Lecture 5

Deaf & Hard of
Hearing
Ching-fen Hsu
2013/10/18
A Given Gift
•
•
•
•
•
•
•

The process of hearing is remarkable
Being able to hear
Turn sounds into meaning
With hearing ...
Dorothy Brett
•
•
•
•
•

Born in noble British family
Partially deaf entire life
Slade Art College in London
Bloomsbury Gr...
Historical Context
• 1520-1584 Pedro Ponce de Leon: Spanish monk, 1st
teacher of Deaf students---successful teaching Deaf ...
Debate on Teaching Method
• Laurent Clerc (Deaf Frenchman): father of Deaf
education in US
• Hundred years’ war: oral comm...
Challenges for Hearing Loss
• Several groups could be divided:
(1)Mild to moderate hearing loss people profit
from hearing...
Gallaudet University & Laurent Clerc
National Deaf Education Center
• Dr. Mason Cogswell & Thomas Hopkins
Gallaudet were n...
Defined Terminologies
Process of Hearing
Structure of Human Ears
• Pinna: outer structure of the ear
• Eardrum: vibrates with presence of sound waves &
stimulates ...
Conductive Hearing Loss
•
•
•
•
•
•

one type of hearing impairment
blockage/damage to outer/middle ear
prevent sound wave...
Sensorineural Hearing
Loss
• Hearing impairment due to damage to
inner ear/auditory nerve
• Nerve deafness
• Difficult to ...
Age of Onset
• Congenital hearing loss: at/before birth
• Acquired hearing loss: after birth
• Onset vs. oral language dev...
Degree of Hearing Loss
• Mild (21-40dB): only soft speech/sound at a
distance difficult to hear
• Moderate (41-55dB): typi...
Causes

(1) Heredity/genetics: most common cause of deafness in
children, congenital/ sensorineural
(2) Meningitis: 2nd mo...
Prevalence
•
•
•
•
•
•
•

Hearing loss is associated with age
> 65y have hearing problem
1:3 in 65y population
25% use hea...
Prevention
• Avoid German measles
• Major cause of deafness
in newborns
• 1972 accounted for 11%
• 1998 1% for
immunizatio...
•
•
•
•
•

Hearing Aid

Amplification of sounds in E
Most commonly used device
From hearing trumpet to today’s hearing aid...
Hearing Aid Photo
Cochlear Implant
FM Transmission Device
• Frequency modulated
• Overcome distance &
noise problem
• wireless microphones
clipped to shirt &...
Audio Loop
• Listening device directs sound from the
source directly to listener’s ear through
specially designed hearing ...
What’s on the Horizon?
• Blue Cross Insurance Company reimburses implanted
hearing aids surgery
• Middle-ear bones vibrate...
Auditory Assessment
• pure sounds generated by
audiometer
• Sound waves of specific frequencies
at combinations of Hertz (...
• Travis’s hearing
diagram
• Conductive hearing
loss
• Mild range of 40 dB
• Bone conduction test
closes to 0 dB
• A heari...
• Heather’s
audiogram
• Sensorineural
hearing loss
• 30 dB hearing
loss
• Mild hearing
loss with a
hearing aid on
• Speech...
Early Intervention
• Early intervention is very important at four aspects:
(1)Early identification allows children to be f...
Communication First
• Dina The Deaf Dinosaur
• Importance of learning ASL
• Note culture differences & family
experiences
...
Tips for Classroom
Management
•
•
•
•
•

Place Ss as close to the speaker as possible
Face Ss when talking
Reduce backgrou...
Review Objectives
After this course, you should be able to….
• Explain variables that must be considered when
planning ins...
Hands Are Bridges
Questions?
L5 deaf & hard of hearing
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L5 deaf & hard of hearing

