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 believedResidential schools and sign language

caused segregationFeared 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 believedStrongly opposed all of Bell’s positionsHe 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