Essex Primary SCITT Training Including children with a hearing impairment

1. Essex Primary SCITT Training Including children with a hearing impairment Matthew Bysouth Lead Specialist Teacher & Educational Audiologist for Hearing Impaired Children Specialist Teaching and Preschool Service SEN/AEN Provider Services, ELS Essex County Council Telephone: 03330138261 | Mobile: 07825144548 Email: matthew.bysouth@essex.gov.uk | www.essex.gov.uk

2. Objectives for the session: • Understand the basic implications of deafness on educational outcomes • Understand the support that is available to teachers in Essex with deaf children in their class • Understand what successful inclusion/High Quality Teaching looks like for HI children

3. Essex Primary Schools and Deafness As a primary school teacher you are 100% guaranteed to be teaching children who are experiencing a temporary hearing loss. Permanent hearing loss in children is low incidence (1/2000) but the impact on outcomes can be very significant - 30% of deaf children achieve 5 GCSEs at A-C (65% of hearing children). There are over 700 deaf children in Essex (deafness officially meaning anyone with a hearing impairment).

4. Essex Primary Schools and Deafness 85% of deaf children in Essex are attend a non-specialist maintained school (or are pre-school). 12% attend a school that hosts a specialist Enhanced Provision for hearing impaired children. These children have access to specialist staff onsite and a deaf peer group whilst attending a school alongside hearing children. The Specialist Teacher Team employs a team of qualified teachers of the deaf who support schools in order to ensure the inclusion of their deaf learners. The provision of a local authority teacher of the deaf service is mandatory.

5. Specialist Teacher for Hearing Impairment – our website http://www.essexlocaloffer.org.uk/listing/hearing-impairment/

6. http://www.essexlocaloffer.org.uk/wp-content/uploads/2016/11/Provision-Guidance-v3.pdfhttp://www.essexlocaloffer.org.uk/wp-content/uploads/2016/11/Provision-Guidance-v3.pdf Essex Provision Guidance Hearing Impairment section written by teachers of the deaf Includes advice under the three headings – High Quality Teaching, Additional School Intervention and High Needs. Each section includes detailed descriptions of hearing impairments and proven inclusion strategies for inclusion and successful outcomes. Can be used to plan and audit inclusion and support. Contextualises the support and provision put in place.

7. Hearing Loss • Every country in the world with an organised health care system has a screening programme for deafness. • In the UK there is universal screening at birth for hearing impairment. Why?

8. Hearing Loss • Language deprivation – which affects thinking, memory, literacy and outcomes • Early identification = early intervention = better outcomes.

9. The Ear

10. What can go wrong? Pinna

11. Types of Hearing Loss: Conductive Loss

13. Types of Hearing Loss Sensori-Neural Loss

14. The Practical Difficulties of a Hearing Loss • Children with a conductive loss hear all sounds, including speech, at a reduced level of loudness. • Children with a sensori-neural loss may only be able to hear distorted speech sounds.

15. The Audiogram –degrees of loss quiet LOUD Low High

16. X=left O=right X X X X X The Audiogram –hearing test quiet LOUD Low High

17. X=left O=right O O O O O The Audiogram –hearing test quiet LOUD Low High

18. X=left O=right X X X X X The Audiogram –hearing test quiet LOUD Low High

19. X=left O=right O O O O O The Audiogram –hearing test quiet LOUD Low High

20. Speech Discrimination quiet LOUD Low High

21. The Audiogram –typical moderate hearing loss quiet X=left LOUD O=right Low High

22. The Audiogram –typical high frequency hearing loss quiet X=left LOUD O=right Low High

23. Technological Support Hearing Aids

27. Technological Support BAHA

30. Permanent fitting Trialling a BAHA on a soft band

31. Technological Support Cochlear Implant

32. Internal Implant

33. However… None of this technology can make you hear ‘normally’!

34. Limitations of hearing aids • Cannot restore sound to normal level. They make sounds louder. Sounds, including speech, will still be distorted if certain nerve cells have been irreparably damaged. • Pupils will often mishear or misunderstand what is said – even in ideal listening conditions. • Despite sophisticated technology they cannot always select the most relevant or meaningful sounds from the environment. Unwanted background noise is still amplified. • Ineffective over more than 2 metres. Less than one metre is best.

35. Implanted children should avoid: - contact sports (and helmets should be worn for some other sports) Limitations of Cochlear Implants • The sound heard does not have a natural quality • It is difficult to listen in noise or at a distance • It is difficult to localise sound with only one implant but most children now receive two if their hearing loss requires it - static electricity • certain medical procedures (eg MRI scans) • sand and water

36. Common Difficulties • Children cannot always be within arm’s length of their teacher • Classrooms frequently have background noise • Some acoustic environments are impossible to improve A common solution to these problems is a radio aid system. Many deaf children in Essex schools use a radio aid.

37. What is a Radio Aid ? • A radio aid transmits the speaker’s voice directly to the hearing aid user without the sound being “lost” in the environment. • It consists of two parts • A microphone and transmitter worn by the teacher and • Receiver(s) attached to the child’s hearing aid(s)/cochlear implant(s)

38. Basic Classroom Strategies Visual Support Support for Understanding

39. Visual Support Seating Position: • Pupil should be at the front of the class • Better ear should be nearer teacher • What is the best position for: – group – or whole class work? –1:1

40. Visual Support Support for lip-reading: • Ensure room is well lit • Avoid speaking in front of window • Try to stand still • Avoid speaking whilst writing on the board • Avoid covering your face or lips

41. Visual Support Are you giving supportive visual clues? • Write key words on board • Use visual aids as much as possible • Write up instructions and homework details in full • Think of visual ways to clarify meanings of words Key words

42. Visual Support Limitations of visual support: • Be aware that a child cannot lip-read and look at objects at the same time • Allow time for child to look after you have finished speaking • For older pupils: listening, watching and taking notes at the same time is impossible OR

43. Support for Understanding Check understanding: • Better to ask open questions than simply asking if child can hear • Check child is picking up group information and not just copying others • Set up a friend or ‘buddy’ to check that messages have been understood

44. Support for Understanding Managing class discussion / questions and answers: 2nd 1st • Identify each speaker clearly • Ensure one child speaks at a time • Summarise, review and recap main points • Pass around the radio aid microphone • Repeat other pupils’ answers 3rd

45. Support for Understanding Working with an LSA/TA: • Give a copy of key vocabulary and concepts for topic/lesson ahead of time • Support their role in pre-viewing and reviewing work • Arrange for short withdrawal times in a good listening environment as appropriate • Set aside time for regular liaison

46. The impact of acoustics on immature language users Classrooms are traditionally noisy environments. Introducing sound soaking materials to all parts of the school will reduce background noise levels. carpets and rugs soft furnishings cushions Rubber feet for chair and table legs fabric blinds or curtains displays

47. The End Any final questions