Hearing impairment and DETA criteria about ear health and signal processing hearing improves with knowing key issues in Hearing impairment

1. Review of DETA Criteria
for Hearing Impairment

2. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Key issues for the Review in HI
• Aligning DETA definitions and criteria with national and
international standards
• Examining the links between the hearing impairment and the
activity limitations/ participation restrictions for different degrees of
hearing loss
• Evaluating the effectiveness of the verification form introduced in
July 2006
• Identifying when a review of verification is appropriate
• Investigating ways to better identify and support students in
schools with high incidence of Otitis Media
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3. education adjustment program Department of Education, Training and the Arts
Definitions of HI:
International and National Criteria
• The range of normal hearing is 0-20dB
(WHO, AH)
• Research - effects of mild hearing loss
• Research – effects of classroom acoustics

4. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
New Criteria (from November 12 2007)
Criterion 1
• Evidence of a hearing loss greater than 20dB at any
one frequency in either ear
• Audiogram and written report from an audiologist or
otolaryngologist
• The most current audiogram accepted for permanent
Hearing Loss
• Fluctuating conductive (‘temporary’) hearing loss –
audiogram within previous 12 months and history of
persistent hearing loss
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5. education adjustment program Department of Education, Training and the Arts
New Criteria (from November 12 2007)
Criterion 2
• The hearing loss must be shown to manifest
itself in activity limitation and participation
restriction in the school context

6. Hearing Impairment -
Activity Limitation / Participation
Restriction in the school context

7. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
ICF Activity (Limitation) and Participation
(Restriction) Domains:
1. Learning and applying knowledge
2. General tasks and demands
3. Communication
4. Mobility
5. Self care
6. Domestic life
7. Interpersonal interactions and relationships
8. Major life areas
9. Community, social and civic life
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8. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Possible Activity Limitation and Participation
Restriction due to HI: Some ICF Examples
Difficulty with:
• Learning through listening (d115)
• Receiving spoken messages (d310)
• Engaging effectively in conversation (d350)
• With one person (d3503)
• With many people(d3504)
• Engaging in discussion (d355)
• Remunerative employment (d850)
• Engaging in some forms of recreation and leisure (d920)
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GREAT INDIVIDUAL VARIATION: hearing impairment,
environmental and personal factors

9. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Hearing Impairment, Activity Limitation and
Participation Restriction: Classroom examples
Difficulty with:
• Attending/ tuning in to what is going on
• Accessing spoken information - teachers & other students
• Taking part in discussions
• Accessing audio, TV, videos etc
• Listening for long periods – fatigue factors
• Learning information incidentally
• Responding quickly to questions or commands
• Making sense of new information
• Learning new vocabulary and using words appropriately
National Deaf Children’s Society – Deaf Friendly Classrooms Project
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10. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Hearing Impairment, Activity Limitation and
Participation Restriction: Social examples
Difficulty with:
• Learning social behaviour incidentally
• Communicating effectively with others
• Initiating conversations
• Using appropriate language when interacting with others
• Being fully included in large groups
• Expressing feelings and emotions verbally
• Developing confidence and a positive self image
National Deaf Children’s Society – Deaf Friendly Classrooms Project
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11. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Activity Limitation and Participation Restriction:
Degrees of Hearing Impairment
The review focused on current evidence relating to:
– Mild hearing loss, including CHL due to otitis media
– Unilateral hearing loss
• Variable impact of mild and unilateral hearing loss:
physical environment (eg noise, distance, reverberation,
lighting)
communication factors (eg size of group, demands of the
activity)
personal factors (eg coping strategies, fatigue levels)
• Inside a classroom a mild hearing loss can be disabling
• Outside school context mild or moderate hearing loss may be
an impairment but not a disability
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12. The Verification Form:
Hearing Impairment

13. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Verification Form:
The HI verification form trialled in July 2006 has
been accepted with only a few modifications
Scaffolds best practice
Encourages communication between schools
and the AVT: HI
Enhances links between the impairment,
effects and appropriate educational
adjustments
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14. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Information about the hearing impairment
Specialist teacher report:
• Degree and type of hearing loss
• Age of onset – pre or post-lingual
• Age of diagnosis and history
• Associated medical conditions
• Other impairments
• Consistent use of amplification or cochlear implant
• Auditory skills
• Communication mode and competence
• Speech and language development
completed by a teacher with recognised qualifications in the area of hearing impairment
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15. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Reporting on activity limitation and
participation restriction for HI verification
Describe how the student’s hearing impairment affects their ability
to access, participate and demonstrate what they know and can do
to achieve positive outcomes
Focus areas of the EAP are used:
• Curriculum (including disability specific curriculum)
• Communication
• Social participation/ emotional well being (including behaviour)
• Health and personal care
• Safety
• Learning access and the environment
The school team comments on the activity limitations and participation
restrictions resulting from the hearing loss
using information obtained from discussions with
the parent and teacher of the deaf
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16. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Reporting on activity limitation and
participation restriction
Consider the primary impairment:
• Direct impact of hearing impairment – participation in classroom
activities, access to the spoken language and the curriculum,
communication restrictions
Consider any secondary impairment:
• Speech and language impairment occurring as a result of hearing
impairment
• Associated learning and other difficulties
• Social or emotional difficulties
‘Impairments may result in other impairments' - ICF
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17. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Hearing in the classroom
• Detection *Noise and
• Discrimination Reverberation
• Identification
• Comprehension *Distance
• Attention *Direction
• Effort/ fatigue *Group size
• Speaker variables
• Technology, media
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sounds
syllables
words
phrases
messages

18. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
The (hearing impaired) student may not know that
s/he has not heard or misheard:
• may not be able to hear enough to make sense of
what is said
• may think they have understood fully and not realise
that they have missed out on important information
• may misunderstand what is said or written
You don’t always know what you don’t know
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19. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
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It is not always possible to observe when a student
has not heard or has misheard in the classroom

20. Verification Reviews and
Removal from Category

21. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Review of HI Verification
• No mandatory review for permanent hearing losses
• Review required for:
• mild hearing loss
• fluctuating conductive hearing loss
• permanent conductive hearing loss where
medical intervention occurs
• Review and date of review determined by the verifier
Removal from HI category
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22. Identification of students with
hearing impairment in school
communities with a high
incidence of CHL: OM

23. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
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– Second level
• Third level
– Fourth level
» Fifth level
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education adjustment program Department of Education, Training and the Arts
Identification and Support for students in
schools with High Incidence of Otitis Media
Current external verification process not appropriate for
identifying high incidences of CHL:OM in indigenous
populations
– Problems collecting information to fit verification criteria
– Under-reporting of CHL:OM through verification process compared
with prevalence (1.46% of indigenous students verified HI)
– Verification is suited to low incidence disability
– Resource intensive
– Match identification and support: The Whole School
Approach
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24. education adjustment program Department of Education, Training and the Arts
education adjustment program Department of Education, Training and the Arts
Verification Review Recommendations:
Conductive Hearing Loss: Otitis Media
Students in school communities with a high incidence of CHL: OM:
That DETA investigate methods of identification for whole schools with high
incidences of CHL: OM, rather than individually identifying and supporting
students through the EAP process. This process would be developed in
consultation with local communities with the aim of becoming an integrated
identification and service delivery model, to be implemented within a cost-
neutral framework.
Students with CHL: OM experiencing educational impact requiring individual support
and intervention greater than the general school population to be submitted for
verification on an individual basis.
Students with a hearing impairment not identified as CHL: OM to be submitted to
verification on an individual basis even though they are attending an identified
school with a high incidence of CHL: OM
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25. education adjustment program Department of Education, Training and the Arts
Contact Details
Joy.MacDougall@deta.qld.gov.au
• For HI specific verification questions
– Ph: 3240 9312 (Monday, Tuesday, Friday)
• For general verification questions
– Ph: 3240 9348 (Jeannie Grace)
– Fax: 3240 9300
• EAP Verification Team
141 Merton Rd
WOOLLOONGABBA Q 4102