DIFFICULTY IN HEARING
Objectives:
understand the nature and causes of deafness.
demonstrate skills in identifying learners with hearing difficulty.
THE ALPHABET SIGN LANGUAGE
Introduction
Hearing is one of the most important senses for each individual
that is concerned about perception of sounds. It allows and leads our
everyday lives without limitations. It enables us to work, communicate,
socialize and stay connected to the outside world. Moreover, it keeps us
safe by warning us of possible danger.
Hearing is all about auditory perception that refers to the capacity
of the brain to interpret and generate a clear impression of sounds.
Good auditory skills allow us to determine between different rhythms,
volumes, pitches and sources of sounds as well as words that will aid
teaching-learning reading the easiest way. It can also be the sense of
sound perception which can be detected through vibrations or the
changes in the pressure of the surrounding medium through time,
through an organ such as the ear.
Learners with Difficulty in Hearing have the right to equal access to
education and provide them the best possible education as regular
pupils/learners are enjoying. Their increasing numbers who are in school
is a manifestation that there is a need for regular school teacher to help
these children as an answer to the inclusion program of the Special
Education.
This handbook could somehow help our regular teachers in the
holistic development of the Learners with Difficulty in Hearing (LWDH).
Description
Hearing loss can be:
congenital - present at or soon after birth;
acquired - which develops later;
pre-lingual - before a child has fully developed speech;
post-lingual - after the development of speech;
conductive - caused by blockage or damage in the outer
and/or middle ear
sensorineural - caused by damage to, or malfunction of,
the cochlea, or hearing nerve, or a combination of both.
DEGREE OF HEARING LOSS
Deaf/Deafness refers to a person who has a profound hearing loss
and uses sign language.
Hard of hearing refers to a person with a hearing loss who relies
on residual hearing to communicate through speaking and lip-
reading.
Hearing Impaired/Difficulty in hearing is a general term used
to describe any deviation from normal hearing, whether permanent
or fluctuating, and ranging from mild hearing loss to profound
deafness.
CHARACTERISTICS OF LEARNERS
WITH DIFFICULTY IN HEARING
Observations that a learner is suspected to have difficulty in
hearing:
____ shows strained expression when listening
____ less responsive to noise, voice or music
____ moves closer to speaker when talked to
____ watches face especially the mouth and the lips of the speaker
____ often asks for repetition when talked to
____ delayed or no responses to questions
____ makes use of natural gestures, signs and movements
____ has a limited or no speech
____ has limited vocabulary
____ speaks in words rather in sentences
____ talks with poor rhythm
What Causes Hearing Loss in Young Children?
Hearing loss can be present at birth, or it may develop sooner or
later in life. It may be hereditary, or it may be caused by problems during
pregnancy or delivery. It is often difficult to pinpoint what has caused
hearing loss in a particular child. Hereditary factors cause a large
percentage of hearing loss in children. The hearing loss may be caused
by a defect of the outer or middle ear, but more often the damage exists
in the inner ear (cochlea).
Genetic counselling can be helpful to the family in determining
whether heredity is the cause.
Hearing loss may also be the result of:
- maternal illness during pregnancy (German measles, chicken
pox, mumps, diabetes, menopausal)
- exposure to certain drugs (gentamicin, neomycin, streptomycin,
kanamycin, quinine sulfate)
- complications during delivery (eclampsia, placenta previa)
Acquired hearing loss occurs after birth:
- may result from prematurity,
- low birth weight/malnutrition
- incompatibility of the Rh factor of blood between the parents,
- use of ototoxic drugs during the neonatal period
- over dosage on antibiotics
- cytomegalovirus (CMV) or oxygen deprivation
- Illness (meningitis, encephalitis, mumps, jaundice, high fever)
- accidents
- loud sounds
- excessive/often cleaning of inner ear
TYPES OF HEARING LOSS
1. Conductive hearing loss
- an obstruction of air conduction that prevents the proper
transmission of sound waves through the external auditory canal
and/or the middle ear.
- may be temporary or permanent, depending on the cause that
can be differentiated by which part of the ear it affects - either
the outer or middle ear:
CAUSES:
Outer ear
Stenosis or a narrowing of the ear canal
Wax impaction
Exostoses (bone-like protrusions that can develop
inside the ear canal and cause potential cause
blockages)
Otitis externa (also known as swimmer's ear)
Obstructions caused by foreign bodies inserted into
the ear (i.e. insects, foreign objects)
Middle ear
A breach in the tympanic membrane caused by injury,
ear infections or extreme and rapid air pressure
changes
Tympanosclerosis or a thickening of the tympanic
membrane (pus)
Otitis media or a buildup of fluid in the middle ear
Blockages in the eustachian tube, which connects the
middle ear to the back of the nose and throat
Otosclerosis, a rare medical condition that causes the
middle ear bones to freeze up
Abnormal growths or tumors that form within the
middle ear, such as cholesteatoma or glomus tumours
Ossicular chain discontinuity or a break in the
connection between the bones of the middle ear,
caused by injury or heavy trauma.
