DIFFICULTY IN

HEARING
PREPARED BY:
FRANCIS QUARRE
LYKA JANE ROGUEL
JOHN LESTER ROMERO
ALANA MAREES DOLOSO
INTRODUCTION

Hearing ability is important for children to develop speech

and language skills as they grow. In the past, hearing loss in
children often went undetected until the child was around
two years old, when it became obvious that he or she
wasn't talking yet.
Research from a 2005 National Health Surgery conducted by
the Centers of Disease Control and Prevention (CDC) stated
that the data varies, roughly 1.4 babies per 1,000 newborns
have a hearing loss. It indicated that five (5) out of every
1,000 children are impacted by hearing loss, with cases
being diagnosed between ages 3 and 17.
Unfortunately, hearing loss is becoming more commonplace
in youth due to the noise in our environment. In 2013, the
CDC estimated at least 12.5 percent of children and
adolescents age 6 to 19 have suffered permanent damage
to their hearing due to excessive noise exposure.
KEY FACTS ACCORDING TO WHO

• Around 466 million people worldwide have disabling

hearing loss (1), and 34 million of these are children.
• It is estimated that by 2050 over 900 million people will
have disabling hearing loss.
• 60% of childhood hearing loss is due to preventable
causes.
• Hearing loss may result from genetic causes,
complications at birth, certain infectious diseases, chronic
ear infections, the use of particular drugs, exposure to
excessive noise, and ageing.
• 1.1 billion young people (aged between 12–35 years) are
at risk of hearing loss due to exposure to noise in
recreational settings.
DEFINITION OF HEARING IMPAIRMENT
OR DISABILITY

Hearing impairment or disability refers to reduced function

or loss of the normal function of the hearing mechanism.
Deafness refers to an inability to comprehend verbal
language due to an inability to hear.
• Hearing impairment is defined by IDEA as "an impairment
in hearing, whether permanent or fluctuating, that
adversely affects a child's educational performance."
• Deafness is defined as "a hearing impairment that is so
severe that the child is impaired in processing linguistic
information through hearing, with or without
amplification."

Individuals with
Disabilities Education Act
According to the age of onset, hearing impairment can be
congenital when the condition is present at birth or
adventitious when it is acquired after birth or later on.
When the condition occurs before the child learns to talk,
deafness is prelingual. Deafness is postlingual when it is
acquired after the child has learned speech usually at the
age of two.
CLASSIFICATION OF HEARING
IMPAIRMENT
A conductive hearing loss occurs in the outer and middle
ear thereby blocking the passage of the acoustic energy.
The blockage may be caused by abnormal growths or
complications of the outer or middle ear. Malformation,
incomplete development, or abnormal growth and
improper movement of ossicular chains can cause
conductive hearing loss.
A sensorineural hearing impairment occurs in the inner ear.
The sensitive mechanismsand the auditory nerve may be
damaged. Sensorineural hearing losses may be congenital
or adventitious because of illness or traumatic incidents.
Only a very small percentage of sensorineural deafness can
be reversed by medical intervention.
A mixed hearing impairment results from a combination of
both conductive and sensorineural hearing loss.
Any dysfunction in the central auditory nervous system
between the brain stem and the auditory cortex in the brain
results in a central hearing disorder.
Another basis of classifying hearing impairment is its being
unilateral or present in one ear only, or bilateral or present
in both ear.
As mentioned earlier, deafness may be congenital or
adventitious. The degree of severity of hearing impairment
may be slight, mild, moderate, severe and profound.

Sound is measured in decibels (dB) or units that describe its

intensity, that is, its loudness and softness.
CHARACTERISTICS OF PERSON WITH
HEARING IMPAIRMENT

Some of the observable behavioral and learning characteristics

of a child with hearing impairment are as follows:
• Cups hand behind the ear, cocks ear/tilts head at an angle to
catch sounds
• Has strained or blank facial expression when listening or
talked to
• Pays attention to vibration and vibrating objects
• Moves closer to speaker, watches face especially the
mouth and the lips of the speaker when talked to
• Less responsive to noise, voice, music and other sources
of sounds.
• Uses more natural gestures, signs, and movements to
express self
• Shows marked imitative at work and play
• Often fails to respond to oral questions
• Often asks for repetition of questions and statements
• Often unable to follow oral directions and instructions
• Has difficulty in associating concrete with abstract ideas
• Has poor general learning performance
IDENTIFICATION AND ASSESSMENT OF
CHILDREN WITH HEARING IMPAIRMENT

Early identification of a hearing impairment increases the

chances for the child to receive early treatment and special
education intervention. The assessment program includes
audiological evaluation, test of mental ability, and test of
communication ability.
1.Audiological Evaluation
Audiology is the science of testing and evaluating
hearing ability to detect and describe hearing impairments.
Audiological Evaluation is done by an audiologist
through the use of sophisticated instruments and
techniques. The audiometer is an electronic device that
generates sounds at different levels of intensity and
frequency.

