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  1. 1. Hearing<br />Impairment<br />By: Heather Motter, Sarah Urchuck, Megan Daley, Lindsay Kimes, and Amanda Vogler<br />
  2. 2. Background<br /><ul><li>Hearing Impairment- the full or partial decrease in the ability to detect or understand sounds
  3. 3. Can happen to any organism that perceives sound
  4. 4. Caused by a range of biological and environmental factors
  5. 5. Trauma to the ear, genetic factors, diseases like meningitis
  6. 6. Categories of hearing loss: neural/sensorineural, conductive, combination
  7. 7. Hearing impairment can lead to social isolation and someone who deals with this must use many adaptations to live independently
  8. 8. Otologist and audiologist will primarily treat those with hearing impairments.
  9. 9. Some of the speech problems that will be dealt with include omitting speech sounds, distortion of consonants, and substitution of sounds.</li></li></ul><li>Background<br /><ul><li>Some of the speech problems that will be dealt with include omitting speech sounds, distortion of consonants, and substitution of sounds.
  10. 10. More specifically there are four major ways in which hearing loss affects children:
  11. 11. It causes delay in the development of receptive and expressive communication skills (speech and language).
  12. 12. The language deficit causes learning problems that result in reduced academic achievement.
  13. 13. Communication difficulties often lead to social isolation and poor self-concept.
  14. 14. It may have an impact on vocational choices.
  15. 15. Treatment includes cochlear implants and possible gene therapy
  16. 16. Statistics
  17. 17. 2006- 37 Million adults in the U.S. had trouble with hearing (full range)
  18. 18. Males are more likely to be hearing impaired than females.</li></li></ul><li>Respiratory & Phonatory<br /><ul><li>Production because the primary basis for learning language is hearing
  19. 19. It (if you can’t hear it, it will be hard to produce it)
  20. 20. Voice problems that result from improper use of the respiratory system:
  21. 21. Breathiness, roughness, diplophonia, poor pitch, inability to control intensity
  22. 22. Speech problems in the phonatory system include:
  23. 23. Poor articulation, poor vowel discrimination, improper placement of articulator
  24. 24. It is important to notice signs of hearing impairment early. The “critical period” of cognitive development in children ranges from birth to 6 years of age. The earlier the diagnosis, the earlier the treatment, and therefore the child can stay on track developmentally. They can lead a closer to normal life.</li></li></ul><li>Respiratory & Phonatory<br /><ul><li>Ways to foster communication with a hearing impaired child:
  25. 25. Spoken Language Approaches:
  26. 26. 1)Auditory/Oral: makes use of residual hearing through hearing aids or cochlear implants and lip reading to maximize input
  27. 27. 2) Auditory/Verbal: believes that children with hearing loss can be taught to use any residual hearing they have. Encourages listening without visual cues such as sign language or lip reading.
  28. 28. 3)Cued Speech: a visual system to demonstrate phonetic info with hand signals along with natural speech movements. Therapists will also use tactile cues to increase input.
  29. 29. A video online that shows a therapist working with a deaf child on pitch and intensity:
  30. 30. http://www.teachertube.com/viewVideo.php?video_id=116192&title=No_8_intensity_pitch_deaf_spech</li></li></ul><li>Articulatory<br /><ul><li>Voice quality may be harsh, breathy, nasal, and/or monotone
  31. 31. Sounds may be distorted and/or omitted from words
  32. 32. Example: “I caught a fish” may be spoken or written as “I cau_ fi_”
  33. 33. -May drop plural and possessive endings
  34. 34. Example: “The boy hat” for “The boy’s hat.”
  35. 35. Pitch, rhythm, stress, inflection and/or volume are inappropriate
  36. 36. Difficulty following oral and written directions people with a hearing impairment also have a limited vocabulary
  37. 37. A child with such a loss as difficulty learning the speech sounds
  38. 38. Child tends to distort, substitute, and omit many speech sounds
  39. 39. Childs voice will lack normal intonation and rhythm; the voice may also be of higher pitch
  40. 40. Children with hearing loss comprehend and produce shorter and simpler sentences than children with normal hearing.
  41. 41. Children with hearing loss may not hear their own voices when they speak. They may speak too loudly or not loud enough. They may have a speaking pitch that is too high. They may sound like they are mumbling because of poor stress, poor inflection, or poor rate of speaking</li></li></ul><li>Anatomy of the Auditory System<br /><ul><li>Middle Ear
  42. 42. Ossicles
  43. 43. malleus, incus, stapes
  44. 44. eustachian tube
  45. 45. Outer Ear
  46. 46. Pinna
  47. 47. ear canal
  48. 48. ear drum
  49. 49. Inner Ear
  50. 50. vestibular system
  51. 51. Cochlea
  52. 52. auditory nerve</li></li></ul><li>Types of Hearing Loss<br /><ul><li>Conductive
  53. 53. damage to outer/middle ear
  54. 54. air conduction
  55. 55. Sensorineural
  56. 56. damage to inner ear/auditory nerve
  57. 57. bone conduction
  58. 58. Mixed</li></li></ul><li>
  59. 59. Effects of Hearing Impairment<br /><ul><li>delay in development of receptive and expressive language
  60. 60. Articulation
  61. 61. final consonant deletion
  62. 62. volume of voice
  63. 63. socialization may be limited</li></li></ul><li>Treatment and solutions<br /><ul><li>Udiologist
  64. 64. hearing tests
  65. 65. hearing aids
  66. 66. Speech-Language Pathologist
  67. 67. pure tone hearing screenings
  68. 68. assist in language/speech problems
  69. 69. Other
  70. 70. face the other person
  71. 71. speak clearly</li></li></ul><li><ul><li>Sound waves vary in amplitude and in frequency. Amplitude is the sound wave's peak pressure variation. Frequency is the number of cycles per second of a sinusoidal component of a sound wave. Loss of the ability to detect some frequencies, or to detect low-amplitude sounds that an organism naturally detects, is a hearing impairment.</li></ul>Speech Variables<br /><ul><li>The hearing loss usually affects the highest frequencies (18 to 20 kHz) early on and gradually affects the lower frequencies; it usually becomes clinically significant when it affects the critical 2- to 4-kHz range around age 55 to 65 (sometimes sooner). The loss of high-frequency hearing significantly affects speech comprehension. Although the loudness of speech seems normal, certain consonant sounds (eg, C, D, K, P, S,T) become heard to hear.
  72. 72. Deaf children have limited control over their voice loudness. Pitch of a considerable number of deaf children is on the high side with inappropriate rise and fall variations. </li></li></ul><li>Clinical Application<br /><ul><li>Cochlear Implants
  73. 73. An electronic device that directly stimulates the auditory nerve by bypassing a person’s damaged cochlea.
  74. 74. Implants are able to detect and transmit a wide range of frequencies.
  75. 75. Parts: microphone, signal processor, transmitter and receiver/stimulator, and electrode array
  76. 76. This is used with sensorineural hearing loss.
  77. 77. When speech has more contextual cues and linguistic structure, then fewer electrodes in the implant need stimulated.
  78. 78. Hearing with the implants is very different and actually needs to be learned.</li></li></ul><li>Clinical Application<br /><ul><li>Hearing Aids
  79. 79. Hearing aids amplify sounds, they only make them louder.
  80. 80. They are limited in the high frequency range.
  81. 81. Styles: in-the-canal, in-the-ear, and behind-the-ear aids
  82. 82. Parts: microphone, amplifier, and speaker
  83. 83. If there is greater damage to the hair cells in the inner ear, then greater amplification is needed.
  84. 84. Other options include American Sign Language or Speech Reading</li>