Download Severity of Hearing Loss

Severity of Hearing Loss
Mild – At 15dB – can miss up
to 10% of speech signal if
more than 3 feet away
At 30dB – can miss 25-40% of
speech signal
AT 35-40dB(unaided) – can
miss up to 50% of class
discussions
Moderate
– At 40dB(unaided)Can miss 50-75% of
conversation unless standing
3-5 feet away (face-to-face)
At 50dB(unaided) – can miss
up to 100% of the
conversation (Speech and
language are most likely to
be affected with this type
of loss)
Impact of Deafness
Moderate/Severe
– Without
amplification, conversation
must be very loud to be
understood. At 55dB a
person can miss all of the
speech information. A
student may exhibit delayed
language abilities and have
difficulty with school
situations requiring verbal
communication
Severe
– A person may hear loud
voices a foot away from the
ear. If there is
appropriate amplification at
90dB or better then
environmental sounds and all
speech sounds should be
detectable. If the hearing
loss is prelingual then oral
speech and language may have
not developed spontaneously
and may be delayed.
Impact of Deafness
Profound
– A person with a loss
in this range would be aware
of vibrations and rely on
visual information for
communication and learning.
Detection of speech may be
dependent on type of loss
and amplification. Speech
and language will not
develop spontaneously.
Unilateral
– (One ear with
normal hearing and one with
a permanent, Mild loss)
Difficulty understanding
speech with background
noises and understanding
soft speech on “bad ear”
side in group discussions.
This group is 10 times more
likely to fail a grade (as
cited in Anderson, 1996)
This list compiled from information provided by Karen L. Anderson &
Noel D. Matkin, (1991)
Impact of Deafness
Severity of Hearing Loss
Normal
0 – 19dB
Mild
20 – 40dB
Moderate
41 – 55dB
Moderately/
Severe
56 – 70dB
Severe
71 – 90dB
Profound
91dB +
Impact of Deafness
Red Flag Behaviors
™ Appears to not be paying attention
™ Requests repetition frequently
™ Hears inconsistently
™ Has speech, language, or voice
problems
™ Has allergies, frequent colds or ear
infections
™ Does not use word endings such as
“sh”, “s”, “th”, or “f”
™ Seems to be very visual
Impact of Deafness
Red Flag Behaviors
™ Gives answers unrelated to questions
asked
™ Complains of ear pain or tugs ear
™ Seems to have poor balance
™ Complains that noises are too loud
™ Has short attention span (may not only
be hearing loss)
™ Is easily distractible
™ Appears immature
™ Does not follow oral directions well
Impact of Deafness
Red Flag Behaviors
™ Frequently loses place while reading
™ Strains to listen or favors an ear
™ Has inappropriate speaking behavior
™ Concentrates on the faces of those
speaking
This list compiled and adapted from information provided by Barbara Sims 2000
Impact of Deafness
IDEA 300.7
(b) (3) Deafness means a hearing
impairment that is so severe that the
child is impaired in processing
linguistic information through hearing,
with or without amplification, that
adversely affects a child’s educational
performance.
(b) (5) Hearing impairment means an
impairment in hearing, whether
permanent or fluctuating, that
adversely affects a child’s educational
performance but that is not included
under the definition of deafness in this
section.
U.S. Department of Education (1997)
Impact of Deafness
23 Illinois Administrative
Code 226.75
Deafness – A hearing impairment that is
so severe as to impede the processing of
linguistic information through hearing
with or without amplification.
Hearing impairment – An impairment
in hearing, whether permanent or
fluctuating, that is not severe enough
to constitute deafness.
