Deaf and Hard of Hearing

Introduction to Special
Education: Making a Difference
Chapter 10
Definitions, generally

 Deaf – those with profound hearing loss

who cannot understand sounds with or
without hearing aids

 Hard of Hearing – those with hearing

losses that impair their understanding of
sounds, including communication
Definitions according to IDEA ‘04
 Deaf a hearing impairment that is so severe that the
child is impaired in processing linguistic information
through hearing, with or without amplication, that
adversely affects a child’s educational performance

 Hard of Hearing an impairment in hearing, whether

permanent or fluctuating, that adversely affects a
child’s educational performance but that is not
included under the definition of deafness

 IDEA ’04 recognizes these two groups, but it considers

them to belong to one special education category
which it calls hearing impairments see chart on pg. 355
Historically. . .

 Attitudes towards the deaf have varied

 Ponce de Leon, a Spanish monk from the
1500s, is credited as the first teacher of deaf
students
 William Holder and John Wallis, in the 1600s,
are credited with the first founding of a school
for the deaf. It was in England
 Thomas Hopkins Gaullaudet and Laurent
Clerc founded the first school for the deaf in
the U.S. in 1817.
The debate about communication

 Huge historical debate over the benefits

of oral communication versus manual
communication. Jokingly called “the
Hundred Years’ War”
 Debate was fueld primarily by Thomas
Gallaudet’s son, Edward, and Alexander
Graham Bell. Both had deaf mothers.
Bell vs. Gallaudet

 Bell believed
 Residential schools and sign language
caused segregation
 Feared it encouraged deaf people to marry
other deaf people and would result in the
loss of hearing for the entire human race
 Began legislation to prevent 2 deaf people
from marrying, eliminate residential schools,
prohibit sign language, and ban deaf people
from becoming teachers
Bell vs. Gallaudet cont’d

 Galludet believed
 Strongly opposed all of Bell’s positions
 He won support from Congress for the
manual approach and for separate center
schools

But the conflicts did continue for some time

Early Hearing Devices

 Old versions are primarily hearing trumpets

which amplify sound
 The development of battery technology,
especially during World War II greatly
advanced hearing aid devices
 The earliest devices were bulky and hard to use
 Small transistors, like the radio, were designed to
go over the ear in the 1950s
 Today, hearing aids use microchips to amplify
sound
Hearing Loss

 Occurs when the hearing mechanism is

damaged or obstructed in such a way
that sounds cannot be perceived or
understood.

 Can occur anytime before or after birth

Challenges of Hearing Loss

 Most of us communicate through hearing

and learning. This corresponds to how
we learn
 Deaf people and people who are hard of
hearing have a restricted ability to
communicate which reshapes the ways
in which they must be taught
Types of hearing loss
 First, check out how hearing works
 Sensorineural Hearing Loss damage to the inner ear
or the auditory nerve
 Much more difficult to correct than conductive hearing loss
 Are able to hearing different frequencies at different intensity
levels; means their loss is not flat or even
 Less common in children
 Conductive Hearing Loss blockage to the outer or
middle ear.
 Generally, this results in mild to moderate hearing loss.
 Most of us have or will experience this in our lives (ex: air
pressure in a plane, colds, ear infections etc.).
 On any given day 20% of elementary school students
experience conductive hearing loss
Decibels, or dB, which are used to measure
sound, help us to identify levels of hearing
Degree of Hearing Loss
 Mild Hearing Loss (21-40 dB): only speech that is
soft or is produced at a distance is difficult to hear
 Moderate Hearing Loss (41-55 dB): typical
conversation speech is hard to follow
 Moderately Severe Hearing Loss (56-70 dB): only
loud speech can be heard
 Severe Hearing Loss (71-90 dB): even loud speech
is hard to understand
 Profound Hearing Loss (91 dB+): considered
“deaf,” assistive listening devices alone enable the
individual to understand information presented orally
Should be noted that it is hard to accurately classify hearing loss
The Age of Onset
 Prelingually Deaf those who are deaf before they
learn to speak and understand language. Apprx. 95%
of all deaf children are prelingually deaf. These people
may be capable of oral communication, but if so,
usually develop oral language skills much later than
they developmentally should

