By: Pam George How will I communicate with this student? Do I need to learn sign language? Can...
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Transcript of By: Pam George How will I communicate with this student? Do I need to learn sign language? Can...
By: Pam George
How will I communicate with this student?Do I need to learn sign language?
Can he/she hear me when I am teaching a lesson?
Who is the hearing support teacher and what does that person do?
Who is the interpreter and what does that individual do?
What is this chart with X’s and O’s on it? What does a hearing loss sound like?
Resource for information regarding hearing loss In-service staff in school building about hearing loss
Ensuring student success rates in mainstream setting
Addressing any and all concerns classroom teacher may have
Troubleshooting equipment “Hub” of IEP team
On-going communication between team members Caseload manager
Familiarizing teachers with specially designed instruction and student needs Modifications to tests, assignments, etc.
Outer Ear (Pinna)The part of the ear you see every day.Made of cartilage and skin.
Ear Canal (External Auditory Meatus)You find ear wax in this part of the ear.
Purpose of the Outer EarAmplifies soundAssists in localization of sound, especially
elevation and front and back
Tympanic Membrane (Eardrum)Thin layer of skin stretched tightly to allow
vibration of sound Ossicles
Malleus, Incus, Stapes- the smallest bones in the body!
Eustachian TubeRuns from the middle ear to the back of the
throat Purpose of the Middle Ear
Serves as a bridge from the outer ear to the inner ear
Cochlea The hearing portion of the ear filled with fluid Shaped like a snail Has tiny hairs that move to create impulses
that are sent to the brain Beyond the cochlea
The VIII Nerve Carries impulses from cochlea to brainstem
The Brainstem Serves as a relay station
The Brain Receives signals from the brainstem and interprets
the signals in terms of their sound content
Four types of hearing loss: Conductive
Caused by injury, obstruction, or disease of the outer or middle ear that prevents the ear from conducting sound.Fluid in the middle ear, wax build-up, absence or
malformation of the outer ear, ear infectionsThe loss CAN be medically or surgically
corrected
Sensorineural Damage to the sensory hair cells of the inner ear
or the auditory nerve that leads to the brainEffects the way one hears clearly and how one
understands speech correctlyThe loss is permanent and CANNOT be corrected
Mixed A combination of conductive and sensorineural
lossesPart of the damage is in the outer ear or
middle ear and the other part is in the inner ear.
Central The outer, middle, and inner ear are intact. The impairment is to the VIII nerve or brain.
Degree of Hearing Loss
Hearing Loss Range(db HL)
Normal -10 to 15
Slight 16 to 25
Mild 26 to 40
Moderate 41 to 55
Moderately Severe 56 to 70
Severe 71 to 90
Profound 91+
Decibel: the unit measurement of intensity, or loudness, of sound
MILD (26 to 40 dB)Difficulty understanding faint or distant speechMay need work to develop vocabularyFavorable seating and lighting in classroom
MODERATE (41-55 dB)Understands speaker face to face or a short
distanceMay miss as much as 50% of class discussionMay need vocabulary development, speech
therapy, or special class placement in primary grades
MODERATELY SEVERE (56-70 dB)Conversation must be loud to be heardWill need a hearing aid and training with its useIs likely to have problems pronouncing sounds,
have language delays, and limited vocabularyWill need extra help in Language Arts, speech
therapy SEVERE (71-90 dB)
May hear loud voices or sounds very close to earSpeech and language development are delayed.Will need extra help with language skills, concept
development, speech, intensive communication building skills should be taught
May be a candidate for cochlear implant(s)
PROFOUND (91+ dB)May be a candidate for cochlear implant(s)Socializing with hearing peers may be
difficultMay have language delays, very limited
vocabulary, intensive speech therapyNote-taking, captioning, and other visual
enhancement strategies are necessary
http://www.audibel.com/understanding/simulator_flash.html
Gives us volumes of information about what a student can and cannot hear.
It is conducted by an audiologist in a sound-proof booth
Child wears headphones and listens for tones, or beeps, and gives a conditioned response Raising handPlacing toys into bins
Red: Right Ear
Blue: Left Ear
Low
Soft
High
Loud
Does this student have a hearing loss? Take a look at the DEGREE of hearing loss chart and
compare…
Approximately 28 million Americans have a hearing impairment. Hearing loss affects approximately 17 in 1,000 children under age 18.
Incidence increases with age: Approximately 314 in 1,000 people over age 65 have hearing loss and 40 to 50 percent of people 75 and older have a hearing loss.
About 2 to 3 out of every 1,000 children in the United States are born deaf or hard-of-hearing. 9 out of every 10 children who are born deaf are born to parents who can hear.
Everyday in the United States, approximately 1 in 1,000 newborns (or 33 babies every day) is born profoundly deaf with another 2-3 out of 1,000 babies born with partial hearing loss, making hearing loss the number one birth defect in America
o Only 1 out of 5 people who could benefit from a hearing aid actually wears one.
