Types and Identification of learners with difficulty in Seeing and Hearing

1. Types, Characteristics,
and Identification of
Learners with Difficulty
Seeing and Hearing

2. Intended Learning Outcome
 Characterize the different types of learners
with difficulty seeing and hearing.

3. “LEARNERS WITH DIFFICULTY
SEEING”

4. Terms and Definitions:
 Visual Acuity– refers to the ability to distinguish
forms or discriminate among details
 Legal Blindness- having a visual acuity of 20/200
or less in the better eye
- vision restricted to an area no greater
than 20 degrees

5.  Partially Sighted- individuals who has visual
acuity in the better eye after correction falls
between 20/70 and 20/200.
 Tunnel Vision- condition of having a perception of
viewing the world through a narrow tube

6.  Visual impairment - in educational perspective, means
having impairment in vision that even with correction
adversely affect a learner’s educational performance
 Total Blindness- refers to receiving no useful information
through the sense of vision
- in this case, a learner uses tactile and auditory senses for
learning
 Functional Blindness- means having so little vision that one
learns primarily through the tactile and auditory senses.

7. Characteristics of Learners with
Difficulty Seeing
I. Cognition and Language
 Learners with difficulty seeing perform poorly in terms of
cognitive tasks that requires comprehension or relating
various kinds of information
 It’s more difficult for them to see and understand
relationships among various experiences
II. Motor Development and Mobility
 -Blindness may result to delays and deficits and motor
development
 -a child with vision problems may experience painful
contact with environment

8. III. Social Adjustment and Interaction
 Children with visual impairment may engage in less play
which could affect their social skills development
 In adults, having visual impairment may increase social
isolation
 Their condition keeps them from benefitting from role
models due to their inability to observe them.
 Its difficult for them to see and respond to social signal of
others

9. Stereotypic Behavior- are prone to develop in persons
with visual impairment
 -repetitive body movements may call negative attention
to other people and can make socialization hard

10. TYPES AND CAUSES OF
VISUAL IMPAIRMENT

11.  Amblyopia – Reduction or loss of vision in the weaker eye
from lack of use
Remarks and Implications :
Close work may result in eye fatigue, loss of place, or poor
concentration. Seating should favour the functional eye

12.  Astigmatism- distorted or blurred vision caused
by irregularities in the cornea and other surfaces
of the eye
Remarks and Implications:
Avoid long periods of reading or close tasks that
cause discomfort, child may complain of headaches
and fluctuating vision

13.  Cortical Visual Impairment (CVI)-impaired vision caused by
damage to or malfunction of the visual cortex or optic nerve
-many children with CVI have additional disabilities such as cerebral
palsy, seizure disorders, or intellectual disabilities
Remarks and Implications:
-some children with CVI use their peripheral vision, some are
photophobic, some are attracted to bright light, may fail to blink at
threatening motions

14.  Hyperopia (farsightedness)- difficulty seeing near objects
clearly but able to focus on distant objects
Remarks and Implications:
Loss of Accomodation when objects are brought close to the
face
-Avoid long periods of reading or close tasks that cause
discomfort

15.  Muscular Degeneration- central area of the retina gradually
deteriorates causing loss of clear vision in the center of the visual
field
Remarks and Implications:
Tasks such as reading and writing are difficult
Prescribe low vision aid, provide good illumination, avoid glare

16.  Myopia (nearsightedness)- distant objects are blurred or
not seen at all but near objects are seen clearly
Remarks and Implications:
Encourage child to wear prescribed glasses or contact
lenses
Child may be comfortable without glasses and bringing work
close to face

17.  Nystagmus- Rapid, involuntary, back-and-forth movement of
the eyes makes it difficult to focus on objects
Remarks and Implications:
Close tasks for extended period can lead to fatigue. Some
children turn or tilt head to obtain the best focus; do not
criticize

18.  Strabismus- inability to focus on the same object with
both eyes because of an inward or outward deviation of
one or both eyes
Remarks and Implications:
Classroom seating should favour student’s stronger eye
Frequent rest period may be needed during close work

19. IDENTIFYING LEARNERS
WITH DIFFICULTY SEEING

20. EYE APPEARANCE:
 Turning of eye in or out anytime
 Reddening of eyes or eyelids
 Excessive tearing of eyes
 Encrusted eyelids
 Frequently developing stye on lids
 Frequently complaining doing desk works
 Feeling nauseous or dizzy
 Blurring vision after a short time

21.  BEHAVIORAL SIGNS
 deficits in eye movement abilities (ocular motility)
 Turning of head as one reads across the page
 Frequently losing place during reading
 Needing the use of finger or marker to keep place on
what is being read
 Short attention span in copying or reading
 Frequent omission of words
 Writing uphill or downhill direction on paper
 Rereading or skipping lines without being aware of it
 Poor page orientation of drawings

