KULIAH 4: 4 MAC 2022

ž How will I communicate with this student?

¡ Do I need to learn sign language?
ž Can he/she hear me when I am teaching a
lesson?
ž Who is the hearing support teacher and what
does that person do?
ž Who is the interpreter and what does that
individual do?
ž What is this chart with X’s and O’s on it?
ž What does a hearing loss sound like?
ž Resource for information regarding hearing loss
ž In-service staff in school building about hearing loss
¡ Ensuring student success rates in mainstream setting
ž Addressing any and all concerns classroom teacher may
have
ž Troubleshooting equipment
ž “Hub” of IEP team
¡ On-going communication between team members
¡ Caseload manager
ž Familiarizing teachers with specially designed instruction
and student needs
¡ Modifications to tests, assignments, etc.
ž Outer Ear (Pinna)
¡ The part of the ear you see every day.
¡ Made of cartilage and skin.
ž Ear Canal (External Auditory Meatus)
¡ You find ear wax in this part of the ear.
ž Purpose of the Outer Ear
¡ Amplifies sound
¡ Assists in localization of sound, especially
elevation and front and back
ž Tympanic Membrane (Eardrum)
¡ Thin layer of skin stretched tightly to allow
vibration of sound
ž Ossicles
¡ Malleus, Incus, Stapes- the smallest bones in the
body!
ž Eustachian Tube
¡ Runs from the middle ear to the back of the
throat
ž Purpose of the Middle Ear
¡ Serves as a bridge from the outer ear to the inner
ear
ž Cochlea
¡ The hearing portion of the ear filled with fluid
¡ Shaped like a snail
¡ Has tiny hairs that move to create impulses that
are sent to the brain
ž Beyond the cochlea
¡ The VIII Nerve
¢ Carries impulses from cochlea to brainstem
¡ The Brainstem
¢ Serves as a relay station
¡ The Brain
¢ Receives signals from the brainstem and interprets the
signals in terms of their sound content
ž Four types of hearing loss:
¡ Conductive
¢ Caused by injury, obstruction, or disease of the outer
or middle ear that prevents the ear from conducting
sound.
— Fluid in the middle ear, wax build-up, absence or
malformation of the outer ear, ear infections
— The loss CAN be medically or surgically corrected

¡ Sensorineural
¢ Damage to the sensory hair cells of the inner ear or
the auditory nerve that leads to the brain
— Effects the way one hears clearly and how one
understands speech correctly
— The loss is permanent and CANNOT be corrected
¡ Mixed
¢ A combination of conductive and sensorineural losses
— Part of the damage is in the outer ear or middle ear
and the other part is in the inner ear.

¡ Central
¢ The outer, middle, and inner ear are intact.
¢ The impairment is to the VIII nerve or brain.
 Degree of Hearing Loss Hearing Loss Range(db HL)
Normal -10 to 15
Slight 16 to 25
Mild 26 to 40
Moderate 41 to 55
Moderately Severe 56 to 70
Severe 71 to 90
Profound 91+

Decibel: the unit measurement of intensity, or

loudness, of sound
v MILD (26 to 40 dB)
v Difficulty
understanding faint or distant speech
v May need work to develop vocabulary
v Favorable seating and lighting in classroom

v MODERATE (41-55 dB)

v Understands speaker face to face or a short
distance
v May miss as much as 50% of class discussion
v May need vocabulary development, speech
therapy, or special class placement in primary
grades
v MODERATELY SEVERE (56-70 dB)
v Conversation must be loud to be heard
v Will need a hearing aid and training with its use
v Is likely to have problems pronouncing sounds,
have language delays, and limited vocabulary
v Will need extra help in Language Arts, speech
therapy
v SEVERE (71-90 dB)
v May hear loud voices or sounds very close to ear
v Speech and language development are delayed.
v Will need extra help with language skills, concept
development, speech, intensive communication
building skills should be taught
v May be a candidate for cochlear implant(s)
v PROFOUND (91+ dB)
v May be a candidate for cochlear implant(s)
v Socializing with hearing peers may be difficult
v May have language delays, very limited
vocabulary, intensive speech therapy
v Note-taking, captioning, and other visual
enhancement strategies are necessary
ž http://www.audibel.com/understanding/simulator_flash.html
ž Gives us volumes of information about what
a student can and cannot hear.
ž It is conducted by an audiologist in a sound-
proof booth
ž Child wears headphones and listens for
tones, or beeps, and gives a conditioned
response
¡ Raising hand
¡ Placing toys into bins
 Low High

