Republic of the Philippines

Tarlac State University

COLLEGE OF EDUCATION
CENTER OF DEVELOPMENT
Lucinda Campus, Tarlac City
Tel. No. (045) 493-0182; Fax No. (045) 982-0110
Re-Accredited Level IV by the Accrediting Agency of Chartered Colleges and Universities of the
Philippines (AACCUP), Inc.

Foundations of Inclusive and Special Education

EDUC 104

Nicolette Rein S. Pereras

BSED ENGLISH 2-1

Joeanne Marie Igoy-Escalona, Ph.D., LPT

Course Instructor
LESSON 10 - Students with Hearing Impairment

At the end of this lesson, the learners are expected to:

a. Understand how Hearing Impairment occurs;
b. Identify the causes of hearing impairment;
c. Have insights on how they can support people with hearing impairment;
d. Avoid the risk factors of acquiring hearing impairment and know the
underlying preventions for this disability; and
e. Be aware of the importance of undergoing a hearing test.

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Pre-test:
A. Encircle the correct answer.
1. This makes a person experience difficulty in hearing or understanding sounds.
a. Deafness
b. Birth defects
c. Hearing Impairment

2. Can cause hearing impairment.

a. Eating unhealthy foods
b. Ear wax blockage
c. Excessive drinking

3. A disability that gradually develops.

a. Hearing Impairment
b. Autism
c. Dyslexia

4. How to take care of your hearing?

a. Listen to loud music
b. Maintain ear hygiene
c. Swim in filthy water

5. To avoid birth defects, an expectant mother should

a. Drink alcohol and smoke nicotine
b. Undergo x-rays frequently
c. Take vitamins and have regular checkups.

B. Identification
________ 1. This happens when there is a problem with one or more parts of
the ear, the nerves coming from the ears, or the hearing part of the brain.
________ 2. This happens when sounds cannot get through the outer and
middle ear. It may be hard to hear soft sounds.

________ 3. Problems with the nerve pathways from your inner ear to your
brain can also cause?

________ 4. The loss of hearing before speech and language develop.

________ 5. Is a loss of hearing after spontaneous speech and language has
developed?

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________ 6. Plays an important role in student development and daily
performance.

________ 7. Occurs when there's a problem with or damage to one or more

parts of the hearing mechanism.
________ 8. Is one of the most important senses.

________ 9. Continues to improve but still has limitations.

________ 10. Enable hearing students to retrieve information about what is
happening in their environment.

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Main Causes of Hearing Impairment
1. A family history of hearing loss.
2. Some antibiotics and chemotherapy treatments that may have hearing loss as
one of the side effects.
3. Down Syndrome, Pervasive Development Disorder, Autism, Alport Syndrome
and Crouzon Syndrome.
4. Frequent and/or recurring ear infections an infant or toddler.
5. Meningitis, Measles and CMV (Cytomegalovirus) Infection.

Other Causes of Hearing Impairment

Before Birth:

a. Family history of childhood deafness – Deafness in family members

b. Consanguineous Marriages-Marriage between close relations such as
uncle-niece, first cousin.
c. Blood group complications or Rh incompatibility –
d. Infectious diseases or illnesses during pregnancy (e.g. syphilis, German
measles or Rubella with fever, mumps)
e. Very poor physical condition of the expectant mother.
f. Excessive alcohol or nicotine intake by the expectant mother.
g. Intake of ototoxic drugs. (Ototoxic drugs are drugs that can damage the
hearing mechanism if used indiscriminately. For e.g. Gentamycin, amikacin,
quinine preparations etc.)
h. Excessive exposure to X-rays.

During Birth Process:

a. Birth Asphyxia (lack of oxygen supply to the new born due to inability to
breathe normally resulting in blueness of baby due to various reasons)
b. Delayed or feeble birth cry
c. Birth weight less than 1200 grams

After Birth:
a. Injury to the head and /or ear – (by accidents etc.)
b. Continuous exposure to loud sounds. High blood pressure, diabetes.
c. Aging
d. Tumor on the auditory nerve.
e. Middle ear infections, ear discharge etc.

