Understanding Hearing Impairment

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The Basics of Hearing Impairment: Learning

CharacteristicsDealing with a Hearing Impaired Student in an

Inclusive ClassroomPractical Teaching

Strategies

Communicating with the H.I.

Training Outline

MODULE 1

Understanding Hearing Impairment:Myths and Facts of

Hearing Impairment

Over 5% of the world’s population – 360 million people – has disabling

hearing loss.

Living with hearing loss is not a big deal.

If someone has a hearing impairment, he’d certainly know

about it

Deaf people are good lipreaders.

Hearing aids can restore hearing.

Sign Language is a universal or

international language.

If I shout, the deaf person can understand

me more clearly.

The deaf sometimes seem to hear me only when they feel like it.

People who are deaf lead totally different lives

than other people

Noise is a major avoidable cause of

hearing loss

People who are deaf cannot appreciate the

arts because they can’t hear music, movies.

People who are deaf are less intelligent.

All people who are deaf use sign language to

communicate

Gradual hearing loss can affect people of all ages .

Over 5% of the world’s population – 360 million people – has disabling

hearing loss.

Living with hearing loss is not a big deal.

If someone has a hearing impairment, he’d certainly know

about it

Deaf people are good lipreaders.

Hearing aids can restore hearing.

Sign Language is a universal or

international language.

If I shout, the deaf person can understand

me more clearly.

The deaf sometimes seem to hear me only when they feel like it.

People who are deaf lead totally different lives

than other people

All people who are deaf are mute.

Noise is a major avoidable cause of

hearing loss

People who are deaf cannot appreciate the

arts because they can’t hear music, movies.

People who are deaf are less intelligent.

All people who are deaf use sign language to

communicate

Gradual hearing loss can affect people of all ages .

HEARING IMPAIRMENT

There are 360 million persons in the world with disabling hearing loss

DATA: PREVALENCE

This is 5.3% of the world’s population - 32 million of these are children. Disabling hearing loss is defined as:• adults (15 years and older):

hearing loss greater than 40 dB in the better hearing ear;

• children (0 – 14 years of age): hearing loss greater than 30 dB in the better hearing ear.

• Approximately 0.5-5 of every 1000 infants are born with or develop in early childhood disabling hearing loss

• Early detection and management is important in providing appropriate support for deaf and hearing-impaired babies that will help them enjoy equal opportunities in society.

DATA: PREVALENCE

• Nearly one out of every three persons over 65 are affected by hearing loss.

• Age-related hearing loss can be managed effectively through a variety of means, including hearing aids

DATA: PREVALENCE

HEARING IMPAIRMENT AND DEAFNESS

• A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 25dB or better in both ears – is said to have hearing loss.

• ‘Hard of hearing’ refers to people with hearing loss ranging from mild to severe.

• ‘Deaf’ people mostly have profound hearing loss, which implies very little or no hearing.

•deaf- audiological condition of not hearing.

•Deaf – particular group of people who share a language and culture

CLASSIFICATION OF H.I.

1. According to the age at onset of deafness

• Congenitally deaf – born deaf

• Adventitiously deaf – born with normal hearing and became deaf through accident/illness

2. According to language development

• Prelingually deaf – born deaf oer lost hearing before speech and language were developed

• Post lingually deaf- lost hearing after development of spontaneous speech and language

Classification

3. According to place of impairment

• conductive hearing loss – hearing loss due to the interference in the transmission of sound to and through the sense organ (outer or middle ear)

• Sensory-neural hearing loss – due to the abnormality of the inner ear or the auditory nerve, or both

• mixed hearing loss - combination of both; sometimes called a flat loss

Classification

4. According to degree of hearing loss

Classification Degree of Hearing Loss

Slight 27-40 dB

Mild 41-55 dB

Moderate 56-70 dB

Severe 71-90 dB

Profound 91 dB or more

CAUSES OF HEARING LOSS

• The causes of hearing loss and deafness can be divided into congenital causes and acquired causes

CONGENITAL CAUSES• Congenital causes lead to hearing loss being

present at or acquired soon after birth. • Hearing loss can be caused by hereditary and

non-hereditary genetic factors or by certain complications during pregnancy and childbirth, including:• maternal rubella, syphilis or certain other

infections during pregnancy;• low birth weight;• birth asphyxia (a lack of oxygen at the time

of birth);• inappropriate use of ototoxic drugs during

pregnancy; and• severe jaundice in the neonatal period,

which can damage the hearing nerve in a newborn infant.

