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= STUDENTS WITH DEAFNESS AND HEARING LOSS = Hearing losses are classified into 5 basic types: 1. Conductive hearing loss - malfunctioning of the outer or middle ear, with the inner ear and central nervous system perfectly fine. A common cause of this is associated with upper respiratory infections, but trauma or physical blockage, such as excess wax, can also disrupt the transmission of sound. 2. Sensori-neural hearing loss is due to inner ear dysfunction. It’s the most prevalent and also is a irreparable type of disorder. This means that there has been damage to the sensory or nerve in the inner ear, the auditory nerve or the auditory cortex of the brain. 3. Central loss is the most difficult to evaluate. Some of the causes include congenital brain damage or malformation, brain trauma or tumor, or ototoxic drugs. 4. Mixed loss - both a conductive and sensori-neural loss in the same ear. 5. Functional loss - the hearing impairment has no organic basis. Physical: No impairment. A loss of 26 dB or better in the better ear and would indicate little or no hearing problems. People who are at this level can still hear whispers. Slight impairment - A loss of 27 - 40 dB in the better ear for adults. A loss of 20 - 40 dB for children. People who are at this level can hear some words spoken in a normal voice at 1 meter. Counselling and hearing aids may be recommended at this level. Mild impairment - A loss of 41 - 55 dB in the better ear. People who are at this level can hear and repeat words spoken in a raised voice at 1 meter. Usually a recommendation of hearing aids. Moderate impairment - A loss of 56 - 70 dB in the better ear. People who are at this level can hear some words when shouted into the better ear. They must use hearing aids. Recommended: teaching lip reading and signing. Severe impairment - A loss of 71 - 90 dB. People who are at this level can hear some words when shouted into the better ear. Hearing aids are a necessity. Recommended: Teaching lip reading and signing. Profound impairment - A loss of 90 dB or greater in the better ear. People who are at this level are unable to hear and understand a shouted voice. Hearing aids may help understanding words in some cases. Recommended: teaching lip reading and signing. Deafness - Typically involves complete inability to hear in both ears. People with hearing impairments will have: - Recurring ear infections - They may wear hearing aid - They may move around the class to get closer to where the sound is coming from - They may appear to have poor locomotive skills and/or look uncoordinated in some activities Cognitive/Academic (includes listening characteristics): - People with hearing impairments are very dependent on visuals (reinforcements and/or cues) - They demonstrate uneven performance that may result in overall underachievement academically - Their reading skills may be below grade level - Their reading comprehension skills are weaker than word recognition skills - They have difficulty moving from the concrete to the abstract - They don't seek assistance when necessary - They have problems following written directions and sequencing information - They will watch or copy other students before starting tasks - They need frequent repetition/clarification of instructions and content material - Their written language is noticeably feebler than their oral language - this is reflective of their oral language difficulties - They continue to use very basic vocabulary and syntax in written language - They have hardship in processing oral information - They struggle hearing in an environment that has a lot of noise (i.e. background noise) - They have difficulty hearing the speaker at distances greater than 1m or when the speaker is not directly in front of them - They may show a preference for listening with one ear (the one with better hearing in most cases) - They are unable to distinguish certain aspects of speech, e.g. high frequency consonants such as s, t and th Social/Emotional/Behavioural: - They tend to choose younger and/or handicapped students to befriend or have as peers because they can relate more with them - They may be isolated due to communication problems - They generally misunderstand their peers - They may use physical contact to get attention - They use gestures/body language to communicate when speaking to someone - They usually respond to noises rather than responding to words - They may rarely move from one activity to another - They may seem to be "excessively social" or "nosey" - They may demonstrate aggressive behaviour due to frustration - They may have adversity when negotiating (communication barriers) with others in decision-making/problem-solving situations - They may appear bored and/or lethargic at times (not paying attention) - They may act out of impulse - They are extremely shy and lack self confidence - They usually do not participate in group activities and are usually agitated in large group activities As an Adult, you should suspect a hearing loss if: > settings or at work Your child’s hearing should be checked if he or she: In Manitoba, students with hearing impairments have the option to attend the Manitoba School for the Deaf. The school offers academic programming from kindergarten to grade 12 and high school students are able to graduate with full credit requirements. Since all students attending the school have some form of hearing impairment, no one is automatically assigned an Individual Education Plan. IEPs are reserved for students with other impairments (such as autism, Down syndrome or cerebral palsy) in addition to hearing loss. A typical class has 5-6 students (with larger classes reaching 12 students), administered by a single teacher. Students on IEPs may warrant an educational assistant in the class as well. The environment at the school is bilingual; students are instructed in both American Sign Language and English. Extracurricular activities include sports, track and field, photography, video production and a robot gladiator club! On-staff special educators include o Assesses hearing status and coordinates hearing aids o Assesses communication skills and provides language instruction Students who are hearing impaired and choose a mainstreamed education are coordinated by an //Itinerant Teacher of the Deaf and Hard of Hearing//. These special educators travel between schools to support students with hearing impairments as well as the staff who work with these students. Itinerant Teachers