Three out of 4 children experience ear infection (otitis media) by the time they are 3 years old.
There are approximately 22 million hearing-impaired persons in the U.S. Deaf people have safer driving records than hearing people nationally. The huddle formation used by football teams originated at Gallaudet
University, a liberal arts college for deaf people in Washington, DC, to prevent other schools from reading their sign language.
Misconceptions: All students use residual hearing the same way. Examples:
A student with a PROFOUND hearing loss may use speech only and is a good lip reader and another student with a PROFOUND loss may use sign language with no speech and does not lip read.
When I talk, the student looks like she’s heard me and understands what I’ve said. If you hear a person speaking Japanese, you HEARD it,
but did you UNDERSTAND it?
Hearing aids and cochlear implants cure hearing loss. Yelling at a deaf person will help him/her understand you better. All deaf and hard of hearing students use sign language. Politically correct: Deaf and Hard of Hearing
Amplification allows a better chance of understanding speech
Help a child access residual hearing and learn how to use this hearing in the most optimal way
Let’s take a look at different listening devices and assistive technology…
How they work:All have a…
Microphone: receives sound/signal Amplifying circuit: shapes the sound to make
it louder Receiver: changes the signal back into sound
that can be heard Earmold: the colored ear piece in the ear canal
Are powered by batteries Internal controls are set by an audiologistExternal controls are set by the user
(volume)
Most common among children Can attach to assistive listening devices
(FM) Microphone is on the back part behind
the ear May hear “squealing” from the aid
This is called FEEDBACKDue to the closeness of the microphone to
the receiver, there is “feedback” or squealing when the earmold is loose or too small
Each group has a hearing aid, stethoscope, battery tester, and a battery
1st: Check the battery in the tester 2nd: Put into the hearing aid 3rd: Put canal part of earmold into the
stethoscope hose 4th: Turn on hearing aid 5th: Ling Six Sound Test
Say: /ah/, /ee/, /oo/, /s/, /sh/, /m/How did it sound?????
In the Ear (ITE)
In the Canal (ITC)
These types of hearing aids are rarely used with children.
Surgically implanted device Offers severe-to-profoundly deaf children
access to sound Bypasses the damaged part of the inner
ear, stimulates nerve, sends information directly to brain
Three parts:Receiver- the part that is implantedTransmitter- head piece (circular piece)Speech Processor- worn on the body,
shapes sound
Sound waves enter the microphone located in the headpiece
Sound is sent through the transmitter and along the wire to the speech processor
Speech processor changes the sound into a special signal that is sent to the implanted receiver
The receiver sends the signal to the brain where it is interpreted into sound
LET’S WATCH!!
How a cochlear implant works...
Cochlear Implant Simulations
What is an FM?Frequency-Modulated system that allows a
D/HH student hear over a distance and sends the speaker’s voice directly to the hearing aid or cochlear implant
*Without an FM, the speaker’s voice can be difficult to understand when paired with everyday background noise (heaters, buzzing lights, pencil sharpeners, etc.)
An assistive listening device that’s microphone is worn 6 inches from the mouth
Improves the sound-to-noise ratio by reducing distance of sound source
Each personal FM system can be very different depending on the hearing aid type and its unique features
Campus S Easylink
Accessibility of the teacher’s voice to all students in the classroom
A microphone is worn around the neck Sound is sent from the microphone to
amplifier that is connected to loudspeakers
Carpeted box in all of the classrooms Has several benefits to both D/HH
students AND hearing students
Many children benefit from sound field systems:Children with hearing lossChildren with central auditory processing
disorderStudents with ADD and ADHDStudents with developmental delaysPreschoolers, kindergarteners, and first
graders who are in crucial learning stages of language development
ESL studentsStudents with dyslexia
•Several Different Modes:•Auditory/Oral•Auditory-Verbal•American Sign Language (ASL)•Cued Speech•Signed English or (SEE)•Total Communication•Rochester Method•Contact Signing•Manually Coded English (MCE)
There is no ONE PERFECT mode for every child. Each child’s hearing loss is unique and his/her communication mode should match that loss.
Responsibilities: Facilitate communication Sign everything that is voiced Will stand/sit close to teacher
Not responsible: Classroom management Tasks such as teaching, grading papers,
making copies Disciplining students (deaf and hearing)
Language delayed Spoken language
Not uncommon for students to speak with nasal or atonal quality
Academic performance Vocabulary development delays Reading and writing difficulty Difficulty in comprehension across academic subjects
Idioms and familiar English phrases interpreted literally Written and oral language will reflect the way he/she hears
-Word endings –s,-ed, -ing Depends on age child was diagnosed with a hearing loss.
