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Alison King, MSP, CCC-SLP, LSLS Cert.AVT
• Gain a better understanding of the unique
role that medical and educational facilities
have in assisting students who have a hearing
loss
• Gain an understanding of hearing loss as a
medical diagnosis
• Learning to recognize the unique speech and
language characteristics of students who have
a hearing loss based on communication
methodologies
• Learn how to find other resources which may
be beneficial for you as a professional to best
serve your student’s needs
• http://www.ted.com/talks/deb_roy
_the_birth_of_a_word.html
•
In 2005, 91.5% of the nearly 4 million babies born in the
US had their hearing screened prior to leaving the hospital
(CDC).
•
Early Hearing Detection and Intervention (EHDI) laws or
voluntary hearing screening programs are in place in all 50
states and the District of Columbia (ASHA, n.d.).
•
1 month= All infants are screened for hearing loss prior to
discharge from birthing/neonatal facilities, or within one
month of birth.
•
3 months= All infants referred from the screening process
complete diagnostic audiological evaluation.
•
6 months= All infants with diagnosed hearing loss receive
appropriate interventions including amplification and Early
Intervention.
• Medical definition – clinical
measure (arbitrary) used to
determine eligibility for federal
benefits
• Educational definition – considers
the impact of hearing loss on
educational performance
• "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 the child’s educational
performance. 34 CFR § 300.7 (c) (3)
• "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. 34
CFR § 300.7 (c) (5)
Virginia DOE Statistics
2010 Child Count Data
There were 1,473 students between
the ages of 0-22+ that had the label of
Hearing Impairment and 25 who had
the label of Deaf-Blindness.
http://www.doe.virginia.gov/special_ed/reports_plans_stats/ch
ild_count/
There were 357 students provided
services in state operated programs.
111 students provided services at
VSDB Staunton.
– HI – 71 (under 5% of total population)
– VI – 35
– DB – 5
• Congenital – hearing loss is present at birth
– Genetic
– Prenatal infections (ex. CMV)
• Acquired – hearing loss after birth
–
–
–
–
Progressive hearing loss (hereditary)
Trauma (Turn down your earbuds!)
Ototoxic medications
Otitis Media (ear infections)
Important to note that it is estimated that 9095% of all children born with a hearing loss are
both to parents with normal hearing. (White,
2006).
• Conductive -Occurs when sound is not
conducted efficiently through the outer
ear canal to the eardrum and the tiny bones
of the middle ear. This type of hearing loss
can often be corrected medically or
surgically.
• Sensorineural - (SNHL) occurs when there
is damage to the inner ear (cochlea), or to
the nerve pathways from the inner ear to
the brain. Most of the time, SNHL cannot be
medically or surgically corrected.
• Mixed – Combination of both conductive
and sensorineural
dB (decibels) – loudness level
Hz (hertz) – frequency (pitch)
Degree of hearing loss
Hearing loss range (dB HL)
Normal
–10 to 15
Slight
16 to 25
Mild
26 to 40
Moderate
41 to 55
Moderately severe
56 to 70
Severe
71 to 90
Profound
91+
• Hearing aids – Selected and
programmed based on an
individual’s loss (dB and
frequency)
• Cochlear implants – Does NOT
restore hearing! Used for
sensorineural hearing loss or
auditory neuropathy
• How Cochlear Implants Work
• http://www.youtube.com/watch?v=Poyj7U2wzhQ
• ASL (American Sign Language) –
bilingual approach which uses
American Sign Language and
English; ASL has it’s own distinct
grammar and linguistic principles.
• http://www.youtube.com/watch?v=5-fwQpCylW4
• Auditory-Verbal- Emphasis of
developing spoken language
through listening
• http://www.youtube.com/watch?v=v6UQBX8sNPY
• http://www.youtube.com/watch?v=6yNPTFjNyzI
• Auditory-Oral - An approach that
teaches a child to use his/her
remaining hearing through
amplification and the use of
speechreading/natural
gestures/visual cues to aid the
child’s understanding of language.
• Cued Speech - An auditory-visual
communication approach with the use of
hand cues with the natural mouth movements
of speech, specifying each sound (phoneme)
of spoken language clearly
• http://www.youtube.com/watch?v=QFStsUmr
wUQ
• Simultaneous Communication- an
educational philosophy that uses
spoken language and sign
language simultaneously. The
sign is English-based.
