Early Childhood and Hearing Loss

1. Early Childhood and Hearing Loss A presentation on the needs of having a young one with a hearing loss in your class

2. Hearing Impairment • Hearing impairment is the decreased ability to hear and discriminate among sounds. It is one of the most common birth defects. Each year in the United States, about 12,000 babies (3 in 1,000) are born with significant hearing impairment. (Centers for Disease Control and Prevention (CDC). Early Hearing Detection & Intervention Program. May 9, 2007 ). http://www.marchofdimes.com/professionals

3. Infant Screening • The Centers for Disease Control and Prevention (CDC) recommends that all babies be screened for hearing impairment before 1 month of age, preferably before they leave the hospital. (Centers for Disease Control and Prevention (CDC). Early Hearing Detection & Intervention Program. May 9, 2007 ) • This is because language and communication develop rapidly during the first two to three years of life, and undetected hearing impairment can lead to delays in developing these skills. Without newborn screening, children with hearing impairment usually are not diagnosed until 2 to 3 years of age. http://www.marchofdimes.com/professionals

4. What are some signs of hearing impairment in infants and young children? • Failure to startle at loud sounds • Not turning toward the sound of a voice or imitating sounds after about 6 months of age • Lack of babbling at 9 months of age • Not using single words by 18 months of age • Using gestures instead of words to express needs http://www.marchofdimes.com/professionals

5. How are newborns screened for hearing impairment?Newborns are screened for hearing impairment with one of two tests. Both tests measure how a baby responds to sound. The tests take five to 10 minutes, are painless and can be done when the baby is sleeping. • In the otoacoustic emissions (OAE) test, a small microphone is placed in the baby's ear. The microphone, connected to a computer, sends soft clicking sounds or tones into the ear and records the inner ear's response to sound. • In the automated auditory brainstem response (AABR) test, soft clicking sounds are presented to the ear through small earphones. Sensors placed on the head and connected to a computer measure brain wave activity in response to sound http://www.marchofdimes.com/professionals

6. Parents should be concerned about hearing impairment in older children if they: • Develop vocabulary more slowly than their peers • Have speech that is difficult to understand or that is too loud or too soft • Often ask for words to be repeated • Turn on the TV too loud • Appear inattentive at school and have difficulties learning to read or perform simple mathematics. http://www.marchofdimes.com/professionals

7. Types of Hearing Loss • Sensorineural • Conductive • Mixed

8. Severity of Hearing Loss (in terms of decibel loss) • mild = 25-40 dB • moderate = 41-70 dB • severe = 71-90 dB • profound = >90 dB

9. Getting ready for the new deaf or hard-of-hearing student • Learning about the child’s preferred mode of communication and preparing the other children for the integration process. • Language is such an important part of the integration, ask the parent or a referring specialist many questions, such as: • Is this a child who uses American Sign Language (ASL)? • Is this a child who uses signs in English word order as well as spoken language (Total Communication)? • Is this a child who depends primarily on a hearing aid and spoken language? (Auditory / Oral) • If the child has language acquisition and how much language is important for you to know before this child comes into your room. “Access For All” Solit, G., Bednarczyk, A., & Taylor, M. (1992) Access for All: Integrating Deaf, Hard of Hearing, and Hearing Preschoolers. Pre-College National Mission Programs, Gallaudet University, Washington, DC.

10. Preparing the ClassTechniques to help the new child feel safe and comfortable • Introduce the topic of deafness: • It is important you show no hint of patronizing or pity—emphasis should be on the uniqueness of the deaf individual • Talk to the hearing children about how people hear and what they can do if they cannot hear • Use tools to help with this, such as children’s books (i.e. “I’m Deaf and It’s Okay” by Lorraine Aseltine, Evelyn Mueller, Nancy Tait; “Communication” by Aliki; “Silent Observer” by Christy Mackinnon) • Learn/ Teach a few basic signs (only if deaf person signs or will be signing) • “Good Morning”, “Please”, “Thank You”, “Bathroom”, “I need…”,” Stop”, “Eat”, “Yes”, “No”, “Friend”, “Help” • Giving each person in class a name sign • An effective way for children to learn about deaf individuals is to invite a deaf adult to come tell/ read stories in sign language. “Access For All” Solit, G., Bednarczyk, A., & Taylor, M. (1992) Access for All: Integrating Deaf, Hard of Hearing, and Hearing Preschoolers. Pre-College National Mission Programs, Gallaudet University, Washington, DC. • How to approach different reactions about the deaf child • It is normal for children to have questions about the deaf child • All questions need to be encouraged and answered honestly • Hurtful comments or gestures must NOT be allowed • Pretend play SHOULD be accepted and is not viewed as disrespectful

11. Welcoming Deaf and Hard of Hearing Children • Many techniques that early childhood/ child care professionals use to introduce any new child can be used to integrate a deaf or hard-of-hearing child into the group. • Ask parents to send in photos of family members friends or pets and names of each. • Try to have consistency for the first few days to help student adjust to the new class. Having an adult greet the child in his/her familiar language each day will be comforting. • Visual environment: • Drawings, Photos or Boardmaker for daily schedule & routines • Photos of each area and what goes on in each area • Labeling shelves pictorially around the room • Anything addressing Communication is great additions • posters, puzzles, books, games, DVDs/ videos, small materials “Access For All” Solit, G., Bednarczyk, A., & Taylor, M. (1992) Access for All: Integrating Deaf, Hard of Hearing, and Hearing Preschoolers. Pre-College National Mission Programs, Gallaudet University, Washington, DC.