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An adult or a child may experience these following symptoms if
they have hearing impairment
1. Muffling of speech and other sounds;
2. Difficulty understanding word, especially against background noise or in a
crowd of people;
3. Frequently asking others to speak more slowly, clearly, and loudly;
4. Needing to turn up volume of the television or radio;
5. Withdrawal from conversations; and
6. Avoidance of some social setting.
If a child or an adult suffer from the following symptoms mentioned above,
then it is advised best to go to their nearest ENT and ask for hearing test.

Risk Factors in Hearing Loss

1. Aging
2. Heredity
3. Occupational Noise
4. Some Medications
5. Some Illness

Suffering from hearing loss or hearing impairment may lead to

experiencing psychological effects
1. Isolation and Withdrawal
2. Depression and Anxiety
3. An often false sense that someone is angry with you
4. Lack of concentration
5. Anger and Denial
6. Insecurity and Embarrassment
7. Self-criticism and low self confidence
8. Fatigue

If any of your family or peers is suffering from hearing impairment, it is important

that you observe their behaviour and talk to them if you’ll notice changes on
the way they act and behave. People around the person who suffers from
hearing impairment should be aware of the following psychological effects
because it may later lead to more complicated situations.

There are several ways you can support people with hearing disability and
several ways to cope if you’re suffering from it:

1. Tell you friends and family

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 2. Position yourself to hear
3. Turn off background noise
4. Ask others to speak clearly but not more loudly
5. Choose quiet settings
6. Considering using an assistive listening device
7. Try to have the other person's attention before speaking

Hearing loss is difficult for individuals who suffer from it, but you should know
that there are treatments available. Doctors are actually advising individuals
to get a hearing test to avoid further complications and to see if they have it.
Since they are not familiar with the underlying risk factors and symptoms of this
disability, some people are unaware that they are suffering from it. Some
people also disregard the symptoms that could lead to a more serious hearing
loss, and they believe that it is untreatable. If you know someone who has
hearing loss, it's necessary to let them know about the possible benefits of
undergoing treatments.

Benefits of Treatments
1. Greater self-confidence
2. Closer relationships with loved ones
3. Improved outlook in life

In the first part of this paper, the following factors that causes hearing
impairment were mentioned. A child could suffer from hearing Impairment
caused even before birth or during the birth process, but if the child survived
those stages without a loss of hearing, then it is important that they prevent the
other factors that can cause hearing impairment after birth.

1. Protect your ears in the workplace. Wearing protective construction ear plugs
or earmuffs is a great way to protect your ears in workplace. Always wear ear
protection if you work in a noisy environment.
2. Have your hearing tested. Hearing test is essential especially for new born
babies since it can diagnose as early as possible if the baby suffers from hearing
loss. This is a way of preventing further complications and easier treatments.
3. Avoid Recreational Risk. Avoid listening to loud music especially if you’re
wearing earphones or headsets. Also, avoid going to loud areas.
4. Maintain good ear hygiene:
 Keep the ears clean, free from dust, water, wax etc.
 Sharp things such as matchsticks, hairpins, pencils, and other pointed
objects should not be used to clean or scratch your ears. It has the
potential to rupture the eardrum or cause damage to the ear canal.
 Avoid blowing your ear because it can result in an irreversible hearing
problems.

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  Keep an eye on small children who are playing with small objects such
as beads or seeds. If they put them in their ears, they risk rupturing the
eardrum or injuring the ear canal.
 Oil or any other liquid should not be put in the ear since it might cause
pain, swelling, and ear discharge. Always keep your ears dry.
 Swimming in filthy water is not a good idea. Ear infections can be
caused by contaminated water entering the ear. Always use cotton to
block your ears while swimming, especially when diving. This keeps water
from getting into your ear and rupturing your eardrum.
 Do not let roadside quacks clean your ears. They use unclean tools that
could spread infection. The eardrum may also be harmed. Regularly
clean your ears with cotton buds or have them cleaned by a doctor.
 Avoid using unwashed pillowcases, towels, and other items that have
been used by someone who has ear discharge. Your ear may also
become infected as a result of this.
 If a baby's head is elevated while being fed, milk may enter the ear
cavity (through the small passage connecting the throat and the ear).
It might result in ear pain, swelling, and discharge.

Diagnosing hearing loss or hearing impairment is not complicated. there are

several methods that doctors can use to test or diagnose if a newborn, child,
or an adult has hearing impairment. Doctors advise that everyone get their
hearing tested as soon as possible to avoid further complications and to begin
treatment as soon as possible. It is preferable to address one's hearing
impairment sooner rather than later since more severe complications may
arise if it is not diagnosed early, and hearing impairment that have been
diagnosed earlier can be treated quickly and easier.