 Postlingually Deaf those who experience profound

hearing loss after they have learned to speak and
understand language. Many retain their ability to use
speech and communicate with others orally
What IDEA ’04 says about hearing
loss
 Stresses the importance of the communication needs
and style of students with hearing loss
 When developing an IEP the following should be
considered
 The individual’s language and communication needs
 Opportunities for direct communication with peers and
professional personnel in the student’s language and
communication mode
 The student’s academic level
 The student’s full range of needs, including opportunities
for direct insturction in her or his language and
communication mode
Other factors to consider for hearing
impaired students
 30-40% of those who are deaf or hard of
hearing have additional disabilities that often
result from the same condition, disease, or
accident that caused their hearing loss
 Individuals with mild to moderate hearing loss
are sometimes overlooked when it comes to
other special needs because it is assumed
their hearing devices fully compensate for their
disability
Deaf Culture
 Unlike people with other disabilities, many people with profound
hearing loss do not consider themselves people with disabilities,
but rather as a minority group
 They consider themselves “Deaf.” Notice the capital “D”
 Deafness is not a disability for them, but rather one aspect of
their lives that binds them together as a minority group rich in
culture, history, language, and the arts
 The language for the American Deaf community is ASL
 Plays are written in ASL
 Performed by deaf actors using ASL
 Being Deaf of Deaf (born Deaf of Deaf parents) or CODA (Child
of a Deaf Adult) is a source of considerable pride
 ASL is their native language
 Not preoccupied by deafness, but engaged in childhood and play
 Deafness is a language difference not a disability
 This only represents about 5% of the deaf population
 American Sign Language ASL
 In the U.S. the primary language for the deaf and the hard
of hearing is ASL
 ASL:
 Uses manual communication signs
 Has all the elements of other languages
 Is not parallel to English in either structure of word order
 Is not a mere translation of oral speech or English language
(as is signed English)
 Is a fully developed language
 Many schools allow ASL to fulfill the foreign language
requirement for their students
 Some argue that children with severe hearing loss should
learn ASL as their primary language, but this is discouraged
as it may alienate/isolate them from their family and culture

Only 11% of teachers of the deaf use ASL in the classroom. Instead, they use manual
communication methods that use grammatical structures that are similar to English.
Academic Achievement

 It is important for the hearing impaired to

develop strong reading skills to aid in the
usage of captions
 TV and Film
 Internet, Email
 Individuals who are deaf and who have higher
reading abilities are more likely to graduate from
college
 Reading is a challenge for many people who
are deaf -By age 20 half of deaf students
tested scored below the mid-fourth grade
reading level ask Dr. Garner why.
Prevalence

 Hearing loss is associated with age. Over half

of the people with hearing problems are over
65. Although only 25% of them use a hearing
aid

 Hearing loss is the #1 birth defect in the U.S.,

but it is still low incidence affecting only 0.13%
of students. 1 in 1,000 babies is born
profoundly deaf and 2-3 have less severe
hearing loss
Causes of Hearing Loss

 The cause most often associated with

hearing loss in children is unknown, but
it is suspected that 50% of children born
with deaf do so due to genetics
Causes of Hearing Loss cont’d
 The most common causes of hearing loss in children in order of
prevalence
 Heredity and Genetics can be congenital and sensorineural. Most
children whose deafness is hereditary are less likely to have multiple
disabilities
 Meningitis a disease that affects the central nervous system. Most
hearing loss caused this way is due to bacterial meningitis. There are
vaccines available to prevent this disease, but there is no national
immunization program
 Otis Media infections of the middle ear that result in an accumulation of
fluid behind the eardrum that interrupt the process of hearing. Can be
corrected with antibiotics. Depending on the frequency and duration of
infection, it can affect speech development and can result in a language
impairment that affects future learning. Chronic, untreated Otis Media
can cause a permanent conductive hearing loss
 Noise OSHA (U.S. Occupational Safety and Health Admin) set
standards for safe exposure. Exposure at or above 105 dB for one hour
or more is unsafe. An average rock concert averages 125 dB. This type
of hearing loss usually occurs slowly, across years of exposure, without
pain or awareness
Technology

