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Chapter Twelve
Individuals With
Hearing Impairments
• https://www.youtube.com/watch?v=-
3jmo14zZDo
• https://www.youtube.com/watch?v=pcGz7uwnPr
s
• https://www.youtube.com/watch?v=RTOjcIR_MU
Q
• https://www.youtube.com/watch?v=ln8NHzVfJk
Q
• https://www.youtube.com/watch?v=lc7S_MhqVl
s
Definitions and Concepts in the Field of
Hearing Impairment
• Hearing impairment
‒ Disordered hearing
• Hearing sensitivity loss
‒ Described in range from mild to profound
• Deaf/deafness
‒ Nonfunctional hearing; federal definition refers
to the educational impact due to the hearing loss
• Hard of hearing
‒ Residual hearing ability
• Minimal hearing loss
– Difficultly hearing at a distance or with
background noise
4
The Anatomy
of the Auditory System
The ear is divided into four connected sections:
– Outer ear: The outer ear functions to protect the middle
ear, direct sound into the ear canal, and enhance sound
localization. In addition, the outer ear serves to enhance
the intensity of sounds in the mid-frequency range where
the sound spectrum of speech is located.
– Middle ear: Sound waves travel to the inner ear and cause
vibrations that are converted in energy.
– Inner ear: This energy is transformed into electrical nerve
impulses that are sent to the brain for decoding.
– Central auditory nervous system: transmits energy to the
brain for interpretation.
• SEE PICTURE NEXT SLIDE
5
6
Classifications of Hearing Loss
• Conductive hearing loss
– Sound transmission is blocked in the middle or
outer ear
• Sensorineural hearing loss
– Involves the inner ear (cochlea) and/or the auditory
nerve
• Mixed hearing loss
– Combination of conductive/sensorineural loss
• Central hearing loss
– Dysfunction in the central nervous system
7
Measurement of Hearing Impairments
• Audiogram
• Frequency
• Hertz (Hz)
• Decibels (dB)
• Pure-tone audiometry
8
9
10
Other Types of Hearing Assessment
• Air-conduction audiometry
• Bone-conduction audiometry
• Play audiometry
• Speech audiometry
• Speech recognition threshold (SRT)
• Auditory evoked potentials
• Evoked otoacoustic emissions
• Acoustic inmittance
11
Age of Onset
• Prelingual: present at birth or before speech
onset
• Postlingual: deficit acquired after speech
onset
12
Brief History of the Field
• 1817: First school for students with hearing
impairments (American Asylum for the Education of
the Deaf and Dumb)
• 1864: First college for the hearing impaired (today
named Gallaudet University after Thomas
Gallaudet)
13
Communication Methods
• Manual communication- sign language/finger
spelling
• Oral communication- encouraged use of residual
hearing and speech reading
• Total communication- combination of spoken and
manual communication
Prevalence of Hearing Impairment
• Almost 69,500 students ages 6-21 were
identified as having a hearing impairment and
receiving a special education during the 2011-
2012 school year.
• Approximately 9,300 preschoolers were
receiving a special education due to a hearing
impairment.
• Number of Americans with a hearing loss has
almost doubled in the past 10 years.
15
Etiology of Hearing Impairments
• Genetic/Hereditary factors
– Down syndrome
– Usher syndrome
– Waardenburg syndrome
• Infections
– Cytomegalovirus (CMV), rubella, otitis media
• Developmental abnormalities
– Atresia
• Environmental/traumatic factors
– Loud noise, low birth weight, prescription
medication, head injuries
16
17
Characteristics of Individuals
with Hearing Impairments
– Intelligence: Intelligence is distributed similarly to individuals
without hearing impairments. Intellectual development for
people with a hearing impairment is more a function of
language development than cognitive ability
– Speech and language: Most severely affected area due to a
hearing impairment particularly for children who are born deaf.
Students who cannot hear the sounds of spoken language may
have difficulty learning the meanings associated to the sounds
and also may have difficulty using spoken language because
they lack early experiences with the sounds of language.
– Social development: Social-emotional development relies
heavily on communication skills and children with a hearing loss
hear less auditory information. Children with hearing
impairments may play differently due to a limited ability to
share abstract ideas and often prefer to work with pairs of
children rather than large groups.
