Presented by Diana Bratlien Fall 2002 and beyond… Teacher Inservice Presented by Diana Bratlien Fall 2002 and beyond…

About the Inservice Project title Intended Audience So you have a Hard of Hearing Student in Your Class…Now What? Intended Audience General education teachers who currently have hard of hearing students in their classrooms. Goals and Objectives Understand Social-Emotional Impact of Hearing Loss Understand Hearing Loss Levels Develop an Empathy towards those with a hearing loss Understand Academic implications

Abstract This presentation was designed to ease general education teachers’ fears over working with students’ who have a hearing loss. In addition, it was designed to help teachers develop an empathy towards working with hard of hearing students. As any inservice, this is a work in progress. It is meant to be presented repeatedly to schools each year as more teachers have mainstreamed students who are hard of hearing. The notes on the bottom of the slides are functional notes and meant to be guidelines for you as you present. Some notes may be altered depending on the age levels the general education teachers work with. Currently, the notes are divided for two individuals since it has been presented by a partnership of Teachers for the Deaf and Hard of Hearing.

My Hearing Loss by a former student of Bemidji Area Schools I feel, I wish, I could hear everyday. I feel that I could hear more, Including sounds I have never heard. I feel lonely, I wish I could have more friends. I wish I wouldn’t be picked on. I want to be treated like everyone else. You can’t change it, And you sit there waiting for a possible Miracle, breakthrough. My life is full of sadness. Up as BHS teacher enter room. Explain that this poem was written by a former student from Bemidji High School that was Deaf.

So You have a Hard of Hearing Student in class… Now…what?

Our Goals today… Understand Social-Emotional Impact of Hearing Loss Understand Hearing Loss Levels Develop an Empathy towards those with a hearing loss Understand Academic implications Introduce ourselves & Sue: explain goals

Are You Lucky Enough to Need Glasses? Lens Crafters ad 2002 This is the most recent slogan for Lens Crafters.

Are You Lucky Enough to Wear Hearing Aids? It just doesn’t have the same ring to it… SUE: The first ad was a lens crafters ad… What is the latest ad you’ve seen on t.v. for hearing aids? What do people look like on vision ads? How do they portray people on hearing aid ads?

Social Stigmas Weight, attractiveness, etc. Race Gender Vision Loss Hearing Loss DIANA: Talk about targeting students…we wouldn’t target students and say “Could everyone over 200 pounds please move to the front” or “Could all of the Native American students sit on the left, the African American students sit on the right and the Caucasians sit in the back.” Yet within the our school district there was a teacher (that is no longer in the district) that specifically said in class on the first day of school, “Will the three hearing impaired girls please move to the front so I know who you are?” These girls were adolescent, they felt targeted, and they wanted to crawl in a hole and hide. I don’t enjoy being in front of a large crowd speaking, and I’m sure it isn’t your idea of the most enjoyable thing in the world either. So you can imagine how these students felt. They were mortified! Typically we think of elderly people as having hearing aids however glasses just seem to be acceptable for any age or social class.

VISION PROBLEMS? AIRPLANE Sue With vision problems you may not be able to read this word…however if you put classes on…

AIRPLANE HERE ARE SOME GLASSES… Sue Glasses take what is blurry and clarifies it so you can see it.

HEARING PROBLEMS? Sue With a hearing problem you may be able to detect that a sound is being said…however if you put on a hearing aid

Here is a Hearing aid… Sue The sound will be amplified but not clarified. It has recently been discovered that people with a hearing loss that have been born that way are literally incapable of decoding the garbled sounds they are hearing. This word says “FIRETRUCK”.

Understanding Hearing Loss Conductive Hearing Loss vs. Sensorineural Hearing Loss Handout sample audiogram with speech banana PLEASE TAKE OUT YOUR AUDIOGRAM HANDOUT…DIANA Now we are going to go over the two types of hearing loss…Conductive losses and Sensorineural losses.

Conductive Loss Hearing loss would show a flat line Hearing aid turns all sounds up the same degree (like a radio) DIANA Talk about where in the ear a conductive loss takes place (middle ear…)The sound comes in and is not traveling through your middle ear normally. It is usually related to the bones within the ear however you could also have fluid within your middle ear that is preventing the bones from transmitting the sound through the middle ear to the inner ear. There could also be problems with the tympanic membrane. Perhaps a child’s ear drum has burst several times due to ear infections and that scarring is preventing the ear drum from vibrating as easily. Talk about anything above the line is sounds that a student cannot hear and anything below the line are sounds they can hear. In addition, a hearing aid for a conductive loss can be quite helpful because it turns up all of the sounds the same degree.

Sensorineural Loss Loss shown all over audiogram (may be sloping, rising, or curved) Hearing aid amplifies sounds we need and sounds we don’t need. SUE…EXPLAIN what sensorineural loss means…A sensorineural loss is a loss that is occurring as a result of problems in your inner ear. In your inner ear is a cochlea that is a coiled shaped organ. This is filled with fluid and along the outer wall of the cochlea is Sue…explain SLOPING AND RISING LOSS RISING…Here is a diagram of a rising sensorineural loss. With this type of loss a person is missing out on more of the low frequency sounds. So if you looked at the diagram they might not be able to hear a truck but they would be able to hear an airplane.

