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McGaha 1 Abby McGaha Mrs. Thomas English IV Honors 08 March. 2012 Senior Graduation Paper My project will be focusing on the hearing impaired in children and how society and technology has developed through the years to assist the hearing impaired. There will be many subtopics as well such as: mainstreaming and deaf schools and I would also like to explain the difference between Cochlear Implants and hearing aids. I want to study these topics because I would really like to become a speech pathologist and I believe my paper will help educate me in the subject. I hope by doing this paper I will answer the question of why the hearing feel the need to fix the hearing impaired. What does it mean to be Hearing Impaired or Deaf? According to Merriam Webster to be deaf means “Lacking the power of hearing or having impaired hearing,” but people still seem vague on the different types hearing impairments and what can ca use them. “Physiologically speaking there are two types of deafness: Conductive deafness, which is when the person has some type of deformity or slight problem with the structure of their ear. Sometimes surgery can be done to help with hearing. Nerve Deafness, is when there is an issue with the nerves in the ear which causes complications relaying information to the brain. This type of deafness cannot always be fixed with surgery. One can also classify deafness with the age one became deaf.” (“What is Deafness”). McGaha 2 “Prelingual deafness happens when the child is hearing impaired at a young age (Deafness at birth can be caused by either genetic traits or rubella virus (German measles)).” (“What causes deafness”) These children have no prior experience with the spoken language. In this case many have trouble with literacy and the spoken language. They often communicate best with sign language. When a person has had the ability to hear for some part of their life and then lose their hearing later in life is called “‘Acquired Deafness,’ which can be caused by many different events such as: illness, injury, viral infections, excessive noise, or reactions to drug treatments.” (“What causes deafness”) People with ‘Acquired Deafness’ have the advantage of knowing the spoken language and it is easier for them to lip read and understand the written language. As people age their hearing can degenerate and this is the most common type of hearing loss. Almost all adult over the age of seventy have had some degree of hearing loss. This is because as you age the “mechanical parts of the ear (ear drum and ossicles) start to wear out or the nerves may gradually deteriorate with age.” (“What causes deafness”) In order to figure out how extreme ones hearing loss is there are two test to determine it. There are two main test that measure hearing levels. They are called The Otoacoustic Emissions Test (OAE) and Automated Auditory Brainstem Response (AABR) both can be performed in a doctor’s office or schools. Anne M Delaney, wrote an article explaining the Otoacoustic Emissions Test saying it is “The primary purpose of otoacoustic emission (OAE) tests is to determine cochlear status, specifically hair cell function. This information can be used to (1) screen hearing (particularly in neonates, infants, or individuals with developmental disabilities), (2) partially estimate hearing sensitivity within a limited range, (3) differentiate between the sensory and neural McGaha 3 components of sensorineural hearing loss, and (4) test for functional (feigned) hearing loss. The information can be obtained from patients who are sleeping or even comatose because no behavioral response is required.” (“Newborn Hearing Screening”). A small click stimulus delivered to the infants’ ear by small disposable earphones that eliminate background noises. The earphones are set to a 35 dB Hearing level [HL]. Majority of the AABR compare “infant's waveform with that of a template developed from normative ABR infant data. A pass or fail response is determined from this comparison.” This test can be an effective for an infant as young as six months old, however, it is not a reliable source to know whether or not the child will have permanent hearing loss and follow up test are necessary. If the child fails the hearing test it is recommended for the parents to bring the child back within a month for more elaborate testing. The main test used is Auditory Steady-State Response testing (ASSR). This is a very useful test which can identify moderate to profound hearing loss by providing discrete frequency-specific information. If the child is diagnosed with a hearing impairment there are steps the guardians can take to attempt to make the child’s hearing as clear as possible. Hearing impaired children may gain better hearing with the assistants of a hearing aid or Cochlear Implant (CI). A Cochlear Implant is a “surgically implanted electronic device that allows people with severe hearing loss to recognize some sounds. It consists chiefly of a microphone and receiver, a processor that converts speech into electronic signals, and an array of electrodes that transmit the signals to the auditory nerve in the inner ear.” ("Cochlear implant”). It will take the user time to be able to perceive sound and understand its meaning. The accuracy of a CI will also vary depending on the person. CIs in addition, are permanent unlike hearing aid which can be removed. Yet, while I McGaha 4 researched the topic many in the Deaf culture disagree with the use of CI’s. They feel giving a child that is born deaf a CI is not going to help them in the long run because they have never been able to recognize sounds. There is also the debate of giving a CI to a young child is unethical because the child is too young to form their own decisions on the matter. For those that agree with CI’s they believe the CI allows the child to be exposed to a new world they would not be able to be a part of without the CI. The CI allows children to hear sounds and themselves. A hearing aid is a small electronic apparatus that amplifies sound and is worn in or behind the ear to compensate for impaired hearing. ("Hearing aid".) Hearing aids can be helpful with intensifying sounds, but like CIs it can vary from each person. They have also been know to be expensive and can emit a loud whining noise if not fitted properly. Both hearing aids and cochlear implants can be groundbreaking for the hearing impaired, but like regular school and mainstreaming it really depends on the family to decide what steps they want to take for their child. Growing up with a hearing impairment and attending school with a hearing impairment can make certain aspects of a school life difficult. Many children struggle with vocabulary skills, reading and socializing with peers. When I shadowed at Nags Head Elementary I met a six year old student named Royce with Warrensburg’s syndrome who had two Cochlear Implants. When we met he was completing a spelling test. I