18
• Educational achievement: Educational
achievement may be delayed although the
student may have average, or above-average,
intelligence. Reading skills are often delayed
due to limited understanding of sound/word
relationships. Educational environments often
rely on spoken words to transmit information
Assessment of Individuals
with Hearing Impairments
• Cognitive assessment requires the use of non-
verbal assessment measures
• Speech assessment
– Articulation, pitch, loudness, quality, rate
• Personal/social/behavioral assessment
– Social adjustment, self-image, emotional adjustment
20
21
22
23
– Educational Approaches
• Bilingual/bicultural: Considers American Sign Language (ASL)
to be the natural language of the Deaf culture and urges
recognition of ASL as the primary language choice with
English considered a second language
• Total communication: Supports the belief that simultaneous
use of multiple communication techniques enhances an
individual’s ability to communicate, comprehend, and learn
• Auditory-Oral: Supports the belief that children with hearing
impairments can develop listening/receptive language and
oral language expression (English) skills; emphasizes use of
residual hearing (the level of hearing an individual
possesses), amplification (hearing aids, auditory training,
etc.), and speech/language training
Instructional Interventions
• Methods of communication
– Sign language
– Oral
– Cued speech
– Total communication
– Fingerspelling
• Audiologist
• Interpreter
25
26
27
Services for Young Children
with Hearing Impairments
• Importance of early identification
• Early intervention services
• Family support
28
Transition and Individuals
with Hearing Impairments
Transition planning includes:
– Family support
– Higher education
– Employment
– Personal, social, community adjustment
29
Services for Adults with Hearing
Impairments
• State commission or office on deafness
– Advocacy, information sharing, agency
referrals, interpreting services, employment
assistance
• State vocational rehabilitation services
– Employment services
• National Association for the Deaf
– Political advocacy, information sharing
• Alexander Graham Bell Association
– Clearinghouse for materials and information
30
Family Issues
• Most children with hearing impairments have
hearing parents
• Acceptance of the disability
• Family relationships
31
Issues of Diversity
• People who identify with the Deaf culture are
proud of their heritage including their
language, history, values, and literature
‒ The term Deaf (with a capital D) refers to
individuals who identify with the Deaf culture
‒ The term deaf (lowercase d) refers to the physical
condition
‒ Deaf culture considers American Sign Language
(ASL) to be the natural language of the Deaf
culture and urges recognition of ASL as the
primary language choice with English considered a
second language
32
Issues of Diversity
• 49% of all students in programs for the deaf and hearing
impaired are from culturally diverse groups
• Research is needed to address the needs of students with
hearing impairments who come from non-English speaking
families
Technology and Individuals with Hearing
Impairments
• Hearing aids
• Auditory training devices
• Computers
• Alerting devices
• Captioning
• Telecommunication devices
• Cochlear implants
34
35
Trends, Issues, and Controversies
• Appropriate educational methods
• Move from child-centered to family-centered
approach
• Total communication
• Deaf culture
• Full inclusion
36

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Understanding Hearing Impairments

  • 1.
  • 3. • https://www.youtube.com/watch?v=- 3jmo14zZDo • https://www.youtube.com/watch?v=pcGz7uwnPr s • https://www.youtube.com/watch?v=RTOjcIR_MU Q • https://www.youtube.com/watch?v=ln8NHzVfJk Q • https://www.youtube.com/watch?v=lc7S_MhqVl s
  • 4. Definitions and Concepts in the Field of Hearing Impairment • Hearing impairment ‒ Disordered hearing • Hearing sensitivity loss ‒ Described in range from mild to profound • Deaf/deafness ‒ Nonfunctional hearing; federal definition refers to the educational impact due to the hearing loss • Hard of hearing ‒ Residual hearing ability • Minimal hearing loss – Difficultly hearing at a distance or with background noise 4
  • 5. The Anatomy of the Auditory System The ear is divided into four connected sections: – Outer ear: The outer ear functions to protect the middle ear, direct sound into the ear canal, and enhance sound localization. In addition, the outer ear serves to enhance the intensity of sounds in the mid-frequency range where the sound spectrum of speech is located. – Middle ear: Sound waves travel to the inner ear and cause vibrations that are converted in energy. – Inner ear: This energy is transformed into electrical nerve impulses that are sent to the brain for decoding. – Central auditory nervous system: transmits energy to the brain for interpretation. • SEE PICTURE NEXT SLIDE 5
  • 6. 6
  • 7. Classifications of Hearing Loss • Conductive hearing loss – Sound transmission is blocked in the middle or outer ear • Sensorineural hearing loss – Involves the inner ear (cochlea) and/or the auditory nerve • Mixed hearing loss – Combination of conductive/sensorineural loss • Central hearing loss – Dysfunction in the central nervous system 7
  • 8. Measurement of Hearing Impairments • Audiogram • Frequency • Hertz (Hz) • Decibels (dB) • Pure-tone audiometry 8
  • 9. 9
  • 10. 10
  • 11. Other Types of Hearing Assessment • Air-conduction audiometry • Bone-conduction audiometry • Play audiometry • Speech audiometry • Speech recognition threshold (SRT) • Auditory evoked potentials • Evoked otoacoustic emissions • Acoustic inmittance 11
  • 12. Age of Onset • Prelingual: present at birth or before speech onset • Postlingual: deficit acquired after speech onset 12
