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worldwide Deaf Awareness Fact Sheet 360 million people worldwide have disabling hearing loss. Over 32 million of these are children. No deaf child is the same Different levels of hearing loss Deafness and hearing problems are different for each individual and no deaf child is the same. The way deafness affects a child depends on a range of different factors, including the following: • what type of hearing loss they have • what caused their hearing loss • how old they were when they were diagnosed with a hearing loss • the level of hearing loss they have • whether the hearing loss is in one or both ears • the way they prefer to communicate • the level of communication skills they have. There are different levels of hearing loss. In medical terms, these are: mild deafness, moderate deafness, severe deafness or profound deafness. • It is rare for a child not to hear anything at all • Deafness can affect the loudness and clarity of sounds, noises or speech • Even if voices are amplified (made louder), a deaf child may have difficulty understanding them. How we hear Sound is an invisible vibration. It travels in waves, spreading outwards from the source (whatever caused it). Sounds have different loudness and different frequencies (or pitches). The ear is made up of three main parts: the outer ear (the part you can see), the middle ear and the inner ear. The ear is part of the hearing system which allows us to turn sound waves into signals our brains can understand as sounds, noises or speech. There are different parts to the hearing system and all of them must be working to allow us to hear. Types of hearing loss ated Undrstnd Deaf Upd g Deafness Latest 2009_Understandin Page 10 16/11/2010 16:41 5 s There are two main types conductive deafness iogram Auofddeafness: and sensori-neural deafness (also known as nerve deafness). n the one below, know e n on a chart Conductive deafness is when sound waves ur child’s tesSensori-neural deafness orlik nerve deafness is t results will be writte d at what frequency, an , yo be of to s Some und ha d aaso louis w ho art (as u yo s one ch cannot pass through the ear due to something when there problem in the inner ear. The ow sh d It s may be plotte on as an audiogram. ur child’s test result ica Yo it. ind s ar ay he n alw ca s ild sse blocking their journey. The most common cause problem may be with the auditory nerve (thete r ur ch . Cro rately before yo r sepa ea ch ea for e, sid e by deaf in one ea ild may be(the or twoincharts, sid ur chcochlea below of conductive deafness is the build-up of )fluid ear. Yothe hearing nerve) or part htwith rig the for s cle cir in both d If your child is deaf s for the left ear, an s). ult es res afn de l era lat the middle ear (known as glue ear). This type of of the inner ear that produces nerve signals). (bi rs ea ferent in th dif bo or or s) es (unilateral deafness) rs (symmetrical deafn both ea in r ila sim be y deafness is usually temporary but if glue ear or Sensori-neural deafness is permanent. ma s ears, the deafnes ess). ear infections go untreated for a longea time r (asymmetrical deafn quency, ch eathere h frequency or low fre o be described as hig als sound. A y a ma of s ch es pit is a risk of permanent damage to the ear and afn de the ’s Your child nk of frequency as thi ly on mm co right and We the z). on permanent hearing loss. measured in hertz (H to high-pitch sounds low-pitch on the left s from piano keyboard run same. the is el (dB) the audiogram described as a decib afness. These can be de ibed using of scr els de lev or t it) en ar fer There are dif your child to he for be to s ha d un d a so ry quietest sounds are hearing level (how lou or ‘profound’. The ve re’ ve ‘se , te’ era od ’, ‘m . terms such as ‘mild u look down the page , getting louder as yo art ch the of top the at sounds It is possible for children to have a combination of sensorineural and conductive deafness. range of ever yday dness and pitch of a of the lou Visual representation ) Frequency in Hertz (Hz of Le ls of vels Leve ess: de afnes deafn Soft sounds 0 F F 10 O R R Y F Se re vere Seve afn de esss deafnes dB 95 dB 71 95 71 els (dB) j F 60 i oa r mdb n ng el u 50 F O R R Y 70 F 80 F F 10 F F B U Z Z F O R R Y O R R Y O R R Y O R R Y O R R Y Loud sounds F F O R R Y 100 O R R Y O R R Y 110 L O R R Y BAND 120 s Society tional Deaf Children’ The Na F O R R Y 90 F Pro nd found Profou afn de esss deafnes 95 dB 95++ dB k ch sh O R R Y 40 O R R Y p hg zv O R R Y 30 F Hearing level in decib Mo ratee derat Mode es afn de deafness dB 41 70 db 41 -- 70 O R R Y 20 f sth F O R R Y ld Mi Mild ess afnes de deafn dB 40db 24--40 21 8000 4000 2000 1000 500 250 125 -10 High PITCH Low Understanding your Child’s Hearing Tests Causes of hearing loss There are various different causes of childhood deafness. Some of them can happen before birth and some of them can happen when children are babies, infants or growing up. It is not always possible to identify the cause of deafness. Causes before birth (pre-natal causes) Genetic factors can also cause hearing loss in children. Deafness can be passed down in families even if there appears to be no family history of deafness. 90% of deaf children are born to hearing parents and typically have no previous experience of deafness in their families. Sometimes deaf children may have additional disabilities or health problems when they are born. Deafness can also be caused by illness or complications during pregnancy. Certain medicines (known as ototoxic drugs) that are sometimes given to women during pregnancy can damage the hearing system of a baby before they are born. Causes after birth (post-natal causes) Premature babies are at an increased risk of becoming deaf. They are often at risk of infections that can cause deafness. They may also be born with severe jaundice or experience a lack of oxygen at some point. Both of these can cause deafness. There are a range of causes of deafness in early childhood, 50% of which are preventable according to the World Health Organisation. Diseases such as meningitis, rubella, measles and mumps can cause deafness. Ototoxic drugs, used to treat other types of infections, can also damage children’s ears and cause deafness. Occasionally, an injury to the head or exposure to loud noise can damage a child’s hearing system and cause deafness. Signs of Deafness It’s important to spot hearing loss as soon as possible as the sooner a child is identified; the sooner they can be supported to develop language and communication skills. Some signs that could indicate