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

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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

11. 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.

12. 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.

13. 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.

14. 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.

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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?

21. 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