ACQUIRED CAUSES• Infectious diseases• Chronic ear infection• Collection of fluid in the ear (otitis media) can cause hearing

loss. • Use of ototoxic drugs at any age, such as some antibiotic and

antimalarial medicines for example, can damage the inner ear. • Head injury or injury to the ear can cause hearing loss.• Excessive noise• Age-related hearing loss (presbycusis) is caused by

degeneration of sensory cells. • Wax or foreign bodies blocking the ear canal

Among children, chronic otitis media is the leading cause of hearing loss.

Half of all cases of hearing loss are avoidable through primary

prevention.

PRIMARY PREVENTION

• Immunization• Early screening and treatment• Improving antenatal and perinatal

care• Referring babies with high risk

factors • Reducing exposure (both

occupational and recreational) to loud noises

• Healthy ear and hearing care practices

ASSESSMENT OF HEARING LOSS

In the absence of an AUDIOMETER, the following simple tests may be administered:

• Noise Maker Test • Whisper Test

• Calling Name Test

• Watch-Tick Test

• Ballpen-Click Test

• Command Test

Significant Observations1. Watches face, especially the mouth of the

speaker when talked to

2. Makes use of more natural gestures, signs, movements to express himself

3. Shows strained expression when listening

4. Cocks ear/tilts head at an angle towards the source of the sound

5. Pays more attention to vibration and vibrating objects

6. Often asks for repetition of questions or statements

Assessment-observations7. Fails to respond immediately

8. Has blank facial expression when talked to

9. Often unable to follow oral directions/instructions

10. Is less responsive to noise, voice or music

11. Shows marked imitativeness at work/play

12. Has difficulty associating concrete with abstract ideas

13. Has poor general learning performance

MODULE 2

Understanding Hearing Impairment:

Learning Characteristics

IMPACT OF HEARING LOSS

“ Hearing impairment is not only the handicap of not being able to hear. It encompasses

emotional problems, problems in socialization, in learning

disabilities…”

Helen Keller says…

“ The problems of deafness are deeper and more complex. It is a much

worse misfortune for it means the loss of the most vital stimulus, the sound of voice, that brings language,

sets thoughts astir and keeps us in the company of

man. “

Vocabulary Deficits

• May see a word but not be able to understand its meaning

• Vocabulary develops more slowly in children who have hearing loss. The gap between the vocabulary of children with normal hearing and those with hearing loss widens with age

Improper use of words and their meanings

• Difficulties with figurative language (such as alliteration, similes, metaphors, personification, and idioms)

• Difficulty understanding abstract concepts

• Has difficulty with concepts of time, space, quantity, size, and measurement

• Word knowledge may be below expectancy

Asks questions and/or responds inappropriately

• Is slow to respond during verbal interaction or following verbal cues• may also closely watch

their peers to emulate behavior and body language (echopraxia)

Inappropriate use of grammar when talking or writing

Teacher, Why no class? Have sun. PAGASA said typhoon where?

• Has problems understanding rules and patterns for sentence formation

• Grammar follows different syntax and order

Has difficulty breaking words into sounds and syllable

• Poor spelling skills• Has problems understanding rules and

patterns for word formation• Word substitutions may occur frequently in reading and writing HonseBananaAppelBirtday

May isolate themselves from social situations

• Hesitates or refuses to participate in activities where speaking is required

• Is inattentive and has difficulty with concentration

• May not initiate or maintain eye contact • May become easily frustrated

IMPACT OF HEARING LOSS

1. It causes delay in the development of receptive and expressive communication skills (speech and language).

2. The language deficit causes learning problems that result in reduced academic achievement.

3. Communication difficulties often lead to social isolation and poor self-concept.

MODULE 3

HOW DO DEAF CHILDREN DEVELOP

CONCEPTS?