2. Sensorineural hearing loss
- occurs when the sensory receptors of the inner ear became
dysfunctional.
- it is the most common type of hearing loss and It is
permanent.
CAUSES:
- damaged tiny hair-like cells in the inner ear or to the auditory
nerve
- congenital malformation of the inner ear, intense noise,
trauma, viral infections, ototoxic drugs (e.g., cisplatin,
salicylates, loop diuretics)
- fractures of the temporal bone, meningitis, ménière's
disease, cochlear otosclerosis, aging (i.e., presbycusis)
3. Mixed hearing loss
- A combination of sensorineural and conductive hearing loss.
CAUSES:
- illness
- trauma
- wax impaction
- aging
CATEGORIES OF HEARING LOSS
The definition of hearing loss is not the same for everybody. The
different degrees of hearing loss are divided into categories. The most
common categories of hearing loss classifications are mild hearing loss,
moderate hearing loss, severe hearing loss and profound hearing loss.
Mild Hearing Loss
On average, the quietest sounds that people can hear with their
better ear are between 25 and 40 dB. People who suffer from mild
hearing loss have some difficulties keeping up with conversations,
especially in noisy surroundings.
Moderate Hearing Loss
On average, the quietest sounds heard by people with their better
ear are between 40 and 70 dB. People who suffer from moderate hearing
loss have difficulty keeping up with conversations when not using a
hearing aid.
Severe Hearing Loss
On average, the quietest sounds heard by people with their better
ear are between 70 and 95 dB. People who suffer from severe hearing
loss will benefit from powerful hearing aids, but often they rely heavily on
lip-reading even when they are using hearing aids. Some also use sign
language.
Profound Hearing Loss
On average, the quietest sounds heard by people with their better
ear are from 95 dB or more. People who suffer from profound hearing
loss are very hard of hearing and rely mostly on lip-reading, and/or sign
language.
The level of severity of hearing loss is defined as follows:
10 to 15 dB HL Normal Hearing
16-25 dB HL Slight Hearing Loss
26-40 dB HL Mild Hearing Loss
41-55 dB HL Moderate Hearing Loss
Moderate-Severe Hearing
56-70 dB HL
Loss
71-90 dB HL Severe Hearing Loss
>90 dB HL Profound Hearing Loss
(Average threshold level re for 0.5, 1 and 2 kHz, Clark (1981)
Normal sloping to Moderate mixed hearing loss for the left
moderate sensorineural hearing loss in the ear.
left ear.
Moderate conductive hearing loss in the left Mild to moderate conductive hearing loss
ear. Normal sloping to in the right ear
moderate sensorineural hearing loss in the
right ear.
Degree of difficulty in hearing is measured by the decibels (a unit
used to measure the intensity of a sound or the power level of an
electrical signal by comparing it with a given level on a logarithmic scale.
It also measures the degree of loudness.)
The Speech Banana is used to explain the area where the
phonemes (sounds of human speech) appear on an audiogram. When the
phonemes are plotted out on the audiogram they take the shape of a
banana, therefore audiologists and other speech professionals refer to
that area as the speech banana. While many other sounds fall outside of
the speech banana, audiologists are most concerned with the frequencies
within the speech banana because a hearing loss in those frequencies
can affect a child's ability to learn language.
The speech banana enables you to understand further the
audiogram test given by the audiologist in your area.
In the audiogram test, the symbol “x”, typically marked in blue,
corresponds to the left ear.
The symbol “o” typically marked in red,
corresponds
to the right ear.
If the audiogram test of the child is graphed within the range of 0-
20dB, he will likely to hear water drops, falling and whistling of leaves
and the chirping of birds, thus categorizing him to have a normal
hearing.
If the audiogram test falls under the range of 20-40dB, he will likely
to hear the ticking of the clock and some phonemes ( l, ng, n, m, v, f, th,
s) thus categorizing him to have a mild hearing loss.
If the audiogram test falls under the range of 40-70dB, he will likely
to hear the cry of a baby, dogs barking and some phonemes ( j, z, g, i, u,
b, d, a, o, r, p, -ch, -sh, h, k) thus categorizing him to have a moderate
hearing loss.
If the audiogram test falls under the range of 70-90dB, he will likely
to hear the piano keys and telephone ringing relying to its vibration thus
categorizing him to have a severe hearing loss.
