Deaf & Hard of Hearing

Ching-fen Hsu

2013/10/18

Lecture 5

A Given Gift • The process of hearing is remarkable

• Being able to hear

• Turn sounds into meaning

• With hearing learning is possible

• About thoughts, ideas, feelings of others

• By listening to others

• Through exchanging knowledge expanded,

ideas shared, emotion expressed,

workplaces/social settings functioned

Dorothy Brett • Born in noble British family

• Partially deaf entire life

• Slade Art College in London

• Bloomsbury Group member

• Horizon broadened by Virginia

Woolf & John Maynard Keynes

• 1924 followed D.H. Lawrence to

new Mexico

• Remained staying in US

Historical Context • 1520-1584 Pedro Ponce de Leon: Spanish monk, 1st

teacher of Deaf students---successful teaching Deaf to

read/write/speak

• 1600s William Holder & John Wallis instituted

educational programs in England for Deaf---writing &

manual communication teaching method

• 1700s school for Deaf established: Henry Baker in

England & Thomas Braidwood in Edinburgh & Abbe

Charles Michel de l’Epee in France & Samuel Heinicke

in Germany & Thomas Hopkins Gallaudet in US (with

Laurent Clerc)

• 1817 1st Deaf school in Hartford in Connecticut (manual

communication, Martha’s vineyard children there)

Debate on Teaching Method • Laurent Clerc (Deaf Frenchman): father of Deaf

education in US

• Hundred years’ war: oral communication vs.

manual communication teaching method debate

• Edward Gallaudet: strongly supported manual

approach & separate center schools

• Alexander Graham Bell: sign language foster

segregation/ legislation should ban two Deaf

persons married each other/ Deaf should not teach

• Advances in battery design make great impact on

their lives of hearing loss

• World War II battery-operated hearing aid possible

Challenges for Hearing Loss • Several groups could be divided:

(1)Mild to moderate hearing loss people profit from hearing aids

= not qualify to receive SE

= does assistive devices fully compensate disabilities?

(2)Using oral language in learning & communication

(3)Using sign language

= separate from hearing society

= ASL becomes a debate

(4)Colorful sign language life

Gallaudet University & Laurent Clerc National Deaf Education Center

• Dr. Mason Cogswell & Thomas Hopkins Gallaudet were neighbors in Connecticut

• Mason sent Thomas to Europe for learning SE of Deaf

• 1856 Amos Kendall donated estate for elementary school of Deaf

• I King Jordan: president of university

• Pioneers in Deaf culture/community movement

• National centers: host social activities, sporting events, competitions

• http://clerccenter.gallaudet.edu

Defined Terminologies

Process of Hearing

Structure of Human Ears • Pinna: outer structure of the ear

• Eardrum: vibrates with presence of sound waves & stimulates the ossicles of middle ear

• Ossicles: three tiny bones in middle ear for passing info to cochlea

• Eustachian tube: equalize pressure on both sides of eardrum

• Cochlea: structure for containing hearing organs

• Hair cells: part of cochlea for responding to different frequencies of sounds & producing electrochemical signals sent on to brain

• Otoacoustic emissions (OAEs): low level of sound produced when hair cells vibrates in inner ear

Conductive Hearing Loss • one type of hearing impairment

• blockage/damage to outer/middle ear

• prevent sound waves from traveling to inner ear

• cause mild to moderate hearing disability

• temporary experience in our lives (airplane)

• 20% elementary students & 80% children bet

kindergarten & fifth grade

• able to be corrected with hearing aids & surgery

& medical techniques (cleanup ear infection)

Sensorineural Hearing Loss

• Hearing impairment due to damage to inner ear/auditory nerve

• Nerve deafness

• Difficult to correct

• Patients can hear different frequencies at different intensity levels

• Their hearing losses are not flat/even

• Less common type in young children

Age of Onset • Congenital hearing loss: at/before birth

• Acquired hearing loss: after birth

• Onset vs. oral language development

(1) Prelingually deaf: become deaf before they learn to speak & understand language

born deaf/lose hearing during infancy

95% children & youth (1:10 one deaf parent)

severely influence communication & learning

mainly learn sign language

(2) Postlingually deaf: profound hearing loss after speech development/ able to have oral communication ability

