Hearing Impairments

1. Hearing Impairments

2. Background Information • Intensity (loud versus quiet) is measured in decibels (dB) • Frequency of sound (high versus low) is measured in hertz • Assessment is conducted by an Audiologist • Results are scored on audiogram

3. Normal Hearing • 0 – 15 dB • 0 indicates no loss • Numbers > 0 indicate the degree or amount of loss

4. Definitions • The inability or limited ability to receive auditory signals…a hearing loss • Degrees of hearing losses • Mild-loss of 25-40 dB. Difficulty with conversations. • Moderate-loss of 40-70 dB. Difficult keeping up with conversations when not using a hearing aid.

5. continued • Severe-loss of 70-95 dB. Benefits with a powerful hearing aid; yet still relies on lip reading. Some sign language is used. • Profound-loss of 95 or more dB. Hard of hearing. Relies on lip reading and or sign language.

7. Characteristics • Person has trouble hearing others. • Person appears to be not “paying attention.” • Speech Impairments

8. Warning Signs • Daydreaming • Inattention • Behavior Issues • Not following simple verbal directions • “huh?” “I don’t know”

9. continued • Limited speech or vocabulary • Inappropriate responses to questions • Difficulty with phonics • Unusual voice quality (soft, nasal, monotone) • Watching others for instructional cues

10. Challenges • Learning language – greatest challenge • Low expectations by teachers • Lower than expected reading levels (4th-5th level as graduates) • No difference in self-esteem • Not hearing “social cues” • Social/emotional growth and needs

11. Types of Losses • Conductive • Outer or middle ear blockage • May be temporary • Usually mild to moderate • Improved through amplification

12. continued • Sensorineural – Inner ear • Sound not delivered to brain • Prelingual or post lingual • Congenital – present at birth • Adventitious – later in life

13. Some causes • Premature birth/birth complications • Heredity (10% have parent who is hard of hearing) • Maternal rubella (vaccine in 1969) • Other viruses contracted by fetus • Meningitis (after birth) viral infection • Otis media (after birth) inflammation of middle ear

14. Assessment Procedures • Infant Screening • Performed at the hospital, days after birth. • Tests performed: • Automated auditory brainstem response (AABR). • Conventional auditory brainstem response (ABR).-Electrodes are placed on baby’s head. Sound is introduced to baby’s ear through tiny earphones, while child sleeps. Electrodes pick up sound that reaches brain. Painless. 5 min.

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

16. Assessment Procedures, cont. • School Aged Screening • If a teacher suspects a student has trouble hearing, the teacher will notify the school nurse. • The school nurse or school audiologist can perform a hearing test on the child, with parent’s permission. • The child’s parents can also take the child to the child’s regular doctor and have the doctor perform a hearing test.

17. Prevalence and Causes • Causes • Ageing • Exposure to frequent loud noise • Result of disease or infection • Inherited • Result of physical damage to ears or serious injury to the head

18. Prevalence and Causes, cont. • Prevalence • Get tested • Use a hearing aid • Learn sign language or how to lip read • Avoid noisy situations as much as possible…cover your ears • Treat diseases and infections as soon as possible

19. Accommodating Students with Some Residual Hearing • Position yourself to child’s better ear • Lip reading considerations • Watch glare and shadow

20. continued • Remain in one place as much as possible. • Speak slowly but naturally. • Be careful not to drop your voice at the end of a sentence. • Try to use shorter sentences and pause between phrases. • When possible, repeat the questions or responses of other students in the classroom.

21. Speaking Individually with Students Who are Deaf • Get the student’s attention with a touch or a visual sign. • Use gestures, body language, and facial expressions to support communication. • Use paper and pencil if necessary. If a computer is available, typing may be faster than writing.

22. continued • Face the student directly and maintain eye contact. • Avoid asking, “Do you understand?” Instead, use open-ended questions to check comprehension. This prevents students from nodding without really understanding.

23. Adapting the Classroom for Students Who Are Deaf • Incorporate as many visuals as possible • Non-verbal communication is crucial • Put an outline of the class agenda • Provide the student with vocabulary lists and definitions of new terms and concepts. • Additional time • Grade writing on content, not grammar • Encourage social interaction

24. Encourage the student to use on-line and other computer sources to increase their exposure to course specific terminology. • Try to incorporate “hands-on” assignments • When reading to the class, provide the student with a copy of the text. • If possible, copy the in-class notes of another student for the student who is deaf. • You might ask other students to help you monitor the pace and clarity of lessons.

25. Working with Interpreters • Control the pace of the class. Speak slowly and pause more often. • Speak to the student, not to the interpreter. • Speak clearly so the interpreter can understand.

26. continued • When asking a question to the class, wait until the interpreter has finished signing before calling on a student. This allows the student with the hearing impairment the opportunity to participate. • Interpreting is a physically demanding job. Build breaks into your lesson to allow the interpreter time to rest.

27. Reading is often much faster than extemporaneous speech. When reading to the class, pause often. If possible, provide the interpreter with a copy of the text. • Only one person should speak at a time in the classroom. Multiple conversations cannot be interpreted. • The student who is hearing impaired must be able to see the teacher, the interpreter, and the board or overhead projector. Keep this visual line open.

28. Allow the interpreter time to reposition whenever necessary. • Interpreters avoid sitting in front of a bright window because the bright light can be tiring to a student’s eyes. • Teach other students how to better accommodate the student who is hearing impaired.

29. Interpreters are not content experts. • Consider giving the interpreter a copy of your lecture notes before class. • Read out loud any thing you write on the board or overhead. • Many words (including technical terms and proper names) must be “fingerspelled.” Provide interpreters with the correct spelling of such words in advance. Or, even better, write these words on the board.

30. Videos are often fast-paced and dense in content. Use captioned videos whenever possible. Or, allow the interpreter to view the video ahead of time or provide the interpreter with a summary. • If a video must be signed, alert interpreters ahead of time so they can bring a small, portable light. This will allow the student to see the interpreter even after the lights are turned off. • When working with the chalkboard or overhead projector, pause briefly so the student may first look at the board/screen and then at the interpreter.

31. Provide overhead notes to the student before class. • Written English can be difficult for many students with hearing impairments. Interpreters may need to translate written tests into sign language. • Interpreters are experts in communication between the hearing world and individuals with hearing impairments. Ask the interpreter how to modify your lessons to accommodate students with hearing impairments.

32. Technology for Students with Hearing Impairments • Radio Microphone System: The teacher wears a microphone which transmits speech to a receiver worn by the student. This helps to eliminate distracting background noise. This system does not work to transmit comments of other students.

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

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

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