Chapter Twelve Individuals With Hearing Impairments

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Definitions and Concepts in the Field of Hearing Impairment Hearing impairment ‒Disordered hearing Hearing sensitivity loss ‒Described in range from mild to profound Deaf/deafness ‒Nonfunctional hearing; federal definition refers to the educational impact due to the hearing loss Hard of hearing ‒Residual hearing ability Minimal hearing loss – Difficultly hearing at a distance or with background noise 4

The Anatomy of the Auditory System The ear is divided into four connected sections: – Outer ear: The outer ear functions to protect the middle ear, direct sound into the ear canal, and enhance sound localization. In addition, the outer ear serves to enhance the intensity of sounds in the mid-frequency range where the sound spectrum of speech is located. – Middle ear: Sound waves travel to the inner ear and cause vibrations that are converted in energy. – Inner ear: This energy is transformed into electrical nerve impulses that are sent to the brain for decoding. – Central auditory nervous system: transmits energy to the brain for interpretation. SEE PICTURE NEXT SLIDE 5

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Classifications of Hearing Loss Conductive hearing loss – Sound transmission is blocked in the middle or outer ear Sensorineural hearing loss – Involves the inner ear (cochlea) and/or the auditory nerve Mixed hearing loss – Combination of conductive/sensorineural loss Central hearing loss – Dysfunction in the central nervous system 7

Measurement of Hearing Impairments Audiogram Frequency Hertz (Hz) Decibels (dB) Pure-tone audiometry 8

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Other Types of Hearing Assessment Air-conduction audiometry Bone-conduction audiometry Play audiometry Speech audiometry Speech recognition threshold (SRT) Auditory evoked potentials Evoked otoacoustic emissions Acoustic inmittance 11

Age of Onset Prelingual: present at birth or before speech onset Postlingual: deficit acquired after speech onset 12

Brief History of the Field 1817: First school for students with hearing impairments (American Asylum for the Education of the Deaf and Dumb) 1864: First college for the hearing impaired (today named Gallaudet University after Thomas Gallaudet) 13

Communication Methods Manual communication- sign language/finger spelling Oral communication- encouraged use of residual hearing and speech reading Total communication- combination of spoken and manual communication

Prevalence of Hearing Impairment Almost 69,500 students ages 6-21 were identified as having a hearing impairment and receiving a special education during the school year. Approximately 9,300 preschoolers were receiving a special education due to a hearing impairment. Number of Americans with a hearing loss has almost doubled in the past 10 years. 15

Etiology of Hearing Impairments Genetic/Hereditary factors – Down syndrome – Usher syndrome – Waardenburg syndrome Infections – Cytomegalovirus (CMV), rubella, otitis media Developmental abnormalities – Atresia Environmental/traumatic factors – Loud noise, low birth weight, prescription medication, head injuries 16

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Characteristics of Individuals with Hearing Impairments – Intelligence: Intelligence is distributed similarly to individuals without hearing impairments. Intellectual development for people with a hearing impairment is more a function of language development than cognitive ability – Speech and language: Most severely affected area due to a hearing impairment particularly for children who are born deaf. Students who cannot hear the sounds of spoken language may have difficulty learning the meanings associated to the sounds and also may have difficulty using spoken language because they lack early experiences with the sounds of language. – Social development: Social-emotional development relies heavily on communication skills and children with a hearing loss hear less auditory information. Children with hearing impairments may play differently due to a limited ability to share abstract ideas and often prefer to work with pairs of children rather than large groups. 18

Educational achievement: Educational achievement may be delayed although the student may have average, or above-average, intelligence. Reading skills are often delayed due to limited understanding of sound/word relationships. Educational environments often rely on spoken words to transmit information

Assessment of Individuals with Hearing Impairments Cognitive assessment requires the use of non- verbal assessment measures Speech assessment – Articulation, pitch, loudness, quality, rate Personal/social/behavioral assessment – Social adjustment, self-image, emotional adjustment 20

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– Educational Approaches Bilingual/bicultural: Considers American Sign Language (ASL) to be the natural language of the Deaf culture and urges recognition of ASL as the primary language choice with English considered a second language Total communication: Supports the belief that simultaneous use of multiple communication techniques enhances an individual’s ability to communicate, comprehend, and learn Auditory-Oral: Supports the belief that children with hearing impairments can develop listening/receptive language and oral language expression (English) skills; emphasizes use of residual hearing (the level of hearing an individual possesses), amplification (hearing aids, auditory training, etc.), and speech/language training

Instructional Interventions Methods of communicatio n – Sign language – Oral – Cued speech – Total communication – Fingerspelling Audiologist Interpreter 25

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Services for Young Children with Hearing Impairments Importance of early identification Early intervention services Family support 28

Transition and Individuals with Hearing Impairments Transition planning includes: – Family support – Higher education – Employment – Personal, social, community adjustment 29

Services for Adults with Hearing Impairments State commission or office on deafness – Advocacy, information sharing, agency referrals, interpreting services, employment assistance State vocational rehabilitation services – Employment services National Association for the Deaf – Political advocacy, information sharing Alexander Graham Bell Association – Clearinghouse for materials and information 30

Family Issues Most children with hearing impairments have hearing parents Acceptance of the disability Family relationships 31

Issues of Diversity People who identify with the Deaf culture are proud of their heritage including their language, history, values, and literature ‒The term Deaf (with a capital D) refers to individuals who identify with the Deaf culture ‒The term deaf (lowercase d) refers to the physical condition ‒Deaf culture considers American Sign Language (ASL) to be the natural language of the Deaf culture and urges recognition of ASL as the primary language choice with English considered a second language 32

Issues of Diversity 49% of all students in programs for the deaf and hearing impaired are from culturally diverse groups Research is needed to address the needs of students with hearing impairments who come from non-English speaking families

Technology and Individuals with Hearing Impairments Hearing aids Auditory training devices Computers Alerting devices Captioning Telecommunication devices Cochlear implants 34

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Trends, Issues, and Controversies Appropriate educational methods Move from child-centered to family-centered approach Total communication Deaf culture Full inclusion 36