HEARING LOSS Everything You Need to Know as a Classroom Teacher

What You Need to Know: How the Ear Hears Types of Hearing Loss Amplification & Assistive Devices Teaching Strategies

How the Ear Hears Structure Outer ear The pinna is a collector of sound wave vibrations that are sent through the external ear canal. Middle Ear A tympanic membrane and three tiny bones, incus, malleus and stapes, move in harmony to send the vibrations into the inner ear. Inner Ear The vibrations are changed into electrical impulses that are sent to the brain to create what we understand as hearing.

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Types of Hearing Loss Conductive Hearing Loss Sensorineural Hearing Loss Mixed Hearing Loss Progressive Hearing Loss

Types of Hearing Loss Conductive Definition Loss of hearing that originates in the outer or middle ear. A mild hearing loss is caused from the fluid buildup in the middle ear from a middle ear infection, or otitis media.

Healthy tympanic membrane Acute otitis media with fluid Chronic otitis media Otitis media with tympanic membrane hole or perforation Otitis media treatment - tympanic membrane hole or perforation with a ventilator tube in place Conductive - Tympanic Membranes

Types of Hearing Loss Sensorineural Damage in the inner ear. Usually causes a permanent hearing loss

Types of Hearing Loss Mixed Hearing loss that involves the middle and inner ear.

Audiogram – Picture of Hearing Levels Normal 0-15 Mild Moderate Severe Profound

Types of Hearing Loss Progressive A gradual and increasing loss of hearing over time Immediate medical referral and treatment is necessary

Amplification & Assistive Devices Hearing Aids cannot fix a hearing loss Hearing Aids only amplifies incoming sound for the child Types of Hearing Aids

Amplification & Assistive Devices - Aid Types Programmable Computer programmed to provide some flexibility and enhanced sound quality with minimal fine tuning to the hearing loss Digital Computer programmed to provide maximum flexibility and exceptional sound quality with fine tuning to the hearing loss

Behind the Ear Hearing Aid Earmold Digital Hearing Aid Digital Hearing Aid & Earmold

Amplification and Assistive Devices - FMs A transmitter is worn by the teacher with a microphone near the mouth, and the student hears the teachers voice on their personal FM receiver. An FM receiver is worn by the student as a personal listening device allowing them to have direct listening to the teachers voice.

Classroom with partitions and hard slick surfaces are acoustic problems.

FM System in the Classroom Reduces the signal-to-noise ratio. Brings the teachers voice closer to the students ears.

Microphones, transmitter, receiver, neckloop transducer, and external earbud. FM Equipment

Amplification & Assistive Devices – FMs FMs are flexible and ESSENTIAL for children with hearing loss In ANY classroom or cooperative learning situation Can be self-contained functioning as a hearing aid Can be attached to a childs hearing aids

Amplification & Assistive Devices – Cochlear Implants The cochlea is electrically stimulated with surgically inserted device. Children with profound loss have a better chance of good language and literacy skills when implanted early.

Cochlear implants are used to bypass damaged nerve fibers. Transmitter headpiece and BTE processor Transmitter headpiece with a diagram of the electrode in the cochlea.

Problems Caused by Hearing Loss Causes development delays for students Academically Socially Vocationally

Problems Caused by Hearing Loss - Academically Delays in auditory processing skills affect language skill development Delays from auditory processing affect the receptive and expressive language skills for speech Language developmental delays affect learning causing delays in academic development

Hearing Loss is an invisible filter – information is distorted.

Hearing loss causes distorted input to the brain.

