HEARING IMPAIRMENT

Definitions and Concepts in the Field of Hearing Impairment

 Hearing impairment
◦ Disordered hearing
 Hearing sensitivity loss
◦ Described in range from mild to profound
 Deaf/deafness
◦ Nonfunctional hearing; federal definition refers to the educational impact due to the
hearing loss
 Hard of hearing
◦ Residual hearing ability
 Minimal hearing loss
◦ Difficultly hearing at a distance or with background noise
 Deaf culture
◦ The term Deaf with a capital D refers to individuals who identify with the Deaf culture

Anatomy of the Auditory System

Classifications of
Hearing Loss

 Conductive
hearing loss
◦ Sound

transmission is blocked in the middle or outer ear

 Sensorineural hearing loss
 ◦ Involves the inner ear (cochlea) and/or the auditory nerve
 Mixed hearing loss
◦ Combination of conductive and sensorineural loss
 Central hearing loss
◦ Dysfunction in the central nervous system
 Auditory neuropathy/auditory dys-synchrony
◦ Absence of neural functioning
 Functional or nonorganic hearing loss
◦ Reported hearing loss that is not substantiated by testing

Causes of Hearing Impairment

 CONDUCTIVE HEARING IMPAIRMENT

◦ Otitis Media
◦ Otitis Externa
◦ Congenital malformation of the outer and middle ear
◦ Genetic syndromes
◦ Impacted cerumen (ear wax)
◦ Blockage of the external auditory meatus by a foreign object
◦ Cleft palate
◦ Tramatic brain injury (TBI)

 SENSORIAL HEARING IMPAIRMENT

◦ Congenital viral infection
◦ Maternal rubella
◦ Prematurity and low birth weight
◦ Rh factor incompatibility
◦ Maldevelopmental of the inner ear
◦ Heredity (congenital or acquired)
◦ Meningitis
◦ Encephalitis
◦ Measles
◦ Mumps
◦ Influenza
◦ Unexplained high fever auditory nerve tumors

Identification of Hearing Problems

Symptoms that might indicate hearing impairments in the classroom

 Titling the head at an angle in order to receive a better sound
 Inattentive behavior
  Failure to respond when questioned
 Defective articulation, particularly when sounding of words is important
 Peculiar voice quality, often high-pitched and flattish in nature
 Tendency to avoid association with other people
 Tendency to run words together
 Poor oral reading ability
 Discrepancy between academic performance and IQ tests scores
 Louder speech than would be indicated by situation
 Tendency to watch the face of speaker with considerably greater attention

External Appearance/Signs
 Deformities of the outer ear
 Discharge from ear
 Undue muscular tension
 Breathing through the mouth
 Blank facial expression

Complaints of children who have hearing difficulties

 Buzzing or ringing in the head
 Earaches
 Nausea or dizziness
 Inability to understand directions

Assessment and Measurement

Measurement of Hearing Impairments

 Audiologist
 Audiometry/Audiogram
◦ Includes: pure-tone, air-conduction, bone-conduction, speech recognition, play
observations, inner ear acoustics, acoustic transmission
 Age of onset
◦ Prelingual: present at birth or before speech onset
◦ Postlingual: deficit acquired after speech onset

Effects on child’s development

 Language Development
◦ At a great disadvantage in acquiring language skills
◦ The grammar and structure of English often do not follow logical rules
◦ Vocabularies are smaller and sentence structure simpler and mo0re rigid
 ◦ Tend to write short, incomplete and improperly arranged sentences
◦ May omit endings of words such as –s, -ed, -ing
◦ Difficulty in differentiating questions from sentences

* It is important to note that with proper education, they are eventually able to learn the right grammar
and structure

 Cognitive and Academic Performance

◦ Most of them posses normal intelligence – they are not deficient or deviant in cognitive
abilities
◦ If they do not do as well as expected in acquiring reading, writing and literacy skills, it is
probably because the manner which they are being taught is inappropriate for them.
◦ Excluding the effects of the amount, type or quality of instruction, other variables affect
the academic achievement of HI students:
 Severity of the hearing loss
 Age at the onset
 Intelligence
 Family’s socio economic status
 Hearing status of parents

 Social and Psychological Factors

◦ Behavior depends largely on other people’s attitudes and the child’s ability to
communicate in some mutually accepted way
◦ Hearing impaired persons frequently express feelings of depression, withdrawal and
isolation particularly those who experience adventitious loss
◦ Deaf children of deaf parents are thought to have higher levels of social maturity,
adjustment to deafness and behavioral self-control than do deaf children of hearing
parents largely because of early use of manual communication between parents and
child
◦ Deaf people tend to associate primarily with other deaf people and is often mistakenly
viewed as clannishness of having a separate cultural group

The planning for an educational program for the hearing impaired shall primarily consider the degree of
hearing handicap.

