Deafness

Deafness & Hearing Loss General Information

Deafness, hearing impairment, or hearing loss is a partial or total inability to hear. It is caused by many different factors, including but not limited to age, noise, illness, chemicals and physical trauma. There is a diagnosis to determine the severity of the hearing impairment, and it is measured in decibels. It may be ranked as mild, moderate, moderately severe, severe or profound. There are a number of measures that can be taken to prevent hearing loss, but in some cases it is impossible to reverse or prevent.

From http://en.wikipedia.org/wiki/Deaf

There is a vast amount of variance between deaf people in terms of their degree of hearing loss, ability to speak and ability to lipread. No two deaf people are exactly alike in those respects. Hearing loss can range from mild (soft conversation) to profound (total deafness), and can be in one or both ears. The ability to speak or lipread varies depending on many factors such as age of hearing loss onset, degree of hearing loss, preferred communication method, and personal choice. Deafness is commonly a symptom or outcome of other severe illnesses or disabilities such as meningitis, so it is not uncommon for hearing loss to be comorbid with other physical or developmental challenges.

According to Hearing International, an established 600 million, or 10% of the world's population, has some degree of hearing loss, with 4 to 5% having moderate or worse hearing losses requiring significant aid. Hearing loss is one of the most common worldwide conditions. In Canada, approximately six children in every 1000 births has some degree of hearing loss.

The single most critical thing for a child with hearing loss is early detection. The optimal time for people to learn language and communication ability is between 0-3 years, so the earlier a hearing loss is detected, the earlier a program can be put in place to expose the child to language in a form that he or she is able to comprehend and understand. Failure for a child to learn some form of language by this time frame can potentially cause lifelong problems. Research has shown that a child is not negatively affected in any way whether he or she is exposed to spoken language, sign language, or both at the same time as long as he or she is actually capable of seeing or hearing it clearly. Many places have early hearing screening tests, which may or may not be mandatory for all births. If a newborn is not screened and hearing loss is suspected, a hearing test can be obtained at most audiology labs.

Warning signs that your child may have a hearing loss:

• Does not respond when he hears soft sounds such as your voice, when there is no other background noise
• Uses the words "what?" or "huh?" many times a day
• Carefully watches the faces of speakers
• Cannot understand what you are saying with other noises in the background
• Sits close to the TV set when the volume is adequate for others or "turns up" the volume to unreasonably loud levels
• Cannot understand voices over the telephone or switches ears often when using the phone
• Does not startle when he hears very loud sounds
• Cannot locate the source of a sound
• Has problems speaking, listening, learning and paying attention in school which may be noticed by a teacher or family member

How Can Hearing Loss Affect My Child?

If your child has hearing loss, the earlier it is identified and intervention is put in place, the better the outcome. Studies indicate that children with hearing loss, even if it is mild and undetected, may have:

• Delays in speech and language
• Learning problems, especially in reading and math once the child starts school
• Social, emotional and behavioral problems that often lead to low self-confidence

From http://www.ncnewbornhearing.org/LateOnset.html

It is important to note that deafness itself does not cause any problems or delays in a child. Rather, it is the deprivation of early language and communication by parents, family, etc. who are either unaware of the hearing loss or do not know a way to communicate with the child, such as sign language. For instance, trying to speak to a child with severe hearing loss, no matter how loudly, will not expose the child to any kind of language because he is completely unable to understand what is happening. 

Options for Children with Hearing Losses

Hearing Aids

Hearing aids are a straightforward solution for children with mild to moderate hearing loss. Hearing aids work by enhancing residual hearing – therefore, they are only effective if a child has at least some hearing ability. The more a child can hear, the more effective a hearing aid will be. Hearing aids may not work if a child has a severe to profound hearing loss.

Sign Language

Sign languages are complete languages in their own right. Just like English, French, Spanish or any other common spoken language, sign languages have their own rules, grammar structure, and syntax. Sign languages are not literal translations of spoken languages. Such translations do exist, such as Signed Exact English (SEE), but those are insufficient to allow full freedom of expression and are best used as learning tools and aids rather than as a primary means of communication. The dominant sign language in Canada and the U.S. is American Sign Language, a derivate of French Sign Language. Sign language is an excellent option for many children with moderate to profound hearing loss, as it offers them a method of communication that allows them to fully express themselves, whether with other Deaf people, interpreters or anyone close to them who has learned the language.

