled.” proper names) must be “fingerspelled.” Provide interpreters with the correct Provide interpreters with the correct spelling of such words in advance. Or, spelling of such words in advance. Or, even better, write these words on the even better, write these words on the board.board.

Videos are often fast-paced and dense in content. Videos are often fast-paced and dense in content. Use captioned videos whenever possible. Or, Use captioned videos whenever possible. Or, allow the interpreter to view the video ahead of allow the interpreter to view the video ahead of time or provide the interpreter with a summary.time or provide the interpreter with a summary.

If a video must be signed, alert interpreters If a video must be signed, alert interpreters ahead of time so they can bring a small, portable ahead of time so they can bring a small, portable light. This will allow the student to see the light. This will allow the student to see the interpreter even after the lights are turned off.interpreter even after the lights are turned off.

When working with the chalkboard or overhead When working with the chalkboard or overhead projector, pause briefly so the student may first projector, pause briefly so the student may first look at the board/screen and then at the look at the board/screen and then at the interpreter.interpreter.

Provide overhead notes to the student before Provide overhead notes to the student before class. class.

Written English can be difficult for many Written English can be difficult for many students with hearing impairments. students with hearing impairments. Interpreters may need to translate written Interpreters may need to translate written tests into sign language.tests into sign language.

Interpreters are experts in communication Interpreters are experts in communication between the hearing world and individuals between the hearing world and individuals with hearing impairments. Ask the with hearing impairments. Ask the interpreter how to modify your lessons to interpreter how to modify your lessons to accommodate students with hearing accommodate students with hearing impairments.impairments.

Technology for Students Technology for Students with Hearing with Hearing ImpairmentsImpairments

Radio Microphone System:Radio Microphone System:

The teacher wears a The teacher wears a microphone which transmits microphone which transmits speech to a receiver worn by the speech to a receiver worn by the student. This helps to eliminate student. This helps to eliminate distracting background noise. This distracting background noise. This system does not work to transmit system does not work to transmit comments of other students.comments of other students.

Induction Loop:Induction Loop:

The teacher wears a microphone The teacher wears a microphone which transmits speech to an induction which transmits speech to an induction loop fitted around the perimeter of the loop fitted around the perimeter of the room. Sound is amplified through the room. Sound is amplified through the student’s hearing aid which must be student’s hearing aid which must be within the magnetic field of the loop. within the magnetic field of the loop. This system helps to eliminate This system helps to eliminate background noise but only the teacher’s background noise but only the teacher’s voice is amplified.voice is amplified.

Micro Cassette Recorders:Micro Cassette Recorders:

Students may choose to tape record Students may choose to tape record lectures. The recorder must be lectures. The recorder must be positioned close to the speaker at all positioned close to the speaker at all times. Teachers should avoid moving times. Teachers should avoid moving around the room when speaking. around the room when speaking. Students can use the tapes at their Students can use the tapes at their leisure to clarify any words or sentences leisure to clarify any words or sentences which were difficult to understand in which were difficult to understand in class.class.

Speed Text:Speed Text:

This is a “Windows-based” service This is a “Windows-based” service which requires two laptops, one for the which requires two laptops, one for the student and another for the operator. student and another for the operator. The operator types all that is said onto The operator types all that is said onto his or her laptop which is then his or her laptop which is then immediately transmitted to the student. immediately transmitted to the student. The student is able to type comments or The student is able to type comments or questions which are transmitted to the questions which are transmitted to the operator.operator.