2.7 Hearing impairments
11 min read•august 21, 2024
Hearing impairments affect a person's ability to perceive sound, ranging from mild to profound loss. Understanding types, causes, and impacts helps educators tailor support. Proper diagnosis, , and communication methods are key to addressing challenges.
Educational implications include language development delays, academic struggles, and social-emotional effects. Classroom accommodations, individualized education programs, and early intervention are crucial. Recognizing and fostering self-advocacy skills support student success.
Types of hearing impairments
- Hearing impairments encompass a range of conditions affecting an individual's ability to perceive sound
- Understanding different types of hearing impairments informs appropriate educational strategies and accommodations in special education settings
- Proper classification helps educators tailor instruction and support to meet the unique needs of students with hearing impairments
Conductive vs sensorineural
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- occurs in the outer or middle ear, impeding sound transmission to the inner ear
- Caused by blockages, infections, or structural abnormalities (ear wax buildup, otitis media)
- Often temporary and treatable through medical interventions
- involves damage to the inner ear or auditory nerve
- Results from damage to hair cells in the cochlea or issues with the auditory nerve
- Usually permanent and may require assistive devices or
- combines elements of both conductive and sensorineural impairments
- affect the brain's ability to interpret sound signals
Degrees of hearing loss
- Measured in decibels (dB) and categorized into levels of severity
- Mild hearing loss ranges from 26-40 dB, affecting perception of soft sounds and some speech
- Moderate hearing loss spans 41-55 dB, impacting understanding of conversational speech
- Moderately severe hearing loss covers 56-70 dB, requiring louder speech for comprehension
- Severe hearing loss ranges from 71-90 dB, necessitating very loud speech or sign language
- Profound hearing loss exceeds 91 dB, with little to no ability to hear speech or environmental sounds
Unilateral vs bilateral
- Unilateral hearing loss affects only one ear
- Challenges include difficulty localizing sound sources and understanding speech in noisy environments
- May impact academic performance and social interactions
- Bilateral hearing loss involves both ears
- Varies in severity and can be symmetrical or asymmetrical
- Often requires more comprehensive interventions and support in educational settings
- Comparison of impacts on language development and learning strategies
- Considerations for assistive technology and classroom accommodations differ between unilateral and bilateral cases
Causes of hearing impairments
- Hearing impairments can result from various factors, influencing their onset, progression, and potential interventions
- Understanding causes helps educators anticipate potential challenges and implement appropriate support strategies
- Awareness of etiologies aids in early identification and intervention planning for students with hearing impairments
Genetic factors
- Hereditary hearing loss accounts for approximately 50% of childhood hearing impairments
- Autosomal dominant inheritance patterns (one parent carries the gene)
- Autosomal recessive inheritance (both parents carry the gene but may have normal hearing)
- Syndromic hearing loss associated with other genetic conditions (Usher syndrome, Waardenburg syndrome)
- Non-syndromic hearing loss occurs without other associated symptoms or conditions
Environmental factors
- Prenatal exposure to infections or toxins (rubella, cytomegalovirus, alcohol)
- Complications during birth (prematurity, low birth weight, lack of oxygen)
- Childhood illnesses (meningitis, measles, mumps)
- Exposure to loud noises or ototoxic medications
- Head injuries or physical trauma affecting the auditory system
- Occupational hazards in certain professions (construction, manufacturing)
Age-related hearing loss
- Presbycusis refers to gradual hearing loss associated with aging
- Typically affects high-frequency sounds first, progressing to lower frequencies
- Influenced by genetic predisposition and cumulative environmental factors
- May impact older students or adult learners in special education programs
- Strategies for adapting instruction and communication for age-related hearing loss
Diagnosis and assessment
- Accurate diagnosis and assessment of hearing impairments are crucial for developing effective educational plans
- Multidisciplinary approach involving audiologists, speech-language pathologists, and educators
- Ongoing assessment helps track progress and adjust interventions as needed in special education settings
Audiological evaluations
- Pure-tone measures hearing thresholds across different frequencies
- assesses ability to recognize and understand speech sounds
- Tympanometry evaluates middle ear function and eardrum mobility
- Otoacoustic emissions (OAE) test checks cochlear function, especially in infants
- Auditory brainstem response (ABR) measures neural responses to sound stimuli
- Results plotted on an audiogram to visualize hearing loss across frequencies
Behavioral observations
