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Hearing Impairment
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Types of Hearing Impairments
• Congenital Hearing Loss – present at birth
• Acquired Hearing Loss – happens later in life
• Hard of Hearing – hearing is defective but functional for ordinary
purposes.
Levels of Hearing Loss:
Mild
Moderate
Moderately
Severe
26 to 30 dB HL
31 to 50 dB HL
51 to 70 dB HL
Severe
71 to 90 dB HL
Profound
90+ dB HL
General Statistics
• 1 in 5 Americans have hearing loss in at least one ear.
• 20% of the US population ages 12 and older have hearing difficulties
severe enough to impact communication.
• 3 out of every 1000 children is born deaf or hard-of-hearing.
• About 26 million Americans between the ages of 20 and 69 have high
frequency hearing loss due to exposure to loud noises at work or
during leisure activities.
How the Ear Works
S
O
U
N
D
Outer/Middle Ear Damage
Effects ability to
hear loudness of
speech.
Also called
conductive
hearing loss
Can
sometimes be
corrected with
medications or
surgery
Inner Ear Damage
Effects the
clarity of speech
heard as well as
loudness
May be treated
with hearing aids
or cochlear
implants
Also called
sensorineural
hearing loss
Other common Hearing Impairments
• Auditory Neuropathy Spectrum Disorder
• Outer hair cells of the cochlea work properly but the inner do not.
• Causes the transmission of sound from the inner to the brain to be
disorganized.
• Individuals with the disorder can develop strong language skills with the help
of medical devices, therapy and visual communication techniques.
• Auditory Processing Disorder (APD)
• Individual can hear well in a quiet environment but may have difficulty
hearing a noisy one.
• Can be treated with therapy.
Characteristics of a Hearing Impairment
• More response to vibration and touch than to speech and sound.
• More alertness to visual cues such as movement.
• Little or no babbling during infancy.
• Delayed speech language development.
• Gestures rather than speaking.
• Frequent requests to have things repeated.
• Irrelevant answers to discussion at hand.
• Below level academic performance.
• Understands more when watching the speaker’s face.
• Deviations in speech.
Causes of Hearing Impairments
• Conductive hearing loss –
• Otisis Media: ear infection that affects the middle ear. It causes a buildup of
fluid or puss behind the eardrum, which can block the transmission of sound.
A person’s hearing will usually return to normal afterwards.
• Blockages in the ear, impacted earwax or dirt, fluid from colds/allergies.
• Partial ear damage including the eardrum, ear canal ossicles, inserting a
cotton swab too far into ear, sudden explosion or loud noise, change in air
pressure, head injury, or repeated ear infection.
Causes of Hearing Impairments
• Sensorineural hearing loss –
• Genetic disorders
• Injuries to the ear or head
• Complications during pregnancy or birth; infections the mother had while
pregnant
• Infections or illness; mumps, measles, chickenpox, brain tumors
• Medications; anti-biotics and chemotherapy
• Loud Noise; noise induced hearing loss
How can a Hearing Impairment be improved?
1.
2.
3.
4.
Reconstructive Surgery
Hearing Aid
Cochlear Implant
Auditory training
Hearing Aids
• Amplify sound in a controlled manner.
• Components
• Microphone: picks up surrounding sounds
and converts them into electrical signals.
• Receiver: Converts the amplified signals
back into sounds of greater strength.
Cochlear Implant
• Bypasses the damaged inner ear and sends
signals directly to the auditory nerve.
• Components:
• Microphone: Placed behind the ear; picks up sound
waves.
• Receiver: Placed under the scalp; receives sound
waves from microphone. The receiver then transmits
impulses directly to the auditory nerve. These
impulses are then perceived as sound allowing a
person to hear.
Auditory Training For Choral techniques.
• Often used in conjunction with a hearing aid or cochlear implant.
• Emphasis on critical listening and an understanding of listening errors
that are likely to occur.
• Need to develop skills in using other clues for listening such as facial
expression and gestures.
• “speech/lip reading” – using visual cues for listening purposes.
Utilizes facial expressions, gestures, body movements, and immediate
physical setting.
• Hearing loss can result in the deterioration of speech skills, so
auditory training hopes to limit the amount of deterioration that will
happen.
Cognitive Impact of Hearing Impairments
• Lack of communication skills.
• Hearing is a two way street of listening and hearing. It is based on the
ability to handle faint as well as loud speech, mumbled as well as clear.
• Hearing acts as a receptive monitoring function in oral speech. An infant
perceives speech patterns of others and through hearing he monitors
his imitative speech attempts.
• Monitoring continues through development of speech skills as you hear
new words and sounds.
• Early identification is key for children to develop normal hearing skills.
Social Impacts of Hearing
Impairmentsproblems for Choral teachers to
be aware of
• Reduced social activity or problems participating in social activites.
• Problems communicating with friends, family and colleagues.
• Problems communicating in school.
• Isolation and withdrawal.
• Lack of concentration.
• Especially hard if hearing loss occurs later in life after developing
speech and hearing skills.
Emotional Impacts of Hearing Impairments
• Embarrassment, shame, guilt and anger.
• Sadness or depression.
• Anxiety and suspiciousness.
• Self-criticism and low self-esteem and confidence.
What can we do in the rehearsal?
• Technologies –
• Programmable hearing aids that can be adjusted to different environments.
• FM systems where the teacher wears a transmitter connected to a receiver
that the student wears.
• Cochlear implants.
• Real time captioning videos.
• Voice recognition software for note taking.
• ASL – American Sign Language
• Language used by the deaf community.
• Learn a few basic signs and the alphabet.
• Students will sometimes have an ASL interpreter with them if it is needed.
Accommodations
• Seat hearing impaired students near the front of the chorus near
speakers so they can feel the vibrations coming from them.
• Always face the HI student while speaking so they can read your lips
easier.
• Keep rehearsal room well lit so that the HI student can take in all
visual cues.
• Use lots of visual cues including pictures, modeling, overheads and
gestures.
• When playing instruments or singing, have the HI student play the
lower pitched ones so they can more easily feel the vibrations.
Additional Resources
• Butler, M. (2004). How Students with Hearing Impairments Can Learn and Flourish in Your Music Classroom.
Teaching Music, 12(1), 30-34.
• Nilo, E. R. (1969). Needs of the Hearing Impaired. The American Journal of Nursing, 69, 114-116.
• Hearing Health Foundation. (2011). Hearing Loss Statistics. Retrieved February 23, 2013, from Hearing Health
Foundation website: http://hearinghealthfoundation.org/85
• Touchette. (2012). Consequences of Hearing Loss. Retrieved February 23, 2013, from Paradise Hearing &
Balance Clinics, Inc. website: http://www.paradisehearing.com/pages/ consequences-of-hearing-loss
• Schraer-Joiner, L., & Prause-Weber, M. (2009). Strategies for Working with Children with Cochlear Implants.
Music Educators Journal, 96(1), 48-55.
• Music and the Deaf. (2010). Music and the Deaf. Retrieved February 22, 2013, from Music and the Deaf
website: http://matd.org.uk/publications/
• Morlet, T. (Ed.). (2012). Hearing Impairment. Retrieved February 22, 2013, from Teens Health website:
http://kidshealth.org/teen/diseases_conditions/sight/hearing_impairment.html
• https://www.youtube.com/watch?v=2A9j4t8gY-4