Understanding Hearing Impairments & Speech Disorders

1. Hearing Impairments and Speech

5. Genetic causes of hearing impairment • The narrow ear canals association with Down syndrome can make them prone to ear infections • Cleft palate can expose areas to infection which can carry on to the ears • RH incompatibility can cause high-frequency hearing loss even if the infant survives

6. TO is for toxoplasmosis, from handling cat feces or undercooked lamb R is for rubella C is for Cytomegalalovirus, passed through the placenta to the child. HS is herpes simplex Environmental factors (TORCHS)

7. Less-frequent causes of deafness • Noise pollution. Stereos, particularly in automobiles; close exposure to gunfire; close exposure to jet engines or drag racers • Meningitis • Otitis media • Asphyxia or lack of oxygen during birthing

8. Factors affecting impact of hearing loss • Prelinguistic or post? • Unilateral or bilateral? • Identified & taught sign language before 2 1/2 or after? • Severity of loss

9. Indicators of hearing loss • Physical problems associated with the ears • Articulates poorly and omits consonant sounds (speech banana) • Turns up volume on radio, TV, stereo • Requests repetitions; “huh?” • Unresponsive to normal voice • Reluctant to participate in oral activities

11. Special learning challenges for the hearing-impaired • Multiple word meanings such as mole or box • Syntax as it relates to word order: “The parent spanked the child” as compared to “The child spanked the parent.” • Figurative language such as “He’s one up on me” and “Give me some slack.” • Idioms such as “He pulled himself up by his bootstraps”

12. Total Communication Method • Combines finger spelling, speech reading, speech, and auditory amplification • Most common method of classroom communication, followed by oral-aural • Manual communication was not reported as a major mode of instruction in any school

13. Where do you seat the hearing impaired • For unilateral losses, with the good ear towards you, the teacher • For bilateral, second row, middle, rather than on the front

14. FM transmitters/receivers • Student wears receiver with earphone • Teacher wears transmitter, microphone • Amplifies teacher’s voice without amplifying all other classroom noise • Take it off when you aren’t using it! If you don’t want to embarrass yourself.

15. Speech & Language Disorders

16. Definitions • Communication is the exchange of thoughts, information, and ideas • Speech is the systematic oral production of the words of a given language • Audition is the thought transformed into words by a listener through hearing • Language is an organized system of symbols that humans use to express and receive meaning.

17. Communication disorder • Communication disorder is a broad term that includes both disorders in speech or language

18. Speech disorder • A speech disorder is a disorder affecting articulation, voice, or fluency

19. Language disorder • A language disorder is the impairment of deviant development of comprehension or use (or both) of a spoken, written, or other verbal symbol system. • It could include reception (auditory)

21. What kinds of communication disorders are there? Glad you asked . . .

22. Disorders of Articulation--Phonology • Substitutions--wight for right, toat for coat, wove for love, aminal for animal • Distortions--brlu for blue, crat for cat • Omissions such as oke for poke, at for hat, inging for singing • Addition of extra sounds such as aluminininum for aluminum

23. Disorders of fluency and speech timing (stuttering) • Stuttering is characterized by repetitions and prolongations of sound, syllables, or words, that interrupt the flow of speech. • It is not know exactly what produces stuttering. • Stutterers sometimes acquire secondary characteristics or tics such as stamping the foot or throwing the head around to get the sound out.

24. Language Disorders (1 of 3) • Form of Language: • Phonology is the sound system of a language and the rules that govern the sound combination. For instance, English has a ph blend but not a hp. • Morphology is the system that governs the structure of words and the construction of word forms. “Unhappy” is a possible word but not “hapunpy”

25. Language disorders (2 of 3) • Syntax is the system governing the order and combination of words to form sentences, and the relationships among the elements within a sentence. • “He kissed her” does not mean the same things as “Her kissed him.” • “The shooting of the hunters was awful” is nearly indeciferable because of the violation of syntax.

26. Language disorders (3 of 3) • Semantics is the system that governs the meanings of words and sentences • Pragmatics is the system that combines all of the language components into functional communication

27. Voice disorders • Voice disorders are inappropriate variations in quality, pitch, or loudness • Include breathiness, hoarseness, or harshness • Vocal nodules can cause these

28. Laryngectomees • More likely to be seen in parents than in children • Result of the surgical removal of the larynx most usually due to cancer • May use esophageal speech or assistive technology • Recognize by gauze on throat

29. Assessment issues in speech • Concomitant retardation or learning disability? • Dialect? • Regionalisms? • Facial structure such as cleft palate?

30. Service delivery models • Inclusion. There is little reason to exclude the speech impaired student all day long from the classroom • Consultative service • Itinerant service--pathologist comes to classroom • Pull-out speech--child goes to “the magic speech room” once a week • Intensive-cycle scheduling

31. Suggestions to improve student’s self-esteem • Disregard moments of nonfluency • Show acceptance of what the child has expressed rather than how he expressed it. • Treat the stutterer like any other child • Acknowledge nonfluency without labeling the child • Help the child feel in control of his/her speech