• http://www.youtube.com/watch?v
=MeGSIixY4jc
• Dependent communication methodology
being used
• Have a clear understanding of where the child
is with regards to auditory, speech, and
language or sign development
• Sit on the side of the “better” ear
• Best practice = personal FM systems
• Best to say it again in the same way – child is
still processing how you said it the first time
• Have child repeat back directions
• Have high expectations
• Never Assume!
• The first seven years of life are critical for
learning verbal language. Past those 7 years, it
becomes much more difficult to acquire
verbal language and the window of
opportunity slowly closes neurologically
(Lillard & Erisir, 2011).
• Demographic data suggests that 40% of all
students with a hearing loss have a secondary
disability (Wiley & Moeller, 2007). Due to
UNHS, hearing loss is identified prior to many
of these disabilities (i.e. autism, learning
disabilities).
• Yoshinago-Itano (2003) found that
early identification of hearing loss and
early amplification by either the use of
hearing aids or cochlear implants have
positive effects on the language,
speech, and social-emotional
development of children.
• As professionals, we must support
parental choices!
• Families have options. If they choose
for their child to use sign, then they
must learn sign at a faster rate than the
child.
• The development of sign language
does not equate exactly to the
development of spoken language.
• Auditory skills are developmental and
coincide with language and speech
development.
• Without access to sound, a child with
a hearing loss will not develop
articulation and vocal quality the
same as their hearing peers –
physiologically impossible.
• However, with early and appropriate
amplification, a child with a hearing
loss can develop articulation and
voice commensurate to their hearing
peers.
Personal FM systems – connects
directly to the HA or CI
•
Decreases the “distance” factor
•
Provides the best opportunity for
the child to hear and not miss
important information from the
teacher.
Soundfield amplification – speakers
in the classroom
• Things to consider…
– History
– Communication modality
– How long they have been hearing
– Parental choices
– LRE (?)
It is all about LANGUAGE!
• Early Identification
– UNHS
• Early Amplification
– Parental decision
• Early Intervention
– Communication methodology can
change over time based on the
child/family needs
– Language learning is the key!
Who decides what (or if) amplification should
be used?
Who decides what communication option
should be used?
When are these decisions made?
What is the role of EI providers and Early
Childhood Educators?
What are 3 important items that we
need to take away from tonight?
AG Bell Association for the Deaf and Hard of Hearing
http://listeningandspokenlanguage.org/
National Cued Speech Association
http://www.cuedspeech.org
National Association of the Deaf
http://www.nad.org
VCU Cochlear Implant Program
http://www.vcu.edu/ent/cicenter/
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American Speech-Language Hearing Assocaition. (n.d.). Early Hearing
Detection and Interventon (EHDI). Retrieved from:
http://www.asha.org/advocacy/federal/ehdi/.
Lillard, A. & Erisir, A. (2011). Old dogs learning new tricks:
Neuroplasticity beyond the juvenile period. Developmental Review,
31 (4), 207-239.
Virginia Department of Health. (2003). Virginia early hearing detection
and intervention Program 2003 annual report. Retrieved from:
http://www.vdh.virginia.gov/ofhs/childandfamily/childhealth/hearing/
documents/2012/publications/pdf/2003.pdf.
White, K. R. (2006). Early intervention for children with permanent
hearing loss: finishing the EDHI revolution. The Volta Review, 106,
237-258
Wiley, S. & Moeller, M. (2007). Red flags for disabilities in children
who are deaf/hard of hearing. The ASHA Leader. Retrieved from
http://www.asha.org/Publications/leader/2007/070123/f070123b.htm.
Yoshinaga-Itano, C. (2003). From seening to early identification and
intervention: discoveringpredictors to successful outcomes for
children with significant hearing loss. Journal of Deaf Studies and
Deaf Education, 8(1), 11-30.
• http://www.ted.com/talks/deb_roy_the_birth_of_a_word.
html
• http://www.doe.virginia.gov/special_ed/reports_plans_st
ats/child_count/
• http://www.medel.com/blog/photographic-tour-of-thecochlea
• http://www.asha.org/public/hearing/Degree-ofHearing-Loss/
• http://www.youtube.com/watch?v=5-fwQpCylW4
• http://www.youtube.com/watch?v=v6UQBX8sNPY
• http://www.youtube.com/watch?v=6yNPTFjNyzI
• http://www.youtube.com/watch?v=QFStsUmrwUQ
• http://www.youtube.com/watch?v=MeGSIixY4jc