Soft

Red: Right Ear

Blue: Left Ear

Loud
ž Does this student have a hearing loss?
¡ Take a look at the DEGREE of hearing loss chart and compare…
ž Approximately 28 million Americans have a hearing impairment.
ž Hearing loss affects approximately 17 in 1,000 children under age 18. Incidence
increases with age: Approximately 314 in 1,000 people over age 65 have hearing
loss and 40 to 50 percent of people 75 and older have a hearing loss.
ž About 2 to 3 out of every 1,000 children in the United States are born deaf or
hard-of-hearing. 9 out of every 10 children who are born deaf are born to parents
who can hear.
ž Everyday in the United States, approximately 1 in 1,000 newborns (or 33 babies
every day) is born profoundly deaf with another 2-3 out of 1,000 babies born with
partial hearing loss, making hearing loss the number one birth defect in America
o Only 1 out of 5 people who could benefit from a hearing aid actually wears one.
ž Three out of 4 children experience ear infection (otitis media) by the time they
are 3 years old.
ž There are approximately 22 million hearing-impaired persons in the U.S.
ž Deaf people have safer driving records than hearing people nationally.
ž The huddle formation used by football teams originated at Gallaudet University, a
liberal arts college for deaf people in Washington, DC, to prevent other schools
from reading their sign language.
ž Misconceptions:
¡ All students use residual hearing the same way.
¡ Examples:
¢ A student with a PROFOUND hearing loss may use speech only
and is a good lip reader and another student with a PROFOUND
loss may use sign language with no speech and does not lip
read.
¢ When I talk, the student looks like she’s heard me and
understands what I’ve said.
— If you hear a person speaking Japanese, you HEARD it, but
did you UNDERSTAND it?

§ Hearing aids and cochlear implants cure hearing loss.

§ Yelling at a deaf person will help him/her understand you better.
§ All deaf and hard of hearing students use sign language.
§ Politically correct: Deaf and Hard of Hearing
ž Amplification
allows a better chance of
understanding speech

ž Helpa child access residual hearing and

learn how to use this hearing in the most
optimal way

ž Let’s
take a look at different listening
devices and assistive technology…
ž How they work:
¡ All have a…
¢ Microphone: receives sound/signal
¢ Amplifying circuit: shapes the sound to make it
louder
¢ Receiver: changes the signal back into sound that can
be heard
¢ Earmold: the colored ear piece in the ear canal
¡ Are powered by batteries
¡ Internal controls are set by an audiologist
¡ External controls are set by the user (volume)
ž Most common among children
ž Can attach to assistive listening devices (FM)

ž Microphone is on the back part behind the

ear
ž May hear “squealing” from the aid
¡ This is called FEEDBACK
¡ Due to the closeness of the microphone to the
receiver, there is “feedback” or squealing when
the earmold is loose or too small
ž Each group has a hearing aid, stethoscope,
battery tester, and a battery
ž 1st: Check the battery in the tester
ž 2nd: Put into the hearing aid
ž 3rd: Put canal part of earmold into the
stethoscope hose
ž 4th: Turn on hearing aid

ž 5th: Ling Six Sound Test

¡Say: /ah/, /ee/, /oo/, /s/, /sh/, /m/
How did it sound?????
ž In the Ear (ITE)

ž In the Canal (ITC)

ž These types of hearing aids are rarely used

with children.
ž Surgicallyimplanted device
ž Offers severe-to-profoundly deaf children
access to sound
ž Bypasses the damaged part of the inner ear,
stimulates nerve, sends information directly
to brain

ž Three parts:
¡ Receiver- the part that is implanted
¡ Transmitter- head piece (circular piece)
¡ Speech Processor- worn on the body, shapes
sound
ž Sound waves enter the microphone located
in the headpiece
ž Sound is sent through the transmitter and
along the wire to the speech processor
ž Speech processor changes the sound into a
special signal that is sent to the implanted
receiver
ž The receiver sends the signal to the brain
where it is interpreted into sound

¤LET’S WATCH!!
ž How a cochlear implant works...

