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WHEN EYES MUST HEAR Understanding Hearing Loss Centre on Aging Spring Research Symposium May 03, 2010 1 2 Hearing Loss The Invisible Disability 3 Definitions Hard of Hearingg ◦ Applies pp to anyy pperson who has a hearingg loss ◦ Usual means of communication is spoken p language ◦ Includes late deafened ◦ Those Th d deaff in i childhood hildh d and d educated d t d orally ll 4 Definitions Late Deafened ◦ An individual who may have grown up hearing or hard of hearing but lose all hearing at some point. ◦ May also self identify as deafened or oral deaf ◦ Can be caused by trauma, illness, surgery or unknown reasons 5 Definitions deaf - lower case d ◦ Used to describe those with early onset hearing loss who have little or no residual hearing. ◦P Preferred f d mode d off communication i ti is i speechh and speechreading ◦ Many with cochlear implants fall into this category g y 6 Definitions Deaf – upper case D ◦ These individuals are members of a sociolinguistic g and cultural group g p whose preferred mode of communication is sign language 7 Definitions Hearing impairment Denotes limitation of one or more basic components of the auditory system. 8 Definitions Handicap Handicap refers to social and environmentall factors f and d results in disadvantage g in areas such as education, employment, leisure and recreation 9 Definition Hearing Disability Disability refers to the lack, loss or reduction d off the h ability b l to pperform certain tasks such as listening, using the telephone and communicating 10 The Ear Classification of Hearing Loss Conductive Sound cannot get through the outer or middle ear. Generally medically correctable. x Ear wax x Cold/ infections x Foreign object in ear x Perforation or holes in eardrum x A break in the hammer, anvil or stirrup p x Blows to head,, loud noises/explosions 12 Classification of Hearing Loss Sensorineural y Occurs when the nerve endings or fibres in the cochlea or auditory nerve cannot pick up or transmit information to the brain. y Most often permanent. y Most common type of hearing loss experienced by adults. 13 Causes of Sensorineural Loss Congenital ◦ Maternal M t l contact t t with ith rubella b ll ◦ Inherited 14 Causes of Sensorineural Loss Acquired q after birth x High fever illness x Exposure to certain medications x Exposure to loud noises x The aging process 15 Damaged Hair Cells Damaged hearing hair cells in the cochlea 16 Presbycusis I can hear you talking but I can’t ’ UNDERSTAND U S you! 17 Presbycusis y Multidimensional disorder y Impaired cochlea and y Impaired p central auditoryy system y includingg the brain stem and auditory cortex y Can vary in severity from mild to severe 18 Effects of Presbycusis y Unable to hear the high g frequency q y sounds y People will sound as if they are mumbling y Decline D li iin speech h understanding d di will ill be b greater than could be expected from h i loss hearing l alone l because b off the th involvement of the central auditory system t 19 Effects of Presbycusis Will have ggreater difficultyy hearingg in noisy environments y Will have ave difficulty cu ty comprehending co p e e g rapid ap speech y May have trouble remembering the entire sentence in multiword sentences y This memory loss may be attributed to dementia or senility rather than hearing loss y 20 “Huh???” Huh??? 1. “You _ _ould _ _e _ery _ y careful when _aving your _in”. 2. “I _ared my _resh _ruit with _aron aron”. 3 3. “The _ewing “Th i gum was stuck t k under the _elf. “Huh???” Huh??? 4. “I _ose to read the last _apter _irst.” 5. “I _ave a terrible _ruise on my _in.” 6. “I _opped my _eese cube on the _ag g rug.” “Huh???” Huh??? 1. “You should be very careful when shaving your chin.” 2. “I shared my fresh fruit with Sharon.” 3. “The chewing gum was stuck under the shelf.” “Huh???” Huh??? 4. “I chose to read the last chapter p first.” 5. “I have a terrible bruise on my shin.” 6. “I dropped my cheese cube on the shag rug. Classification System Degree of Hearing Loss N Normal l H.L Range In Decibels dB -10 10 to 15 Slight 16 - 25 Mild 26 - 40 Moderate 41 – 55 Moderately Severe 56 – 70 Severe 71 – 90 Profound 91+ 25 Sentences y I don’t want to go to the movies tonight. y Put that cookie back in the box. y How do spell your name? y This suit needs to go to the cleaners. y Where have you been all this time? 26 Unfair Hearing Test 1. FILL 6. WEDGE 2. CATCH 7. FISH 3. THUMB 8. SHOWS 4. HEAP 9. BED 5 WISE 5. 10 JUICE 10. 27 Impact of hearing loss y Frustration y Anger y Anxiety y Withdrawal y Isolation y Depression 28 Difficult Communication Situations Speaker p ◦ Speaking too fast, or too slow ◦ Poor enunciation ◦ Face covered or turned away ◦ Something in/covering mouth 29 Difficult Communication Situations Speaker p y Tongue piercings y Accents y Beards and moustaches y Speaking from another room 30 Difficult Communication Situations Environment y Large rooms y Background noise y Bare walls and floors 31 Difficult Communication Situations Environment y Poor lighting y No/poor public address system y Conversations in vehicles 32 Difficult Communication Situations Environment y Lectures, etc depend on good pp.a. Lectures a system and using it y Lighting, surfaces y telephones 33 Difficult Communication Situations Hard of hearingg individual y Doing two or more things at once y Hearing aid fatigue y Not wearing aids y F ti / t ffeeling Fatigue/not li wellll physically h i ll 34 Communication Tips Speaking p g y Enunciate but do not over exaggerate y Speak at normal pace using appropriate pauses y Normal volume y S ll out if needed Spell d d y Rephrase if needed 35 Communication Tips Bodyy Language g g y Face the person y Use body language y Keep face in view y D nott whisper Do hi 36 Communication Tips Bodyy Language g g y Limit head movements y Speak directly to person y Be aware of beards , moustaches etc 37 Communication Tips Environment and location y Quiet spot y Avoid backlighting so you are not in shadow y Stairwells cars, Stairwells, cars busy streets/malls 38 Living with Hearing Loss Program y Designed to help Hard of Hearing and Late D f d Adults Deafened Ad lt to t cope effectively ff ti l att home, h at work and at play. y Includes practical Speechreading exercises y Teaches how to LIVE with your hearing loss and to adapt to difficult listening situations without stress y Assertiveness training 39 Does speechreading Help? Condition of Test % of Speech U d t d Understood Listening no aid no lipreading Listening, 21% Listeningg with lipreading, p g, no aid 64% Listening with aid, no lipreading 64% Listening with aid and lipreading 90% 40 Does speechreading Help? The results on the pprevious slide were first obtained in controlled experiments at the University of Manchester and have been verified since. i Th Those tested t t d were adults d lt off various ages who had developed a hearing loss after school age. 41 Living with Hearing Loss Program Lesson Outline: 1. 2. 3. 4. 5. 6 6. 7. 8 8. Warm-up using familiar words, phrases etc. Examination of Speech p Movement Practice with mirrors Discussion of coping skills/strategies Exercises Group activity Assignment R i and Review d Ti Tip ffor EEveryday d Living Li i 42