If the audiogram test falls under the range of 90-120dB, he will
likely to hear a truck siren, lawn mower, gunshot, airplanes and
helicopters that are about to take off thus categorizing him to have a
profound hearing loss.
ACCOMMODATIONS TO SUPPORT HEARING IMPAIRED/DIFFICULTY IN HEARING
LEARNERS
CLASSROOM ASSISTIVE PARENT’S TEACHING SUGGESTED
ACCOMMODATIO TECHNOLOGIES / AWARENESS STRATEGIES ACTIVITIES
N SUPPORT SYSTEM
MILD -Regular -Hearing Aids -Home -Use real -Group
classroom setting Visitations materials, activities
and may apply -Frequency objects, Picture
Modulation (FM) -Psycho Exchange -Film Viewing
MODERATE -Put the learner Education Communication
HEARING close to the -Telecommunications Seminars System (PECS) -Manipulation
LOSS teacher for better Device for the of objects and
sound reception Deaf(TDD) -Information -Total hands on
and visual clues dissemination communication activities
-Teletypewriter (TYY) during (using ASL and
-Reduce auditory barangay spoken language -Role playing
distractions -Speech therapist assemblies simultaneously)
-Proper hand
-Get the learners -Through the -Explicit and eye
attention before help of a instruction coordination
starting the class medical (repetitive
practitioner instruction) -Vocabulary
-Make use of the enrichment
residual hearing -Through -Collaborative (Pictographs,
by talking aloud advertisements learning spelling,
(television, -Oral puzzles,word
-Speak slowly, radio. communication hunt)
clearly and face pamphlets and (teach without
to face with the flyers) signing since the -Arts for fine
learner learner has motor
-Listening to residual hearing) (drawing, clay
-Rephrase success stories molding,
-Field beads making,
-Write key words -Counseling trips(school and scribbling)
and outline community)
-Puppetry
-Clearly enunciate -Sign language -Keep narrative
speech program for report -Sorting
parents -Matching or
-Specialized -Step by step pairing
seating directions
arrangement -Family support -Seizing
-Captioning or (search)
-Enhance scripts for
speechreading television, -Classifying
conditions videos, movies,
filmstrips -Sequencing
- Clearly
enunciate speech -visual -Identifying
supplements
-Educational -Comparing
interpreter
-Recognizing
-Obtain student’s
attention prior to -Solving
speaking Problems
(simple)
-Reduce visual
distructions -Organizing
Ideas
-Present
information in
simple,
structured,
sequential
manner
-Allow extra time
for processing
information
-Frequently check
for understanding
SEVERE
-Regular -Hearing Aids -Home -Practice and -Enhance
and classroom setting visitation allow Lip speech
may apply -Frequency Reading ( wear reading
PROFOUN Modulation (FM) -Psycho red lipstick for conditions
D HEARING -Put the learner education women (avoid hands
LOSS close to the - seminars teachers) in front of
teacher for better Telecommunications face, no gum
visual clues Device for the -Information -Use Picture chewing)
Deaf(TDD) dissemination Exchange
-Reduce during Communication -Allow extra
classroom noise -Teletypewriter (TYY) barangay System (PECS) time for
assemblies processing
-Get the learners -Cochlear Implant -Provide information
attention before -Through the communication
starting the class -Smartphone apps help of a through Basic -Frequently
(android, ios) medical Sign Language check for
-Specialized practitioner (ASL, FSL, understanding
lighting Localized signs)
-Through -Repeat or
-Captioning or advertisements -Assign a buddy rephrase
labeling things (television, for note sharing information
inside the radio, and discussion when
classroom (for pamphlets and necessary
familiarization) fliers) -Field
trips(school and -Group
-Use of visual -Listening to community) activities
supplements success stories
(overheads, -Keep narrative -Film Viewing
chalkboard, -Counseling report
charts, -Manipulation
vocabulary lists, -Sign language -Step by step of objects and
lecture outlines) program for directions hands on
parents activities
-Vibrating alert -Captioning or
devices (used to -Family Support scripts for -Role playing /
signal fires, television, Pantomime
doorbells, videos, movies,
weather warnings filmstrips -Proper hand
and more. These and eye
devices can be -visual coordination
used in the supplements
classroom to alert -Vocabulary
to schedule bells enrichment
and other (Pictographs,
important spelling,
announcements) puzzles,word
hunt)
-Arts for fine
motor
(drawing,clay
molding,
beads making,
scribbling)
-Puppetry
-Seizing
(search)
-Classifying
-Sequencing
-Identifying
-Comparing
-Recognizing
-Solving
Problems
(simple)
-Organizing
Ideas
OTHER BASIC SIGN LANGUAGE
NUMBER CHART
Days Of The Week
SIMPLE GREETINGS
WH- QUESTIONS