never considered how complicated it had to be to try to spell words when you cannot comprehend the sounds in the words. Royce had an interpreter sign the words to him and enunciated each sound very slowly. Royce would then finger spell each letter before writing them on a paper. After his reading class he took me to his speech therapy class. Sue Daniels, his therapy teacher explained to me that with his new CIs he had the hearing McGaha 5 comprehension of a six month old. She told me how they were encouraging him to use his words and make sounds. He would say the first letter of each word phonically. For example, when we had a tea party he would say “p-ppp-pour.” Sue Daniels would say the words directly in his ear so he would be forced to hear her not read her lips. He also practiced counting out loud. After speech therapy it was time for Royce to go to lunch. He sat with his interpreter and I realized that he did not have anyone else, but his interpreter with whom to connect. The other students acted as if he did not really exist or were scared of him. He seemed a little shocked when his interpreter went away for a few moments and I attempted to sign with him and though I use mostly Signing Exact English “Signed English (or S.E.) uses the vocabulary of A.S.L. but follows the word order, sentence structure and grammar that we are familiar with in spoken English.” (“The Art of Signing”) we were still able to communicate for the most part. He told me about how much he loved ‘Angry Birds’ and how his favorite color was blue. He wanted to tell me everything possible because he did not have any other peers with whom to talk. I later asked his interpreter if he socializes with any of his classmates, she responded, “Some were with him in Kindergarten, so they know some very basic signs. He has one girl that he spends a lot of time with because she likes him.” I watched him play during recess and could not help cringing when I heard one child call him a freak. This highlighted the issue of how little understanding hearing people actually have with people who are hearing impaired. Dare County does not have a school for the deaf this means most hearing impaired children or families will either relocate to somewhere that has a school for the deaf or mainstream. It is then their decision to decide what type of school they want the child to attend. There are two different kinds of schools for the deaf residential McGaha 6 schools and day schools. A residential school is a school where the students live on campus and do not come home except on holidays and weekends. Day schools are your basic go to school and return home schools. They both have the benefit of the student being fully immersed in deaf culture. It also allows the student to make friends with people to whom they can relate to. Mainstreaming is when a hearing impaired student goes to a regular school for the hearing. This is not necessarily a bad thing, but it can be costly and difficult for the family. The parents would need to know if the school could give a hearing impaired child a proper education and have the resources to do so. Most students would need a translator who could follow them and translate all of their class or at least have a teacher who was fluent enough to communicate with the student. The student would benefit from hearing aids or CIs so they could hear a little. They would need to know how to use them and know if something was not working properly so they could inform a teacher. If the student has hearing friends that they can connect with it can make school much more enjoyable and the student can get help when needed. The advantages of a hearing impaired student going to a regular school: the student is able to improve their social skills, obtain a better understanding of the spoken language, and learn how to interact in the hearing world. This can be a complicated decision for the parents, but in the end the child and parents are the only ones who can make the decision for which is a better school choice. While many believe that the hearing impaired have a disability, I do not. I believe they have a different lifestyle. They may not hear or speak the same way we do, but I do not think they are any less educated or able. At times they have heightened sense to make up for the fact they cannot hear. While shadowing, Royce’s interpreter explained that McGaha 7 Royce is extremely observant and has a very detailed memory. Within the five minutes I first introduced myself he commented on my very red hair and that I sign more with my left hand. Later he recalled my favorite color, which I had mentioned briefly. I see this as proof that the hearing impaired make up for their lack of hearing with other abilities. Throughout history we have always been trying to fix people with hearing impairments when in all reality there’s nothing to fix. From my research I have found the hearing society continuously tries to fix the hearing impaired by CI’s or speech therapy, but as I spent more time with Royce I could not but to think maybe it is the hearing society that needs to be fixed. McGaha 8 Works Cited Anne M Delaney. “Newborn Hearing Screening.”emedicine.medscape.com. Medscape Refernce, 31 Jan 2012. Web. 28 Mar 2012. Brown, Christopher. The Art of Sign Language. Malaysia: PRC Publishing Limited, 2004. Print "Cochlear Implant." Dictionary.com. Houghton Mifflin Company, n.d. Web. 28 Mar 2012. Daniels, Sue. Personal. 06 February 2012. 10 May 2012 “Deafness.” Dictionary.com. Houghton Mifflin Company, n.d. Web. 28 Mar 2012. "Hearing Aid." Dictionary.com. Houghton Mifflin Company, n.d. Web. 28 Mar. 2012. “What causes of deafness.” hayfield .org.uk. Hayfield Ltd. 04 October 2011. Web. 30 April 2012. “What is deafness.” hayfield.org.uk. Hayfield Ltd. 04 October 2011. Web. 30 April 2012. McGaha 9 There are four types of Otoacoustic Emissions; they are (SOAEs) “Spontaneous otoacoustic emissions which is when sounds are emitted without acoustic stimulus”, “Transient otoacoustic emissions (TOAEs) or transient evoked otoacoustic emissions (TEOAEs) - Sounds emitted in response to an acoustic stimuli of very short duration; usually clicks but can be tone-bursts”, (DPOAEs) “Distortion product otoacoustic emissions: sounds emitted in response to 2 simultaneous tones of different frequencies” and last (SFOAEs) Sustained-frequency otoacoustic emissions: sounds emitted in response to a continuous tones” (Otoacoustic Emissions article by . Kathleen C M Campbell, PhD, December 20, 2010). The Automated Auditory Brainstem Response AABR is “an ‘electro physiologic’ measurement that is used to assess auditory function from the eighth nerve through the auditory brainstem. AABR measurements are generally obtained by placing disposable surface electrodes high on the forehead, on the mastoid, and on the nape of the neck” (Anne M Delaney, PhD; Chief Editor: Arlen D Meyers, MD, MBA) (The American HeritageScience Dictionary. Houghton Mifflin Company. 28 Mar. 2012. <Dictionary.com)