Cochlear Implants

A cochlear implant is a device implanted in a hollowed out portion of the skull and connected directly to the brain. It is connected via a magnetic connector to an external receiver worn over the ear much like a hearing aid. Cochlear implants deliver sounds directly to the brain bypassing the ear altogether. The decision whether or not to have a cochlear implant installed is a very big decision since it has many potential benefits and drawbacks, and is a permanent option since a hole is made in the skull to accommodate the device. A cochlear implant may allow users to understand and differentiate sounds, but it is not the same experience as natural hearing. Therefore, if a child had any residual hearing in the ear the implant was placed at, it is destroyed due to the nature of the implantation surgery and the child has to re-learn how to hear. There is no way to be certain whether a cochlear implant will be successful for any given child. Some will find it extremely effective, especially if they had preexisting speech and lipreading skills or were relatively young at time of implantation. There is an ongoing controversy on the use of cochlear implants in young children due to the many risks involved, the permanent nature of any consequences, and the inability of the child to make his own choices.

Deaf Communities

In almost any major metropolitan area, it is likely that a deaf community of some sort exists. Community members are drawn to each other by their shared experiences, frustrations and triumphs stemming from their deafness, and often find kinship and lifelong friendships in fellow members. They also serve as a powerful tool for positive self esteem, as members do not feel isolated from others and can communicate freely and openly with other deaf peers. Most deaf communities use the dominant local sign language as a primary means of communication, but almost all will include many people with at least some speech and lip reading skills, as well as a limited ability to hear. Those communities also often include like-minded hearing people – friends, families, and professionals who work with the deaf and who have embraced the deaf way of communication and kinship. Often some of the biggest communities are found in places which contain a dedicated school for the deaf such as Montreal, Edmonton or Vancouver.

Deafness in the Classroom

Meeting a deaf child’s needs in the classroom is a team effort requiring the participation of parents, teachers, school administrators, and any support staff such as EAs, interpreters, speech-language pathologists and so on. Those efforts cannot be limited to the classroom – they must also include the child’s home life and out of class locations such as the playground, recess, or other social hotspots. Giving a deaf child the tools to succeed in whatever he or she desires is a big task and takes a lot of hard work and effort, but is very rewarding in the end. Every deaf child is unique, not only in personality but also in language form and ability, lipreading and speech skills, and level of hearing. There is no single method that will work for all students. A student who has been profoundly deaf from birth and is fluent in sign language has very different – not more or less - needs from a student with moderate hearing loss who prefers oral communication.

Language Delays

There is no difference in intelligence or comprehension levels between deaf and hearing children. However, due to a variety of factors such as late hearing loss detection, failed attempts to teach language and a lack of communication in the home, deaf children are more likely to arrive at school with underdeveloped literacy and communication skills. Some children may only have extremely limited speech ability or even no language at all. This must be accounted for, as trying to jump straight into education with those children will result in failure due to their inability to understand teacher instructions. 

Professionals

A deaf child may make use of professionals to aid in his or her education. The sign language interpreter is one example, acting as the voice of a student who is skilled in sign language, helping to convey his words, thoughts and feelings to the teacher, other staff, and students. Many students with some residual hearing ability will also be involved with a speech language pathologist, who works with the students to develop their speech and lipreading abilities. Some students, especially in more rural areas, may have an advocate from a nearby deaf community who ensures the student gets the accommodations and adaptations they need to succeed. Some deaf students may have educational assistants to aid them due to language delays or comorbid disabilities.

Technologies in the classroom
Within the classroom, assistive technologies may be available, with the nature and accessibility depending on things like school location, student population, school board policies and available staff, and so on. Possible technologies include special notetaking paper, assistive listening systems such as FM, voice to print technology such as CART,  and captioned or subtitled educational media.

Hearing Loss and Deafness Resources

Childhood Acquired Hearing Loss Information 

http://www.ncnewbornhearing.org/LateOnset.htm

Canadian Association of the Deaf

http://www.cad.ca/

Canadian Hard of Hearing Association

http://www.chha.ca/chha/

Cochlear.com

www.cochlear.com