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ECE 28, CLASS NOTES, WEEK 5, Chapter 6: SENSORY IMPAIRMENTS: HEARING & VISION The Exceptional Child, Inclusion in Early Childhood Education, Fifth Edition, Thomson-Delmar Learning

OBJECTIVES: After discussion of hearing & vision impairments:

Discuss hearing & vision problems, and describe their impact on the development of young children.

Explain why hearing loss, more than other sensory losses, interferes with early development.

List three warning signs indicating possible hearing loss in an infant.


Identify signs indicating possible hearing loss in a child with language.

Understand the characteristics of an appropriate early intervention program for children who are blind or visually impaired.

Describe strategies that teachers may use to facilitate inclusive learning experiences for children with vision loss. KEY TERMS:

American Sign Language


cortical blindness


orientation & mobility

residual hearing

* The most serious & the most prevalent sensory impairments are hearing & vision losses. TWO KEY PRINCIPALS OF DEAFNESS & HARD OF HEARING:

1. The greater the loss, the greater the interference with development.

2. The earlier in life the loss occurs, the greater the interference with development.

amplification device cochlear implant cumulative effect low vision pediatric ophthalmologist sensory impairment

audiologist conductive hearing loss deafness manual interpreter peripheral vision signing


Deafness refers to a hearing loss so severe that the individual cannot process spoken language even with amplification devices.

Hard-of-hearing refers to a lesser loss, but one that nevertheless has a definite effect on social, cognitive, & language development. DEAFNESS & HARD OF HEARING LOSSES:

Pre-lingual occurring prior to speech and language have a chance to develop.

Post-lingual occurring after the onset of language.


A loss in the outer or middle ear produces a conductive hearing loss.

A loss in the inner ear (cochlea or auditory nerve) produces a sensorineural hearing loss.

A loss in the in the higher auditory cortex produces central deafness.

A combined loss refers to two or more of the above.


Chronic or frequent ear infections, especially those with fluid accumulation, can lead to intermittent hearing loss.

Recurrent hearing losses can lead to delays in children's language & development.

Identifying intermittent hearing loss is difficult.

Children (& adults) whose loss is too severe to be helped by hearing aides may benefit from a cochlear implant.


National Institute on Deafness & other Communication Disorders

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. A surgically inserted device, called a cochlear implant, can be provided for children as young as eighteen months.

The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin.

An implant has the following parts:

A microphone, which picks up sound from the environment.

A speech processor, which selects & arranges sounds picked up by the microphone.

A transmitter & receiver/stimulator, which receive signals from the speech processor & convert them into electric impulses.

An electrode array, which is a group of electrodes that collects the impulses from the stimulator & sends them to different regions of the auditory nerve.

An implant does not restore normal hearing.

Instead, it can give a deaf person a useful representation of sounds in the

environment & help him or her to understand speech. HEARING LOSS WARNING SIGNS :

Does not respond when spoken too.

Does not understand, or looks puzzled when addressed directly with a simple question or request.

Tilts his/her head to one side & studies speaker face, or watches the speaker's mouth.

Says "huh?" or "what?".

Turns one ear to the source of sound or speech.

Is inattentive.

Seems shy, avoids children & teachers.

Makes inconsistent or irrelevant responses.

Complains of ringing or buzzing in the ears.

Has an articulation or voice problem.

Speaks too loudly or softly. IMPACT OF HEARING LOSS ON DEVELOPMENT :


Early speech & language development, sometimes called the critical years.

Cognitive development.

Social development.

Family life.


American Sign Language (ASL). This is the sign language of the majority of deaf people in the United States & Canada. It is a language with it's own words & grammar.

Signed English. This is a sign language that parallels the English language. For every word there is a sign. Word order is the same

as spoken English.

Finger Spelling. This system is made up of an alphabet of 26 hand-formed letters that correspond to the regular alphabet. One hand is held in front of the chest & the other hand spells out the words, letter by letter.

Total or Simultaneous Communication. This is a system that combines both speech & a sign system.

Informal systems. These include pantomime, gestures, & body movements that accompany speech & are used naturally by most


American Indian Hand Talk is a more formalized system that nevertheless is flexible & free of grammatical

complications. CONSIDER THIS:

Early intervention.

Guidelines for teachers.

Amplification devices.

FM systems.


Children with visual disabilities tend to be classified as blind, or as having residual or partial vision.

Foundation for the Blind provides these definitions:

Blind - visual loss is severe enough that it is not possible to read print, requiring the child to be educated through the use of Braille & other materials using touch or sound.

Low Vision - Residual vision is sufficient to allow a child to read large print or possibly regular print under special conditions & to use other visual materials for educational purposes. TYPES OF VISION PROBLEMS :

Vision losses vary as to cause, type & severity:

Physical abnormalities.

Muscular abnormalities.

Identifying vision problems:

Congenital blindness usually identified in the first year of life.

Partial vision loss is more difficult to identify.

Many children identified through routine screening at school.

Warning signs & alerts.


A child who is blind from birth or early childhood is likely to have significant developmental delays.

Unable to scan environment.

Affects language, motor, cognitive & social development because the child's ability to interact with people, objects & activities is curtailed. EARLY INTERVENTION PROGRAMS:

Intervention programs serving infant & toddlers usually focus on the parent as a teacher.

First & second year home-based.

Programs for older toddler & preschool children most often are center-based.

Transition to preschool may occur as early as 2.5 to 2.8 years old.

Specialists provide services to the child in preschool.