participate in developing IEPs, offer professional development sessions to school staff and visit students, usually on a weekly basis to assist with language development, care and maintenance of hearing aids and academic instruction. In Manitoba, each school division is responsible for coordinating its own services and supports for students with hearing impairments. The department of education also hosts the //Manitoba Services for Students who are Deaf and Hard of Hearing// which can provide supports such as ASL translators on request. As a teacher, there are several strategies you can use to assist students with hearing impairments: Minimize Noise Maximize Speaker’s Voice Maximize Visual Access Communicate Clearly Encourage Group Work Hearing loss in children is most often determined at age two. In two out three children, it is the parents who are likely to detect the hearing loss. When parents get confirmation that their child does suffer from a hearing loss, they are obviously shocked and often feel like they are helpless. It completely shakes up their world. They will have many questions about what they can do for their child and what's next. It is important that parents are open-minded and try to gather as much information as possible. They should ask lots of questions about what the situation is all about. They should also seek help from doctors, audiologists, and other parents and families who also have children with a hearing loss. The parents should also remember that supporting their child is the main focus especially when the child begins to attending school as they might feel as if they are different from the other students. The sooner that parents can accept that their child has a hearing loss, the sooner they can focus on building a positive and supportive environment for them. Another important thing for parents to do is to determine what type of aid to give to their child. Parents can choose either cochlear implants or hearing aids. Cochlear implants are surgically implanted electronic devices that provide a sense of sound to the person. Hearing aids are devices that are placed behind the ear designed to amplify sound. The main difference between these two types of aids is that the implants involve surgery while the hearing aids do not. Surveys have shown that once the child receives the implant or hearing aid, the stress level of the parents goes down because they don't have to worry about how their child is going to hear. Once the child gets older, parents must decide whether to put their child in school with students who don't have a hearing loss or put them in a school for the hearing impaired. Another option is to integrate the child by keeping them separated from the children who don't have a hearing loss initially and then putting them with these students after a period of time. The decision will ultimately come down to how comfortable the child is around other students and how comfortable the parents are putting their child into a traditional school setting. Parents should seek the opinions of psychologists and other parents who have children with a hearing loss to help make their decision. However, as stated before, it all comes down to the comfort level of the parents and the child. Parents need to remember that just because their child has been diagnosed with a hearing loss, it doesn't mean that the child can't have a successful and productive life. New technologies have made it easier for parents and families to help their children feel more like the rest of the people around them who don't have a hearing impairment. Parents also need to realize that at the end of the day, their child is still the same child as when they were born. The only thing different is the way that they perceive their child. They will still love their child the same amount as before the diagnosis which is the most important thing of all. Hearing loss is the fastest growing, and one of the most prevalent, chronic conditions facing Canadians today. While hearing loss has many causes, age-related (presbycusis) and noise-induced hearing loss (NIHL) are the two most common types. Here are some interesting statistics that drive our work at The Hearing Foundation of Canada: · Get 10 people to line up in front of the class. · Get one person to sit down, tell the others this child represent the 1 in 10 “Primary” children with a hearing impairment. · Get a second person to sit down, to represent the child that will acquire a hearing impairment by 15 years, · Then get 7 more to sit down, for retirees. This simile activity really visualizes the high number of people who “experience damaged hearing” during their lives. You will require a pair of ear muffs, ear plugs or some cotton wool balls for this activity. This activity is designed to help children identify how **even a mild hearing loss makes it more difficult to understand speech**, and how much more **difficult it is to hear in normal background noise**, such as traffic or speech. · Split the class into pairs · Tell person 1 that the other person is going to tell them some things and that they must repeat what they say. · Place ear muffs (or similar product) on person 1 · Ask person 2 to stand about 1 m away from person 1 and to say some of the following, simple phrases in a normal “classroom voice”: · Ask the class to talk quietly (to simulate background noise) and ask the students to repeat the exercise. i. The teacher wants you to read ii. Mr. Ngo wants you to go to the door iii. Brent was first to present today iv. I went to the Forks on Saturday v. Kayla said she'd hand out the papers vi. Drew is sleeping, isn't that funny
 * __DEFINITIONS__**
 * Deafness or hearing loss is defined as either partial or complete hearing loss.
 * Low frequency hearing loss- (125Hz-1000Hz) difficulty hearing lower frequencies. Will have trouble hearing traffic sound, dogs barking, and thunder. Also will have trouble hearing vowels in speech due to their lower frequency
 * High frequency hearing loss-(4000Hz-8000Hz) difficulty hearing high frequencies. Will have trouble hearing higher octaves including a woman's voice or a child's voice. Also will have trouble hearing consonants f, s, t, and z
 * __Prevalence__**
 * Older adults suffer most often from hearing loss. Age-related hearing loss affects 30 to 35 percent of the population between the ages of 65 and 75 years, and 40 percent of the population over the age of 75.
 * It is estimated that 3 in 1,000 infants are born with serious to profound hearing loss.