ž
Cochlear Implant Simulations
ž What is an FM?
¡Frequency-Modulated system that allows a D/HH
student hear over a distance and sends the
speaker’s voice directly to the hearing aid or
cochlear implant
*Without an FM, the speaker’s voice can be
difficult to understand when paired with
everyday background noise (heaters, buzzing
lights, pencil sharpeners, etc.)
ž An assistive listening device that’s
microphone is worn 6 inches from the mouth
ž Improves the sound-to-noise ratio by
reducing distance of sound source
ž Each personal FM system can be very
different depending on the hearing aid type
and its unique features
Campus S Easylink
ž Accessibilityof the teacher’s voice to all
students in the classroom
ž A microphone is worn around the neck
ž Sound is sent from the microphone to
amplifier that is connected to loudspeakers
ž Carpeted box in all of the classrooms
ž Has several benefits to both D/HH students
AND hearing students
ž Manychildren benefit from sound field
systems:
¡ Children with hearing loss
¡ Children with central auditory processing
disorder
¡ Students with ADD and ADHD
¡ Students with developmental delays
¡ Preschoolers, kindergarteners, and first graders
who are in crucial learning stages of language
development
¡ ESL students
¡ Students with dyslexia
•Several Different Modes:
•Auditory/Oral
•Auditory-Verbal
•American Sign Language (ASL)
•Cued Speech
•Signed English or (SEE)
•Total Communication qThere is no ONE PERFECT
•Rochester Method mode for every child.
•Contact Signing qEach child’s hearing loss is
•Manually Coded English (MCE) unique and his/her
communication mode should
match that loss.
 Responsibilities:
ž Facilitate communication

ž Sign everything that is voiced

ž Will stand/sit close to teacher

Not responsible:
ž Classroom management

ž Tasks such as teaching, grading papers,

making copies
ž Disciplining students (deaf and hearing)
ž Language delayed
¡ Spoken language
¢ Not uncommon for students to speak with nasal or atonal quality

¡ Academic performance
¢ Vocabulary development delays

¢ Reading and writing difficulty

¢ Difficulty in comprehension across academic subjects
¡ Idioms and familiar English phrases interpreted literally
¡ Written and oral language will reflect the way he/she hears
-Word endings –s,-ed, -ing
¡ Depends on age child was diagnosed with a hearing loss.
¢ Many deaf children are not “vanilla deaf”

ž Limited phonemic awareness

¡ What does the student hear during everyday conversation? Look at the
Speech Banana.
¢ Example: The fox saw two hens. Even with a mild loss, the student misses most of
those sounds. /e ok aw oo en/
¡ Imagine reading and pronouncing these sounds that D/HH students so
rarely hear.
 Message: Ann needed new shoes.
Question: “Who needed new shoes?”
Student’s response: “Ann nanna”

DID vs. DIG

*A student who uses sign and speech to communicate reads
a passage two times. The first time is with speech ONLY.
He reads, “The boy walked to school. He did this
everyday”. Then, when asked to SIGN the sentences, he
signs The-boy-walk-to-school. He DIG this everyday.

Did he get it right? Is the message still the same? No way!

