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Presented by: Jacqui Herran Teacher for the Deaf and Hard of Hearing Carmel Clay School Corporation How the ear works A conductive hearing loss A sensorineural hearing loss Hearing Testing Hearing Aids Cochlear Implants FM Systems Classroom Modifications and Suggestions Any Questions… Outer Ear Middle Ear Hammer Anvil Stapes Inner Ear Cochlea Auditory Nerve A Conductive Hearing Loss~ This happens when there is a problem with a part of the outer or middle ear. Most kids with conductive hearing loss have a mild to moderate hearing loss. Sometimes it is temporary because medical treatment can help. Causes are: ear infections, wax buildup, fluid buildup, problem in ossicular chain, childhood diseases, congenital abnormalities A Sensorineural Hearing Loss~ This happens when the cochlea is not working correctly because the tiny hair cells are damaged or destroyed. A sensorineural hearing loss means the nerve that carries the messages from the cochlea to the brain is damaged. Sensorineural hearing impairment is almost always permanent and a kid's ability to talk normally may be affected. This loss is often severe to profound. Causes are: birth trauma, head trauma, severe infections/illnesses, noise, lack of oxygen, hereditary, ototoxic drugs When a child is suspected to have a hearing loss, an audiologist will test his/her hearing and record the results on an audiogram. Hearing is measured in decibels (dB HL). The larger the number, the louder the signal needed to for the child to hear it. Normal hearing: 0-25 db HL Mild Loss: 25-40 db HL Moderate Loss: 40-55 db HL Moderate to Severe Loss: 55-70 db HL Severe Loss: 70-90 db HL Profound Loss: 90 db and above The Better Hearing Institute has great examples of common sounds with either a mild or moderate hearing loss: http://www.betterhearing.org/sound/index.c fm Hearing Aids~ Hearing aides simply increase the volume to the user. They do not change the signal in any way. Analog vs. Digital Hearing Aides Some tips for working with HA users: Know how to change batteries and have extras available If “squealing” or giving feedback, check to be sure the ear mold is in tight Remember they may hear you better with HA but still may need processing time or repetition Cochlear Implants~ Cochlear Implants are best suited for those with a severe to profound sensorineural hearing loss. They require a surgical operation to put electrodes and device in place. Sounds through an implant do not sound the same as normal hearing. Speech is described as robot or Donald Duck sounding. Be aware that Electrostatic discharge can damage the cochlear implant. How does a cochlear implant work? 1. The external processor captures sound and converts the sound into digital signals. 2. The processor sends the digital signal to the internal implant components through the magnet. 3. The internal implant converts the signals into electrical energy, sending it to an electrode inside the cochlea. 4. The electrodes stimulate the auditory nerve, allowing the brain to perceive signals as “sound”. Provides localization of sounds Aids in understanding speech Help overcome background noise Take time and training to adjust to input from both signals Can be implanted at same time or one after the other Relatively new procedure in this area FM Systems~ An FM System is a listening device that helps the student in noisy situations or when they are some distance from the speaker. It helps reduce background noise and makes the speakers voice louder than all other sounds. It consists of a microphone worn by the teacher, a transmitter (also worn by the teacher), and a receiver worn by the student. Often these receivers are called “boots” because they clip on like a boot on a foot. Needs to be charged often- should become the student’s responsibility as they are capable. Examples of FM Systems~ Transmitters Receivers Example of a boot on a hearing aid. Some Cochlear Implants have boot that is internal. Checking Hearing Equipment~ To be sure a child’s hearing equipment is working, do a Ling Six Sound check. The Six Sounds: Ahh, Ooo, Eee, Shh, Sss, Mmm If checking hearing aides or cochlear implant, stand behind the student and use a quiet voice. If checking an FM system stand 3 to 9 feet behind the student. Suggestions & Modifications~ When speaking, use a normal voice and rate. Use normal facial expressions and gestures. Arrange seating so student can hear majority of what is happening in class- not always front and center but may be in the middle. Decrease or eliminate background noise as much as possible. Make things as visual as possible and try to have the student’s attention before starting to speak. Auditory fatigue can occur- working at listening all day can be exhausting. Assign a buddy to help student with any missed information. Suggestions & Modifications~ Check comprehension often with open-ended questions. Summarize comments and questions of other students. It is important to remember that a student with a hearing loss may “seem” to hear everything, but will still need help with comprehension and vocabulary knowledge and may not keep up with the pace of a classroom. If the student does not understand… Repeat, emphasizing key words Rephrase, using simpler language Demonstrate or use visual cues Feel free to contact me with any questions or concerns: [email protected] or voicemail 367-2921 Resources: http://kidshealth.org http://www.phonak.com http://www.bionicear.com http://www.cochlearamericas.com http://www.pacificaudiology.com http://www.raisingdeafkids.org Information from Child’s Voice School, The Moog Oral School, and St. Joseph Institute for the Deaf