Test and Diagnosis

Tests to diagnose hearing loss/impairment includes:
1. Physical Examination
2. General Screening Tests
3. App-based Hearing Tests
4. Tuning Fork Tests
5. Audiometer/Audiometry Tests

1. Physical Examination. Your doctor will look in your ear for possible causes of
your hearing loss, such as earwax or inflammation from an infection.

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2. General Screening Test. A thorough check of the ears. It is done to screen
for ear problems, such as hearing loss, ear pain, discharge, lumps, or objects in
the ear.

Babies — All babies should be screened for hearing loss no later than 1 month
of age, or no later than 3 months of age.

Older Babies and Children — Children who are at risk for acquired,
progressive, or delayed-onset hearing loss should have at least one hearing test
by 2 to 2 1/2 years of age.

— Acquired or progressive hearing loss. Hearing loss that gradually

gets worsen.

— Delayed-onset hearing loss. Hearing loss that occurs after the birth
of a baby.

Full Hearing Test — A thorough hearing test should be given to all children
who do not pass the hearing screening. An audiology evaluation is another
name for this test.

Audiologist — An expert trained to test hearing.

A newborn baby is required to undergo a hearing test. Hearing test will

determine whether the baby has hearing impairment or not. This test
prevents more complications and can give treatments as early as
possible. Hearing test is also advisable for people at all age.

Brainstem Auditory Evoked Response (BAER) Test or Auditory

Brainstem Response (ABR) Test — A test that checks how the brain
respond to sounds. ABR focuses solely on the inner ear's function, the
acoustic (hearing) nerve, and a portion of the brain pathways involved
in hearing.
Otoacoustic Emissions (OAE) — A test that checks how the inner ear
respond to sounds.
Behavioral Audiometry Evaluation — Behavioral Audiometry
Evaluation will assess a person's general response to sound.
— It examines the function of the entire ear.
— The person being tested must be awake and respond
actively to the noises that are played during the test.

The audiologist will share the results with the child’s primary care doctor
and other experts:

An otolaryngologist is a doctor who specializes in the ears, nose, and

throat.

An ophthalmologist is a doctor who specializes in the eyes.

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 A professional trained in genetics, sometimes known as a clinical
geneticist or a genetics counsellor.

Check these links for further understanding on how doctors’ conduct Brainstem
Auditory Evoked Response (BAER) Test, Auditory Brainstem Response (ABR) Test,
and Otoacoustic Emissions (OAE):

New born Hearing Test Screening. https://youtu.be/QvrBogzziXA

Non-sedated ABR/BAER/OAE Testing. https://youtu.be/WAjnWpr6_io

3. App-based Hearing Test. Mobile apps that you can use on your tablet to
screen for moderate hearing loss.

hearWHO — Is an app based on validated digits-in-noise technology

developed by the World Health Organization. It allows anyone to check their
hearing status and track it over time using a hearing screener and it also
displays the users' results clearly and saves a personalized record of their
hearing status over time. The app is specifically recommended for those who
commonly listen to loud music over personal audio devices.

Aside from hearWHO, there are also different apps you can use to test your
hearing. Of course, undergoing hearing test to professionals is better but these
apps can be a first step to test your hearing.

1. Sound Alert
2. Insight Timer
3. Mini Hearing Test
4. Sound Print
5. Decibel X

4. Tuning Fork Test. A small metal instrument consisting of a stem, two prongs
and a foot piece, that produces a constant pitch when either prong is struck
against a firm but resilient surface.

Rinne Test. It compares air conduction to bone conduction.

1. A tuning fork is struck and placed on the mastoid bone behind

one ear by the doctor.
2. You notify the doctor when you can no longer hear the sound.
3. The doctor then places the tuning fork near your ear canal.
4. You call the doctor once more when you can no longer hear that
sound.
5. The length of time you hear each sound is recorded by the
doctor.

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 Weber Test. The Weber test is a quick and easy way to determine if you have
hearing loss. The test can detect conductive and sensorineural hearing, and is often
combined with Rinne Test to detect where the hearing loss takes place (e.g. right or
left ear).

