9: Chapter Guided Review
I. Definitions Hearing impairment indicates a hearing loss that adversely affects educational performance and thereby makes the child eligible for special education A child who is deaf uses vision as the primary modality for learning and communication A deaf person may perceive some sounds through residual hearing Children who are hard of hearing are able to use their hearing to understand speech, generally with the help of a hearing aid Many persons who are deaf do not view hearing loss as a disability and consider the term hearing impairment. A. How We Hear Audition, the sense of hearing, is a complex and not completely understood process. The auricle funnels sound waves into the auditory canal 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. B. The Nature of Sound The intensity or loudness in sound is measured in decibels (dB) The frequency, or pitch, of sound is measured in cycles per second or hertz (Hz) II. Characteristics Students with hearing loss comprise an extremely heterogeneous group Levels of functioning are influenced by type and degree of hearing loss, the age oat onset, the attitudes of the child's parents and siblings, opportunities to acquire a first language, and the presence or absence of other disabilities Generalizations about how deaf people are supposed to act and feel must be viewed with extreme caution A. English Literacy A child who is unable to hear the language of other people will not learn speech and language spontaneously Students with hearing loss have smaller vocabularies and difficulty with function words and verb phrases Many deaf students write sentences that are short, incomplete, or improperly arranged B. Speaking Atypical speech is common in many children who are deaf or hard of hearing. C. Academic Achievement Most children with hearing loss have difficulty with all areas of academic achievement, especially math and reading Deafness itself imposes no limitations on the cognitive capabilities of individuals, and some deaf students read very well and excel academically. D. Social Functioning The extent to which a child with hearing loss successfully interacts depends largely on others' attitudes and the child's ability to communicate in some mutually acceptable way III. Prevalence According to ASHA, 95 out of every 1,000 people have a chronic hearing loss. The large majority of persons with hearing loss are adults.
The U.S. Public Health Service estimates 83 out of 1000 children have an educationally significant hearing loss. About 25% of students who are deaf or hard of hearing have another disabling condition IV. Types and Causes of Hearing Loss A. Type and Age at Onset Conductive hearing loss results from abnormalities or complications of the outer or middle ear Sensorineural hearing loss refers to damage to the auditory nerve fibers or other sensitive mechanisms in the inner ear Unilateral hearing loss is present in one ear, and bilateral hearing loss is present in both ears. Congenital hearing loss is present at birth and acquired hearing loss appears after birth Prelingual hearing loss and postlingual hearing loss identify whether a hearing loss occurred before or after the development of spoken language A. Causes of Congenital Hearing Loss Genetic Factors Maternal Rubella Congenital Cytomegalovirus (CMV) Premature birth B. Causes of Acquired Hearing Loss Otitis Media Meningitis Mnire's Disease Noise Induced Hearing Loss V. Identification and Assessment A. Assessment of Infants The two most widely used methods of screening for hearing loss include measures physiological reactions to sound. auditory brain stem response: sensors placed on the scalp measure electrical activity as the infant responds to auditory stimuli otoacoustic emission screening: a tiny microphone placed in the baby's ear detects the "echoes" of cells hearing in the cochlea as they vibrate to sound B. Pure-Tone Audiometry Used to assess the hearing of older children and adults The results are plotted on a chart called an audiogram C. Speech Audiometry Speech audiometry tests a person's detection and understanding of speech D. Alternative Audiometric Techniques Play audiometry Operant conditioning audiometry Behavior observation audiometry VI. Technologies and Supports to Amplify, Provide, Supplement, or Replace Sound A. Hearing Aids Modern hearing aids can differentially amplify selected frequencies and be tailored to each child's individual pattern of hearing loss
Hearing aids make sounds louder but not necessarily clearer The earlier in life a child can be fitted with an appropriate hearing aid, the more effectively he will learn to use hearing for communication and awareness Hearing aids offer minimal benefit in noisy reverberant classrooms. Assistive listening devices can solve problems of distance, noise, and reverberation in the classroom Cochlear implants bypasses damaged hair cells and stimulates the auditory nerve directly. It is surgically placed under the skin behind the ear. It has four basic parts: an external microphone, external speech processor, transmitter, and a receiver/stimulator B. Supports and Technologies that Supplement or Replace Sound Interpreters Speech-to-Text Translation Television Captioning Text Telephones Alerting Devices VII. Educational Approaches A. Oral/Aural Approaches Training in producing and understanding speech is incorporated into virtually all aspects of the child's education Oral emphasis programs typically use several means to develop residual hearing and the ability to speak as intelligibly as possible The oral approach includes: auditory learning, speech reading, and cued speech B. Total Communication Simultaneous presentation of language by speech and manual communication makes it possible for children to use either one or both types of communication Total communication has become the most widely used method of instruction in schools for the deaf: Manually Coded English and Fingerspelling C. American Sign Language (ASL) and the Bilingual-Bicultural Approach ASL is the language of the Deaf culture in the United States ASL is a legitimate language in it's own right ASL does not correspond to spoken or written English The goal of the bilingual-bicultural education approach is to help deaf students become bilingual adults who are competent in their fist language, ASL, and can read and write with competence in their second language, English VIII. Educational Placement Alternatives Approximately 82% of children who are deaf or hard of hearing attend local public schools While full inclusion in regular classrooms has benefited some deaf students, all of the professional and parent organizations involved with educating students who are deaf have issued position statements strongly in favor of maintaining a continuum of placement options A. Postsecondary Education The percentage of students with hearing loss who attend postsecondary educational programs has risen dramatically in the past 20 years About 40% of all students with hearing loss go on to receive higher education. IX. Current Issues and Future Trends
Given the large percentage of children with hearing loss who are educated in regular classrooms for most of the day, it is likely that oral/aural and total communication methods of instruction will continue to be used The bilingual-bicultural approach will probably be used with a growing percentage of the deaf students served in special schools and self-contained classrooms. Many leaders of the deaf community do not view deafness as a disability and oppose efforts to cure it or make them more like the mainstream hearing culure The keys to improving the future for people who are deaf or hard of hearing are access to the language and communication modality best suited to individual needs and preferences, effective instruction with meaningful curriculum, and selfadvocacy.