- Observing responses to environmental sounds and speech in natural settings
- Assessing attention to auditory stimuli and localization abilities
- Monitoring communication behaviors and strategies used by the individual
- Evaluating reactions to different listening environments (quiet vs noisy)
- Documenting changes in behavior or performance related to hearing difficulties
Speech and language assessments
- Evaluating articulation and phonological skills affected by hearing impairment
- Assessing receptive and expressive language abilities
- Analyzing voice quality and prosody
- Measuring speech intelligibility and fluency
- Evaluating pragmatic language skills and social communication
- Considering the impact of hearing loss on overall language development and literacy skills
Educational implications
- Hearing impairments significantly impact various aspects of a student's educational experience
- Understanding these implications helps educators develop appropriate interventions and support strategies
- Addressing educational challenges early can improve long-term outcomes for students with hearing impairments
Language development challenges
- Delayed acquisition of spoken language milestones
- Difficulties with phonological awareness and sound discrimination
- Limited exposure to incidental language learning opportunities
- Challenges in developing vocabulary and complex sentence structures
- Potential gaps in pragmatic language skills and social communication
- Strategies for enhancing language input and fostering communication skills
Academic performance impact
- Reading comprehension difficulties due to limited vocabulary and background knowledge
- Challenges in phonics-based reading instruction for students with severe hearing loss
- Writing skills may be affected by language delays and limited exposure to language structures
- Mathematics concepts relying on verbal explanations may be more challenging to grasp
- Difficulties following verbal instructions or participating in class discussions
- Strategies for adapting curriculum and instruction to support academic achievement
Social and emotional effects
- Potential feelings of isolation or frustration in communication-heavy environments
- Challenges in developing and maintaining peer relationships
- Impact on self-esteem and identity formation
- Increased risk of bullying or social exclusion
- Emotional stress related to communication barriers and academic challenges
- Importance of fostering a supportive and inclusive classroom environment
Communication methods
- Various communication approaches cater to different needs and preferences of individuals with hearing impairments
- Selection of appropriate methods depends on factors such as degree of hearing loss, age of onset, and family choices
- Flexibility in communication strategies supports inclusive education and social integration
Oral communication approaches
- Auditory-Verbal Therapy (AVT) emphasizes listening and spoken language development
- Auditory-Oral approach combines listening, speech reading, and natural gestures
- uses hand shapes near the mouth to supplement lip-reading
- Focuses on maximizing residual hearing through amplification and assistive technology
- Strategies for developing listening skills and speech production
Manual communication approaches
- as a complete visual language with its own grammar and syntax
- follows English word order and grammar
- Fingerspelling used to spell out words or names
- Importance of early exposure to sign language for language acquisition
- Considerations for incorporating in educational settings
Total communication
- Combines oral and manual approaches to maximize communication effectiveness
- Utilizes speech, sign language, fingerspelling, and gestures simultaneously
- Allows flexibility in choosing the most appropriate communication method for each situation
- Supports access to both Deaf culture and the hearing world
- Strategies for implementing in diverse educational environments
Assistive technology
- Assistive technology plays a crucial role in supporting students with hearing impairments in educational settings
- Proper selection and use of devices can significantly enhance access to auditory information and improve learning outcomes
- Ongoing assessment and adjustment of assistive technology ensure optimal benefit for individual students
Hearing aids
- Digital amplify sounds and can be programmed for specific hearing loss patterns
- Behind-the-ear (BTE), in-the-ear (ITE), and completely-in-canal (CIC) styles available
- Features include directional microphones, noise reduction, and feedback cancellation
- Connectivity options for linking to smartphones or other audio devices
- Maintenance and troubleshooting considerations for educational settings
Cochlear implants
- Surgically implanted devices that bypass damaged parts of the inner ear
- Consist of external processor and internal electrode array
- Suitable for individuals with severe to profound sensorineural hearing loss
- Require extensive auditory training and speech therapy post-implantation
- Considerations for educational support and accommodations for students with cochlear implants
FM systems
- Wireless systems that transmit the speaker's voice directly to the listener's hearing aid or cochlear implant
