10 Things You Should Know about Listening Technology

1. Dr. Susan Easterbrooks Professor, GSUDr. Nanci Scheetz Professor, VSU 10 Things You Should Know about Listening Technology

2. I. The ear has three major sections. Each section is uniquely involved with hearing and listening. inner outer middle

3. III. We hear because sound waves are transferred to nerve impulses in our brain by a very complex system? • The sound wave is conducted through the outer ear to the middle ear, where it causes the three bones to vibrate. This vibration is transferred to the inner ear (cochlea), where it turns to electrochemical impulses that stimulate the nerves of hearing to fire. These nerve impulses travel to the brain, where they are interpreted as sound.

4. III. We describe problems with hearing by the part of the ear that is involved. • A problem in the outer and middle ear causes a conductive loss. • A problem in the inner ear causes a sensorineural loss.

5. IV. Most sensorineural losses cannot be fixed? • Many conductive hearing losses respond to medical or surgical treatment to some degree. • Sensorineural losses are generally complicated and do not respond to corrective surgery or medications.

6. V. Listening devices cannot completely correct a hearing loss? • A hearing aid or cochlear implant can only amplify sounds in the frequencies that are not completely damaged. • Also, you hear with your ears, but you listen with your brain, and most brains need to be taught how to make meaning out of the sounds that are coming through a hearing aid or a cochlear implant. • http://www.listen-up.org/haid/with-aid.htm • This website describes what hearing aids can do more completely.

7. VI. We use a variety of technology for testing hearing depending on the age of the child. Otoacoustic Emissions (OAE) A probe is placed in the child’s ear canal. Sounds are presented to the ear. The internal mechanism of the healthy ear creates additional sound (the OAE) that is recorded by a microphone probe fitted in the child’s ear.

8. Auditory Brainstem Response Testing (ABR) • For very young infants, the auditory brainstem response test (ABR) may be used. This test measures the electrical activity occurring in response to sound. Electrodes are placed on the child's scalp. As the child sleeps, sounds are presented through earphones.

9. Traditional Behavioral Testing • As the child grows and matures, more structured testing is available. • Behavioral Observation Audiometry • Visual Reinforcement Audiometry • Play Audiometry

10. Audiometers • Traditional behavioral testing is done on a device called an audiometer. • An audiogram is a graphic representation of a person’s hearing or auditory responses to tones of specific pitch and loudness. • Pitch, or frequency, is measured in Hertz (Hz). • Loudness is measured in decibels (dB).

11. Speech Banana Revisited Do you remember the Speech Banana from the first presentation? You will want to ask and audiologist or teacher of the deaf to show you what your student can hear on this chart with his hearing aids on.

12. VII. There are many kinds of hearing aids • All hearing aids have a microphone, an amplifier, and a receiver. • Microphone- picks up sounds from the environment • Amplifier- makes the sounds louder • Receiver- delivers sound to the ear • All hearing aids have internal controls that are set by the audiologist. • Frequencies amplified • Loudest response (saturation)

13. Hearing aids have external controls. • An on-off control switch. • Avolume control, a small wheel which can be adjusted to increase or decrease the loudness of sound. On some hearing aids the volume control is combined with the on/off switch. • Atelecoil switch which allows the hearing aid to be used with a telephone and some assistive listening devices.

14. BTE - The Behind-The-Ear Hearing Aid Works well for all degrees of hearing loss. This is usually the type recommended for children's use.

15. VIII. Cochlear implants are making it possible for many profoundly deaf children to have access to sounds. • Today many children wear cochlear implants. • These devices are surgically implanted into the cochlea in the inner ear. • The child to the right has a cochlear implant Credits: Centers for Disease Control

16. A cochlear implant is a small, complex electronic device. 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 and arranges sounds picked up by the microphone. • A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses. • An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.

17. An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech. • Source: http://www.nidcd.nih.gov/health/hearing/coch.asp

18. IX. Troubleshooting problems with hearing aids • If you have a child in your class with a hearing aid, you are going to run into problems. • An audiologist or a teacher of the deaf can help you prevent many problems and resolve others. • It is important to have a plan for dealing with a malfunctioning hearing aid as most children with usable residual hearing are lost without their hearing aids.

19. Problems and Solutions • Whistling or squealing • The ear mold may not be inserted properly. Re-insert the hearing instrument or ear mold. • There may be a wax build-up. Send child to the school nurse. • The child may have outgrown the earmold. Refer to the audiologist. • Low or no volume • The child has turned on the hearing aid. • Make sure the batteries a fresh. • There is wax in the earmold. Have child clean it out. • It is accidentally set to telecoil. • While there are many other problems associated with hearing aids, these are the ones you can easily fix in the classroom. Otherwise contact the school audiologist or the teacher of the deaf.

20. X. Troubleshooting problems with cochlear implants • As with hearing aids, if you have a child in your class with a cochlear implant, you are going to run into problems. • An audiologist or a teacher of the deaf can help you prevent many problems and resolve others. • It is important to have a plan for dealing with a malfunctioning implant as most children with implants are deaf when they are not accessing sound through the implant.

21. This book may be downloaded for free from the website below the picture. It provides a wealth of information about cochlear implants. • There are many reasons why children have trouble with their implants. The most important thing you can do is to make sure that the device is turned on. Anything after that should be referred to the school audiologist or the teacher of the deaf as an implant is a very sensitive and expensive computer. http://www.bionicear.com/Professional/ Educational_And_Clinical/ educators_guide.cfm?langid=1

22. References and Resources • http://www.nidcd.nih.gov/health/hearing/coch.asp • This is the website of the National Institute on Deafness and Other Communication Disorders. It contains a lot of up-to-date information about hearing loss. • www.agbell.org • This is the website of the Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell). This association has a lot of resources for teachers. • www.listen-up.org • This website will take you to a variety of links for different vendors of hearing aids and cochlear implants.

23. The following three slides were downloaded from http://clerccenter.gallaudet.edu/CIEC/resources-manufacturer.html • Tools for Schools • The Tools for Schools Program (TFS) is designed to provide parents with support and guidance about topics related to cochlear implants and education, assist cochlear implant centers in providing support to schools, and support school professionals, early intervention professionals, aural rehabilitation specialists, and others who work with children with cochlear implants. Free membership includes: E-Newsletters, resource materials such as the TFS Universal Kit, web courses, email and phone support: toolsforschools@advancedbionics.com; 800-678-2575 8AM to 5PM PST, Monday-Friday, training event notices, and access to new materials as they become available. To sign up go to:  http://www.bionicear.com/webform.cfm?langid=1&formtype=2

24. Educators Guide for Children with Cochlear Implants:http://www.cochlearamericas.com/support/2156.asp • The on-line guide provides information on cochlear implant technology and how to use it, as well as detail on how educational and (re)habilitation professionals can help a child with a cochlear implant reach his full potential. It addresses such topics as what services children need at school and how to prepare a classroom for the child with a cochlear implant. The guide is organized so that you can access materials by chapter.

25. MED-EL hearLIFE Educator CD • This CD contains the following: Handbook for Educators; Handling and Troubleshooting the TEMPO+; HearSay Newsletter; Communication Options; FM Guide; and How a Cochlear Implant Works video. There is a Glossory of Terms and a dynamic table of contents in both the Handbook for Educators and Troubleshooting the TEMPO+. The video clips in Handling and Troubleshooting the TEMPO+ demonstrate some of the information presented in the guide. To obtain the Educator CD, contact, MED-EL Corporation at (888) 633-3524 or www.medel.com