Deaf people are VISUAL learners

Eye Movement

Jumps (saccade

s)Jumps

(saccades) Pauses

(Fixations)Pauses

(Fixations)

Take in important visual information

Regressive- to check/confirm

Help children become more rapid and automatic in unlocking the meaning of words

TEACHER’S CHALLENGE:

Enrich the child’s language “experience”.

TEACHER’S CHALLENGE:

LEVELS OF COMPREHENSION

LITERAL LEVEL-basic facts are understood

INFERENTIAL LEVEL-adds meaning, draws conclusions

CRITICAL LEVEL-assesses the good sense (clarity, accuracy , etc..)

CREATIVE LEVEL-develop new ideas

Factors influencing comprehension

motivation

Reasoning ability

interestsvocabulary

Prior knowledgeskills

In text Supports for vocabulary building

Semantic Cues: cues that come from the meaning of what we are reading (contextual)

Syntactic cues: cues that enable us to draw upon our own experience of language

MODULE 4

Communicating with the Deaf

I CANI can live, I can love

I can reach the heaven’s above

I can right what is wrong, I can sing just any song

I can dance, I can fly

And touch the rainbow in the sky

I can be your good friend

I can love you until the end.

What took you so long to make me feel

I can give love, a love so real

What took you so long to let me know

What took you so long to make me see

How lucky I am cause I am free

Free to do the things I want to be

The Sign Language Continuum

1. Non-verbal Communication

-natural gestures, mimes, facial expressions

- used by Deaf without formal education

2. Sign Language

-concept-oriented

- syntax: most important concept first

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3. Signed English

- follows English syntax

- used by hearing persons who learned sign language

4. Finger Spelling

- letters of the alphabet thru hand signs

5.Simultaneous Method

- speech in conjunction with manual communication

The Nature of the Language of Signs

1. It is a language of natural gestures and pantomimes

2. Signs are made within the signing area: top of the head and just above the waist

3. The sight-line is an imaginary line between the signer and the observer

4. The body of the signer greatly aids in manual signs (ex: tenses, tone, gender)

5. When the basic sign is initialized, it attains a special meaning

Nature of Signs

6. Reduplication of signs denotes plurality or continuous action

7. Signs are directional

8. Synonyms are signed lightly or forcefully according to the intent of the word

9. Antonyms are signed mostly in reverse of the synonym

10.Very large signs are equivalent to shouting

Conduct in Communicating By Signs

1. Get the deaf person’s attention before signing

2. Keep your hands and face toward the deaf person with whom you are speaking

3. Keep your signs and finger spelling smooth and flowing with appropriate pauses and rhythm

4. Adjust your signs and finger spelling within the language level of the deaf with whom you are conversing

Conduct

5. Put across the proper amount of facial expressions, body movements and emphasis

6. Don’t get upset or confused when you find that there are multiple variations in a given sign

7. Be patient with the deaf when their signs appear to be brutally frank in their expressions.

8. Enjoy signing!

Conduct

5. Put across the proper amount of facial expressions, body movements and emphasis

6. Don’t get upset or confused when you find that there are multiple variations in a given sign

7. Be patient with the deaf when their signs appear to be brutally frank in their expressions.

8. Enjoy signing!

“Children with a hearing loss are normal children who do not

hear well. Though this handicap may have a profound

effect on their overall development, they develop

ways to compensate and may sometimes have a unique way of assimilating what they see

and learn…

So don’t forget to enjoy your teaching experience. And by

the end of the school year, you will have made a friend for

life.”

-Amanda Mangiardi, SPED Teacher