- Improve signal-to-noise ratio in noisy classroom environments
- Personal for individual use and soundfield systems for whole-class amplification
- Compatible with various hearing devices and can be used with or without hearing aids
- Strategies for effective implementation and maintenance in educational settings
Classroom accommodations
- Classroom accommodations are essential for creating an inclusive learning environment for students with hearing impairments
- Tailoring accommodations to individual needs ensures equal access to educational content and opportunities
- Regular evaluation and adjustment of accommodations support ongoing student success
Seating arrangements
- Preferential seating near the teacher and away from noise sources
- Circular or U-shaped seating arrangements to facilitate visual access to peers and teacher
- Consideration of lighting to avoid glare and shadows on the speaker's face
- Flexible seating options to accommodate different learning activities and communication needs
- Strategies for managing seating during group work and class discussions
Visual aids and captioning
- Use of visual schedules, graphic organizers, and concept maps to support learning
- Closed captioning for videos and multimedia presentations
- Real-time captioning or transcription services for lectures and discussions
- Visual alerts for classroom signals (bells, announcements)
- Incorporation of sign language interpreters when appropriate
- Strategies for creating and using effective visual supports in various subject areas
Noise reduction strategies
- Installation of sound-absorbing materials (carpets, curtains, acoustic panels)
- Use of noise-reducing furniture (felt pads on chair legs, rubber stoppers on desk feet)
- Minimizing external noise sources (closing windows, sealing gaps under doors)
- Establishing classroom routines to reduce unnecessary noise
- Teaching all students about the importance of maintaining a quiet learning environment
- Strategies for managing noise during different types of classroom activities
Individualized Education Programs (IEPs)
- IEPs are crucial tools for ensuring appropriate education and support for students with hearing impairments
- Collaborative process involving educators, specialists, parents, and when appropriate, the student
- Regular review and adjustment of IEPs ensure ongoing alignment with student needs and progress
Goals and objectives
- Developing specific, measurable, achievable, relevant, and time-bound (SMART) goals
- Addressing academic, communication, and social-emotional needs
- Incorporating both short-term objectives and long-term goals
- Aligning goals with grade-level standards while considering individual needs
- Strategies for writing effective goals that support student progress and independence
Accommodations and modifications
- Distinguishing between accommodations (changes in how material is presented or accessed) and modifications (changes to curriculum content or expectations)
- Specifying necessary assistive technology and support services
- Detailing classroom accommodations (extended time, modified assignments, visual supports)
- Addressing assessment accommodations (sign language interpretation, captioned test items)
- Strategies for implementing and documenting the effectiveness of accommodations and modifications
Progress monitoring
- Establishing clear methods for tracking progress toward IEP goals
- Utilizing both formal assessments and informal observations
- Incorporating data from various sources (teachers, specialists, parents)
- Scheduling regular progress review meetings
- Adjusting goals, accommodations, and interventions based on progress data
- Strategies for involving students in self-monitoring and goal-setting processes
Early intervention
- Early intervention is critical for minimizing the impact of hearing impairments on language and cognitive development
- Timely identification and support can significantly improve long-term outcomes for children with hearing impairments
- Collaboration between medical professionals, educators, and families is essential for effective early intervention
Newborn hearing screening
- Universal newborn hearing screening programs identify hearing loss within the first few days of life
- Otoacoustic emissions (OAE) and auditory brainstem response (ABR) tests commonly used
- Follow-up diagnostic evaluations for infants who do not pass initial screening
- Importance of early detection for timely intervention and support
- Strategies for educating parents about the significance of newborn hearing screening
Family-centered approaches
- Providing comprehensive support and education to families of children with hearing impairments
- Empowering parents as primary facilitators of their child's language development
- Offering counseling and emotional support to address family concerns and challenges
- Connecting families with support groups and community resources
- Involving families in decision-making regarding communication methods and educational options
- Strategies for fostering strong partnerships between families and early intervention professionals
Language acquisition support
- Implementing strategies to maximize exposure to language during critical developmental periods
