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Amy Rinker

Coursework Document: Hearing Impairment Summary
Sherlock Roams – Assignment 1
Service Category Summaries – Hearing Impairment

    Hearing Impairment and Deafness are conditions where an individual has lost some or all of his/her ability to hear. It can be temporary or permanent, mild or severe, apparent at birth or degenerative.

List and describe sub-groups.
    Deaf – The patient has hearing loss so immense that it cannot be used to develop oral language.
Hearing Impaired – A generic term that does not specify the degree of hearing loss. The person can be hard-of-hearing or deaf.

        Congenital Deafness - Those who are born deaf, not caused by any illness or accident.
Adventitious Deafness – Those who are born with normal hearing and experience nonfunctional hearing through illness or accident. There are five main categories of Adventitious Deafness.
            Conductive Hearing Loss – This is characterized by problems with flow of air pressure waves down the ear canal, across eardrum, or through ossicles.
Sensorineural Hearing Loss – This is characterized by problems with nerve cells (auditory nerve in cochlea), brainstem and auditory cortex.

Mixed Hearing Loss – Patients with mixed hearing loss experience any of the problems listed above as well as hereditary factors. This type of hearing loss can be especially challenging for school children.

Functional Hearing Loss – This occurs when the student is trying to compensate for another problem in life. The problem may be real or perceived social or psychological struggle and usually occurs in children from 9 to 13 years.

Central Auditory Disorder – Those with this disorder do not experience any measurable peripheral hearing loss but have suffered lesion or damage to the central nervous system. These students may have difficulty with auditory comprehension and learning as well as language development. The actual cause of this disorder is difficult to discover.

Describe characteristics.
    The characteristics that define hearing loss can include poor speech, limited vocabulary, poor voice quality/tone, strained speech, and unusually high speech. The student may exhibit withdrawn behaviors, difficulty making friends, social immaturity, irritability or anger, and dependence on the teacher. Academic achievement may be below average with unusual spelling of words and limited written language. The student may not respond to verbal instructions or the bell and may seem to be lip reading in communicating.

Identify causes.
    Deafness or Hearing Impairment can be genetic and appear at birth. Conductive Hearing Loss can be caused by wax impaction of the ear canal, infection of the canal, infection, scarring, or perforation of the eardrum, disruption of the ossicles fluid, or impaired movement of the ossicles. Sensorineural Hearing Loss can be caused by drug-induced damage to the cochlea or traumatic damage to the cochlea (noise, blow to the head, or penetrating injury). It can also be caused by age related damage to the cochlea, tumor, or infections such as meningitis. In Functional Hearing Loss the Hearing Impairment is a compensation for other problems the student is having.

Identify number of youngsters.
    Studies show that 14.9% of all school-aged children have some form of Hearing Impairment (Amie L. Gordon-Langbein D.O.).

List assessments used to recognize the presence of the disability.
    A blood sample can determine the presence of congenital hearing loss in infants. Schools usually use a Pure Tone Screening Test. Another type of test is the Threshold Test. An Air Conduction Threshold Test can determine if there is hearing loss and to what degree. The Bone Conduction Threshold Test can diagnose sensorineural hearing loss and is useful for discovering mixed hearing loss. The Speech Reception Threshold Test can tell whether a child can hear and understand speech. A Special Audiometric Test can help physicians treat otitis media, a middle ear infection.

Are there support groups available?
    The following support groups are available for parents of Deaf and Hearing Impaired children: Beginnings For Parents (, CHILDD Advocacy (, Concerned Parents – CPDHH (, Hands and Voices (www.hands&, and Self Help for Hard of Hearing People (

Provide a continuum of severity or extent possible in youngsters.
    Children may experience slight hearing loss in one ear or be totally deaf. In worst cases the child has not been able to develop verbal communication. Since a great deal of what a child learns comes through incidental conversation around him/her the child may have difficulty learning new information. The child may have issues with self-esteem, behavior, academics, and social interaction with others.

What does this prevent a child from doing?
    Deafness or Hearing Impairment will make it difficult or impossible for the student to learn in an auditory format. The child will not work well in situations that rely on verbal instruction. The child may have trouble communicating with others and may benefit from sign language. Again, the child may have problems with self-esteem, academics, and social interaction.

Might a child die from this?
    Deaf and Hearing Impaired people live normal life spans.

Suggest typical age of onset.
    In some cases Deafness or Hearing Impairment is apparent from birth. Hearing loss is also related to aging. The typical diagnosis is 2 ½ years and for mild to moderate Hearing Impairment is 4 years.

Impact: Is this a school issue or a life issue? – Why?
    This is both a school and life issue. The student needs to be approached in a way that they can learn, using visual, tactile, or kinesthetic means of delivering material. The child needs to learn life skills and means of communication to thrive in society. Self-esteem and social issues will need to be worked on at school and at home.

Impact: How does this affect home?
    Deafness and Hearing Impairment affects home life in many ways. The child may need an alternative method of communication that family members will need to learn, such as sign language. As the child may not respond to auditory stimuli, special phones or smoke alarms may need to be installed. Extra help with schoolwork at home will be needed.

Name someone who has achieved greatness.
    Helen Keller

Name a teacher who overcame this or is helping a child overcome it.
    Anne Sullivan

What can you do to make a difference for this child?
    As the teacher of a Hearing Impaired student I can make sure the child sits close to where I would stand to speak and try to modify verbal delivery of lessons/instructions in to a visual, tactile, or kinesthetic form. Elimination of background noise and use of clear enunciation in speech would also be helpful. I could also learn a form of sign language and teach some basic instructions to the class. The student may also benefit from a social activity or club, such as chess club, that doesn’t rely on sound. Communication with the family is key in identifying and working on academic and social goals.

What can you do to support the parents?
    Communication with the parents in learning the preferred method of communication and working together to improve verbal communication is important. I could help to get the family involved in a support group. I could learn sign language or have an interpreter in class. Together we could work on certain individual goals.

Published on Thu Aug 8 23:21:07 MST 2002 NAU Logo Copyright 2002 Northern Arizona University