Download Deaf

Chapter Twelve
Individuals With
Hearing Impairments
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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
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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.
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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
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Measurement of Hearing Impairments
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Audiogram
Frequency
Hertz (Hz)
Decibels (dB)
Pure-tone audiometry
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Other Types of Hearing Assessment
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Air-conduction audiometry
Bone-conduction audiometry
Play audiometry
Speech audiometry
Speech recognition threshold (SRT)
Auditory evoked potentials
Evoked otoacoustic emissions
Acoustic inmittance
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Age of Onset
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Prelingual: present at birth or before speech
onset
Postlingual: deficit acquired after speech
onset
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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)
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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
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Almost 69,500 students ages 6-21 were
identified as having a hearing impairment and
receiving a special education during the 20112012 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.
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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
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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.
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• 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 nonverbal assessment measures
• Speech assessment
– Articulation, pitch, loudness, quality, rate
• Personal/social/behavioral assessment
– Social adjustment, self-image, emotional adjustment
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– 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
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Sign language
Oral
Cued speech
Total communication
Fingerspelling
• Audiologist
• Interpreter
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Services for Young Children
with Hearing Impairments
Importance of early identification
• Early intervention services
• Family support
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Transition and Individuals
with Hearing Impairments
Transition planning includes:
– Family support
– Higher education
– Employment
– Personal, social, community adjustment
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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
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Family Issues
Most children with hearing impairments have
hearing parents
• Acceptance of the disability
• Family relationships
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Issues of Diversity
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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
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Issues of Diversity
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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
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Hearing aids
Auditory training devices
Computers
Alerting devices
Captioning
Telecommunication devices
Cochlear implants
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Trends, Issues, and Controversies
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Appropriate educational methods
Move from child-centered to family-centered
approach
Total communication
Deaf culture
Full inclusion
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