Many deaf children are not “vanilla deaf” Limited phonemic awareness
What does the student hear during everyday conversation? Look at the Speech Banana. Example: The fox saw two hens. Even with a mild loss, the student misses
most of those sounds. /e ok aw oo en/
Imagine reading and pronouncing these sounds that D/HH students so rarely hear.
Message: Ann needed new shoes.Question: “Who needed new shoes?”Student’s response: “Ann nanna”
DID vs. DIG *A student who uses sign and speech to communicate reads a passage two times. The first time is with speech ONLY. He reads, “The boy walked to school. He did this everyday”. Then, when asked to SIGN the sentences, he signs The-boy-walk-to-school. He DIG this everyday.
Did he get it right? Is the message still the same? No way!
•Use visual aids whenever possible
•Use overhead instead of the board
•Have key vocabulary accessible visually
•Provide a note-taker or hand-out of notes
•Allow for breaks •Educate the class about hearing loss
•Eliminate or reduce extraneous noise
•Reduce the distance from you to student
•Face the student when speaking
•Appropriate use of equipment
•Advantageous seating for student
•Repeat questions and comments other students make
•Do not speak with back faced to class
•Point out who is speaking in class discussions
•Do not stand or sit in front of a bright window
•Write announcements and assignments on board
•Always use captioned films/videos
•Flicker lights to get classroom attention
•Avoid chewing gum while lecturing
•Lecture from the front of the room, avoid pacing
•Speak directly to the student, not the interpreter
What can be done to setup the deaf student for success?SEATING
“U” shaped desk arrangement Close to where teacher will be doing most of lecturing Facing away from the windows Students with cochlear implants should sit with C.I. side closest to
speaker. At ear level to the sound field, if used, approximately 3-6 feet away Avoid seating the student next to noisy heaters and fans, buzzing lights,
computers/printers, projectors, pencil sharpeners, or classroom sink
ACOUSTICS Cover hard, smooth surfaces with sound-absorbing materials like
carpeting, felt, table cloths. When noise is present, the student will have difficulty understanding or
attending to discussion. Inappropriate acoustics can compromise understanding speech,
behavior, language experiences, concentration and academic achievement.
Modified curriculum Accessibility to communication via an educational
interpreter Clear desk prior to new assignment Establish eye contact prior to giving directions Management of noise level in classroom Increased wait time to allow for language processing Use of appropriate amplification (hearing aids, C.I.’s,
etc.) Modify assignments to meet language needs Preferential seating Frequent review of skills and concepts
•Exposure to loud noises over an extended period of time damages the hair cells in the ear.•These hair cells cannot grow back causing noise-induced hearing loss.•Examples of harmful loud noises:
•Motorcycles•Firecrackers•Explosions•Concerts•MP3 players at loud volume•Chainsaws•Jet Engines
•The length of time exposed to these noises will determine whether a person will acquire
noise-induced hearing loss.
•What can be done to prevent it?•Limit exposure and time of exposure to loud harmful sounds
•Wear protective hearing devices or earplugs
American Speech-Language-Hearing Association. (2005). Acoustics in Educational
Settings: Position Statement [Position Statement]. Available from www.asha.org/policy
Bess F. The minimally hearing-impaired child. Ear and Hearing, 1985; 6:43-47
Centers for Disease Control and Prevention. National Center for Birth Defects and
Developmental Disabilities, Early Hearing Detection and Intervention Program. http://www.cdc.gov/ncbddd/ehdi/default.htm.
"Interesting Facts about the Deaf." DeafNet. 19 July 2008 <www.deaf.net>.
http://kidshealth.org/parent/general/eyes/cochlear.html website
Laughton, Joan. "Educating Children Who are Deaf or Hard of Hearing: Cochlear Implants." ERIC Clearinghouse on Disabilities and Gifted Education Reston, VA. 15 Sep. 2008 <www.ericdigests.org/1998-2/implants.htm>.
“Mainstreaming the Student Who is Deaf or Hard-of-Hearing.” Guidebook. Melanie Doyle, M.Ed., Linda Dye, M.A., CCC-A Director of CCHAT Center, SanDiego. January 2002.
National Association of the Deaf website. Community & Culture.
<www.nad.org>
"Noise-Induced Hearing Loss." www.nidcd.nih.gov. 1 May 2007
<nidcd.nih.gov/health/hearing/noise.asp>.
http://www.nidcd.nih.gov/health/hearing/coch.asp website
Images:
http://www.bcchildrens.ca/NR/rdonlyres/1E47B20B-D686-44BF-A811-B4AE48E4DCB7/16095/BTE.jpg
http://www.theitinerantconnection.com/images/hearing%20aid%20in%20ear.jpg
http://mortonplant.com/images/In%20canal.jpg
http://www.youtube.com/watch?v=SmNpP2fr57A
http://www.phonak.com/de/professional/productsp/instrumentsp/digitalp/products_instruments_digital_micropower.htm?activetab=31736
http://www.netac.rit.edu/gphx/tipsheets/cued.gif