1. Hearing Sounds and Silences By: Erin Sanders Emily Chandler

2. The Hearing System External, middle, and inner ear

3. Defining Hearing Loss Commonly effects the receptive and expressive development of spoken language Different degrees- slight, mild, moderate, severe, and profound Hearing loss depends on many variables: Severity Age of onset Age at discovery Age at intervention Hearing loss after spoken language is learned usually has less impact on speech and language

4. Prevalence and Incidence 10-15% of children who receive hearing screenings at school fail the screening; however, these children have a transient conductive hearing loss Fewer than 1.3% of children younger than 18 years have a hearing impairment

5. Causes Hearing losses present at birth are congenital Hearing losses developed after birth are acquired Traditionally hearing loss is 1/3 genetic, 1/3 acquired, and 1/3 unknown More recently, research indicates at least ½ of hearing loss is genetic

6. Genetic Cleft palate Pre, Peri, and Postnatal Factors Exposure to viruses, bacteria, and other toxins such as drugs prior to or following birth Infections Intrauterine and following birth, rubella, toxoplasmosis, herpes, syphilis, and cytomegalovirus Middle Ear Disease Trauma Ototoxic Agents antibiotics used to treat severe bacterial infections may be toxic to the cochlea

7. Identification The average age is 2.5 years with the initial intervention being give at 3.5 years Testing at younger is possible Identification and intervention prior to age 6 months, regardless of degree of hearing loss, can lead to typical communicative development by age 3

8. Early Intervention Family adaptation to and acceptance of special needs Integrate with community services Parent support groups Decisions about future options

9. Amplification Hearing aids, assistive listening devices Used by children of any age Should be fitted as soon as persistent or permanent hearing loss has been identified

10. Surgical Interventions Cochlear implants

11. Modifications of Classroom for Young Children with Cochlear Implants Barrier walls Carpeted walls Draperies Acoustic ceiling tiles Tennis balls on chair legs in rooms without carpet

12. Communication and Education Education and intervention should focus on developing listening skills, and all aspects of language including syntax and grammar, increasing speech or sign language production or expanding vocabulary Different language learning options include: Oralism Cued speech American Sign Language Total communication English-based sign system Bilingual-bicultural approach

13. Communication and Education Students should receive instruction and specialized curriculum areas: Deaf studies Use of assistive technology ASL Speech and speech reading Auditory training Social skills Career and vocational education

14. Language-Learning Options Oral educational methods emphasize the teaching of: listening skills Speechreading speech articulation Including cued speech English-oriented sign systems combine to represent the English sentence structure: ASL vocabulary coined signs fingerspelling Total communication incorporates oral and manual communication modes such as: listening skills speech reading English oriented signing or ASL gestures/mime anything that facilitates comprehension Bi-lingual and bi-cultural proposes that children must first be immersed in ASL so they have full access to and acquire the meaningful use of a language before they can attain spoken language

15. Speech Development Need to focus on: Rhyming Sequential tasks Written words Initial consonants Vowels Fricative sounds (f and z)

16. Classroom Accommodations Talk to the child and not the aid Provide lots of visuals Use sign and spoken language together Providing material ahead of time Treat the child like any other child in your classroom