Sensorineural Loss Loss shown all over audiogram (may be sloping, rising, or curved) Hearing aid amplifies sounds we need and sounds we don’t need. SUE…EXPLAINwhat sensorineural loss means Sue…explain SLOPING AND RISING LOSS SLOPING… With a sloping loss more of the high frequency sounds are lost.

Sensorineural Loss Loss shown all over audiogram (may be sloping, rising, or curved) Hearing aid amplifies sounds we need and sounds we don’t need. DIANA…EXPLAIN U-SHAPED AND UMBRELLA SHAPED LOSS Talk about speech banana and the possibility of the speech being out of the range of their hearing. U-SHAPED… Talk about student having a harder time hearing sounds within the range of speech and yet being able to hear “quieter” sounds on the low and high ends of frequency. So in this case a student may be able to hear some background sounds easily depending on their pitch and yet they are unable to hear speech sounds of the same loudness because it is the wrong frequency. This particular type of hearing loss is the most difficult to amplify because when you start to amplify it…the background sounds are cranked up and can become painful.

Sensorineural Loss Loss shown all over audiogram (may be sloping, rising, or curved) Hearing aid amplifies sounds we need and sounds we don’t need. UMBRELLA SHAPED… Just the opposite…high and low frequency sounds are lost while the middle frequency sounds are understood. So some speech sounds would be lost on this particular audiogram and yet others are able to be detected. This is one of the most rare types of loss.

Special education Criteria First and foremost…an audiologist has tested the child and found a hearing loss that verifies one of the following… Diana…say that before a student can qualify for services they must be tested by an audiologist to see if they have a hearing loss that qualifies under one of the following criteria.

Special education Criteria Continued A 20 decibel or greater loss in both ears Or….. A 45 decibel or greater loss in one ear. Sue…explain these two areas…Look at audiogram handout…can see that a mild loss falls under the 20 dB range. Explain that a 45 dB loss is a unilateral loss.

Levels of Hearing Loss Mild Moderate Moderate to Severe Severe Profound Diana… Here are the levels of hearing loss that we will talk about. Each of these levels qualify for Spec. Ed. Services and we will also address normal hearing and a minimal loss.

What is normal hearing defined as? Students can detect all speech sounds (whispering, etc.) On your sample handout… they would have a -10 decibel (dB) to +15 dB hearing range. Sue Refer them to audiogram handout

How is a minimal hearing loss defined? Students may have difficulty hearing faint or distant speech. Peer conversation and teacher instructions presented too rapidly, particularly in noisy classrooms, are likely to result in missed information. Loss is between 16 to 25 decibels. Diana… Read through and refer to audiogram handout

What is mild hearing loss? mild = small…so it doesn’t affect them right? Student may miss up to 50% of class discussions. Students will require the use of a hearing aid or personal FM system. Loss is between 26 to 40 decibels on your handout. SUE A mild hearing loss is similar to having both of your ears plugged with your fingers.

What is a moderate hearing loss like? Classroom conversation from 3 to 5 ft. away can be understood if they know the context. Hearing aids and/or personal FM systems are essential. Specific attention directed at language development, reading and written language. Loss is between 41 to 55 decibels. Diana Read through and refer to handout

What is a moderate-severe loss? Without amplification students can miss up to 100% of speech information. Full time use of amplification is essential. They will probably require additional help in all language based academic subjects. Loss is between 56 to 70 decibels. Sue, Read through and refer to handout

What is does it mean to have a severe hearing loss? Students can only hear loud noises at close distances. They require individual hearing aids, intensive auditory training and specialized instructional techniques in reading, language, and speech development. Loss is between 71 to 90 decibels. Diana Read through and refer to handout

So what’s a profound loss then? These students rely on their eyes and not their ears! Usually a candidate for signing systems and specialized instructional techniques in reading, speech, and language development A loss of 91 decibels or more is described as profound. They are Deaf. Sue… Read through and refer to handout

Insight to some of the questions you’re dying to ask. How about some empathy? Insight to some of the questions you’re dying to ask. Diana… We knew you wanted to ask us these so we decided to give you a bit of insight.

The Why’s Diana…So we’re going to go through some of the “Why” questions. My niece is infamous for always asking why and we have some sample why questions that teachers have asked us too.

The Why’s Why isn’t speech/lipreading enough? Sue: Don’t show words right away… give lip reading test

What we really said… Zoo Fondue Six Nest Car So here are the words we actually said. How many had all 5 right? 4 right? 3 right? 2 right? So you probably get the point that speech reading isn’t the most reliable way to receive information.

The Why’s Why can’t I just talk louder? It seems like talking louder would help…however, studies show that talking louder only increases vowel energy and not consonant energy. Ironically, yelling increases audibility but not intelligibility. Diana Explain difference between audibility and intelligibility. Talk about recent loud concerts…for example…“Bats in the Dark”…you could hear the band! (related to our homecoming week pep fest) They were audible…but you couldn’t understand the band…it wasn’t intelligible. When I looked at the interpreters during that song…they were signing “I have no idea!”