12. Fair and Effective Classroom Communication • Having deaf and hard-of-hearing children in a classroom requires a different orientation for teachers who are used to working exclusively with hearing children. • Getting everyone’s attention before an announcement is made to make sure the importance of paying attention both visually and auditorially is demonstrated: • Lightly touching child on shoulder • Lights switched on/off in a few consecutive motions • Tapping the table in front of them • Waving your hand to visually get their attention • Soliciting the help of another child • In many situations, role playing or modeling this for the first time is a positive way to encourage the kids to learn to do this in polite ways also.

13. Classroom Communication (Con’t) • Try to stay within close range of child who is wearing hearing aid(s) approximately 3-4ft. Or allow the student to move closer to sound source (i.e. Speaker’s Voice, movie, sound speakers, etc.) • Be aware of when speaking from across the room or too far away, it may confuse or frustrate deaf or hard-of-hearing children. • Student’s should be seated away from auditory distractions such as air conditioners, doors & windows, animal cages, bathrooms, sinks and computers or any kind of visual distraction that will take student’s focus away. • The student should have a clear view of the faces of the speaker and other students. • Maintain eye contact • Be at student’s eye level • Keep mouth clearly visible; avoid covering face or mouth, stand still, face student and don’t exaggerate lip movement *Remember the learning environment is an important consideration for all students, and some may have to be adjusted to the individual needs of a student.

14. Soundproofing Classroom • Using tennis balls on chair legs or table legs to muffle sounds of moving furniture. • “Whisper Glides” are available online through http://whisperglides.com/ for small chair legs to help reduce noises from moving furniture or objects • Rugs or carpets help with noise reductions • Curtains or blinds also help muffle outside noises *See building codes and or directors before sound proofing your room.

15. Modifying Early Childhood Activities (Circle Time) • During Circle Time deaf or hard of hearing children need • A clear view of the speaker’s mouth • No bright lights or glares from the window on the speaker’s face • To know they can move if they need to see better • To have one person speaking at a time • Messages repeated with appropriate facial expressions • Messages rephrased using different vocabulary or language structure • Messages demonstrated or acted out • To be in a group if four to six children • To be in a location away from noisy equipment, such as air conditioners

16. Modifying Early Childhood Activities (Story Time) • During Story Time when reading to deaf children, the biggest concern is how to hold the book to show the children the picture and sign the words at the same time. Some suggestions are… • Utilize a deaf and hearing team teaching approach by having one person read the story and hold up the pictures and another person sign the story. • Put the book on a stand or easel. This will allow the reader to read and sign at the same time. • If no book holder is available first share the picture on the page before laying the book down to read and sign it. Show the picture again after signing the words. • Have one person tell a commonly known story without a book. • This is a good time to teach sign language. Use some signs without voice and see if the children understand. • Have a skilled sign language storyteller visit the class as often as possible and tell stories. • Use a flannel board or specially made puppets as visual aids to the stories and books.

17. Modifying Early Childhood Activities (Music and Movement Time) • To give the deaf child a chance to enjoy music, the following suggestions are suggested: • Increase the bass on the music player. • Do not make the music excessively loud because it will distort the sound. • If you are using a recording that gives directions, review and demonstrate the directions before using the recording. • When the music is turned on, make sure that the deaf child can see the leader easily. • Add signs and visual props.

18. Small Group Activities • Working in small groups facilitates communication and participation in hearing, deaf and hard-of-hearing children. • First the teacher may have to demonstrate or show the deaf or hard-of-hearing child how to do an activity, and then point out relevant words or signs associated with activity. • Prompting and modeling the socially acceptable behavior and communications between children during small group will encourage positive interactions between the children. “Access For All” Solit, G., Bednarczyk, A., & Taylor, M. (1992) Access for All: Integrating Deaf, Hard of Hearing, and Hearing Preschoolers. Pre-College National Mission Programs, Gallaudet University, Washington, DC.

19. Pretend Play and Drama • “Pretend play and drama are great ways for children to internalize what it means to have a hearing loss or hearing.” • “Encouraging interactions between the deaf/hard-of-hearing and hearing children.” • “Children often use imaginative play spontaneously to work out concepts they need to understand.” • Role playing others or pretending to be like them is developmentally appropriate for cognitive and psychological development. • Structured drama that incorporates mime, gestures, and role playing help children to feel comfortable with language and an ability to express themselves. “Access For All” Solit, G., Bednarczyk, A., & Taylor, M. (1992) Access for All: Integrating Deaf, Hard of Hearing, and Hearing Preschoolers. Pre-College National Mission Programs, Gallaudet University, Washington, DC.

20. Bibliography • http://www.marchofdimes.com/professionals • “Access For All” Solit, G., Bednarczyk, A., & Taylor, M. (1992) Access for All: Integrating Deaf, Hard of Hearing, and Hearing Preschoolers. Pre-College National Mission Programs, Gallaudet University, Washington, DC.