  1. 1. Lecture 5 Deaf & Hard of Hearing Ching-fen Hsu 2013/10/18
  2. 2. A Given Gift • • • • • • • The process of hearing is remarkable Being able to hear Turn sounds into meaning With hearing learning is possible About thoughts, ideas, feelings of others By listening to others Through exchanging knowledge expanded, ideas shared, emotion expressed, workplaces/social settings functioned
  3. 3. Dorothy Brett • • • • • Born in noble British family Partially deaf entire life Slade Art College in London Bloomsbury Group member Horizon broadened by Virginia Woolf & John Maynard Keynes • 1924 followed D.H. Lawrence to new Mexico • Remained staying in US
  4. 4. Historical Context • 1520-1584 Pedro Ponce de Leon: Spanish monk, 1st teacher of Deaf students---successful teaching Deaf to read/write/speak • 1600s William Holder & John Wallis instituted educational programs in England for Deaf---writing & manual communication teaching method • 1700s school for Deaf established: Henry Baker in England & Thomas Braidwood in Edinburgh & Abbe Charles Michel de l’Epee in France & Samuel Heinicke in Germany & Thomas Hopkins Gallaudet in US (with Laurent Clerc) • 1817 1st Deaf school in Hartford in Connecticut (manual communication, Martha’s vineyard children there)
  5. 5. Debate on Teaching Method • Laurent Clerc (Deaf Frenchman): father of Deaf education in US • Hundred years’ war: oral communication vs. manual communication teaching method debate • Edward Gallaudet: strongly supported manual approach & separate center schools • Alexander Graham Bell: sign language foster segregation/ legislation should ban two Deaf persons married each other/ Deaf should not teach • Advances in battery design make great impact on their lives of hearing loss • World War II battery-operated hearing aid possible
  6. 6. Challenges for Hearing Loss • Several groups could be divided: (1)Mild to moderate hearing loss people profit from hearing aids = not qualify to receive SE = does assistive devices fully compensate disabilities? (2)Using oral language in learning & communication (3)Using sign language = separate from hearing society = ASL becomes a debate (4)Colorful sign language life
  7. 7. Gallaudet University & Laurent Clerc National Deaf Education Center • Dr. Mason Cogswell & Thomas Hopkins Gallaudet were neighbors in Connecticut • Mason sent Thomas to Europe for learning SE of Deaf • 1856 Amos Kendall donated estate for elementary school of Deaf • I King Jordan: president of university • Pioneers in Deaf culture/community movement • National centers: host social activities, sporting events, competitions • http://clerccenter.gallaudet.edu
  8. 8. Defined Terminologies
  9. 9. Process of Hearing
  10. 10. Structure of Human Ears • Pinna: outer structure of the ear • Eardrum: vibrates with presence of sound waves & stimulates the ossicles of middle ear • Ossicles: three tiny bones in middle ear for passing info to cochlea • Eustachian tube: equalize pressure on both sides of eardrum • Cochlea: structure for containing hearing organs • Hair cells: part of cochlea for responding to different frequencies of sounds & producing electrochemical signals sent on to brain • Otoacoustic emissions (OAEs): low level of sound produced when hair cells vibrates in inner ear
  11. 11. Conductive Hearing Loss • • • • • • one type of hearing impairment blockage/damage to outer/middle ear prevent sound waves from traveling to inner ear cause mild to moderate hearing disability temporary experience in our lives (airplane) 20% elementary students & 80% children bet kindergarten & fifth grade • able to be corrected with hearing aids & surgery & medical techniques (cleanup ear infection)
  12. 12. Sensorineural Hearing Loss • Hearing impairment due to damage to inner ear/auditory nerve • Nerve deafness • Difficult to correct • Patients can hear different frequencies at different intensity levels • Their hearing losses are not flat/even • Less common type in young children
  13. 13. Age of Onset • Congenital hearing loss: at/before birth • Acquired hearing loss: after birth • Onset vs. oral language development (1) Prelingually deaf: become deaf before they learn to speak & understand language born deaf/lose hearing during infancy 95% children & youth (1:10 one deaf parent) severely influence communication & learning mainly learn sign language (2) Postlingually deaf: profound hearing loss after speech development/ able to have oral communication ability
  14. 14. Degree of Hearing Loss • Mild (21-40dB): only soft speech/sound at a distance difficult to hear • Moderate (41-55dB): typical conversational speech is hard to follow • Moderately severe (56-70dB): only loud speech can be heard • Severe (71-90dB): even loud speech is hard to understand • Profound (91dB+): considered “deaf” assistive listening devices needed • Residual hearing