 Technology and assistive listening

devices (official IDEA ’04 lingo) are
credited with much of the improved
access to mainstream society
experienced by people with disabilities

 The continual advances in this arena are

promising for the future
Hearing Aids
 Hearing Aids assistive listening devices that amplify
sounds but are not surgically implanted. The most
commonly used device
 Behind the ear – BTE (these tend to be the most effective, but
are the least used because they are the most visually apparent)
 In the ear ITE
 In the canal ITC
 Completely in the canal CIC
 Digital Hearing Aids automatically adjust the volume by
amplifying sounds only to the degree necessary to
compensate for loss
 Analog Hearing Aids amplify all sounds equally, making it
impossible to discriminate speech from background noise
Cochlear Implants
 Surgically implanted devices that use a small speech
processor and microphone to detect sound and then
send electrical signals to the implanted
receive/stimulator, which ultimately passes this
information to the brain.
 FDA approved them in 1990
 At first were only used for adults who experienced
severe hearing loss later in life
 New data shows that they aid in the development of
speech and language for children who are born deaf.
Many children who have cochlear implants, first had
them implanted before the age of 2
What IDEA ’04 says about Assistive
Listening Devices
 IDEA ’04 explicitly addresses the use of hearing aids
and indirectly addresses the use of cochlear implants
 Assistive technology devices and/or services are made
available to a child with a hearing disability
 Hearing aids worn in school by children with hearing
impairments are functioning properly
 The term assistive technology device does not include a
surgically implanted medical device or its replacement
 The term related services does not include a surgically
implanted medical device, nor does it include
optimization of functioning, maintenance, or
replacement of the above
Telecommunication Devices: Devices to aid in
access to TV and Cinema and Phone
 Captions (The French Chef With Julia Child was the 1st show to offer
captions
 Open Captions –seen by all viewers regardless of hearing impairment
 Closed Captions – captions that can be turned off or on
 Rear Window Captioning – projects captions from a message board on
the theater’s rear wall to a piece of clear plastic that attaches to the
moviegoer’s seat
 Text telephone (TTY) – A machine that prints out the voice messages
from a phone. A drawback is that a device must be on both ends of the
phone for this to work.
 Telecommunications Relay Service – required by the FCC, allows a
TTY user to “talk” to a person using a standard phone. An operator at a
relay center places the call on a voice line and reads the typed message
from the TTY to the non-TTY user. This relay service uses a 1-800
number
 Voice Carry Over - a TTY that includes the option of using both voice
and text. A relay operator types what the hearing person says, which is
then displayed on the text phone.
 Personal Data Assistants PDAs – increasingly popular with the hearing
impaired. PDAs are reducing the needs for TTYs
Speech-to-Text Translations

 Real Time Captioning – practically

instantaneous translations of speech into
print; an accommodation for students
who are deaf and attending lectures

 Automatic Speech Recognition –

technology that converts speech into text
almost instantaneously
Alerting Devices

 Assistive devices for people who are

deaf to make them aware of events in
their environment through a loud
sound or other means (ex, the bird
“chirping” on many new crosswalks)
Early Identification
 Universal Newborn Hearing Screening – in 41
states (text from 2007) and Washington DC is now
required

 Young children with profound hearing losses who

receive early intervention services have much better
outcomes than those who do not

 Children who are identified before they are 6 months

of age experience half the delays of children who are
identified after they are 18 months old
Average Hearing Levels and
Identification
 Chart on pg 372