Impact of Deafness
Receptive Language Milestones
•
•
•
•
•
•
Points to one named
body part on request
Follows two step
commands
Follows three step
commands
Understands 200 words
Understands 800 words
Understands about 1500
words
1 year
20 months
2 years
2 years
3 years
4 years
Expressive Language Milestones
•
•
•
•
•
•
Imitates the sounds
of others
Refers to self by name
Says 50 - 200 words
Uses plurals
Speech is 75 - 80%
intelligible
Says 6 - 8 word sentences
1 year
21 months
2 years
2 years
3 years
4 years
Information provided by The Center for Applied Research in Education, 1995
Impact of Deafness
A ge of Identification
in Illinois
Mean Age
25.3 months
Geographic Location
27.9 months
Chicago Area
Downstate IL
22.8 months
Ethnic Origin
Caucasian
Other
23.4 months
30.5 months
Degree of Loss
Moderate
Moderate/Severe
Severe
Profound
40.4
34.5
26.8
16.4
months
months
months
months
Information provided by research completed by Barbara Sims,
1995
Impact of Deafness
Early Intervention
Eligibility
30% delay in one or more areas of
development, based on adjusted age as
measured by a global instrument or a
domain specific instrument
OR
Bilateral sensori-neural hearing
impairment of greater than 40dB
OR
Informed clinical opinion
Impact of Deafness
Effects of Early Identification
and Intervention
ƒ Children with normal cognitive abilities, identified
before 6 months of age, have language levels
comparable to those of their hearing peers.
ƒ Children benefit from early identification
regardless of communication mode, gender,
ethnicity, age, or socioeconomical status.
ƒ Early identification results in better
socioemotional development.
ƒ Identification by age 6 months, followed by
appropriate intervention, is the most effective
strategy for normal language development.
ƒ Only 14% of later-identified children have
language skills at or above those of children
identified before 6 months of age.
Arehart, Kathryn Hoberg & Yoshinage-Itano, Christine. (March 1999). The role of educators
of the deaf in early identification of hearing loss. American Annals of the Deaf. 144(1), p.1923
Impact of Deafness
IEP Considerations
300.346 (a)(2) (iv)
Consider the communication needs
of the child, and in the case of a
child who is deaf or hard of hearing,
consider the child’s language and
communciation needs, opportunities
for direct communication with peers
and professional personnel in the
child’s language and communication
mode, academic level, and full range of
needs, including opportunities for direct
instruction in the child’s language and
communication mode.
Impact of Deafness
Degree of Loss vs.
Language Delay
Degree of Loss
Language Delay
in Years
15-26dB
1.2years
27-40dB
2.0 years
41-55dB
2.9 years
56-70dB
3.5+ years
As cited by Anderson, 1997.
Impact of Deafness
Modes of
Communication
Auditory / Verbal
Oral
Cued Speech
Total Communication
Bilingual / Bicultural
Impact of Deafness
“Unless special measures are taken,
the average deaf child will have only
fifty to sixty words at the age of six,
whereas the average hearing child
has three thousand.”
“If communication goes awry, it
affects the intellectual growth, social
intercourse, language development,
and emotional attitudes, all at once,
simultaneously and inseparable.”
Oliver Sachs
Seeing Voices
Impact of Deafness
“The future of a child born with a
significant hearing impairment depends to
a very large degree on early
identification… If hearing impaired
children are not identified early, it is
difficult, if not impossible, from many of
them to acquire the fundamental language,
social and cognitive skills that provide the
foundation for later schooling and success
in society. When early identification and
intervention occur, hearing impaired
children make dramatic progress, and are
more successful in school, and become
more productive members in society. The
earlier the intervention and habilitation,
the more dramatic the benefits.”
US Dept. of Health &
Human Services
Healthy People 2000
Impact of Deafness
Considerations for
Choosing A
Communication Method
♦ How much time will be
involved?
♦ Is this an appropriate
method for my family?
♦ Can we as parents and
siblings use this method?
♦ Is the child happy or
frustrated learning this
method?
♦ What results can we expect
when using this method?
Impact of Deafness
yths
Fit the child with a hearing aid!
What about a cochlear implant?
A person who is deaf can
read lips, right?
The students have an interpreter
therefore they will succeed!
Impact of Deafness
Tips for Accommodation
™ Take turns speaking
™ Face the person with the hearing
loss
™ Do not cover your face or mouth
when talking
™ Be aware of environmental noises
(air conditioning, overhead fan,
etc.)
™ Be sensitive to visual fatigue
™ Check for understanding (be wary
of the “smile and nod”)
Impact of Deafness
Tips for Accommodation
(Continued)
™ Eliminate excess noise (close
windows, doors, etc.)