22.  Dysfunction in eye teaming (binocularity)
 Complaining of having double vision
 Repeating of letters within words
 Omission of numbers, letters, or phrases
 Misalignment of digits in number columns
 Frequent squinting
 The need to close or cover one eye to see better
 Extreme tilting of head during desk work
 Consistent gross postural deviations when doing
desk work

24. Other behavioural Indicators:
 Deficits in eye-hand coordination abilities
 The need to feel things to assist in any interpretation required
 Not using the eyes to “steer” hand movements
 Handwriting that is crooked, poorly spaced
 Inability to keep alignment of both horizontal and vertical series
of numbers
 Using hands or fingers to keep place on the page
 Using the other hand as “spacer” in order to keep space and
alignment
 Repeatedly getting confused with left-right direction

25.  PROBLEMS IN VISUAL PERCEPTION
 Errors in words with similar beginnings
 Failure to recognize same words in subsequent sentences
 Reversal of letters or words in writing and copying
 Confusion with likenesses and minor differences
 Confusion with similar beginnings and endings of words
 Failure to visualize what is read
 Whispering to oneself for reinforcement while reading
silently
 Regressing to ‘drawing with fingers’ to decide likes and
differences

26.  PROBLEMS WITH REFRACTIVE STATUS(farsightedness,
nearsightedness, etc.)
 Diminished comprehension as once continues to read
 Mispronouncing similar words as one continues reading
 Excessive blinking when doing desk work and/or reading
 Holding book too closely
 Avoiding possible near centered tasks
 Complaints tasks that demand visual interpretation
 Closing or covering one eye when reading or doing desk work
 Making errors in copying from the board
 Squinting to see the board or requesting to move closer
 Constant rubbing of eyes when doing visual activities
 Easily fatigued when doing visual activities

27. The Snellen Chart
 Used to test visual acuity
 Develop by a Dutch Opthalmologist in 1962 and
still widely used in measuring visual acuity today

29. The Vision Services Severity Rating
Scale
(VSSRS)
 Developed by the Michigan Department of
Education (2013) in order to assist the Teacher
Consultant for the Visually Impaired (TCVI) in
making recommendations for services to students
who are blind or visually impaired

30. “LEARNERS WITH DIFFICULTY
HEARING”

31. Terms and Definitions:
 Deafness- defined as severe hearing loss in that the learner is
impaired in processing linguistic information through hearing
which negatively affects a learner’s educational performance.
 Hearing Loss- pertains to loss in hearing whether permanent or
fluctuating
 Residual Hearing- refers to some sounds perceived by most deaf
people
 Hard of hearing- people who can use their hearing to understand
speech generally with the help of hearing aid
 Deaf Culture- prefers terms such as Teacher of the Deaf, School
for the Deaf, and Deaf Person

32.  Decibels (dB)- refers to the intensity or loudness
of sound.
 Zero hearing threshold level- the smallest sound
a person with normal hearing can perceive (also
called as the audiometric zero)
 Hertz- pertains to the frequency or pitch of sound

34. CHARACTERISTICS OF
LEARNERS WITH
DIFFICULTY HEARING

35.  LITERACY
 Have smaller vocabularies compared to people with
normal hearing
 Learn more concrete words easily than abstract ones
 Have difficulty with function words such as linking verbs,
articles etc.
 Tendency to omit word endings
 Difficulty in learning words with multiple meanings
 Encounter problems in differentiating questions from
statements, and understanding and writing sentences in
passive voice.

36.  SPEAKING
 Cannot hear their own voice which makes it difficult to
asses and monitor
 Tends to speak loudly or not loudly enough
 Have problems in terms of having abnormally high pitch or
improper stress or inflection
 ACADEMIC ACHIEVEMENT
 Performs poorly than their peers with normal hearing
 Note that academic performance does not equate to
intelligence
 Some students with difficulty hearing excel in their
studies (Hellen Keller)

37.  Helen Adams Keller was an
American author, disability rights
advocate, political activist and
lecturer.
 Born in West Tuscumbia, Alabama,
she lost her sight and her hearing
after a bout of illness at the age of
19 months.
 She then communicated primarily
using home signs until the age of
seven, when she met her first
teacher and life-long companion
Anne Sullivan.
 Sullivan taught Keller language,
including reading and writing. After
an education at both specialist and
mainstream schools,
 Keller attended Radcliffe College
of Harvard University and became
the first deafblind person to earn a
Bachelor of Arts degree.