Educational Needs and Placement

Degree Probable Educational Needs and Programs
 o may benefit from hearing aid as loss approaches to 40 dB
o attention to vocabulary development
Slight loss
o needs favorable seating and lighting
o may need speech reading instruction and speech correction
o should be referred to special education evaluation for educational
follow-up
Mild loss o May benefit from individual hearing aid and training in its use
o Favorable seating and possible special education supports especially
for primary age children
o likely to needs resource teacher or to be in a special class
o Should have special help in language skills, vocabulary development
usage, reading, writing, grammar, etc
Moderate loss o can benefit from hearing and through evaluation and auditory
training
o Speech reading instruction
o Speech conversation and speech correction
o likely to need a SPED program with emphasis on language skills,
concept development, speech reading and speech
o needs specialized program supervision and comprehensive support
Severe loss services
o Can benefit from individual hearing evaluation
o Auditory training on individual and group aids
o part-time regular class placement as profitable for the student
o will need SPED
o emphasis on language skills, concept development, speech reading
and speech
o needs specialized program supervision and comprehensive support
services
Profound loss
o continuous appraisal of needs on regard to oral and manual
communication
o Auditory training
o Sign language
o part-time regular class

Types of Programs

Full Integration
  Enrolment in a regular class with or without supplementary services by SPED teacher
 This is for hard-of-hearing with a slight hearing loss (27-40 dB)

Partial Integration
 For hard-of-hearing with a mild loss (41-70 dB)
 Integration of pupils can be in basic subjects, such as communication arts and mathematics, or
in activity subjects such as physical education, work education, music and art

Reverse Integration
 This plan is functional in SPED centers/self-contained classes of the HI within the regular schools.
 Normal children are invited to come into the class of the HI to participate in curricular/co-
curricular activities.
 This is for those with moderate hearing losses (41-70dB)

Partial/Modified Segregation
 This is for the deaf with severe hearing loss (71-90 dB or more)
 Deaf should be educated with other children in SPED self-contained classes or in classes in SPED
centers within the regular schools
 Normal and deaf children can interact with each other during free time play activities or in some
activities as scouting, school programs and others

Full Segregation
 This is for the severely and profound deaf
 HI are educated in day-residential and/or residential schools

Twin-School Concept
 This is feasible when a special school for the deaf is close to a regular school with the same level
of instruction.
 As in a consortium, there can be exchange of students: deaf getting some subjects in the regular
school and vice versa
 There can also be an exchange of teachers

Alternative Programs
 To improve educational services for the HI, a modified replica of the conceptual model based on
Reynold’s framework (1962) and Deno’s cascade (1970) cited in the 1973 edition of Dunn’s
Exceptional Children in School is being presented
 The inverted pyramid shows how educational rehabilitation is geared to the needs of hearing
handicapped
Classroom Management
 To lessen mental retardation among HI pupils, certain favorable conditions must be taken into
consideration:
◦ HI should be seated in the front area
◦ Teacher should see to it that there is enough light so the child can have a clear view of
the teacher and the blackboard/powerpoint/whiteboard
◦ Room size: standard or depends on the class size
◦ Room should be suitable à reverberation of internal and external room noises is
reduced to a minimum

Special Equipment and Facilities

 Audiometer à measures the hearing loss
 Auditory training materials
◦ Noisemakers (drum, wood clappers, bell, whistle, tambourine, rattle, maracas)
◦ Radio, phonograph, tape recporder, musical instruments
◦ Hearing aids (individual or group)
 Speech and language materials
◦ Speechtrainer, mirror, penlight, tongue depressors(or popsicle sticks), toothpicks,
baloons, feathers, pompons, Northampton Chart, fitzgerald Key, Sign Language
Handbook
 Educational Support services
◦ Tutorial services, peer tutoring for the integrated program, speech reading and auditory
training, remedial instruction, training in sign language, educational intercepting

Principles of Curriculum Development for the HI

 Every hearing impaired child must begin his education as early as possible or a soon as the
impairment has been detected
 Every hearing impaired child should be able to use his residual hearing in a functional manner
  Every hearing impaired child may be able to speak intelligibly if given maximum speech
rehabilitation/habilitation
 Every HI person must live and develop in the mainstream of society
 Every HI, being unable to hear, is denied adequate verbal communication with most people he
interacts with. Therefore, he needs other means by which to effectively communicate

5 Choices in the selection and implementation of a curriculum for HI Children

1. Use a curriculum that has been specifically designed for students who are hearing impaired or
deaf
2. Use the general education curriculum, attempting to meet the same standards as for other
students by allowing for other students by allowing for special services and special teaching
methods
3. Use of general curriculum but reduce the level of complexity of material presented
4. Use a curriculum from a lower grade level
5. Use curricula that have been developed for students with exceptionalities

* Major concern is the language curriculum à they may have problems with spoken and written English;
they might need to learn about language through curricular activities that stress structure and grammar
since they do not learn them from hearing.

Sg  2015