™ Stand in the same place. Don’t
move around while teaching
™ Avoid standing with your back to
the window
™ Do not talk while writing on the
board
™ Use videotapes that are captioned
Impact of Deafness
Supplementary Aides & Services
Audiological Services: Testing hearing
acuity & meeting with the audiologist for
information and training
Auditory Training: Teaching a child to
respond and identify specific sounds
Speech & Language Services: Receiving
instruction from therapists trained to work
with speech sounds and language delays
Consultations: Meetings between special
educators and general educators to discuss
optimal teaching strategies
Impact of Deafness
Supplementary Aides & Services
Continued
Curriculum Adaptations
Provide materials beforehand
Assign a notetaker
Assign a student “buddy”
Use an interpreter
Classroom Adaptations
Use signal lights
Use FM systems
Provide hearing aids
View captioned videotapes
Impact of Deafness
Service Delivery System
™ Access to all communication
™ Access to full continuum of
services and placement options
™ Access to a critical mass of peers
™ Access to a professional and
language proficient staff
™ Access to knowledgeable and
supportive administration
Impact of Deafness
“The IEP team has the
responsibility to determine
placement and programming
that “fits” the child, not to
“fit” the child to a particular
program or educational
philosophy”
-- NASDSE
Impact of Deafness
“The major barriers associated
with deafness relate to language
and communication. Many
children who are deaf, unlike
most children who hear, enter the
educational system without a
competent language base.
Learning a language- any
language- is such a complex
process that is not yet fully
understood even by researchers.
We do know, however, that
learning a language requires
interpersonal interaction and
simple communication
-- COED
opportunities.”
1988
Impact of Deafness
“The communication nature of
(hearing loss) is inherently isolating,
with considerable effect on the
interaction with peers and teachers
that make up the educational
process. This interaction, for the
purpose of transmitting knowledge
and developing the child’s selfesteem and identity, is dependent
upon direct communication. Yet,
communication is the area most
hampered between a deaf child and
his or her hearing peers and
teachers.”
U.S. Department
of Education
Federal Register 1992 & 1994
Impact of Deafness
“If all my possessions were
taken from me with one
exception, I would chose
to keep the power of
communication, for by it I
would soon regain the
rest”
-- Daniel Webster
Impact of Deafness
Newborn Hearing
Screenings
™ Should have hearing screening
before leaving the hospital
™ Should have hearing screening
before 3 months old if not born
in hospital
™ Should have audiological and
medical evaluation before 3
months old
™ Should have intervention before
6 months old
™ Should have public policy that
reflects unique language, learning
and communication needs
Impact of Deafness
Vocational
Statistics
• 75-85% of adults with a
disability are capable of
being employed however
50-80% are underemployed
• 90% of adults who are d/hh
are underemployed: 1/3 of
those receive some kind of
government assistance
Northern California Center on Deafness. 1998. [Report], Davis, CA: Author & Missouri
LINC. 1988-1989. [Newsletter], Jefferson City, MO: Author.
Impact of Deafness
Internet Information
Internet Resources for Special Children – www.irsc.org
Illinois Resource Service Center – www.interaccess.com
Internet Guide for Deaf and Hard of Hearing Issues & Related Topics –
www. msstate.edu/~jat/ig.html
Mini-seminar online – www.PEPNet.org
www.earinfo.com
www.amarillo.isd.tenet.edu
web7.mit.edu/cuedspeech/ncsainfo.htm
www.cuedspeech.com
Alexander Graham Bell Association – www.agbell.org
Bilingual Bicultural Education of D/HH Children –
www.educ.kent.edu/deafed/ivdle.htm
ERIC Exceptional Children Digests –
www.ericec.org/digests/e550.htm (Numbers 550-560 relate to
deafness)
www.deafness.miningco.com/msubbibi.htm
Laurent Clerc Center on Deafness -- www.clerccenter.gallaudet.edu
Impact of Deafness
Auditory Verbal – www.auditory-verbal.org
www.listen-up.org/a-v.htm
American Society for the Deaf – www.deafchildren.org
Caption Media Program – www.cfv.org
American Association of the Deaf – www.asd.org
Impact of Deafness
Objectives
9 Understand terms associated with
hearing loss and auditory testing
9 Understand types of hearing loss and
how results of tests are recorded on an
audiogram
9 Review the meaning of language and
communication
9 Understand how the auditory deficit
may impact language, communication,
experiences, social interactions,
educational and career opportunities
9 Become familiar with programs and
services for persons with a hearing loss
9 Be aware of curricular and classroom
adaptations that may help a student with
a hearing loss
Impact of Deafness