10 Things You Should Know about Hearing
Loss: Orientation to Terminology and to the
Population
Dr. Susan Easterbrooks
Professor, GSU
Dr. Nanci Scheetz
Professor, VSU
I. How many school-aged children have a
hearing loss?
– 24th Annual Report to Congress on the
Implementation of IDEA
(http://www.ed.gov/about/reports/annual/osep/2002/index.html)
– The 50 U.S. states, Puerto Rico, and the District of
Columbia, schools served the following numbers
during the school year 2000-2001.
–
Ages 3-5
8,243
–
Ages 6-21
70,662
• What does this mean to you as a general education teacher?
– Around the same year there were about 65,000,000 children in school,
or 1 per 1000. This means that most likely sometime during your years
of teaching, you WILL have at least one child with a hearing loss in
your class, or at least in your school building. Depending on the size of
your school/district/state, you may have several.
– Hearing loss is a low incidence disability. Most children are educated
with 6 or fewer of their peers. Some attend schools for the deaf, where
there may be a dozen or more students of the same age, and many are
the sole student with a hearing loss in their county. Many counties share
the services of one teacher of the deaf.
II. What causes a hearing loss?
•
Prenatal
– Genetics/heredity (most common prenatal cause)
– Syndromes
– Ototoxic agents
•
Perinatal
– Prematurity/low birth weight
– Birth trauma- low oxygen, severe jaundice, etc.
– Viral infections (cytomegalovirus, congenital syphillis)
•
Postnatal
– Meningitis (most common postnatal cause)
– Significant ear infections and ototoxic agents
•
In about ½ of the cases, the cause is unknown.
• It is important to talk with someone
knowledgeable about causes of deafness
because different causes lead to different
problems for the child.
– E.g., CMV- likelihood of additional disabilities
– Genetics- likelihood of other members in the family
with hearing loss
III. What are some basic definitions that I need to
know?
• IDEA 2007 defines hearing loss in this manner
• An impairment in hearing, whether permanent or fluctuating, that
adversely affects a child’s educational performance but that is not
included under the definition of deafness. Deafness means a
hearing impairment that is so severe that the child is impaired in
processing linguistic information through hearing with or without
amplification, that adversely affects a child’s educational
performance.
In other words, a deaf child is one who cannot
understand spoken communication even with a
hearing aid. A hard of hearing child is one who can
hear spoken communication, but this does not
necessarily mean that he understands it.
• Two misunderstood terms
– Hearing impaired
• Although this term is still used by the Fed, it is not
preferred by members of the Deaf community
– Deaf and deaf
• “Deaf” refers to an individual who identifies himself
as a member of the Deaf community
• “deaf” with a small d refers to a designation on an
audiogram (described later)
IV. Are all children with hearing loss totally deaf?
• In reality, most children with hearing loss can still hear
SOME information, but this is often more of a curse than
a blessing.
• Because they can hear SOME things, most people
expect them to hear ALL things, and this is not what
happens.
• For example, the child might hear you say “ship”, but
because he can’t hear “sh”, he thinks you said “chip.” As
you can imagine, this will be a problem as the child is
learning to talk and to read.
Another way to define a hearing loss is
by degrees of loss
• Typically these are:
–
–
–
–
–
–
–
0-15 dB
15-25
26-40
41-55
56-70
71-90
>90 dB
Normal
Minimal Hearing Loss
Mild Hearing Loss
Moderate Hearing Loss
Moderately Severe Loss
Severe Hearing Loss
Profound Hearing Loss
(Categories from the National Institutes of Health)
http://www.nih.gov/
V. What learning characteristics are associated with the
different degrees of hearing loss?
The tip sheet associated with this PowerPoint
presents the characteristics and needs of children with differing degrees of hearing loss.
