Title: Georgia State University Series: Early Intervention with Children who are Deaf and Hard of Hearing
1Georgia State University Series Early
Intervention with Children who are Deaf and Hard
of Hearing
- Part 1, Presentation 3
- July 2001
2Orientation to Hearing Loss
3Arent all babies who have hearing loss the same?
- No. There are different levels of hearing loss
ranging from mild to profound. In addition, two
people with the same level of loss will have
different hearing characteristics.
4There are many variables that may effect the
progress of your child.
- Age of onset
- Etiology
- Degree of loss
- Type of loss
- Use of amplification devices
- Health of the child
- Involvement of the family
- Accompanying disabilities
5Etiology
- Unknown
- High Risk Factors
- Meningitis
- Congenital Infections
- Congenital Rubella
- CMV
- Toxoplasmosis
6- Hearing losses can be
- Congenital or acquired
- Affect one or both ears
- Fluctuate or remain constant
- Can be the result of developmental differences in
various parts of the ear - Can be the result of illness
7Degrees of Loss
- Minimal (Borderline) 15 to 25 dB
- Mild 26 to 40 dB
- Moderate 41 to 55 dB
- Moderate to Severe 56 to 76 dB
- Severe 71 to 90 dB
- Profound 90dB
8Slight Loss 15-25 dB
- No significant speech and language delays
- Hearing abilities should be tested on a regular
basis
9Mild Loss 26-40dB
- Possible difficulty hearing faint /distant speech
- May benefit from hearing aid as loss goes toward
40dB - Will not usually have difficulty in school
- Need vocabulary work
- Needs favorable seating and lighting in school
- May need to speech read to increase understanding
of what is spoken - May need speech therapy to correct mispronounced
sounds
10Moderate Loss 41-55dB
- Understands speaker face to face at 3-5 feet
- May miss 50 of class discussion
- Child referred to special education to determine
support needs
- May have limited vocabulary
- Problems pronouncing some speech sounds
- Benefit from FM System
- Need favorable seating
11Moderately Severe Loss 56-70 dB
- Conversation must be loud to hear it
- Needs a hearing aid
- Difficulty in group activities
- Likely to be deficient in language use and
comprehension
- Need special help in language, grammar,
vocabulary, reading and writing - Attends to visual and auditory situations
- Need resource teacher, special class or tutor
12With hearing aid, Can hear
- Clock ticking
- Liquid pouring
- Snapping fingers
- Doorbell
- Knock at door
- Radio at normal level
- Voices
- Singing
- conversation
13Severe Loss 71-90 dB
- May hear loud voices about 12 from the ear
- Speech and language development delayed
- Speech and language will not develop
spontaneously if loss is present before age 2 - May be able to discriminate vowels but not all
consonants
- Education program needs special emphasis on
language skills, concept development, speech,
communication skill development - May be placed in regular class part time
- May benefit from using sign language
14With Hearing Aid, Can hear
- Thunder
- Telephone ringing
- Alarm clock
- Piano
- Auto horn
- Radio at louder than average level
- Group singing
- Loud shots
- Baby crying
15Profound Loss 90 dB or more
- May hear some loud sounds, is aware of vibrations
more than tones - Hearing aid is necessary
- Relies on vision as primary avenue for
communication - May need alternatives to hearing aid
- Continuous assessment of communication needs is
required - Use of sign language will be helpful
- Speech therapy needed for functional
communication development
16With hearing aid, Can hear
- Organ
- Audience applauding
- Heavy objects dropped on a hard floor
- Banging door
- Large deep bell
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18Types of Loss
- Conductive A change in hearing due to reduction
in sound transmission through the outer ear,
middle ear, or both (Ex. Otitis Media) - Sensorineural A change in hearing due to damage
to structures within the cochlea, to the VIII
cranial nerve, or to both - Mixed Conductive and sensorineural hearing loss
occurring simultaneously
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20The Speech Banana
- Most sounds associated with speech are found
within the shaded area of the audiogram
affectionately referred to as the speech banana.
21Impact on Development
- Language Learning
- Education
- Cognition
- Social-Emotional Development
- Communication
22Impact (continued)
- Without early intervention, the deaf infant will
be delayed in normal developmental processes-
self confidence, intellectual curiosity, good
social relations, and the ability to use language
to communicate and further the learning process. - Hayes Northern, 1996
-
23Hearing Aid and Cochlear Implant Facts
- Caregivers must
- have realistic expectations for the hearing aid.
ALL sound is amplified, not just speech.
- Amplification devices, including hearing aids, do
not restore hearing to normal. - A person with a hearing loss will never have
normal hearing.
24Facts (Continued)
- 92-95 of those who are deaf have SOME hearing.
This is called residual hearing. - The goal is to maximize your childs use of his
or her residual hearing. - It is extremely important for parents to
understand that hearing aid use is an ongoing
process due to changes in hearing loss, growth of
the ear canal and advances in technology. - Children as young as 4 weeks old can be fitted
with a hearing aid
25The FDA has approved Cochlear Implantation for
children who
- Have a profound hearing loss in both ears
- Receive little or no benefit from hearing aids
- Have not other medical conditions that would make
surgery risky - Are involved, along with the parents, in all
aspects of the informed consent process
26Cochlear Implant Facts(Continued)
- Understand, along with the parents, his or her
individual role in successful use - Have, along with the parents, realistic
expectations - Are willing to be involved in intensive
habilitation services - Have support from educational programs to
emphasize the development of auditory skills
27- Patience- teach your child how to use the sound
available to them, which will require many
modifications. Be patient! - Access- amplification will give your child access
to the speech signal. - Relevance- make all interactions with the child
meaningful. - Expectations- high, but realistic, expectations
for your child are critical. - Nurture- provide an abundance of affection.
- Time- learning speech and language through
listening is an ongoing process. - Success- what you put in is what you get out!
28Glossary
- Assistive Listening Devices (ALDs)- refers to
systems that improve the signal-to-noise ratio by
transmitting amplified sound directly to the
listener and transforms sound into a visual or
tactile signal. -
- Audiogram- table that summarizes how loud a
sound must be at a particular frequency for an
individual to hear it - Bilateral- affecting both ears.
-
- Cochlea- the osseous (bony) portion of the inner
ear which surrounds the organ of hearing. -
- Decibels (dB)- used to express sound pressure.
-
29- Frequency- perceived by people as the pitch-
low or high spectrum of sound. -
- Inner Ear- the area beyond the bones of the
middle ear space includes the cochlea. -
- Mastoid Bone- the lower portion of the temporal
bone which lies just behind the ear. - Residual Hearing- the amount of hearing that is
left when a hearing loss is present. - Speech Banana- an area on an audiogram (which
holds the shape of a banana) that covers the
frequency area in which speech sounds are
produced. - Unilateral- affecting one ear.