Degree of Hearing Loss • Mild (21-40dB): only soft speech/sound at a

distance difficult to hear

• Moderate (41-55dB): typical conversational

speech is hard to follow

• Moderately severe (56-70dB): only loud speech

can be heard

• Severe (71-90dB): even loud speech is hard to

understand

• Profound (91dB+): considered “deaf” assistive

listening devices needed

• Residual hearing

Causes (1) Heredity/genetics: most common cause of deafness in

children, congenital/ sensorineural

(2) Meningitis: 2nd most common cause, CNS disease,

affect meninges (coverings for brain/spinal cord),

mostly come from bacterial infections, postnatal

deafness, acquired profound sensorineural hearing

loss

(3) Otitis media: middle ear infection, fluid accumulation

behind eardrum, corrected with antibiotics, frequency &

duration of infection matter, permanent conductive

hearing loss, damaged eardrum, mild to moderate

hearing loss, hearing aids work

(4) Noise: >105dB/ hour is unsafe (rock concert 125dB)

Prevalence • Hearing loss is associated with age

• > 65y have hearing problem

• 1:3 in 65y population

• 25% use hearing aids

• 1:1000 babies is profoundly deaf

• 2-3:1000 hearing loss

• Number underestimated for hearing loss

could be a characteristic of other

syndrome (DS)

Prevention • Avoid German measles

• Major cause of deafness in newborns

• 1972 accounted for 11%

• 1998 1% for immunizations

• Avoid dangerous E over 85 dB

• Wear earplugs

Decibel Levels of Noise in US E

Hearing Aid • Amplification of sounds in E

• Most commonly used device

• From hearing trumpet to today’s hearing aid

• Eliminate need for SE

• Profit from general education classes

(1) Behind the ear (BTE)

(2) In the ear (ITE)

(3) In the canal (ITC)

(4) Completely in the canal (CIC)

• Digital hearing aids:

reduce background noise/ amplify sounds according to

individuals’ hearing profiles

• Disposables for keeping clean/preventing damaged

Hearing Aid Photo

Cochlear Implant

FM Transmission Device • Frequency modulated

• Overcome distance & noise problem

• wireless microphones clipped to shirt & receivers small enough attached to hearing aids

• Background noise reduced

• Greater freedom for teachers/ students

Audio Loop • Listening device directs sound from the

source directly to listener’s ear through

specially designed hearing aid/ earphone

• Used in lecture/ concert hall

• Sound travels through radio waves/ wire

connection

• Inexpensive

• Easy to install in rooms up to 100 seats

• Wire picks up audio signal from amplifier

& transmit to electrical current with a

magnetic field within the area encircled

by the wire

• User receivers convert the magnetic

energy back into sound

What’s on the Horizon? • Blue Cross Insurance Company reimburses implanted

hearing aids surgery

• Middle-ear bones vibrate & transmit sound into inner ear

• 85% improvement in hearing

• Do not amplify distracting background noise

• Animals can regenerate hair cells automatically & regain hearing ability

• Humans cannot

• 80% hearing loss results from damaged hair cells in inner ear

• Regenerating hair cells is possible in humans, but the challenging is the number of cells

Auditory Assessment • pure sounds generated by

audiometer

• Sound waves of specific frequencies

at combinations of Hertz (Hz) &

decibels (dB) & pitch & loudness

• Separate testing for L & R ear

• Audiogram: a grid/ graph

• Scores below 0dB has hearing loss

• Air conduction audiometer method

• Bone conduction audiometer method

• Travis’s hearing

diagram

• Conductive hearing

loss

• Mild range of 40 dB

• Bone conduction test

closes to 0 dB

• A hearing aid is

needed

• Heather’s

audiogram

• Sensorineural

hearing loss

• 30 dB hearing

loss

• Mild hearing

loss with a

hearing aid on

• Speech banana:

speech sounds

range

Early Intervention • Early intervention is very important at four aspects:

(1)Early identification allows children to be fitted with

hearing aids (4 weeks old)/ cochlea implants (1y)

(2)Early intervention (>6 months) pays off in reading

achievement & speech abilities in later years

(3)Preschool programs help develop language

(4)Early intervention programs help families better

understand & meet special needs

• Deaf children with deaf parents develop well at

reading > Deaf children with hearing parents

• Sign language becomes their native language

Communication First • Dina The Deaf Dinosaur

• Importance of learning ASL

• Note culture differences & family experiences

• Early identification & early intervention must go hand in hand

Tips for Classroom Management

• Place Ss as close to the speaker as possible

• Face Ss when talking

• Reduce background noise as much as possible

• Do not stand with direct light behind you

• For class discussions, make sure Ss know who is

about to speak & ensure seeing faces in talking

• In discussions, arrange Ss’ chairs in a circle

Review Objectives After this course, you should be able to….

• Explain variables that must be considered when planning instruction for students with hearing problems

• List and explain the major causes of hearing loss

• Describe and justify universal hearing screening of newborns

• Discuss the concept of Deaf culture, list examples or signs of Deaf culture, and describe its importance to the Deaf

• List the major types of assistive technology specifically designed for people with hearing problems, and provide examples for each

Hands Are Bridges

Questions?