–
0-15 dB
Normal
–
15-25
Minimal Hearing Loss
–
–
26-40
Some minor confusion of sounds
Mild Hearing Loss
–
May influence vocabulary and phonics
development
–
41-55
Moderate Hearing Loss
–
Definite influence on communication development
Need support.
–
56-70
Moderately Severe Loss
–
Cannot access spoken communication without
amplification and modifications
–
71-90
Severe Hearing Loss
–
May not be able to access spoken communication
even with amplification. May need alternative
communication options. Require significant
instructional assistance.
Tips
and
Facts
VI. What is an audiogram, and why is it
important?
• An audiogram is a graphic representation of a person’s
hearing or auditory responses (another word is
“thresholds” or the “softest” sound detected 50 percent of
the time).
– Across the horizontal plane of an audiogram are frequencies in
Hertz (Hz), or “pitch” information of the sounds presented during
a hearing evaluation.
– On the vertical plane of the audiogram are labels for “loudness,”
measured in decibels (dB)
•
For more information on reading an audiogram, consult your school’s audiologist or
teacher of the deaf, or go to
http://clerccenter.gallaudet.edu/SupportServices/series/5002.html
Why do we need to look at a child’s audiogram?
• We make decisions about surgery,
communication options, auditory training, and
speech approaches based on the audiogram.
• It is also important so that parents know what to
expect their child to respond to in the
environment.
VII. What is the “Speech Banana” and what does it
tell me?
The audiogram to the
right demonstrates
different sounds and
where they would be
represented on an
audiogram. The yellow,
banana-shaped figure
represents all the
sounds that make up
the human voice when
speaking at normal
conversational levels.
Interpretation
This represents the
hearing of an individual
with normal hearing in
the low frequencies
sloping to a severe high
frequency hearing loss
in the left ear ( blue
Xs)and a moderate to
severe hearing loss in
the right ear(red Os).
Results
The listener is able to hear all the
low and mid speech sounds but is
not able to hear the high pitch
speech sounds in the left ear. The
listener is not able to hear any
normal speech sounds in the right
ear. This person would rely on the
left ear for speech understanding
and would experience difficulty
hearing in noisy environments.
For additional examples, go to:
http://www.hearingresearch.org/Dr.Ro
ss/Audiogram/Audiogram.htm
VIII. What does in mean when some says that the
deaf/hard of hearing population is
heterogeneous?
• The population of children with hearing loss is not a
homogeneous population. Every child is different.
• What you do for one child may be totally ineffective with
another because there are so many differences to
consider.
• These include:
–
–
–
–
–
Deaf or hard of hearing (degree of hearing loss)
Additional learning disorders or not
Early identification and intervention or not
Early, appropriate amplification
Presence or absence of another deaf person in the
home
– Home language
– Age at which child began schooling and number of
years in school.
IX. There are many different ways we can increase
the likeliness that a child has access to sound.
• Although these will be described in greater detail
in an upcoming PowerPoint, here are some
commonly used listening devices:
– Sound field amplification system
– Individual aids (digital and programmable)
– Group amplification systems
– Cochlear implants
X. Ways to communicate visually
with a child who is deaf
• There are many different ways we can represent
English
– Signed English, Signing Exact English, Cued Speech,
Fingerspelling, etc.
• American Sign Language is its own unique language,
separate from signed version of English, and separate
from signed forms from other countries.
• These will be described in greater detail in a later
PowerPoint presentation in this series.
References and Resources
•
http://www.ed.gov/about/reports/annual/osep/2002/index.html
– Location of the 24th Annual Report to Congress on the Implementation
of IDEA.
•
http://clerccenter.gallaudet.edu/InfoToGo/index.html
– This site have hundreds of fact sheets and other resources on deafness.
•
http://www.listen-up.org/htm/toc.htm
– This site has hundreds of resources and suggestions and was developed by
teachers and parents.
•
http://www.deafed.net
– This site was developed by folks in teacher preparation. Along with the
PowerPoint presentations in this series, you will find lots of teaching suggestions.