[“Hearning impairments”]

Analysis and intervention in a case study of hearing

impairment
Psychopedagogical bases of Special Educational Needs

Name and surname: Violeta de Dios Torres

Name and surname: Juan Lucas Galvez Miranda
Name and surname: María Ramírez de Arcos

CASE STUDY
Paula is 6 years old. She is enrolled in the first year of primary education.

Her teacher has noticed that her oral language is not developing at the same pace that of her
classmates. She has a reduced range vocabulary and some of her words are difficult to
understand for interlocutors not familiar with the girl. Sentences do not exceed two or three
words. She is not able to recognize colors or body parts.

The teacher is also concerned with the attention abilities of Paula. Sometimes she pays attention
to what it is been worked in class, for example, when the teacher does a storytelling using a book
or visual images, but other times she seems self-absorbed in her world and does not respond to
her teacher's attention calls. She seems especially clueless when the noise level increases in class
or when students are asked to do body expression activities using music from a player.

Regarding the social relationships with their classmates, sometimes she interacts well with some
children who play quietly by her side, she imitates them and seems happy. However, she does
not like being with those who are more restless (inquietos). Sometimes she even seems scared
of them and has come to even push them. However, she is an affectionate girl, who cares about
others when the interaction occurs face to face.

The teacher, worried about what she is observing, has consulted with the counsellor team
(psychologist and speech-language teacher) of the school and they have informed her that it is
possible that Paula is experiencing a hearing loss.

Then, the teacher decides to call their parents and make an arrangement for a tutorial
(individualized meeting with the parents). While they wait with Paula for the teacher to finish
meeting other parents, the teacher observes the following: the father takes Paula in his arms
while he shows her a story. The girl looks at the images that the father points with the finger, but
when the father asks him to look for something in the story, the girl continues looking at the book
without pointing.

During the interview, the teacher perceives that parents are worried, but they deny the hearing
problem because both are hearing and there are no more no deaf relatives. When asked if there
was a problem in childbirth or pregnancy, the mother only remembers that, before knowing that
she was pregnant, she had an infection in her mouth and took antibiotics and anti-
inflammatories, but that nobody informed her that this could mean any trouble. The family leaves
the interview willing to do whatever it takes to help their only daughter.
 [“Hearning impairments”]

A few weeks later, the parents meet again with the teacher. They have taken Paula to the
doctor and a screening for deafness have been conducted.
The hypothesis of the blocking or restriction in the hearing canal has been discarded; it looks
like a normal auditory channel. So, the pathology seems to be related to a damage in the inner
ear. In the audiometry, they also observed that difficulties are greater when it comes to
perceiving high tones.

1. Based on the teacher observations and the information collected in the parent-teacher
interview, classify the hearing loss of Paula using the four criteria that we explained in
class. Justify your answers (it is not enough to just state that it is, for instance, a mild,
central, prelocutive… hearing loss). (0.5 point)

Based on the teacher observations we could say that Paula is suffering a severe hearing lost,
the first reason that we found is that her diagnoses is a damage in the inner hear. The second
reason is that she is having problems to have normal conversation, but she can still talk. Also,
we can say that is not a hereditary hearing loss because her parents haven´t hearing problems
and it looks like a prenatal hearing impairment because of the mother´s infection in her mouth
and she took antibiotics and anti-inflammatories before she was pregnant.

2. Describe the main difficulties that the hearing loss seem to have caused in the areas of
the cognitive, communicative, socio-emotional development of Paula. (1.5 points)

First of all, the teacher has noticed that the oral language of Paula wasn't developed at the
same pace as her classmates. She has a reduced range vocabulary and some of her words are
difficult to understand.

Sometimes she pays attention to what it is been worked in class but sometimes she is very
distracted and didn't realize when the teacher is calling her. She gets very distracted when
activities involve a lot of sound or noise.

Sometimes she interacts well with children that play quietly, she imitates them and seems
happy. However, she does not like being with those who are more restless. Sometimes she
even seems scared of them and has come to even push them.

3. Paula has been using oral language, but it is still quite undeveloped.
- Considering the family context and Paula´s hearing loss, what communicative system (oral
language, sign language, or bilingual) would you recommend for this student? Justify your
answer. (0.5 point)

In this case, we have a hearing parent and a child with a hearing loss, so the best
communicative system is bilingual, I mean, mixed the oral language with de sign language. If
the parents only use the oral language despite, she still hears a bit will produce a generalized
delay in language acquisition of Paula.
 [“Hearning impairments”]

- Based on your previous answer, what are the main difficulties that you would anticipate in the
acquisition of the communicative system (oral, sign) that you recommended? (0.5 point)

The bilingual way is the difficult one because the parents have to acquire the sign language,
they are hearing parents, so they haven´t need to learn sign language before and this required
time. Also, exposure to information available in the family environment is more limited than
in deaf families if parents do not sign with each other or with other family members.