1. A tuning fork is struck and placed in the centre of your head by

the doctor.
2. You take note of which ear the sound is best heard, whether in
the left, right, or both ears.

Check this link to see how doctors’ conduct Rinne and Weber Test:
Hearing Test (Rinne and Weber Examinations) – ENT.
https://youtu.be/RVH4K4EcsiA

How to Conduct a Hearing Fork Test. https://youtu.be/RVH4K4EcsiA

5. Audiometer/Audiometry Test. Test one’s ability to hear sounds. It examines

sound intensity and tone, as well as balance issues and other concerns relating
to the inner ear's function. This test is administered by an audiologist.

What is Audiometry? – Tests on your Audiogram.

https://youtu.be/G7M1gQLdR5A

Hearing test is really important. It is a great method to test if someone is suffering

from a hearing loss. Some people might suspect that they have hearing
impairment if they’re experience some symptoms such as muffling of speech
and sounds, difficulty in understanding words, needing to turn up television and
phone’s volume to hear it clearly, etc. Being aware of these symptoms are
important since it will give you an idea that you might be suffering from a
hearing loss, but some people also fail to realized that they have hearing
impairment. Sometimes, a person will not be bothered if he/she cannot hear
properly or is experiencing hearing loss symptoms especially because it is a
gradual process. And since hearing loss might be present since birth or
develops over time, some might only suspect they have it if their inability to
hear clearly is already severe. In this case, treatments can be done but it may
take a longer time to treat it, unlike when recognizing earlier that you suffer
from it. To avoid further complications, it is crucial to get your hearing tested
even if you don’t suspect you have hearing impairment. Getting your hearing
tested will give you a lower chance of having more complications and will give
you a higher chance of treating it as early as possible.

During the test, doctors may ask the patient to stay still, don’t move, and be
observant of the sounds they will hear. They might also ask the patient to wear
headphones in a soundproof room to carefully examine his/her hearing. Unlike

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other tests, hearing test is not painful nor difficult. The whole process might only
take 30 minutes depending on what the doctor will do.

A hearing test will show whether you suffer from hearing loss or not. It will show
your hearing health or status enabling you to be aware of how you can take
care of your ear and hearing to avoid suffering from hearing impairment and
avoid making your condition severe. Hearing test will also measure the intensity
of sounds in units called decibels.

If you know someone who has a hearing problem or if you have this problem,
remember that there are several treatments available depending on the
severity of your condition and depending on what your doctor would advise.
Options include:

 Removing Wax Blockage

 Hearing Aids
 Cochlear Implants
 Surgical Procedures

Removing Wax Blockage. Cleaning the outside of the ear by wiping with
a cloth.

1. Cerumenolytic solutions are injected into the ear canal;

2. Ear irrigation or syringing; and
3. Using special devices to manually remove the wax.

Synthesis/Generalization:
Hearing Impairment is a kind of disability that can be treated as early as
it was diagnosed. New born baby should undergo hearing test to determine if
they have hearing loss and treat it right away. Although, it is a well-known
disability among infants, it is sometimes neglected. Some people are also not
aware that they suffer from hearing loss which might lead to more
complications since this disability gradually develops.

Preventive measures are important to avoid the risk of developing

hearing loss, and those who are born with hearing impairment should be
thoroughly check and treated to avoid making the problem severe.

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Post-test
A. Write TRUE if the statement is correct and write the correct answer if the
statement is wrong.
_____________ 1. Tumor on the brain can cause hearing impairment.

_____________ 2. Newborn should be screened for hearing loss no later than 1

month of age, or no later than 3 months.
_____________ 3. OAE Test checks how the brain respond to sounds.

_____________ 4. An audiologist is a doctor who specializes in the ears, nose, and

throat.

_____________ 5. An individual should wear construction ear plugs or earmuffs

in a noisy workplace.

B. Identification

________ 6. Examines the ears by carrying out a basic hearing screening.

________ 7. treat children from the newborn period through the teenage
years.

________ 8. is a physical examination of the ear that involves looking into the
ear with an instrument called an “otoscope”?
________ 9. measures the ability of the middle ear to conduct sound.

________ 10. is the testing of a person’s ability to hear sounds at a range of

frequencies?

C. Give at-least 5 degree and types of Hearing Impairments.

1.
2.

3.
4.
5.

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