- Utilizing play-based interventions to promote language development in natural contexts
- Incorporating visual communication methods (sign language, gestures) as appropriate
- Providing intensive auditory training for children with assistive devices
- Monitoring and supporting pre-literacy skills development
- Strategies for creating language-rich environments at home and in early education settings
Deaf culture and identity
- Understanding and respecting Deaf culture is essential for educators working with students with hearing impairments
- Promoting a positive sense of identity supports social-emotional well-being and academic success
- Balancing cultural perspectives with individual needs and preferences in educational settings
Deaf community perspectives
- Recognizing Deafness as a cultural and linguistic minority rather than a disability
- Understanding the historical context and development of Deaf culture
- Appreciating the role of sign language in Deaf identity and community
- Exploring Deaf art, literature, and media as cultural expressions
- Addressing misconceptions and stereotypes about Deaf individuals
- Strategies for incorporating Deaf culture and history into the curriculum
Bilingual-bicultural approach
- Promoting proficiency in both sign language (ASL) and written English
- Valuing both Deaf and hearing cultures in educational settings
- Incorporating Deaf role models and mentors in the educational process
- Addressing the unique needs of students navigating between Deaf and hearing worlds
- Supporting families in understanding and embracing bilingual-bicultural education
- Strategies for implementing bilingual-bicultural programs in inclusive settings
Self-advocacy skills
- Teaching students to understand and explain their hearing impairment and needs
- Developing skills for requesting accommodations and asserting communication preferences
- Fostering independence in managing assistive technology and support services
- Encouraging participation in IEP meetings and educational decision-making
- Promoting leadership skills and involvement in Deaf community activities
- Strategies for embedding self-advocacy instruction across the curriculum
Collaboration and support
- Effective support for students with hearing impairments requires collaboration among various professionals and stakeholders
- Interdisciplinary teamwork ensures comprehensive assessment, intervention, and ongoing support
- Regular communication and coordination among team members optimize student outcomes
Audiologists and speech therapists
- Audiologists conduct hearing assessments and manage assistive technology
- Speech therapists support speech and language development
- Collaborative goal-setting and intervention planning
- Ongoing monitoring of hearing status and communication progress
- Providing training and support to educators on hearing-related issues
- Strategies for integrating audiological and speech therapy recommendations into classroom practice
Teachers of the deaf
- Specialized educators with expertise in deaf education and communication methods
- Provide direct instruction and support to students with hearing impairments
- Collaborate with general education teachers to adapt curriculum and instruction
- Offer guidance on implementing accommodations and modifications
- Support the development of literacy skills in both sign language and written language
- Strategies for effective co-teaching and consultation models
Interpreters and note-takers
- Sign language interpreters facilitate communication in educational settings
- Real-time captioners or CART (Communication Access Realtime Translation) providers
- Note-takers capture key information for students who cannot simultaneously watch interpreters and take notes
- Coordinating interpreter schedules and ensuring appropriate coverage for all educational activities
- Training staff and students on effective ways to work with interpreters and note-takers
- Strategies for maximizing the benefits of interpreting and note-taking services in various educational contexts
Key Terms to Review (27)
American Sign Language (ASL): American Sign Language (ASL) is a visual language used by the Deaf and hard of hearing communities in the United States and parts of Canada. It is a complete and complex language that employs hand shapes, facial expressions, and body movements to convey meaning, functioning as an essential communication tool for individuals with hearing impairments.
Americans with Disabilities Act (ADA): The Americans with Disabilities Act (ADA) is a comprehensive civil rights law enacted in 1990 that prohibits discrimination against individuals with disabilities in various areas, including employment, public accommodations, transportation, and telecommunications. It plays a crucial role in promoting accessibility and equal opportunity for individuals with disabilities, impacting education, employment, and public services.
Assistive Technology: Assistive technology refers to devices, software, or equipment that help individuals with disabilities perform tasks that might otherwise be difficult or impossible. This technology enhances learning, communication, mobility, and overall independence, making it essential in creating inclusive environments for all learners.