4. With regard to the need to access oral information and communication:

- Is there any augmentative communication system that could facilitate communication

between Paula and their parents? If so, explain what and why would be the best option. (1
point)

The best option by which Paula could adequately communicate with her parents would be
through the cued speech. This communication system consists of a support system for lip
reading. cued speech is about communicating through a set of signals that accompany lip
reading. Also, the signs can contribute to, and clarify, the spoken phoneme.

This is recommended because Paula has damage in the inner ear, so this is a good method with
children with a deaf and parents hearing (using oral language). It can facilite phonetic
discrimination and reading lips.

- Name a list of, at least, 10 tips (recommendations) that you as teacher should follow to
improve the way you teach Paula. These recommendations should also benefit other
students. (1 point)

1. Speak naturally (articulate well, with a strong voice and a normal rate)
2. Restrict your movements while you talk.
3. use visual support like pictograms, conceptual maps, diagrams…
4. Don't talk around the classroom if you are talking.
5. Make sure that Paula maintains eye contact when you talk with her.
6. Make sure that Paula understands everything
7. Write new vocabulary on the board.
8. Videos are helpful for a better understanding
9. Chair noise solutions
10. If you are sitting in small groups, the students should stand up if they want to say
something
 [“Hearning impairments”]

- How would you organize the classroom space (students tables, teacher´s table, whiteboard,
corners…) to optimize listening and lip reading? Represent the classroom space. (1 point)

In order for Paula to better understand everything, the class would be organized as follows:

Paula should be close to the teacher to hear her better, she should have good eye contact. In
addition, Paula's strongest hatred should be placed close to the teacher. It is also important
that the teacher does not meet in front of a window. If possible, use dampeners on the legs of
the chairs to avoid too much sound when they move.

5. Next activities concern with the development of Paula´s oral and written language,

- Propose an activity to stimulate the 5 auditory abilities. Explain (step-by-step) the activity,
provide a list of materials, and the materials themselves if they are designed by you. (1.5
point)

The activity will revolve around the sounds made by farm animals. For the first step (detection),
the sound of a dog will be played intermittently, and you will have to say when you hear it and
when you don't hear it. For the second step (discrimination), you will play the sound of a horse
on one side and a cow on the other and you will have to say whether they are the same or
different. In the third step (identification), the child will be given a list with the names of
different farm animals (hen, sheep, pig, horse and cow) and the sounds of pig, sheep and cow
will be played on a CD, and the child will have to point out on the paper those sounds that are
being played. In the fourth stage (recognition), we will ask the child to repeat the names of the
farm animals seen previously by showing pictures of the animals. Finally, in the final stage
(comprehension), a conversation about the farm animals will be held with the child in which
they will be asked about experiences they have had on the farm and with the animals or if in a
hypothetical case they would not have gone to the farm as they think it would be.

The materials used for this activity will be:

- A CD with recorded animal sounds
- A printed sheet of paper with the names of the animals.
- Printed pictures of the animals
 [“Hearning impairments”]

- Propose an activity to stimulate the vocabulary development. Explain (step-by-step) the

activity, provide a list of materials, and the materials themselves if they are designed by
you. (1 point)

For this activity, which aims to develop vocabulary, in which we will work the association,
we will use a box in which we will put small images of different items of clothing (T-shirt,
trousers, skirt, socks, coat...) if we want to work on the vocabulary of items of clothing, for
example. The children will sit in front of the box, then one of the children will take a picture
at random and without showing it to the others will describe the garment represented
(without mentioning it directly). The other children try to guess what it is. The first one to
guess will go on to select the next image.

The materials to be used are:

- Pictures of the clothes
- A small box

- Propose an activity to improve syntax abilities for Paula. Explain (step-by-step) the activity,
provide a list of materials, and the materials themselves if they are designed by you. (1.5
point)
To work on this type of skill with Paula, she will be given a sheet of paper with a series of single
words at the top of the paper and the rest will be sentences on a random but simple topic that
has been worked on previously in class. These sentences will have a series of blank spaces and
Paula will have to fill in the blank spaces with the words that are at the top of the paper. There
will be approximately ten sentences.

The materials to be used are:

- A sheet of paper with the exercise printed on it
- A pencil and an eraser