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HEARING

IMPAIRMEN
T
Melody L.
Mejia

Definitions

Hearing impairment is an impairment in


hearing, whether permanent or fluctuating,
that adversely affects a child's educational
performance."
Deafness is defined as "a hearing impairment
that is so severe that the child is impaired
in processing linguistic information through
hearing, with or without amplification."
Thus, deafness may be viewed as a
condition that prevents an individual from
receiving sound in all or most of its forms.
(The Individuals with Disabilities Education Act (IDEA), formerly the
Education of the Handicapped Act (P.L. 94-142)

Deaf
One whose hearing disability precludes
successful processing of linguistic
formation through information, audition
with or without hearing aid.

Hard of Hearing
One who generally with the use of
hearing aid, has residual hearing
sufficient to enable processing of
linguistic information through audition;
Will need some necessary special
adaptation to learn. (cited in Hallahan & Kauffman,


Types
of
Hearing
Loss
1. Conductive Hearing loss- problem with
conducting sound vibes to the inner ear
due
to
the
abnormalities
and
complications of the outer or middle ear;
2. Sensorineural Hearing Loss- defects
in the inner ear (cochlea) or auditory
nerve.
3. Mixed Hearing loss- problems in the
outer, middle and inner ear (combination
of conductive and sensorineural hearing
loss; sounds are distorted.

4. Central Hearing Loss- damage in


hearing receptions and pathways of the
brain.
5. Congenital- Present at birth.
6. Adventitious- acquired later in life.
7. Prelinguistic- acquired prior to the
childs development of speech or
language.
8. Unilateral- hearing loss in one ear,
generally learns speech and language
with difficulties; difficulties in localizing
sounds and listening in noisy places.
9. Bilateral- hearing loss in two ears

Causes of Hearing Loss


A. Conductive Hearing
Impairment
Most causes of the conductive
hearing impairment are due to
either inflammation of the
outer ear or middle ear
Otitis Media (Middle ear fluid)
Otitis Externa
Congenital malformation of the
outer and middle ear
Genetic syndromes
Impacted cerumen (wax)
Blockage of the external
auditory meatus by foreign
object
Cleft palate
Traumatic head injury

B. Sensorineural Hearing Impairment

Congenital viral infections (maternal rubella,

congenital syphilis)

Prematurity and low birth weight


Rh-factor incompatibility
Heredity
Meningitis
Encephalitis
Measles
Mumps
Influenza
Unexplained high fever auditory nerve tumor
Unwanted side effects of some antibiotics and
excessive noise levels.
Anoxia at birth

IdentificationofHearingProblems

Symptoms that might indicate hearing impairment in


the classroom:
Tilting the head at an angle in order to receive a
better sound;
Failure to respond when questioned.
Defective articulation particularly when sounding
words is important.
Peculiar voice quality, often high-pitched and flattish
in nature.
Tendency to run words together; poor reading ability.
Louder speech than would be indicated by the
situation.
Tendency to watch face of speaker with considerably
greater attention.

External Appearance/Signs
Deformities of the outer ear
Discharge from the ear
Undue muscular tension
Breathing through the
mouth
Blank facial expression

Complaints of children who


have hearing difficulties:
Buzzing or ringing in the ear
Ear aches
Nausea or dizziness
Inability to understand
directions

Identification process:
Early detection
Audiometric testing- pure-tone
audiometry
Educational assessment (Intelligence
and achievement testing)
Communication
and
language
assessments
expressive
and
receptive vocabulary skills, syntactical
or grammatical skills, nonlinguistic
language competence

Degrees of Hearing
An
individual's hearing impairment
Impairment

is usually
described by the terms SLIGHT, MILD,
MODERATE, SEVERE and PROFOUND depending
on the average hearing level in decibels (dB).
Decibels are units of relative loudness of
sounds; Zero decibels (0 dB) designates the
point at which people with normal hearing can
just detect sound. Each succeeding number of
decibels indicates a certain degree of hearing
loss. These levels of severity according to loss
of hearing sensitivity cut across the broad
classification of deaf and hard of hearing
(Hallahan & Kauffman, 1997).

DEGREE

Slight loss

Mild loss

Moderate
loss

Farthest
sound
heard

Clients on the understanding of


Language and Speech

20~40 dB -May

have difficulty hearing faint or


distant speech.
-School difficulties are not usually present
and can be remediated with careful
seating near the teacher.
40~60 dB -Understands conversation speech at a
distance of 3 to 5 feet (face to face)
-May miss as much as 50 percent of
classroom conversations especially in
noisy environments.
-The child may have limited vocabulary
and oral speech problems.
60~75 dB -Can understand loud conversations only
-Is likely to have impaired speech and
have difficulty in language used and
comprehension.
-Probably will have limited vocabulary
-Most
often
require
special
class
placement or a resource teacher.

DEGREE

Farthest
sound
heard

Clients on the understanding of Language


and Speech

Severe
loss

75~90 dB -May hear loud voices 1 foot from the ear.

