Hearing Impairments and
Speech
Genetic causes of hearing
impairment
• The narrow ear canals association with
Down syndrome can make them prone to
ear infections
• Cleft palate can expose areas to infection
which can carry on to the ears
• RH incompatibility can cause highfrequency hearing loss even if the infant
survives
Environmental factors (TORCHS)
• TO is for
toxoplasmosis, from
handling cat feces or
undercooked lamb
• R is for rubella
• C is for
Cytomegalalovirus,
passed through the
placenta to the child.
• HS is herpes simplex
Less-frequent causes of
deafness
• Noise pollution. Stereos, particularly in
automobiles; close exposure to gunfire;
close exposure to jet engines or drag
racers
• Meningitis
• Otitis media
• Asphyxia or lack of oxygen during birthing
Factors affecting impact of
hearing loss
• Prelinguistic or post?
• Unilateral or
bilateral?
• Identified & taught
sign language before
2 1/2 or after?
• Severity of loss
Indicators of hearing loss
• Physical problems associated with the
ears
• Articulates poorly and omits consonant
sounds (speech banana)
• Turns up volume on radio, TV, stereo
• Requests repetitions; “huh?”
• Unresponsive to normal voice
• Reluctant to participate in oral activities
Special learning challenges for
the hearing-impaired
• Multiple word meanings such as mole or
box
• Syntax as it relates to word order: “The
parent spanked the child” as compared to
“The child spanked the parent.”
• Figurative language such as “He’s one up
on me” and “Give me some slack.”
• Idioms such as “He pulled himself up by his
bootstraps”
Total Communication Method
• Combines finger spelling, speech reading,
speech, and auditory amplification
• Most common method of classroom
communication, followed by oral-aural
• Manual communication was not reported
as a major mode of instruction in any
school
Where do you seat the hearing
impaired
• For unilateral losses, with the good ear
towards you, the teacher
• For bilateral, second row, middle, rather
than on the front
FM transmitters/receivers
• Student wears receiver with earphone
• Teacher wears transmitter, microphone
• Amplifies teacher’s voice without
amplifying all other classroom noise
• Take it off when you aren’t using it! If you
don’t want to embarrass yourself.
Speech & Language Disorders
Definitions
• Communication is the exchange of
thoughts, information, and ideas
• Speech is the systematic oral production of
the words of a given language
• Audition is the thought transformed into
words by a listener through hearing
• Language is an organized system of
symbols that humans use to express and
receive meaning.
Communication disorder
• Communication
disorder is a broad
term that includes
both disorders in
speech or language
Speech disorder
• A speech disorder is a
disorder affecting
articulation, voice, or
fluency
Language disorder
• A language disorder is
the impairment of
deviant development
of comprehension or
use (or both) of a
spoken, written, or
other verbal symbol
system.
• It could include
reception (auditory)
What kinds of communication
disorders are there?
Glad you asked . . .
Disorders of Articulation-Phonology
• Substitutions--wight for right, toat for coat,
wove for love, aminal for animal
• Distortions--brlu for blue, crat for cat
• Omissions such as oke for poke, at for hat,
inging for singing
• Addition of extra sounds such as
aluminininum for aluminum
Disorders of fluency and speech
timing (stuttering)
• Stuttering is characterized by repetitions
and prolongations of sound, syllables, or
words, that interrupt the flow of speech.
• It is not know exactly what produces
stuttering.
• Stutterers sometimes acquire secondary
characteristics or tics such as stamping
the foot or throwing the head around to get
the sound out.
Language Disorders (1 of 3)
• Form of Language:
• Phonology is the sound system of a
language and the rules that govern the
sound combination. For instance, English
has a ph blend but not a hp.
• Morphology is the system that governs the
structure of words and the construction of
word forms. “Unhappy” is a possible word
but not “hapunpy”
Language disorders (2 of 3)
• Syntax is the system governing the order
and combination of words to form
sentences, and the relationships among
the elements within a sentence.
• “He kissed her” does not mean the same
things as “Her kissed him.”
• “The shooting of the hunters was awful” is
nearly indeciferable because of the
violation of syntax.
Language disorders (3 of 3)
• Semantics is the
system that governs
the meanings of
words and sentences
• Pragmatics is the
system that combines
all of the language
components into
functional
communication
Voice disorders
• Voice disorders are
inappropriate
variations in quality,
pitch, or loudness
• Include breathiness,
hoarseness, or
harshness
• Vocal nodules can
cause these
Laryngectomees
• More likely to be seen in parents than in
children
• Result of the surgical removal of the larynx
most usually due to cancer
• May use esophageal speech or assistive
technology
• Recognize by gauze on throat
Assessment issues in speech
• Concomitant
retardation or
learning disability?
• Dialect?
• Regionalisms?
• Facial structure such
as cleft palate?
Service delivery models
• Inclusion. There is little reason to exclude
the speech impaired student all day long
from the classroom
• Consultative service
• Itinerant service--pathologist comes to
classroom
• Pull-out speech--child goes to “the magic
speech room” once a week
• Intensive-cycle scheduling
Suggestions to improve
student’s self-esteem
• Disregard moments of nonfluency
• Show acceptance of what the child has
expressed rather than how he expressed it.
• Treat the stutterer like any other child
• Acknowledge nonfluency without labeling
the child
• Help the child feel in control of his/her
speech