HEARING IMPAIRMENT

Hearing Impairment - occurs when there is a problem with or damage to one or more parts of the ear.
- It is a loss that prevents a person from totally receiving sounds. This includes specifically the
outer ear middle ear, inner ear, hearing nerve and auditory system.
- Is a loss of sixty decibels or more in the better in the conversational range of frequencies.
- It means impairment in hearing, whether permanent or fluctuating, that adversely affects a
child’s educational performance but is not included under the definition of “deafness”.
Basic types of hearing loss:
 Conductive Hearing Loss – caused by any condition or disease that impedes the conveyance of sound in its
mechanical form through the middle ear cavity to the inner ear.
 Sensorineural hearing Loss – occurs from damage to the inner ear, the nerve that runs from the ear to the
brain, or the brain. Some causes of sensorineural loss may be age noise, and diseases.
 Mixed hearing Loss – is a combination of conductive and sensorineural hearing loss, which means there is
damage in both the outer or middle ear and in the inner ear.
Hearing Loss may vary depending on its degree or severity. A decibel ranging from -10 to 15 may be classified as
normal 16 to 25 dB as light, 26 to 40 dB as mild, 41 to 55 dB as moderate, 56 to 70 as moderately severe, 71 to 90
as severe and 91+ dB as profound.
In terms of effective communication, a Slight hearing loss may not experience difficulty in speech understanding.
However, when the decibels range gets higher, effective communication may be affected.
Mild hearing loss may experience reduced speech understanding especially in noisy environments.
Moderate may have a noticeable difficulty in conversation, moderately severe may need speech that is louder than
usual and may have difficulties in group conversations will occur and severe may perceive regular speech is
inaudible, has difficulties even with loud speech and comprehension is often only possible through shouting or
amplification.
Profound hearing loss may have difficulties in understanding even in amplified speech.

HISTORY
1000 BC – Hebrew law provides that the Deaf have limited rights to property and marriage
355 BC – Aristotle says “Those who are born deaf all become senseless and incapable or reason”
360 BC – Socrates mentions the uses of signs by the deaf Plato’s Cratylus. Socrates discusses innate intelligences,
and claims that Deaf people are incapable of language and ideas.
354-430 AD – St.Augustine believed that faith comes by hearing and that deafness is a hindrance to faith. However,
he believed that Deaf people can learn and thus are able to receive faith and salvation. Augustine refers to bodily
movements, signs and gesture and believed that these modes were capable of transmitting thought and belief. He
implies that it is equal to spoken language.
1521 – Rudolf Agricola, a Dutch humanist, believed that the Deaf could communicate via writing. He Advocated the
theory that the ability of speech was separate from the ability of thought.
1501-1576 – Girolamo Cardano was the first physician to recognize the ability of the Deaf to reason and the first to
challenge Aristotle’s belief that hearing was a requirement for understanding.
1591 – Alberti, a German physician, published the first book of any kind specifically regarding deafness: Discourse
on Deafness and Speechlessness. He stated that hearing and speech were separate functions. Alberti believed that
deaf people were rational capable of thought, even though they lacked speech. He showed that the Deaf can read
lips, understand speech, and read, without the ability to hear.
1614-1684 – John Bulwer was a British physician who studied gestures and published Philocopus, also known as the
Deaf and Dumble Man’s Friend in 1648 and Chirologia, also known as the Naturall Language of the Hand in 1644.
These were the first English books on Deaf education and language.
People with Hearing Impairment may generally manifest the following characteristics:
 Intellectual
 Academic
 Behavior
 Communicative Abilities
 Physical/Medical