-May be able to identify environmental sounds


-May be able to discriminate vowels but not all
consonants
-Speech and language likely to be impaired or
to deteriorate
-Speech and language unlikely to develop
spontaneously if loss is present before 1 year
of age.
-Special education placement or special
classroom placement are most likely.
Profoun 91dB and -May hear some loud sounds but senses
up
vibrations more than tonal pattern.
d loss
-Relies on vision rather than hearing as
primary avenue for communication.
-Speech and language are likely too be
impaired or deteriorated.
-Speech and language unlikely to develop

Effects of Hearing Impairment


Language Development:
At a great disadvantage in acquiring language
skills.
The grammar and structure of English often do not
follow logical rules.
Vocabularies are smaller and sentence structure
simpler and more rigid.
Tend to write short, incomplete and improperly
arranged sentences.
May omit endings of words such as -s, -ed, -ing
Difficulty in differentiating question from sentences.
*It is important to note that with proper education,
they are eventually able to learn the right grammar
and structure.

On Cognitive and Academic Performance:


Most of them possess normal intelligence- they
are not deficient in cognitive abilities.
Difficulty in acquiring reading, writing and
literary skills.
Excluding the effects of the amount, type or
quality of instruction, other variables affect the
academic achievement of hearing impaired
students

Severity of the hearing loss


Age at the onset
Intelligence
Family's socio-economic status
Hearing status of parents

On Social and Psychological Factors


Behavior
Expresses
feelings
of
depression,
withdrawal and isolation particularly
those who experience adventitious loss.
SOCIAL
MATURITY
ADJUSTMENT
TO
DEAFNESS: Deaf children of deaf parents
> deaf children of hearing parents)
Deaf people tend to associate primarily
with other deaf people and are often
mistakenly viewed as clannishness or
having a separate cultural group.

EducationalNeedsandPrograms
Degree
Slight
Loss

Mild
Loss

Probable educational needs and programs


-May

benefit from hearing aid as loss approaches


to 40 dB
-Attention to vocabulary development
-Needs favorable seating and lighting
-May need speech reading instruction and speech
correction
-Should
be referred to special education
evaluation for educational follow-up
-May benefit from individual hearing aid &
training
-Favorable seating and possible special education
supports especially for primary age children
-Attention to vocabulary and reading
-May need speech reading instruction
-Speech conversation and correction

-Likely to need a resource teacher or to be in a


special class
-Should have special help in language skills,
vocabulary improvement, usage, reading,
writing, grammar, etc.
-Can benefit from hearing aid through
Moderat evaluation and auditory training
e Loss -Speech reading instruction
-Speech conservation and speech correctionLikely to need a resource teacher or to be in a
special class
-Should have special help in language skills,
vocabulary improvement, usage, reading,
writing, grammar, etc.
-Can benefit from hearing aid through
evaluation and auditory training
-Speech reading instruction

Degree

Probable educational needs and programs

Severe -Likely to need a SPED program with emphasis on


Loss
language skills, concept development, speech

reading and speech


-Needs specialized program supervision and
comprehensive support services
-Can benefit from individual hearing evaluation
-Auditory training on individual and group aids
-Part-time regular class placement as profitable for
the student
Profoun -Will need SPED
d Loss -Emphasis on language skills, concept development,
speech reading and speech
-Needs
specialized
program
supervision
and
comprehensive support services
-Continuous appraisal of needs in regard to oral or
manual communication
-Auditory training
-Sign language

COMMUNICATION METHODS
A. Oral methods
1. Oral-Aural Method- emphasizes speech
sound as part of the curriculum, oral
language is used to transmit information,
teachers use their voices and rely on
speech reading skills and students' use of
their residual hearing; amplification in the
form of hearing aids and other assistive
amplification devices are used in the
teachers
process;
students
are
encouraged to use their voices when
they speak.

2. Auditory training- use of residual hearing,


emphasis on amplification of sounds;
focus
on
basic
sound
detection
(awareness of sounds), discrimination
between sounds and identifying sounds
that are critical in comprehending
message which is focused on listening.

3. Speech reading- or once called lipreading;


involves
the
careful
observation of the entire face;
4. Cued Speech- is a system that relies on
learning and using a specific set of hand
signals to supplement oral speech . (eight hand
shapes that are used to indicate consonant sounds and four hand
positions around the mouth and chin to indicate vowels)

B. Manual Methods
1. Sign language- use gestures to represent
words, ideas and concepts; American Sign
Language (ASL) is a valid linguistic from with
its rules of syntax, semantics and pragmatics
but the rules do not correlate with those of
spoken English; Filipino sign language.
2. Finger spelling- or the manual alphabet,
consisting of 26 special hand and finger
positions that represent English letters.
3. Simultaneous communication- total
communication; use both speech and
signing.

C. Technology
1. Cochlear implants- electrodes are

connected to a receiver that captures and


encodes sounds to electrical stimulation.
2. Microcomputers
3. Assistive communication devicesteletypewriters, telephone systems
4. Captioning
5. Alerting devices- For example, to signal
the doorbell, fire alarm, or alarm clock, a
sound-sensitive switch can be connected
to a flashing light or to a vibrator.

THANK
YOU!