Problems Caused by Hearing Loss - Socially Delays in language could affect the child socially Isolation is often a result of language delays and the childs limited communication abilities

Problems Caused by Hearing Loss - Vocationally Delays in language development can affect the childs job skill development Could limit the childs long term vocational choices

How to Help Students With Hearing Loss Provide better acoustics in the classrooms Classroom strategies to aid the childs instruction Model and promote a positive attitude

Teaching Strategies Acoustics Normal Classroom Acoustics Slick surfaces Noise pollution Low signal-to-noise ratios (voice level to noise level)

Teaching Strategies Acoustics Problems in Classroom Acoustics Sound reflects off slick surfaces and echoes Most surfaces are slick Desk Floors Walls Hearing aids amplify ALL sounds including noise

Teaching Strategies Acoustics Noise Pollution Noise enters the room Hallways Heating and air conditioning vents Outside noises – mowing, playground Other classrooms Noise inside the room Students talking Rustling paper Pencil tapping Chair movements

Teaching Strategies Acoustics Signal-to-noise ratios (teachers voice level to noise level) Is not loud enough for a voices to be heard above the noise The teachers voice level needs to be about dB above the noise level for understanding of words spoken

Ways to Help Students With Hearing Loss - Strategies Strategies to help students with hearing loss Preferential seating to be able to lip-read Face the child when speaking Avoid moving too much around the room Gain the childs attention by a Gentle touch on the shoulder Calling their name Monitor for comprehension Repeat or rephrase instruction Pre-teach vocabulary

Ways to Help Students With Hearing Loss - Strategies Keep a positive attitude and model this for other students benefit Teach the class about hearing loss and the equipment used to help the loss Dont use exaggerated pronunciations – speak normally, but slowly and clearly Repeat what other students say in discussions Provide written, simple instructions Use an overhead to provide visual information

Teaching Strategies Acoustics Improve classroom acoustics Use an FM system Carpeting on floors Fabric wall hangings and cushions Tennis balls on the bottoms of chairs Curtains over windows Suspended ceiling tiles

Amplification helps the child get correct input to the brain.

cochlea Pinna (aruricle) external ear canal Tympanic membrane malleusincusstapes Cochlea & hair cells Ear Diagram Outer Ear Middle Ear Inner Ear

POINTS TO REMEMBER ABOUT HEARING LOSS You cant fix a hearing loss Any hearing loss – even MILD – impact childrens learning Improving classroom acoustics will improve learning for hearing and hearing impaired children If children cant hear, they cant learn

Success in Life Begins With Hearing!

Bibliography Facilitating Hearing and Listening in Young Children Flexer, Carol, (1999). San Diago: Singular Publishing Group, Inc. Hearing in Children Northern, Jerry L., Down, Marion P., (2002). Philadelphia: Lippincott Williams & Wilkins. ASA Workshop, A thorough look at classroom acoustics Shaw, Neil A., Sound and Communication. The Changing Sound of Education Towne, Robin M., Anderson, Karen L.., (1997). Washington: Sound and Vibration Effects of Soundfield Amplification on Spelling Performance of Elementary School Children Zabel, Helen, Tabor, Martha, (1993). IA: Educational Audiology Monograph 3. Acoustics in Educational Settings American Speech-Language-Hearing Association, (1995, March). Position Statement Subcommittee on Acoustics in Educational Settings, Bioacoustics Standards & Noise Standards Committee.

Bibliography The Hard-of-Hearing Student in the Mainstream Clarke School, (September 1994, Vol. 14, No. 2). Northampton:The Mainstream Center. Clarke Mainstream News. Teaching Strategies Using Sound-Field Systems to Teach Phonemic Awareness to Pre- Schoolers. Flexer, Carol, Biley, Kate Kemp, Hinkley, Alyssa, Harkema, Charyl, Holcomb, John, (March 2002, vol. 55 No.3). The Hearing Journal A Process-Oriented Preschool For Hearing and Hearing-Impaired Children Gatty, Janice, Hartblay, Marian, Dobson, Tracy, Judd, Diane, Altman, Holly, Goodrow, Pamela, (October 1994). Northampton Checklist of Important Points About Sound-Field Amplification Sound-Field FM Amplication: Theory and Practical Applicaiton

Bibliography Graphics Ear Diagram Graphics Tympanic Membrane and cochlear implant Graphics Classroom Graphics Hearing Aids