 * In the United States, federal surveys over 30 years showed an increase in the number of people who are three years and older with a hearing loss. 13.2 million (1971), 14.2 million (1977), 20.3 million (1991), 24.2 million (1993), and 28.6 million (2000)
 * In 2008, it was estimated that 35 million Americans had some sort of hearing loss
 * 14.9% of American school children have a hearing loss, 7.1% had at least a low-frequency hearing loss, 12.7 experienced high-frequency hearing loss
 * 16% of children in Canada report signs of hearing loss
 * __Causes__**
 * The most common cause of hearing loss in children is otitis media, a disorder that affects predominantly infants and young children.
 * Otitis media is when fluid builds up in the middle ear, namely the eustachian tube. The fluid can become thick and glue-like which interferes with the normal vibration by sound waves
 * OM also known as Glue Ear
 * Blockage of the ear canal
 * Infections with swelling that shuts the ear canal
 * Foreign bodies in the ear
 * An injury/physical trauma
 * Birth defects
 * A growth in the ear canal (tumors)
 * Age
 * Long-term exposure to environmental noise
 * Genetics- If the dominant gene, it will persist for generations even if only inherited from one parent. If recessive gene, it won't always be apparent due to it needing to be passed down from both parents
 * Disease or illness (ex. meningitis, otosclerosis)
 * __CHARACTERISTICS__**
 * __IDENTIFICATION__**
 * They appear to hear people talk but have difficulty understanding some of the words
 * They’re constantly asking people to repeat themselves
 * They have a hard time understanding women and children’s voices
 * They have a hard time understanding in a crowd
 * It’s hard for them to understand on the phone
 * They favor one ear over the other
 * They complain of a ringing sensation in one or both ears
 * They often appear uncomfortable in social occasions they used to enjoy
 * They seem withdrawn, depressed or irritable
 * Other friends or family members have noticed their difficulty hearing
 * You find yourself continually asking people to repeat themselves
 * Your family or friends complain that you watch TV at a loud volume
 * Voices are unclear on the telephone
 * You find it difficult to understand speech in noisy situations
 * You find yourself straining to understand conversations in social
 * Appears to have articulation problems or speech/language delays
 * Has difficulty locating sounds
 * Has difficulty understanding what people are saying
 * Watches others to imitate what they are doing
 * Responds inappropriately to questions
 * Doesn’t reply when you call him or her
 * Seems to speak differently than other children of the same age
 * Complains of earaches, ear pain, or head noises
 * Turns the TV volume to an excessively high level
 * Has academic or behavioural problems
 * __HOW THEY RECEIVE THEIR EDUCATION__**
 * · American Sign Language Specialist
 * · Educational Audiologist
 * · Speech Language Pathologist
 * __RECOMMENDED EDUCATIONAL PRACTICES__**
 * Students who are hard of hearing can find it difficult to distinguish a speaker’s voice in an environment of excessive noise.
 * Eliminate ambient noises
 * Encourage quiet in the classroom
 * Seat students with hearing impairments at the front of the classroom to maximize their view (both of written material and for speech-reading)
 * Use an FM system
 * FM systems use microphones and receivers to send the teacher’s voice to students via radio waves. They are available as **//personal systems//**, where a receiver is connected directly to a student’s hearing aid or as **//soundfield systems//**, where the teacher’s voice is broadcast over speakers in the classroom.
 * Keep your face visible when you speak to the class
 * Avoid writing and speaking at the same time, or speaking while facing the blackboard
 * Organize group discussions so that everyone is visible to each other
 * incorporate visual cues such as pictures and photographs into your lessons
 * Structure your lessons with clear introductions, conclusions and transitions between each topic.
 * Ensure that one student speaks at a time, and identify that speaker
 * Encourage all students to turn and look at the speaker when listening
 * Repeat or rephrase relevant student comments
 * Smaller groups allow opportunities for active learning and allows students to develop social skills
 * It is easier to note if clarification or explanation is required when students are in a small group
 * __PERSPECTIVES OF PARENTS AND FAMILIES__**
 * __TRENDS AND ISSUES__**
 * According to Statistics Canada, more than one million adults across the country reported having a hearing-related disability, a number more than 50% greater than the number of people reporting problems with their eyesight (StatsCan, 2002). Other studies indicate that the true number may reach three million or more Canadian adults, as those suffering from hearing problems often under-report their condition.
 * A major US study first published in the journal Paediatrics found that "approximately 12.5% of American children and young adults in the U.S. are suffering from a hearing disability known as noise-induced hearing threshold shifts (NITS). NITS is basically a change in hearing sensitivity that is experienced as temporary hearing dullness" (Niskar et al, 2001).
 * Research shows that over the last 10 years, the percentage of second graders with hearing loss has increased by 280%, while hearing loss for eighth graders has increased over 400% (Montgomery and Fujikawa, 1992).
 * A study in the Journal of the American Medical Association reported that nearly 15% of school-aged children had hearing deficits at low and high frequencies (Niskar et al, 2004).
 * __ACTIVITY__**
 * Part a)** **To highlight the number of Canadians with a hearing impairment**
 * Part b)** **To highlight why it is important to protect your hearing.**

REFERENCES [] @http://www.thfc.ca/cms/en/KeyStatistics/KeyStatistics.aspx?menuid=87 [] @http://www.hearingloss.ca/signs-hearing-loss.html [] [] []