How hearing loss is identified

Evaluation: State and District Wide
Assessments
 Most students with hearing loss
participate in annual assessments
required by the NCLB.
 Students who are hard of hearing or who
are deaf who still participate with their
fellow students without disabilities use
the accommodations that are specific to
their IEPs.
The importance of early intervention

 Allows children to be fitted with hearing aids as soon

as possible, which can be as early as four weeks old,
or to be scheduled for cochlear implants which can be
done as early as 1 year old
 Intervention, before the age of 6 mos pays off in better
reading achievement and speech abilities in later
years.
 Preschool programs allow students with hearing
losses to develop language at the righ developmental
period in their lives
 Early intervention programs help families better
understand and meet the very special needs of their
family members
Teaching students with hearing loss

 Remember, on any given day, this applies to 20% of your

school population (but they may not qualify as a student
with a disability)
 The educational needs of every student with hearing loss is
unique
 IDEA ’04 mandates that school placements and methods of
instruction be given individually determined for every
student with a disability
 An array of educational services and placements should be
available to every student who is deaf or hearing of hearing
 Audiologists
 Speech Language Pathologists
 Interpreters
 Teachers of the deaf
Common Sense Practices
 Reduce background noise
 Have a rug and tennis balls on chair legs
 AC running as quietly as possible
 Decrease sound vibrations with curtains
 Seat deaf students away from ‘noisemakers’
 Instructional Tips
 Seat students so they can see everyone
 Use visual displays
 Define key words/topics carefully
 Use multimedia and use captions
 Have students share notes
 Use familiar objects when presenting concepts
 Speaking Tips
 Be aware of your pace and slow down as needed
 Keep your hands away from your face
 Always face students with hearing impairments
 Keep use of figurative language to a minimum
Classroom Management for the
Hearing Impaired
 Place student as close to the speaker as possible
 Instead of a black/whiteboard, use an overhead
projector etc. so that the speaker can face the class
when presenting material
 Reduce the background noise as much as possible
 Do not stand with the light behind you
 For class discussions, make certain the student knows
who is about to speak and ensure that he/she is able
to see the speaker
 For class discussions, arrange students’ chairs in a
circle so the student can see everyone’s face
Access to the General Ed
Curriculum
 IDEA ’04 makes specific statements pg 359,
and pg 366
 Many parents feel the general ed classroom is
not the least restrictive classroom for hearing
impaired students
 Can be restrictive because students cannot
communicate with peers and staff
 Residential schools enable students to
communicate fully in all academic and
extracurricular activities
 For students who use ASL, having a teacher
who is not fluent can be highly restrictive and
isolating
Residential Schools
 The Deaf (minority group) community strongly
advocates for residential schools
 The issue is that people advocating for those with
mental retardation advocated strongly for the closing
of these schools
 Since the birth rate for deafness is low incidence this
means that often deaf children are the only deaf
person in their school or even community which leads
to isolation and estrangement. Residential schools aid
in their feeling more accepted
 This leads many to feel that a separate program best
meets the needs of deaf students and is also the LRE
LRE and Severity of Hearing
Impairment
 The LRE is most controversial with among the
hearing impaired than with any other group
because defining the severity of loss is often
hard

 See pg. 380 for a detailed chart on severity of

loss and the placement considerations
 Most hard of hearing students find the LRE for them
in the regular ed classroom
 Many deaf children do attend their neighboring
schools, however a significant number of deaf
students prefer a school wither their classmates
share their deafness
Validated Educational Practices
 Oral Only Approach – using only oral means to
communicate
 Total Communication Approach – employing any
and all methods of communication (72% of the hearing
impaired are taught using this method)
 Cued Speech – hand signals for “difficult to see”
speech sounds; assist with speech reading
 Bilingual-bicultural approach – combines practices
of ESL and bilingual education; ASL is the native
language and reading and writing in English are taught
as a second language (the newest method)
Partnerships with Families and
Communities
 Acceptance and inclusion from family is
the most important thing for any child,
including those with hearing impairments

 For parents who are Deaf, and have a

Deaf child, this is often cause for
celebration and relief