Audiological evaluations: Audiological evaluations are a series of tests designed to assess a person's hearing ability and identify any hearing impairments. These evaluations help professionals determine the type and degree of hearing loss, guiding the development of appropriate interventions or treatments. They play a crucial role in understanding how hearing impairments affect communication and learning, especially in individuals who may require special educational support.
Audiometry: Audiometry is a hearing assessment technique that evaluates an individual's ability to hear different sounds, including pitches and volumes. This process helps identify the presence, type, and degree of hearing impairment, which can be critical for developing effective interventions for individuals with hearing challenges.
Auditory Processing Disorders: Auditory processing disorders (APD) refer to a range of difficulties in the processing of auditory information in the brain, despite normal hearing abilities. Individuals with APD struggle to understand and interpret sounds, especially in noisy environments or when multiple sounds occur simultaneously. This condition impacts communication skills and can affect academic performance, making it crucial to recognize and support those affected.
Behavioral Observations: Behavioral observations refer to the systematic process of watching and recording an individual's actions and reactions in various situations to assess their behavior, skills, and challenges. This method provides valuable insights into a person's abilities, particularly in educational settings, and is crucial in understanding how they interact with their environment. It aids in developing tailored interventions and supports within the framework of individualized education plans and is especially pertinent when assessing the needs of individuals with specific impairments, such as hearing impairments.
Cochlear Implants: Cochlear implants are electronic medical devices that replace the function of damaged inner ear structures to provide sound signals to the brain. These devices are designed for individuals with severe to profound hearing loss, enabling them to perceive sounds and engage more effectively in communication. By converting sound waves into electrical impulses, cochlear implants can enhance the quality of life for those affected by hearing impairments, serve as adaptive devices for physical disabilities, and are a significant aspect of assistive technology for sensory impairments.
Conductive hearing loss: Conductive hearing loss is a type of hearing impairment that occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones of the middle ear. This can result from various factors such as ear infections, fluid in the middle ear, or blockages in the ear canal. Understanding conductive hearing loss is crucial as it often impacts the ability to hear faint sounds and can affect communication skills.
Cued Speech: Cued speech is a visual communication system that uses hand shapes and placements in conjunction with spoken language to enhance the clarity of speech for individuals with hearing impairments. It helps bridge the gap between speech and sign language, allowing users to perceive phonemes visually, which aids in improving their language comprehension and spoken communication skills.
Deaf culture: Deaf culture refers to the shared values, beliefs, and social norms of individuals who are deaf or hard of hearing, often emphasizing the use of sign language as a primary mode of communication. This culture fosters a strong sense of community and identity among its members, highlighting their unique experiences and perspectives that arise from living with hearing impairments. Within this context, deaf culture encompasses art, literature, and traditions that celebrate the deaf experience, providing a rich tapestry of life that differs from mainstream hearing society.
FM systems: FM systems, or Frequency Modulation systems, are assistive listening devices designed to improve hearing in individuals with hearing impairments. They work by transmitting sound from a microphone directly to a receiver worn by the listener, effectively reducing background noise and enhancing clarity. These systems are particularly beneficial in classroom settings, where they can help integrate students with hearing challenges by providing a direct auditory feed from the teacher or speaker.
Hearing Aids: Hearing aids are small electronic devices worn in or behind the ear that amplify sound to assist individuals with hearing impairments. They are designed to improve hearing ability by making sounds louder and clearer, allowing users to engage more effectively in communication and daily activities. These devices are essential tools in the management of hearing loss and play a significant role in enhancing the quality of life for individuals facing auditory challenges.
Helen Keller: Helen Keller was an American author, activist, and lecturer who became the first deafblind person to earn a Bachelor of Arts degree. Her life and achievements have played a critical role in shaping the understanding of disabilities and advocating for individuals with visual and hearing impairments, highlighting both the challenges they face and their remarkable potential.
Inclusion: Inclusion is an educational philosophy that promotes the full participation of students with disabilities in general education classrooms alongside their typically developing peers. This approach emphasizes the importance of creating supportive and accommodating environments where all students can thrive, fostering social interaction, collaboration, and respect for diversity.
