Deafness and Hearing Loss Chapter 9 Deafness and Hearing Loss Developed by: Blanche Jackson Glimps Tennessee State University

Chapter Objectives State what distinguishes a child who is deaf from a child who is hard of hearing in terms of the primary mode used for learning and communication. Describe how deafness or hearing loss affects a child’s acquisition and use of speech and language, academic achievement, and social functioning. Identify the estimated prevalence of children who are deaf or hard of hearing. Describe basic types of hearing loss, common causes of each, and how age of onset affects a child’s education and learning needs.

Chapter Objectives Describe the information provided by an audiogram. Identify technologies and supports used by students who are deaf and hard of hearing to amplify, supplement, or replace sound. Compare and contrast the underlying philosophies, methods, and key components of oral/aural, total communication, and bilingual-bicultural approaches to educating children who are deaf and hard of hearing.

Chapter Objectives Briefly explain how placement can influence quality of related services, access to language and curriculum content, social opportunities, and cultural identity for a student who is deaf.

Definitions Deafness is a hearing loss that is so severe that the child has difficulty processing linguistic information through hearing, with or without amplification, that adversely affects educational performance. Hearing loss means a loss in hearing that adversely affects educational performance but that is not included under the definition of deafness.

Definitions Deaf: These students use vision as the primary sensory mode for learning and communication. Hard of Hearing: These children use their hearing to understand speech with the help of a hearing aid. Many persons who are deaf do not view hearing loss as a disability.

How We Hear Audition is complex and not completely understood process. The outer ear is the external ear and the auditory canal. Auricle funnels sound waves into the auditory canal and helps distinguish the direction of sound. Sound waves are amplified as they move toward the tympanic membrane. Variations in sound waves cause the eardrum to move in and out.

The Nature of Sound Sound is measured in units that describe its intensity and frequency. Decibels (dB)-intensity or loudness of sound Zero dB represents the smallest sound a person with normal hearing can perceive Sounds of 125 dB or louder cause pain to most persons Hertz (Hz) is the frequency or pitch of sound is measured in cycles per second. Pure tones consist of one frequency only. The frequency range most important for hearing spoken language is 500 to 2,000 Hz.

Characteristics Students who receive special education because of hearing loss are a heterogeneous group. Levels of functioning influenced by: Type and degree of hearing loss Age of onset Attitudes of the child’s family Opportunities to acquire a first language The presence or absence of other disabilities Generalizations about how deaf people are supposed to act and feel must be viewed with extreme caution.

English Literacy Students with hearing loss Have smaller vocabularies than their peers with normal hearing and the gap widens with age Learn concrete words more easily than abstract words Have difficulty with function words and omit endings of words Have difficulty differentiating questions from statements Have difficulty understanding and writing sentences with passive voice and relative clauses

Academic Achievement Atypical speech is common in many children who are deaf or hard of hearing. Students with hearing loss have difficulty with all areas of academic achievement, especially reading and math. The gap in achievement between children with normal hearing and those with hearing loss usually widens as they get older. Problems attributable to inadequate development of a first language and the mismatch between the demands of spoken and written English and the students’ ability to understand and communicate in English.

Social Functioning Behavioral difficulties in school and social situations more likely in children with hearing loss than children with normal hearing Reports of feelings of depression, withdrawal, and isolation frequently reported by children and adults who are deaf with adventitious hearing loss The extent to which a child with hearing loss successfully interacts depends on others’ attitudes and the child’s ability to communicate in some mutually acceptable way.

Prevalence The large majority of persons with hearing loss are 65 years of age or older. Males are more likely than females to experience hearing loss. During the 2012 to 2013 school year, about 77,000 students ages 6 to 21 years received special education services under the disability category of hearing impairment. This represents 1.2% of all school-age students who received special education services and about 0.1% of the student population.

Prevalence A national survey indicated that about 39% of deaf or hard of hearing students had severe or profound hearing loss and about 40% had another disabling condition.

Types Conductive Hearing Impairment Results from abnormalities or complications of the outer or middle ear Sensorineural Hearing Impairment Entails damage to the cochlea or involves abnormality or failure of the auditory pathway Mixed hearing impairment Combination of conductive, sensory, and neural hearing loss Unilateral and Bilateral hearing loss Acquired and Congenital Prelingual and Postlingual

Causes Causes of Congenital Hearing Loss Genetic Factors Maternal Rubella Congenital Cytomegalovirus (CMV) Prematurity Causes of Acquired Hearing Loss Otitis Media Meningitis Ménière’s Disease Noise Exposure

Identification and Assessment The Joint Committee on Infant Hearing recommend that all infants be screened by 1 month of age Auditory Brain Stem Response Otoacoustic Emission Screening Pure-Tone Audiometry Assessed using an audiometer Speech Reception Test Alternative Audiometric Techniques Play Audiometry Operant Conditioning Audiometry Behavior Observation Audiometry

Technologies and Supports Hearing Aids Digital programmable hearing aids The earlier in life a child is fitted the more likely he will learn to use hearing Group Assistive Listening Devices A radio link established between the teacher and the child with a hearing loss Cochlear Implants A cochlear implant bypasses damaged hair cells and stimulates the auditory nerve directly Controversy surrounds cochlear implants in the deaf community

Supports and Technologies that Supplement or Replace Sound Sign Language Interpreters-signing the speech of a teacher or other speaker for a person who is deaf Speech-To-Text Translation-computer devices that translate speech to text Television, Video, and Movie Captioning-printed text that appears at the bottom of the screen Text Telephones-allows the user to send a typed message over telephone lines to anyone who has a teletype. Computer Technology and Alerting Devices

Educational Approaches Oral/Aural Approaches Auditory Learning Speechreading Cued Speech Total Communication Manually Coded English Fingerspelling American Sign Language (ASL) ASL is the language of the Deaf culture in the U.S.A. and Canada Bilingual-Bicultural Approach Which Approach for Whom?

Placement Options The majority of children who are deaf or hard of hearing attend local public schools 54% receive most of their education in regular education classroom with hearing students 17% attend resource rooms for part of the school day 16% are served in separate classrooms 4% attend residential schools for the deaf About 40% of all students with hearing loss go on to college education