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Transcript
Chapter 9 – Hearing Impairment 1. If “deaf” or “hard of hearing”, the person’s most significant developmental obstacle is the acquisition of spoken language. 2. Hearing sensitivity is measured in decibels - dB (units of relative sound loudness) - zero decibels (0 dB) is the point at which the average person with normal hearing can detect the faintest sound - if the person needs a sound to be louder than a normal person (higher number of dB’s) to hear it, then the person has some degree of hearing loss 3. Physiological definitions - deaf: hearing losses of 90 dB or greater across frequencies - hard of hearing: hearing losses of less than 90 dB across frequencies 4. Educational definitions - deaf person has a hearing loss that prevents the processing of linguistic information through audition (with or without a hearing aid) - hard of hearing person, with the use of hearing aid, has sufficient residual hearing to process linguistic information through audition 5. Age of onset of hearing loss (impact of language acquisition) - congenitally deaf: born deaf - adventitiously deaf: acquired deafness at some time after birth - prelingual deafness: at birth or early in life prior to development of speech and language (prior to 18 months of age) - postlingual deafness: after the development of speech and language 6. Prevalence – only .14% of the population from 6-17 is identified as deaf or hard of hearing by the public schools 7. Anatomy & Physiology of the Ear - The outer ear -auricle & external auditory canal ending at the tympanic membrane (eardrum) -least important parts of the ear for hearing - The middle ear -eardrum connects to the ossicles (3 tiny bones) within the middle ear air-filled space - ossicles conduct vibrations from the “eardrum” to the “oval window” -eustachian tube connects the middle ear airfilled spaced to the throat for air-pressure equalization -otitis media: infection of the middle ear caused by viral or bacterial factors preventing Eustachian tubes’ normal function of ventilating and draining the middle ear -otitis media: the most common reason for doctor visits of children 6 & under (eustachian tubes change orientation in older children) -otitis media could result in temporary (but sometimes chronic) conductive hearing loss OR rupture of the tempanic membrane, eardrum (sometimes resulting in some degree of conductive loss) -The inner ear (cochlea & vestibular mechanism) -cochlea is a snail shaped organ at the bottom of the inner ear a. the most important part of the ear for hearing b. vibration of the oval window causes the fluid in the cochlea to electrically stimulate the auditory nerve which sends frequency & loudness information to the brain (danger of loud sounds) 8. Measurement of Hearing Ability -school screening tests a. describe screening procedure b. screening not as accurate as tests done in audiologist’s office -pure-tone audiometry a. establishes an individual’s threshold of hearing at a variety of frequencies (low to high sounds measured in hertz-Hz) b. the threshold for a given frequency is how loud in decibels (dB) the sound must be to first be detected c. described the testing procedure d. most speech sounds are in the low to high frequency range of 500-2,000 Hz -speech audiometry: establishes the dB level (loudness) at which one can understand speech 9. Causes of Hearing Loss -conductive hearing loss – interference with the transfer of sound along the conductive pathway from outer and middle ear -sensorineural hearing loss – involves problems in the inner ear a. genetic or hereditary factors are the leading cause of deafness in children b. acquired sensorineural hearing loss caused primarily by viral infections & repeated loud sounds – gunshots, music, machinery 10. English Language &Speech Development -the most profound effects of a hearing loss are the comprehension & production of the English language -poor speech production in deaf children is due to the lack of auditory feedback -however, if taught American Sign Language (ASL), deaf children acquire ASL at the same language developmental milestones in sign at the same time as children without a hearing loss do in spoken language -current opinion is that ASL is a true language -however, ASL as a person’s only language limits his/her access to the larger society 11. Intellectual Ability -when performance tests, rather than verbal tests, are administered, there is no difference in IQ between the deaf & hearing 12. Academic Achievement -most children with hearing loss have extreme deficits in academic achievement – particularly READING -not uncommon for deaf HS graduates to read at no higher than 4th grade level -however, highest literacy rates come from deaf students who have deaf parents who teach them ASL 13. Social Adjustment -90% of deaf children have hearing parents & many hearing parents do not learn ASL which results in lack of easy communication -loneliness due to isolation in inclusive hearing school placements -the value of associating with the deaf culture – controversy with cochlear implantation 14. Educational Considerations -historical order of teaching communication skills: manual - oral - total communication and now bicultural - bilingual -total communication (in most school settings) a. utilizes both oral (speaking) and manual communication (Signing English systems) b. Speechreading -teaching hearing impaired to use visual information to understand what is being said -very difficult – a large guessing game -bicultural – bilingual approach a. ASL is considered the primary language and English the secondary language b. Deaf individuals contribute to curriculum & Incorporate deaf culture -Accommodations in your classroom a. your teacher behavior b. visual support for instruction