your baby is deaf include: In addition to the above, other signs that could indicate a child is deaf include: • They do not respond to sounds, music or voices • They strain to hear • They appear very watchful • They do not react to loud sounds in response to a loud sound • They misunderstand things you say • They withdraw from social situations • They ask you to repeat things • They tell you they are deaf • The use of sign language. Poverty and deafness The majority of the world’s deaf children (around 80%) live in developing countries. There is a clear link between poverty and deafness. Some of the factors that link poverty and deafness include: • poor sanitation (unclean water can result in poor ear health) • limited access to health services (especially in isolated rural communities) • poor quality health services • limited access to medical treatment (for children in developing countries, longterm ear infections are the leading cause of hearing loss) • low rates of vaccination against rubella, measles and mumps (illnesses that can cause deafness) • high rates of meningitis (an illness that can cause deafness) • the use of ototoxic drugs to treat malaria, tuberculosis, and severe infections • local remedies (which can often cause damage to the ear) • late or no diagnosis (early detection of deafness is vital for deaf children to develop the language and communication skills needed for life) • lack of appropriate support upon diagnosis • limited access to hearing aids and other technology. With the right support and early diagnosis, deaf children and young people can access equal opportunities and communicate effectively alongside their hearing peers. The World Health Organisation (WHO) categorises the impact of deafness into three types: functional, social and emotional, and economic. Functional One of the main impacts of hearing loss is on the individual’s ability to communicate with others. Spoken language development is often delayed in children with deafness. In many cases, access to learning sign language is important both for the deaf child and their family to allow them to communicate effectively at home and with peers. There are a number of ways deaf children can be supported to communicate so that they can achieve alongside their hearing peers (more information provided below). Social and emotional Deaf children do not access services as readily as hearing peers and can often feel excluded in communities causing feelings of loneliness, isolation and frustration. Deafness is an invisible disability making it challenging for many people to understand or accept it. Deaf children are often hidden away, excluded from family and community life, and prevented from going to school. In some communities deafness is seen a curse. Deaf children have the same rights as other children. Through challenging social attitudes and raising awareness of deafness and how deaf people can and do achieve, we can reduce isolation and exclusion. Economic In developing countries, many deaf children do not go to school or if they do, they struggle to learn because poor quality education systems can’t support their needs. Without an education, it can be difficult to break free from a cycle of poverty. Raising awareness of the needs of deaf people, improving access to and the quality of education, as well as providing vocational rehabilitation services, would see an increase in the numbers of deaf children who are educated and are able to enter into employment. Communication There are a variety of communication methods available to deaf children and their families including different types of hearing aids and other hearing technologies. Availability and costs are barriers preventing many deaf children from accessing these technologies though there are a number of other options that deaf children can use to communicate. The way deaf children communicate can differ for each individual child. Deaf children may use one method or a combination of methods to communicate. Some of the options include: • national (official) sign language • local or community developed sign language • speech and language • lip-reading • finger-spelling • gestures and facial expressions • total communication. It is a myth that all deaf people can lip-read well. Lip-reading is a difficult skill to learn. Only around 30% of sounds are visible on the . lips when someone is speaking Lip-reading involves a lot of concentration and can leave deaf children feeling tired. Sign language is a visual language using gestures, hand movements and facial expressions to communicate. It is more common where hearing aids and other technology are not available. Most deaf children who need hearing aids in developing countries do not have them. Each sign language has its own grammar, rules and dictionary. It is not one international language – each country has their own national sign language and there can even be regional variations within countries. Tips for communicating with deaf children • Get the child’s attention before you start talking to them. • Make it clear what the topic of conversation is – and let the child know when it has changed. • Make sure you face the child and keep eye contact as much as possible. • Do not stand with your back to a window – this can create a shadow on your face and make lip-reading difficult. Stand with your face to the light. • Ask the child how they prefer to communicate. • Do not cover your mouth. •K eep background noise down (turn off the TV or radio). •S peak clearly and do not shout. Use an expressive face. •U se visual clues where possible. •U se your normal rhythm of speech (it is not helpful to mouth words slowly). • I t is important to speak one at a time in group conversations, as they can be difficult for deaf children. • Try to keep a deaf child involved and avoid all speaking at once. er h t o g in h t y n a o d n a c Deaf children is s o n g ia d ly r a e n e iv g children can do, . t r a t s e h t m o r f t r and the right suppo Deaf Child Worldwide is the international arm of the National Deaf Children’s Society (registered charity in England and Wales no.1016532 and in Scotland no. SC040779). For more information visit www.deafchildworldwide.info or contact [email protected] Deaf Child Worldwide The National Deaf Children’s Society, Ground Floor South, Castle House, 37–45 Paul Street, London EC2A 4LS Tel: +44 (0)20 7490 8656 (v/t) Fax: +44 (0)20 7251 5020 Email: [email protected] JR0728 www.deafchildworldwide.org The National Deaf Children’s Society is a registered charity in England and Wales no. 1016532 and in Scotland SC040779. worldwide