•Use visual aids •Use overhead instead •Have key vocabulary
whenever possible of the board accessible visually
•Provide a note-taker •Allow for breaks •Educate the class
or hand-out of notes about hearing loss
•Eliminate or reduce •Reduce the distance •Face the student
extraneous noise from you to student when speaking

•Appropriate use of •Advantageous seating •Repeat questions and

equipment for student comments other
students make
•Do not speak with •Point out who is •Do not stand or sit in
back faced to class speaking in class front of a bright
discussions window
•Write announcements •Always use captioned •Flicker lights to get
and assignments on films/videos classroom attention
board
•Avoid chewing gum •Lecture from the •Speak directly to the
while lecturing front of the room, student, not the
avoid pacing interpreter
ž What can be done to setup the deaf student
for success?
¡ SEATING
¢ “U” shaped desk arrangement
¢ Close to where teacher will be doing most of lecturing
¢ Facing away from the windows
¢ Students with cochlear implants should sit with C.I. side closest to speaker.
¢ At ear level to the sound field, if used, approximately 3-6 feet away
¢ Avoid seating the student next to noisy heaters and fans, buzzing lights,
computers/printers, projectors, pencil sharpeners, or classroom sink

¡ ACOUSTICS
¢ Cover hard, smooth surfaces with sound-absorbing materials like carpeting,
felt, table cloths.
¢ When noise is present, the student will have difficulty understanding or
attending to discussion.
¢ Inappropriate acoustics can compromise understanding speech, behavior,
language experiences, concentration and academic achievement.
ž Modified curriculum
ž Accessibility to communication via an educational
interpreter
ž Clear desk prior to new assignment
ž Establish eye contact prior to giving directions
ž Management of noise level in classroom
ž Increased wait time to allow for language processing
ž Use of appropriate amplification (hearing aids, C.I.’s, etc.)
ž Modify assignments to meet language needs
ž Preferential seating
ž Frequent review of skills and concepts
•Exposure to loud noises over an extended period of time damages the hair cells in the
ear.
•These hair cells cannot grow back causing noise-induced hearing loss.
•Examples of harmful loud noises:
•Motorcycles
•Firecrackers
•Explosions
•Concerts
•MP3 players at loud volume
•Chainsaws
•Jet Engines

•The length of time exposed to these noises will determine whether a person will acquire
noise-induced hearing loss.

•What can be done to prevent it?

•Limit exposure and time of exposure to loud harmful sounds
•Wear protective hearing devices or earplugs
American Speech-Language-Hearing Association. (2005). Acoustics in Educational
Settings: Position Statement [Position Statement]. Available from www.asha.org/policy

Bess F. The minimally hearing-impaired child. Ear and Hearing, 1985; 6:43-47

Centers for Disease Control and Prevention. National Center for Birth Defects and
Developmental Disabilities, Early Hearing Detection and Intervention Program.
http://www.cdc.gov/ncbddd/ehdi/default.htm.

"Interesting Facts about the Deaf." DeafNet. 19 July 2008 <www.deaf.net>.

http://kidshealth.org/parent/general/eyes/cochlear.html website

Laughton, Joan. "Educating Children Who are Deaf or Hard of Hearing: Cochlear Implants." ERIC Clearinghouse
on Disabilities and Gifted Education Reston, VA. 15 Sep. 2008 <www.ericdigests.org/1998-2/implants.htm>.

“Mainstreaming the Student Who is Deaf or Hard-of-Hearing.” Guidebook. Melanie Doyle, M.Ed., Linda Dye,
M.A., CCC-A Director of CCHAT Center, SanDiego. January 2002.
National Association of the Deaf website. Community & Culture.
<www.nad.org>
"Noise-Induced Hearing Loss." www.nidcd.nih.gov. 1 May 2007
<nidcd.nih.gov/health/hearing/noise.asp>.
http://www.nidcd.nih.gov/health/hearing/coch.asp website
Images:
http://www.bcchildrens.ca/NR/rdonlyres/1E47B20B-D686-44BF-A811-B4AE48E4DCB7/16095/BTE.jpg
http://www.theitinerantconnection.com/images/hearing%20aid%20in%20ear.jpg
http://mortonplant.com/images/In%20canal.jpg
http://www.youtube.com/watch?v=SmNpP2fr57A
http://www.phonak.com/de/professional/productsp/instrumentsp/digitalp/products_instruments_digital_mi
cropower.htm?activetab=31736
http://www.netac.rit.edu/gphx/tipsheets/cued.gif