Individualized education programs (IEPs): Individualized Education Programs (IEPs) are legally binding documents that outline the specific educational plan and services for a student with disabilities. They are designed to ensure that students receive personalized support tailored to their unique needs, enabling them to access the curriculum effectively. IEPs are crucial for addressing the specific challenges faced by students with disabilities, such as those with hearing impairments or physical disabilities, and they rely on evidence-based practices to create effective learning environments.
Individuals with Disabilities Education Act (IDEA): The Individuals with Disabilities Education Act (IDEA) is a federal law that ensures students with disabilities receive a free appropriate public education (FAPE) tailored to their individual needs. IDEA promotes the rights of children with disabilities and mandates specific educational standards, emphasizing the importance of inclusion in the least restrictive environment and collaboration among educators, families, and service providers.
Mainstreaming: Mainstreaming is the practice of placing students with disabilities in general education classrooms for at least part of the school day, promoting their inclusion in typical learning environments. This approach supports the idea that students with diverse needs can benefit from exposure to their peers and can enhance social interactions and academic achievements when provided with appropriate support.
Marlee Matlin: Marlee Matlin is an acclaimed American actress and advocate for the deaf community, known for her groundbreaking role in the film 'Children of a Lesser God,' for which she won an Academy Award. Her success has made her a prominent figure in raising awareness about hearing impairments and the representation of deaf individuals in media and society.
Mixed hearing loss: Mixed hearing loss is a type of hearing impairment that combines elements of both conductive and sensorineural hearing loss. This means that there are issues in the outer or middle ear that prevent sound from being conducted effectively, as well as damage to the inner ear or auditory nerve that affects sound processing. Individuals with mixed hearing loss may experience difficulties in hearing sounds at certain frequencies and may require specialized interventions to address both components of their hearing challenges.
Oralism: Oralism is an educational philosophy that emphasizes teaching deaf individuals to communicate primarily through spoken language and lip-reading, rather than sign language. This approach reflects a belief in the superiority of verbal communication and the idea that deaf individuals should assimilate into hearing culture. Oralism often involves the use of speech therapy and auditory training as the main methods for developing communication skills.
Sensorineural hearing loss: Sensorineural hearing loss is a type of hearing impairment that occurs when there is damage to the inner ear or the auditory nerve pathways that transmit sound signals to the brain. This condition can affect the ability to hear faint sounds, understand speech, or distinguish between different frequencies and pitches. It's often permanent and can result from factors such as aging, exposure to loud noise, genetics, infections, or head trauma.
Sign language instruction: Sign language instruction refers to the teaching methods and practices used to help individuals learn sign language, a visual language primarily used by the Deaf and hard of hearing communities. This type of instruction is vital for fostering communication skills and social interaction among those with hearing impairments, allowing them to connect with both hearing and Deaf individuals effectively.
Signed Exact English (SEE): Signed Exact English (SEE) is a sign language that follows the grammatical structure of English while using signs from American Sign Language (ASL) and additional signs to represent every word in English. This system aims to facilitate communication for individuals with hearing impairments by providing a visual representation of spoken English, allowing users to convey thoughts in a more structured manner. SEE is particularly beneficial for those who are learning English as a second language or for individuals with hearing loss who are not familiar with ASL.
Speech and Language Assessments: Speech and language assessments are systematic evaluations conducted to measure an individual's communication abilities, including their speech production, language comprehension, and expressive language skills. These assessments are crucial for identifying speech or language disorders, which can be impacted by various factors such as hearing impairments, developmental delays, and other conditions that affect communication.
Speech audiometry: Speech audiometry is a method used to evaluate an individual's hearing ability by measuring their ability to understand and repeat spoken words. This assessment provides important insights into how well a person can process auditory information, especially in the presence of background noise, which is crucial for effective communication. Speech audiometry includes tests such as speech recognition thresholds and word discrimination scores, both of which are essential for diagnosing hearing impairments.
Total Communication: Total communication is an educational philosophy that combines various methods of communication, including spoken language, sign language, body language, and written language, to enhance understanding for individuals with hearing impairments. This approach recognizes that no single method of communication is sufficient for all learners and emphasizes the importance of using multiple modalities to support effective communication and learning.