The purpose of audiological evaluation is to determine frequencies of sounds that a particular person hears.
In the Philippines where formal audiological services are
limited, informal tests of hearing are employed. The
procedures for some of these hearing tests are described
below.
Informal Hearing Tests
a. Whisper test
b. Conversational live voice test
c. Ball pen click test
a. Whisper test
Sit the child comfortably. Ask him or her to stick the tip
of the forefinger in one ear.
The tester sits behind the child where the uncovered
ear is. After a deep breath, whisper some familiar words
that contain high pitch and low pitch tones right behind the
unblocked ear. The child must be able to repeat the words
correctly.
b. Conversational live voice test
Keeping the same position but facing the child, ask
him or her to repeat words that contains high and low pitch
consonants. Start with a whisper and increase the intensity
up to 20 dB moving away from the child little by little. If the
child hears at distance of 3 to 6 meters, hearing is normal. If
the child can repeat the words but speech is unclear, he or
she might be hard of hearing.
c. Ball pen click test
Use a retractable ball pen and place it one inch away
from the ear. While the other ear is blocked by a finger,
press the button of the ball pen down and release it. Do it
only once. The child indicates that he or she hears the click
by either raising one hand or acknowledging it with a yes or
a nod.
2. Cognitive Assessment
The assessment tools that measure intellectual capacity
of children with hearing difficulty do not rely on verbal
abilities. In the United States, The Hiskey - Test of Learning
Aptitude, the Wechsler Intelligence Scale for Children
(WISC) and the Stanford Achievement Test (SAT) are widely
used because of the nonverbal performance subtests.
3. Assessment of Communication Abilities
Assessment of speech and language abilities includes an
analysis of the development of the form, content and use of
language. Articulation, pitch, frequency and quality of voice
are examined.
4. Social and Behavioral Assessment
Hearing impairment brings about significant effects on
social-emotional and personality development as a result of
the restrictions in interactive experiences and
communication activities with their age group. Linguistic
difficulties oftentimes show in low self-concept and social-
emotional maladjustment.
STRATEGIES IN TEACHING

There is a range of inclusive teaching strategies that can

assist all students to learn but there are some specific
strategies that are useful in teaching a group that includes
students with a hearing impairment:
• Ensure that any background noise is minimized.
• Repeat clearly any questions asked by students in the
lecture or class before giving a response.
• Encourage students with a hearing loss to seat themselves
toward the front of the lecture theatre where they will have
an unobstructed line of vision. This is particularly important
if the student is using an interpreter, lip-reading, relying on
visual clues or using a hearing aid which has a limited range.
Be aware that some students may not be comfortable with
this suggestion or have alternate strategies. Respect their
choices.
• Use assistive listening devices such as induction loops if these are
available in the lecture theatre. Hearing aids may include
transmitter/receiver systems with a clip-on microphone for the
lecturer. If using such a microphone, it is not necessary to change
your speaking or teaching style.
• Provide written materials to supplement all lectures, tutorials and
laboratory sessions. Announcements made regarding class times
and activities etc., should be given in writing as well as verbally.
• Do not speak when facing the blackboard. Be aware that
moustaches, beards, hands, books or microphones in front
of your face can add to the difficulties of lip-readers.
Students who lip-read cannot function in darkened rooms.
You may need to adjust the lighting in your teaching
environment. If a sign interpreter is employed, follow the
hints for working with a sign interpreter.
• Allow students to record lectures or, preferably, make
available copies of your lecture notes. Flexible delivery of
teaching materials via electronic media is also particularly
helpful for students who have difficulty accessing
information in the usual ways. For students with a hearing
loss, new technology - and the internet in particular - can
be used to bridge many gaps.
Thank you for listening!