  15. 15. Causes (1) Heredity/genetics: most common cause of deafness in children, congenital/ sensorineural (2) Meningitis: 2nd most common cause, CNS disease, affect meninges (coverings for brain/spinal cord), mostly come from bacterial infections, postnatal deafness, acquired profound sensorineural hearing loss (3) Otitis media: middle ear infection, fluid accumulation behind eardrum, corrected with antibiotics, frequency & duration of infection matter, permanent conductive hearing loss, damaged eardrum, mild to moderate hearing loss, hearing aids work (4) Noise: >105dB/ hour is unsafe (rock concert 125dB)
  16. 16. Prevalence • • • • • • • Hearing loss is associated with age > 65y have hearing problem 1:3 in 65y population 25% use hearing aids 1:1000 babies is profoundly deaf 2-3:1000 hearing loss Number underestimated for hearing loss could be a characteristic of other syndrome (DS)
  17. 17. Prevention • Avoid German measles • Major cause of deafness in newborns • 1972 accounted for 11% • 1998 1% for immunizations • Avoid dangerous E over 85 dB • Wear earplugs Decibel Levels of Noise in US E
  18. 18. • • • • • Hearing Aid Amplification of sounds in E Most commonly used device From hearing trumpet to today’s hearing aid Eliminate need for SE Profit from general education classes (1) Behind the ear (BTE) (2) In the ear (ITE) (3) In the canal (ITC) (4) Completely in the canal (CIC) • Digital hearing aids: reduce background noise/ amplify sounds according to individuals’ hearing profiles • Disposables for keeping clean/preventing damaged
  19. 19. Hearing Aid Photo
  20. 20. Cochlear Implant
  21. 21. FM Transmission Device • Frequency modulated • Overcome distance & noise problem • wireless microphones clipped to shirt & receivers small enough attached to hearing aids • Background noise reduced • Greater freedom for teachers/ students
  22. 22. Audio Loop • Listening device directs sound from the source directly to listener’s ear through specially designed hearing aid/ earphone • Used in lecture/ concert hall • Sound travels through radio waves/ wire connection • Inexpensive • Easy to install in rooms up to 100 seats • Wire picks up audio signal from amplifier & transmit to electrical current with a magnetic field within the area encircled by the wire • User receivers convert the magnetic energy back into sound
  23. 23. What’s on the Horizon? • Blue Cross Insurance Company reimburses implanted hearing aids surgery • Middle-ear bones vibrate & transmit sound into inner ear • 85% improvement in hearing • Do not amplify distracting background noise • Animals can regenerate hair cells automatically & regain hearing ability • Humans cannot • 80% hearing loss results from damaged hair cells in inner ear • Regenerating hair cells is possible in humans, but the challenging is the number of cells
  24. 24. Auditory Assessment • pure sounds generated by audiometer • Sound waves of specific frequencies at combinations of Hertz (Hz) & decibels (dB) & pitch & loudness • Separate testing for L & R ear • Audiogram: a grid/ graph • Scores below 0dB has hearing loss • Air conduction audiometer method • Bone conduction audiometer method
  25. 25. • Travis’s hearing diagram • Conductive hearing loss • Mild range of 40 dB • Bone conduction test closes to 0 dB • A hearing aid is needed
  26. 26. • Heather’s audiogram • Sensorineural hearing loss • 30 dB hearing loss • Mild hearing loss with a hearing aid on • Speech banana: speech sounds range
  27. 27. Early Intervention • Early intervention is very important at four aspects: (1)Early identification allows children to be fitted with hearing aids (4 weeks old)/ cochlea implants (1y) (2)Early intervention (>6 months) pays off in reading achievement & speech abilities in later years (3)Preschool programs help develop language (4)Early intervention programs help families better understand & meet special needs • Deaf children with deaf parents develop well at reading > Deaf children with hearing parents • Sign language becomes their native language
  28. 28. Communication First • Dina The Deaf Dinosaur • Importance of learning ASL • Note culture differences & family experiences • Early identification & early intervention must go hand in hand
  29. 29. Tips for Classroom Management • • • • • Place Ss as close to the speaker as possible Face Ss when talking Reduce background noise as much as possible Do not stand with direct light behind you For class discussions, make sure Ss know who is about to speak & ensure seeing faces in talking • In discussions, arrange Ss’ chairs in a circle
  30. 30. Review Objectives After this course, you should be able to…. • Explain variables that must be considered when planning instruction for students with hearing problems • List and explain the major causes of hearing loss • Describe and justify universal hearing screening of newborns • Discuss the concept of Deaf culture, list examples or signs of Deaf culture, and describe its importance to the Deaf • List the major types of assistive technology specifically designed for people with hearing problems, and provide examples for each
  31. 31. Hands Are Bridges
  32. 32. Questions?

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