1. © 2013, 2009, 2006, 2003, 2000 Pearson Education, Inc. All rights reserved. William L. Heward Exceptional Children An Introduction to Special Education Tenth Edition

2. Chapter 9 Deafness and Hearing Loss

3. Focus Questions  What distinguishes a child who is deaf from a child who is hard of hearing in terms of the primary sensory mode used for learning and communication?  How might deafness affect a child’s acquisition and use of speech and language, academic achievement, and social functioning?  What implications for a child’s education result from the type of hearing loss and age of onset?  How do students who are deaf and hard of hearing use technologies and supports to amplify, supplement, or replace sound?  How do oral/aural, total communication, and bilingual– bicultural approaches to educating children who are deaf and hard of hearing differ in their philosophies and methods?  How might membership in the Deaf culture influence a student’s and his family’s perspectives and wishes regarding educational placement? Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-2

4. Definitions of Hearing Loss IDEA Definition Deafness is a hearing loss that is so severe that the child has difficulty processing linguistic information and it 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 Deaf: Students use vision as the primary sensory mode for learning and communication Hard of hearing: Students 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 Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-3

5. How We Hear Audition, the sense of hearing, is a complex and not completely understood process The outer ear consists of the external ear and the auditory canal We see the auricle which funnels sound waves into the auditory canal and helps distinguish the direction of sound Sound waves are slightly amplified as they move toward the tympanic membrane Variations in sound pressure cause the eardrum to move in and out The vibrations of the bones of the middle ear transmit energy to the inner ear The inner ear is the most critical and complex part of the hearing apparatus Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-4

6. The Nature of Sound Sound is measured in units that describe its intensity and frequency Decibels (dB) the 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) the frequency or pitch of sound is measured in cycles per second Pure tones consist of one frequency The frequency range most important for hearing spoken language is 500 to 2,000 Hz Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-5

7. Characteristics of Students with Hearing Loss 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 parents and siblings 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 Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-6

8. Characteristics (cont.) English Literacy and Speaking Skills 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 May have atypical speech and are unable to monitor their own speech Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-7

9. Characteristics (cont.) Academic Achievement 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 Approximately 30% of deaf students leave school functionally illiterate Academic performance must not be equated with intelligence 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 Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-8

10. Characteristics (cont.) 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 Poor readers were more likely to exhibit problem behavior in school according to one study 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 Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-9

11. Prevalence  The large majority of persons with hearing loss are adults  Males are more likely than females to experience hearing loss  During the 2009-2010 school year, about 1.2% of school age children receive special education services for hearing loss and about 0.1% of the resident student population  A national survey indicated that about 41% of deaf or hard of hearing students had severe or profound hearing loss and about 40% had another disabling condition Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-10

12. Types of Hearing Loss Type of hearing loss is determined by the affected region of the auditory system Conductive Hearing Loss Results from abnormalities or complications of the outer or middle ear Sensorineural hearing loss 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 hearing loss is present in one ear only Bilateral hearing loss is present in both ears Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-11

13. Causes of Hearing Loss Congenital hearing loss is present at birth Causes of congenital hearing loss – Genetic Factors – Maternal Rubella – Congenital Cytomegalovirus (CMV) – Premature birth Acquired hearing loss appears after birth Pre-lingual hearing loss before speech develops Post-lingual hearing loss after speech develops Causes of acquired hearing loss – Otitis Media – Meningitis – Ménière’s Disease – Noise-induced hearing loss Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-12

14. 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 Assessment of Older Children and Adults Pure-tone audiometry Assessed using an audiometer Speech Reception Test Alternative Audiometric Techniques Play audiometry Operant Conditioning Audiometry Behavior Observation Audiometry Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-13

15. Classification of Hearing Loss Classification of hearing loss depends on the average hearing level in decibels across the frequencies most important for understanding speech  Slight  Mild  Moderate  Severe  Profound Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-14

16. Technologies That Amplify or Provide Sound Hearing aids Hearing aids make sounds louder but not necessarily clearer The earlier in life a child is fitted the more effectively he will learn to use hearing To derive maximum benefit a hearing aid should be worn throughout the day Group assistive listening devices A radio link established between the teacher and the child can solve problems caused by distance and noise Cochlear implants A cochlear implant bypasses damaged hair cells and stimulates the auditory nerve directly Tremendous controversy surrounds cochlear implants in the deaf community Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-15

17. Supports and Technologies that Supplement or Replace Sound  Interpreting Signing the speech of a teacher of 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  Computer Technology  Alerting devices Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-16

18. Educational Approaches  Oral/Aural Approaches Auditory Learning Speech reading Cued Speech  Total Communication Simultaneous presentation of language by a variety of forms of communication  American Sign Language (ASL) and the Bilingual- Bicultural Approach ASL is a legitimate language in its own right The goal of the bilingual-bicultural approach is to help deaf students become bilingual adults who can read and write with competence in their second language Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-17

19. Educational Placement Alternatives Approximately three-fourth of children who are deaf or hard of hearing attend local public schools 60% receive most of their education in general education classroom with hearing students 10% attend resource rooms for part of the school day 17% are served in special classrooms 25% attend special schools for the deaf About 40% of all students with hearing loss go on to college education Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 9-18