The Why’s Why do I have to wear a microphone if I have them sitting in front? Children who are hard of hearing internally distort sounds. They need speech 10 times louder than the background noise. SUE Remind them about intelligibility…yelling only takes care of vowels. Amplification will make the teachers voice louder than the background noise AND intelligible (without distortion). Now give unfair spelling test…This will give you an understanding of what it is like to have a high frequency loss in the severe, moderate, and mild range (Use Sound Hearing tape)

Answers to your test Bath Pearl Sour Mouse Learn Wheat Vine Tape Hedge mood Show answers to test

Actual Spelling test of Hard of Hearing Student Explained by Sue…Spelltacular test given at the middle school. In addition, teacher was using amplification while administering the test. These are words that the student had never heard before so you can imagine now presenting new material in your classes. If a student doesn’t have a visual to take the new words off of then they may completely misinterpret what the words actually are and as a result do poorly on tests.

Classroom Teacher Study Study says…half of teachers thought hearing loss and academic problems were not linked. Teachers accused students of daydreaming because they participated most of the time. Study by Ross, Brackett, and Maxon 1991 Diana A study was conducted over 4 years and monitored the academic success of 58 children with an average hearing loss of 40 dB. (Ross, Brackett and Maxon, 1991) It was determined that half of the classroom teachers did not think academic problems had anything to do with their hearing loss, even though they knew the loss existed. The teachers accused the students of “Daydreaming” or not paying attention because they “knew” the students could hear them and participate in class most of the time (p. 45).

Facts on the impact of hearing loss on Education Students with a hearing loss are generally 2 grade levels behind in their reading comprehension. Sue…

Language delays based on levels of hearing loss 15-26 dB loss 27- 40 dB loss 41-55 dB loss 56-70 dB loss 1.2 year delay 2.0 year delay 2.9 year delay 3.5 + year delay Sue…This just shows how the various levels of losses affects a students language level. Even with a so called mild loss a student can have a 1.2 year delay.

Unilateral losses Almost 50% of children with at least a 30 dB hearing loss in one ear, have failed one or more grades…or are receiving support services. Diana…remind them what a unilateral loss is

Classroom noises In a typical classroom…the noise levels can reduce the student’s ability to understand to 60% or as low as 27% without appropriate acoustics (ex. carpet, etc.) Diana… Talk about testing sound in room…factors that affect it…carpet, tile, types of walls (carpet on walls)…acoustics…does the sound really carry?

Won’t a student tell the teacher if they’re not hearing everything? The problem with “not hearing so good” is that you don’t hear what you don’t hear and you don’t know that you didn’t hear because you didn’t hear it! So even if a teacher asks, “Are you hearing me?” They will almost always say “yes!” Sue When checking with students we need to ask higher level, comprehension, questions and not yes or no questions. Any student could answer yes or no and have a 50/50 chance of getting it right.

Comments made by Local Teachers… Diana… Now we’re going to just show you some actual comments made by local teachers over the years…

“I don’t think she needs the speakers, she hears me fine.” Diana

“I have a loud voice…I don’t need the microphone.” Diana

“She just has selective hearing and hears when she wants to.” Diana

“He hears me all the time when I call his name and I don’t have a microphone on.” Diana Kids are conditioned to listen for their name. Think about new information…words they have never heard. When you’re learning new language you’ve never seen those words, you don’t know how to spell them, or pronounce them accurately. How would you take notes? How would you understand what the teacher is talking about?

Some points to ponder… Sue Talk through/read…points to ponder.

Would you take away a person’s wheelchair if you knew that they could crawl without it? Sue

With a hearing loss, the question should never be if the person can hear you. The question should be if the person can understand what you are saying. Sue

Would you take away amplification from a hard of hearing person if they could hear you talking but not understand all the words without it? Sue

Ok…Ok…I get it…So what can I do? Diana… By now…this may be how you’re feeling…so we’ll finally cut to the chase

Receive training (you’re here!!!) Diana Remind them about the handouts available. When you do get that student in that class we will be giving you individualized information regarding their needs. EVERY student is different. Tips for using Soundfield unit, tips for working with a hard of hearing student.

Gain understanding and empathy (we’re trying) Sue Hopefully some of this information has helped. I know that still impacts me (Spelling test of middle school student)

Respect student and don’t question the severity of the loss and it’s social, emotional, and academic impact. Diana

Follow LEGAL IEP modifications and adaptations. Sue Each student is different. Please follow the modifications specific to each student. We don’t hand you paper work for fun.

If you have questions please…ask us, the student or their family. Diana We’re not scary people! Does anyone have any questions right now?

Bibliography Collins, S.H. (1989). Sound Hearing, or…Hearing What you Miss. Eugene, OR: Garlic Press. Flexer, Carol. (September 1995). Classroom Management of Children with Minimal Hearing Loss. The Hearing Journal, 48(9), 53-56. Nussbaum, D. (1988). There’s a Hearing Impaired Child in My Class. Washington D.C.: Gallaudet University Press. Bernard, Susan. (2002). Various handouts and quote collections. Microsoft Office XP Clip Art Powerpoint Presentation