38.  SOCIAL FUNCTIONING
 Hearing loss may result to feelings of isolation,
having no friends, and unhappiness in school
 Learners with difficulty hearing are more likely to
have behavioural difficulties

39. TYPES AND CAUSES OF HEARING LOSS
 Conductive Hearing Impairment-
 Involves a problem with the conduction or hearing
transmission of sound vibration to the inner ear
 Sensory Hearing Impairment
 Refers to damage to the cochlea
 Neural Hearing Impairment
 Refers to the abnormality of the auditory nerve pathway
 Mixed Hearing Impairment
 Refers to any combination of conductive, sensory, and
neural hearing loss

40.  Unilateral Hearing Loss- hearing loss in one ear
 Bilateral Hearing Loss- hearing loss in both ears
 Congenital Hearing Loss- hearing loss present at
birth
 Acquired Hearing Loss- hearing loss that
developed after birth
 Prelingual Hearing Loss- hearing loss before the
development of spoken language
 Post lingual Hearing Loss- hearing loss happened
after the development of spoken language

41. CLASSIFICATION OF HEARING LOSS
Degree of Hearing Loss: 27 to 40dB
Classification: Slight
 Impact on Speech and Language
 No difficulty understanding speech in quiet
settings but noisy environments pose problems to
learning
 May benefit from favorable setting and sound
field amplification

42. Degree of Hearing Loss: 41 to 55dB
Classification: Mild
 Can understand face to face conversation with
little difficulty
 Misses much of classroom discussion
 May have some classmates who are unaware
he/she has a hearing loss
 Benefits from a hearing aid
 Most benefit from speech and language assistance
from a speech-language pathologist

43. Degree of Hearing Loss: 56 to 70 dB
Classification: Moderate
 Without hearing aid can hear conversational
speech only if it is near, loud, and clear
 Finds it extremely difficult to follow group
discussions
 Full time amplification is necessary
 Speech noticeably impaired but intelligible
 Many benefit from time in a special class where
intensive instruction in language and
communication can be provided

44. Degree of Hearing Loss: 71 to 90dB
Classification: Severe
 Can hear voices if they are very loud and 1 foot or less from the
ear
 Wears a hearing aid but is unclear how much it helps
 Can hear loud sounds such as slamming door, vacuum cleaner, and
airplane flying overhead
 May distinguish most vowel sounds but few if any cosonants
 Communicates by speech and sign
 May split school day between a special class and a general
education classroom with an educational interpreter

45. Degree of Hearing Loss: 91 dB or more
Classification: Profound
 Cannot hear conversational speech
 Hearing aid enables awareness of certain very
loud sounds such as bass drum
 Vision is primary modality in learning
 American Sign language likely to be the first
language and principal means of communication
 Has not develop intelligible speech
 Most require full-time special education program
for students who are deaf

46. IDENTIFYING LEARNERS
WITH DIFFICULTY HEARING

47.  SPEECH PROBLEMS
 Inability to say words correctly, delays in language
learning and communication, and opting to use non
verbal gestures over verbal communication
 a lisp is usually not an indicator of hearing problem
 INNATENTIVENESS
 When a child does not respond when being called
 Child consistently looks confused, is slow to answer,
answers incorrectly, or asks things to be repeated
 If a child looks closely on a persons lips when talking (lip
reading)

48.  INCREASING VOLUME
 Child puts volume on tv, radio, or computer too
high
 Speaks louder than most children
 NOT FOLLOWING DIRECTIONS
 -confused by directions, find it difficult to follow
directions
 Consistently asks for instructions to be repeated
 Trouble expressing themselves

49.  LEARNING DIFFICULTIES
 Student does not pay attention, does not listen, does
not follow instructions
 Difficulty in learning vocabulary, grammar, word order,
and idiomatic expressions
 SOCIAL WITHDRAWAL
 -avoids social situations and participate in social
activities like sports, parties, or family gatherings
 -difficulty in explaining their situation to others

50. ASSESMENT OF HEARING LOSS
 Assessment of Infants.
 EXPECTED AUDITORY BEHAVIORS DURING THE
FIRST YEAR
 Birth To 3 Months
 Startles to Loud Noises
 Coos and makes pleasurable gurgling sounds
 Turns to Voices
 Quiet downs or smiles when spoken to
 Stirs or awakens from sleep to a loud sound
relatively close

51. 4 TO 6 MONTHS
 Engages in vocal play when alone, gurgles
 Babbles with speech like sounds
 Turns eye toward direction of sound
 Notice Toys that make sounds
 Laughs and chuckles

52.  7 months to 1 year
 Responds differently to a cheerful voice versus an angry
voice
 Responds to music or singing
 Vocalizes emotions
 Babbling acquires inflection and contains short and long
groups of speech sounds (tata,upup,bibibi)
 Tries to imitate speech sounds of others
 Turns head in the direction of the source of sound
 Ceases Activity when parent’s voice is heard
 Responds to own name and requests such as want more or
come here
 Uses a few words (mama, dada, doggie) by first birthday

53. ASSESMENT OF HEARING LOSS
 Pure Tone Audiometry – used to assess hearing of older children
 Audiometer-an electronic device that generates pure sound
 Speech Reception Test
 -tests a person’s detection and understanding of speech sounds
 Alternative Audiometric Techniques
 Includes Play Audiometry which the child is taught to perform
simple but distinctive activities whenever one hears the signal
speech
 Operant Conditioning Audiometry
 Child receives token when a button is pushed in the presence of
light paired with sound

54. Thank you and
GODBLESS! 