Hearing Impairment may be detected by using various screenings and diagnostics tests. It may be of Medical
diagnosis for the detection and proper treatment of the child or educational assessment for academic purposes.
A., MEDICAL DIAGNOSIS
1. New Born Screening test
2. Physical Exam
Otoscopy is an examination that involves looking the ear with an instrument called otoscope. The examination is
performed by gently pulling the outer part of the ear upwards and backwards. These actions straighten the external
auditory canal, which has a natural curve, and makes it easier to see the eardrum.
3. RINNE and WEBER TEST
Rinne’s test is done to compare the auditory acuity of each ear to bone and air conduction. The tuning fork is
struck gently so as not to produce overtones and dysharmonica.
Weber Test – used for the determination of a conductive vs a sensorineural hearing loss. Used by the striking of
tuning fork and placing base in the center of the forehead or the top of the head.
4. WHISPERED SPEECH TEST – The examiners stand arm’s length behind the seated patients and whispers a
combination of numbers and letters and then asks the patient to repeat the sequence.
5. PURE TONE AUDIOMETRY – A pure tone air conduction hearing test determines the faintest tones a person can
hear at selected pitches from low to high. During this test, earphones are worn so that information can be obtained
for each ear.
6. SPEECH AUDIOMETRY – is used to measure the ability of a patient to perceive speech signals. Speech materials
are presented; the patient repeats the speech materials to determine how well it was perceived
7. TRANSTYMPANIC ELECTROCOCHLEOGRAPHY (ECOG) – Is specialized test which measures the electric
potentials or signals generated in the inner ear in responses to sound. ECOG is performed with recording electrode
placed as close to the inner ear as possible. This is done by passing the electrode through the eardrum and
positioning it next to the inner ear.
B. EDUCATIONAL ASSESSMENT – Assessment tools for students who are deaf or hard of hearing.
1. Meaningful Auditory Integration Scale (MAIS)/Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) –
it is a structured interview schedule designed to assess the child’s spontaneous responses to sound in his/her
everyday environment.
2. Test for Auditory Comprehension of Language-3 (TACL-3) – is receptive language test that assesses a
student’s ability to understand spoken language.
3. Spoken Communication for students who are Deaf or hard of Hearing: A Multidisciplinary – this curriculum includes
a Student Speech Record which is used to evaluate the following non verbal communication (attention, turn taking,
eye contact and breath support) and suprasegmental, vowels and diphthongs, and consonants at the phonetic,
phonologic and pragmatic level.
4. The central Institute for the Deaf (CID) Picture Speech Intelligibility Evaluation (SPINE).- uses colorful pictures to
evaluate speech intelligibility in children as young as 6 years of age.
5. Checklist of emerging ASL (American Sign Language) Skills – the checklist provides a series of indicators to judge
whether a deaf child has components of ASL in his communication system.
PREVALENCE
In the world population, there are 360 million person in the world with disabling hearing loss (5.3% of the world’s
population) 328 million (91%) of these are adults (183 million males, 145 million females) 32 (9%) million of these are
children. The prevalence of disabling hearing loss in children is greatest in south asia, Asia Pacific and sub-Saharan
Africa. Approximately one third of person over 65 years are affected disabling hearing loss.
In the Philippines survey on hearing disability and ear disorders conducted by Better Hearing Philippines, Inc. was
established at 8.8% of the general population with wax problem, otitis media and non infectious conditions as the
leading cause. Further, hearing impairment including mild forms of hearing loss was at 28%.. Is it estimated that
there are 27,792 or 0.63% person who are deaf . In the early enrollment of SPED in the elementary level (SY 2012-
2013) there is an estimated 6,217 children who are deaf from all regions. While as to for the public secondary level in
SY 2011-2012, there are an estimated 1,148 children and teens who suffer from hearing impairment.

CAUSES
There are possible cases of Hearing Impairment:
1. Ear Infection
2. Congenital hearing loss
3. Injury/Trauma
4. Aging
5. Noise induced hearing loss (NIHL)
6. Medications and other chemicals that are toxic to the ear
7. Nutritional Deficiency causes
8.

PROBLEMS, CHALLENGES AND STRUGGLES

Hearing Impairment also entails problems and challenges not only to the hearing-impaired learners but also to their
families and teachers.
A. People with Special learning needs. Some deaf and hard of hearing students struggle to acquire the grammatical
structures of English. The Struggles of being hard of Hearing are enhancing socialization, self-concept, self-
acceptance, public attitudes, education, employment, hearing aids and society values and services.
B. Family – Counselling families of Children with hearing loss struggle with the feeling of isolation and alienation from
mainstream programs for children who are deaf or hard of hearing. They also have the additional burden of trying to
find suitable program and dealing with large array of professionals. Also, parents of s child with hearing loss and
additional special needs tends to remain in denial longer.
Parenting children who are deaf or hard of hearing present unique long-term challenges that can place the parents at
a greater risk for elevated levels of parenting stress.
C. Teachers – Parents Teachers and peers with Normal hearing exposed that 81 adolescents with hearing
impairment, 31 teachers and 30 peers found adolescents who wore hearing aidswere, reported to have
communication difficulties more than half of the time when listening unaided in challenging listening environment.
Teachers and peers perceived the adolescents experienced less communication difficulty that reported by the
adolescents.