  • 13. Brief History of the Field • 1817: First school for students with hearing impairments (American Asylum for the Education of the Deaf and Dumb) • 1864: First college for the hearing impaired (today named Gallaudet University after Thomas Gallaudet) 13
  • 14. Communication Methods • Manual communication- sign language/finger spelling • Oral communication- encouraged use of residual hearing and speech reading • Total communication- combination of spoken and manual communication
  • 15. Prevalence of Hearing Impairment • Almost 69,500 students ages 6-21 were identified as having a hearing impairment and receiving a special education during the 2011- 2012 school year. • Approximately 9,300 preschoolers were receiving a special education due to a hearing impairment. • Number of Americans with a hearing loss has almost doubled in the past 10 years. 15
  • 16. Etiology of Hearing Impairments • Genetic/Hereditary factors – Down syndrome – Usher syndrome – Waardenburg syndrome • Infections – Cytomegalovirus (CMV), rubella, otitis media • Developmental abnormalities – Atresia • Environmental/traumatic factors – Loud noise, low birth weight, prescription medication, head injuries 16
  • 17. 17
  • 18. Characteristics of Individuals with Hearing Impairments – Intelligence: Intelligence is distributed similarly to individuals without hearing impairments. Intellectual development for people with a hearing impairment is more a function of language development than cognitive ability – Speech and language: Most severely affected area due to a hearing impairment particularly for children who are born deaf. Students who cannot hear the sounds of spoken language may have difficulty learning the meanings associated to the sounds and also may have difficulty using spoken language because they lack early experiences with the sounds of language. – Social development: Social-emotional development relies heavily on communication skills and children with a hearing loss hear less auditory information. Children with hearing impairments may play differently due to a limited ability to share abstract ideas and often prefer to work with pairs of children rather than large groups. 18
  • 19. • Educational achievement: Educational achievement may be delayed although the student may have average, or above-average, intelligence. Reading skills are often delayed due to limited understanding of sound/word relationships. Educational environments often rely on spoken words to transmit information
  • 20. Assessment of Individuals with Hearing Impairments • Cognitive assessment requires the use of non- verbal assessment measures • Speech assessment – Articulation, pitch, loudness, quality, rate • Personal/social/behavioral assessment – Social adjustment, self-image, emotional adjustment 20
  • 21. 21
  • 22. 22
  • 23. 23
  • 24. – Educational Approaches • Bilingual/bicultural: Considers American Sign Language (ASL) to be the natural language of the Deaf culture and urges recognition of ASL as the primary language choice with English considered a second language • Total communication: Supports the belief that simultaneous use of multiple communication techniques enhances an individual’s ability to communicate, comprehend, and learn • Auditory-Oral: Supports the belief that children with hearing impairments can develop listening/receptive language and oral language expression (English) skills; emphasizes use of residual hearing (the level of hearing an individual possesses), amplification (hearing aids, auditory training, etc.), and speech/language training
  • 25. Instructional Interventions • Methods of communication – Sign language – Oral – Cued speech – Total communication – Fingerspelling • Audiologist • Interpreter 25
  • 26. 26
  • 27. 27
  • 28. Services for Young Children with Hearing Impairments • Importance of early identification • Early intervention services • Family support 28
  • 29. Transition and Individuals with Hearing Impairments Transition planning includes: – Family support – Higher education – Employment – Personal, social, community adjustment 29
  • 30. Services for Adults with Hearing Impairments • State commission or office on deafness – Advocacy, information sharing, agency referrals, interpreting services, employment assistance • State vocational rehabilitation services – Employment services • National Association for the Deaf – Political advocacy, information sharing • Alexander Graham Bell Association – Clearinghouse for materials and information 30
  • 31. Family Issues • Most children with hearing impairments have hearing parents • Acceptance of the disability • Family relationships 31
  • 32. Issues of Diversity • People who identify with the Deaf culture are proud of their heritage including their language, history, values, and literature ‒ The term Deaf (with a capital D) refers to individuals who identify with the Deaf culture ‒ The term deaf (lowercase d) refers to the physical condition ‒ Deaf culture considers American Sign Language (ASL) to be the natural language of the Deaf culture and urges recognition of ASL as the primary language choice with English considered a second language 32
  • 33. Issues of Diversity • 49% of all students in programs for the deaf and hearing impaired are from culturally diverse groups • Research is needed to address the needs of students with hearing impairments who come from non-English speaking families
  • 34. Technology and Individuals with Hearing Impairments • Hearing aids • Auditory training devices • Computers • Alerting devices • Captioning • Telecommunication devices • Cochlear implants 34
  • 35. 35
  • 36. Trends, Issues, and Controversies • Appropriate educational methods • Move from child-centered to family-centered approach • Total communication • Deaf culture • Full inclusion 36