Hearing Impairment

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Hearing Impairment

• Mr.Hamilton

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Types of Hearing Impairments

• Congenital Hearing Loss present at birth
• Acquired Hearing Loss happens later in life
• Hard of Hearing hearing is defective but
  functional for ordinary purposes.

Levels of Hearing Loss
Moderately Severe
Moderate
Mild
Severe
Profound
51 to 70 dB HL
26 to 30 dB HL
31 to 50 dB HL
71 to 90 dB HL
90 dB HL
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General Statistics

• 1 in 5 Americans have hearing loss in at least
  one ear.
• 20 of the US population ages 12 and older have
  hearing difficulties severe enough to impact
  communication.
• 3 out of every 1000 children is born deaf or
  hard-of-hearing.
• About 26 million Americans between the ages of 20
  and 69 have high frequency hearing loss due to
  exposure to loud noises at work or during leisure
  activities.

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How the Ear Works
S O U N D
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Outer/Middle Ear Damage
Effects ability to hear loudness of speech.
Can sometimes be corrected with medications or
surgery
Also called conductive hearing loss
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Inner Ear Damage
Effects the clarity of speech heard as well as
loudness
May be treated with hearing aids or cochlear
implants
Also called sensorineural hearing loss
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Other common Hearing Impairments

• Auditory Neuropathy Spectrum Disorder
• Outer hair cells of the cochlea work properly but
  the inner do not.
• Causes the transmission of sound from the inner
  to the brain to be disorganized.
• Individuals with the disorder can develop strong
  language skills with the help of medical devices,
  therapy and visual communication techniques.
• Auditory Processing Disorder (APD)
• Individual can hear well in a quiet environment
  but may have difficulty hearing a noisy one.
• Can be treated with therapy.

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Characteristics of a Hearing Impairment

• More response to vibration and touch than to
  speech and sound.
• More alertness to visual cues such as movement.
• Little or no babbling during infancy.
• Delayed speech language development.
• Gestures rather than speaking.
• Frequent requests to have things repeated.
• Irrelevant answers to discussion at hand.
• Below level academic performance.
• Understands more when watching the speakers
  face.
• Deviations in speech.

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Causes of Hearing Impairments

• Conductive hearing loss
• Otisis Media ear infection that affects the
  middle ear. It causes a buildup of fluid or puss
  behind the eardrum, which can block the
  transmission of sound. A persons hearing will
  usually return to normal afterwards.
• Blockages in the ear, impacted earwax or dirt,
  fluid from colds/allergies.
• Partial ear damage including the eardrum, ear
  canal ossicles, inserting a cotton swab too far
  into ear, sudden explosion or loud noise, change
  in air pressure, head injury, or repeated ear
  infection.

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Causes of Hearing Impairments

• Sensorineural hearing loss
• Genetic disorders
• Injuries to the ear or head
• Complications during pregnancy or birth
  infections the mother had while pregnant
• Infections or illness mumps, measles,
  chickenpox, brain tumors
• Medications anti-biotics and chemotherapy
• Loud Noise noise induced hearing loss

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How can a Hearing Impairment be improved?

1. Reconstructive Surgery
2. Hearing Aid
3. Cochlear Implant
4. Auditory training

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Hearing Aids

• Amplify sound in a controlled manner.
• Components
• Microphone picks up surrounding sounds and
  converts them into electrical signals.
• Receiver Converts the amplified signals back
  into sounds of greater strength.

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Cochlear Implant

• Bypasses the damaged inner ear and sends signals
  directly to the auditory nerve.
• Components
• Microphone Placed behind the ear picks up sound
  waves.
• Receiver Placed under the scalp receives sound
  waves from microphone. The receiver then
  transmits impulses directly to the auditory
  nerve. These impulses are then perceived as sound
  allowing a person to hear.

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Auditory Training For Choral techniques.

• Often used in conjunction with a hearing aid or
  cochlear implant.
• Emphasis on critical listening and an
  understanding of listening errors that are likely
  to occur.
• Need to develop skills in using other clues for
  listening such as facial expression and gestures.
• speech/lip reading using visual cues for
  listening purposes. Utilizes facial expressions,
  gestures, body movements, and immediate physical
  setting.
• Hearing loss can result in the deterioration of
  speech skills, so auditory training hopes to
  limit the amount of deterioration that will
  happen.

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Cognitive Impact of Hearing Impairments

• Lack of communication skills.
• Hearing is a two way street of listening and
  hearing. It is based on the ability to handle
  faint as well as loud speech, mumbled as well as
  clear.
• Hearing acts as a receptive monitoring function
  in oral speech. An infant perceives speech
  patterns of others and through hearing he
  monitors his imitative speech attempts.
• Monitoring continues through development of
  speech skills as you hear new words and sounds.
• Early identification is key for children to
  develop normal hearing skills.

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Social Impacts of Hearing Impairmentsproblems for
Choral teachers to be aware of

• Reduced social activity or problems participating
  in social activites.
• Problems communicating with friends, family and
  colleagues.
• Problems communicating in school.
• Isolation and withdrawal.
• Lack of concentration.
• Especially hard if hearing loss occurs later in
  life after developing speech and hearing skills.

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Emotional Impacts of Hearing Impairments

• Embarrassment, shame, guilt and anger.
• Sadness or depression.
• Anxiety and suspiciousness.
• Self-criticism and low self-esteem and confidence.

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What can we do in the rehearsal?

• Technologies
• Programmable hearing aids that can be adjusted to
  different environments.
• FM systems where the teacher wears a transmitter
  connected to a receiver that the student wears.
• Cochlear implants.
• Real time captioning videos.
• Voice recognition software for note taking.
• ASL American Sign Language
• Language used by the deaf community.
• Learn a few basic signs and the alphabet.
• Students will sometimes have an ASL interpreter
  with them if it is needed.

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Accommodations

• Seat hearing impaired students near the front of
  the chorus near speakers so they can feel the
  vibrations coming from them.
• Always face the HI student while speaking so they
  can read your lips easier.
• Keep rehearsal room well lit so that the HI
  student can take in all visual cues.
• Use lots of visual cues including pictures,
  modeling, overheads and gestures.
• When playing instruments or singing, have the HI
  student play the lower pitched ones so they can
  more easily feel the vibrations.

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Additional Resources

• Butler, M. (2004). How Students with Hearing
  Impairments Can Learn and Flourish in Your Music
  Classroom. Teaching Music, 12(1), 30-34.
• Nilo, E. R. (1969). Needs of the Hearing
  Impaired. The American Journal of Nursing, 69,
  114-116.
• Hearing Health Foundation. (2011). Hearing Loss
  Statistics. Retrieved February 23, 2013, from
  Hearing Health Foundation website
  http//hearinghealthfoundation.org/85
• Touchette. (2012). Consequences of Hearing Loss.
  Retrieved February 23, 2013, from Paradise
  Hearing Balance Clinics, Inc. website
  http//www.paradisehearing.com/pages/
  consequences-of-hearing-loss
• Schraer-Joiner, L., Prause-Weber, M. (2009).
  Strategies for Working with Children with
  Cochlear Implants. Music Educators Journal,
  96(1), 48-55.
• Music and the Deaf. (2010). Music and the Deaf.
  Retrieved February 22, 2013, from Music and the
  Deaf website http//matd.org.uk/publications/
• Morlet, T. (Ed.). (2012). Hearing Impairment.
  Retrieved February 22, 2013, from Teens Health
  website http//kidshealth.org/teen/diseases_condi
  tions/sight/hearing_impairment.html
• https//www.youtube.com/watch?v2A9j4t8gY-4