Joan Houghton, Ed.D.
Hearing is the second primary distance sense that is responsible for how learners gather information about events occurring in their environments. This module is an introduction to learners who are deaf or hard of hearing. It is divided into six sections including the (1) federal and state definitions of learners who are hard of hearing, deaf, or functionally deaf, (2) the auditory system, (3) common types of hearing losses and/or deafness, (4) common causes and conditions of hearing losses and/or deafness, (5) medical, educational and functional screenings and assessments, and (6) environmental adaptations and modifications for learners who are deaf or hard of hearing. Each section of this module contains brief descriptions about a particular focus area for learners who are deaf or hard of hearing.
Factors That Impact Auditory Input
Understanding the nature of hearing losses and deafness has many implications for learners, their family members, and their educators. The impact hearing loss has on a learner becomes more evident especially when team members collaborate in planning for the learners' individualized education program (i.e. IEP). The more information that team members have about the nature of the learner's hearing loss, how the learner's hearing is assessed both educationally and medically, and how to use the assessment results will better equip team members in determining the necessary adaptations, modifications, and accommodations the learner needs in his home, school, work, or in the community.
Additional Considerations That Impact Auditory Input
Hearing losses vary in their degree and severity. Learners may be identified as "deaf" or identified as "hard of hearing." If learners are identified as "totally deaf," it usually means they have such a significant hearing loss in both ears, the use of their residual (i.e. remaining) hearing is so limited that learners are unable to obtain clear auditory input of environmental sounds and conversational speech even with correction (e.g., hearing aids, cochlear implants, etc.). If learners are identified as "hard of hearing," it usually means their residual hearing is less severe. Learners who are hard of hearing more than likely have the ability to obtain additional input from their environments and conversational speech with correction.
The causes and types of the hearing losses and the age of onset of the hearing losses will provide further information about how often the learner's hearing should be tested, what type (if any) hearing devices should be used, and what environmental adaptations, modifications, and accommodations are needed for learners to hear more clearly in their immediate environments.
Learners with Hearing Losses and Additional Disabilities
Learners with multiple disabilities (e.g., physical involvement, health care conditions, and/or cognitive difficulties) often have a hearing loss or are deaf. These conditions impact the learner's ability to use his or her residual hearing. For example, a learner with CHARGE Syndrome (refer to Module One Introduction to Learners with Deafblindness) most likely will have difficulty with hearing due to the shape and function of the outer, middle, and inner ear. A learner with health care needs often will have fluctuating hearing losses due to multiple middle ear infections, medications, medical treatment, or syndromes. The learner who has a hearing loss may have difficulty in processing environmental and speech sounds that limits her understanding about (a) what is being communicated to her through expressive speech, and (b) what is occurring in her environment (e.g., traffic sounds, TV news, or musical instruments).
Mental Retardation Is Not the Cause of Hard of Hearing or Deafness
What is most important about learners who are hard of hearing, deaf, and/or who have multiple disabilities is that mental retardation is not the cause of the learners' hearing losses. Unbelievably, there are persons who believe that hearing losses are caused by mental retardation. This is particularly the case for students with additional disabilities.
The physicians and audiologists who believe that mental retardation causes hearing loss typically do not recommend hearing devices (e.g., hearing aids, cochlear implants, etc.) because they do not believe it would make any difference in the learner's abilities to receive and act on auditory input. Therefore, it is essential that the learner's family members and educators locate an audiologist and/or physician who: (1) understands how to test learners with hearing losses, (2) provides information about the different types of hearing aids or assistive listening devices, and (3) has knowledge of modifications, adaptations, and accommodations for the learner's specific auditory needs including those students with additional disabilities.
National, State, and Local Resources for Hard of Hearing and Deafness
There are many national, state, and local resources for learners who are hard of hearing or deaf and their family members, such as:
Any of the above organizations are good resources to locate medical and educational professionals who can provide both medical and functional vision and hearing assessments. Additionally, these resources will provide family members and educators with information, such as how to adapt the environment, determine if some learners need to be restricted from sports involving water activities (e.g., learners with tubes in their ears), and suggest referrals to assistive technology centers that will assist learners to perform activities at home, school, and work. (Refer to Module XXX Assistive Technology for Learners Who Are Deafblind.)
Key Elements of Module 3: Learners Who are Hard of Hearing and/or Deaf
The key elements of this module are the: 1) federal and state definitions of deaf and/or hard of hearing; 2) structure and function of the auditory system; 3) common types and severity of hearing loss; 4) common causes and conditions of hearing losses and/or deafness; 5) common types of clinical and functional hearing assessments; and, 6) environmental assessments, and adaptations, modifications, and accommodations for learners who are deaf or hard of hearing.
The above key elements correspond with the IDOE Division of Professional Standards (IDPS) Instructional Proficiencies and objectives from the Competencies for Teachers of Learners Who Are Deafblind that were developed by members from the Perkins National Deafblind Training Project published in 1997. (Refer to the below listed IDPS Instructional Proficiencies and Objectives 28 through 32 from the Competencies for Teachers of Learners Who Are Deafblind.)
While it is encouraged that you complete all of the Tasks for Completion in this module, persons who would just like to have a basic understanding of learners who are deaf or hard of hearing only need to read or look through the resources included in this module. Individuals who are planning on teaching others about learners with deafness or hearing loss or who may want to receive CRU's or Points for their Professional Development Plans need to complete all of the tasks and activities included in this module.
IDPS Instructional Proficiencies and National Deafblind Competencies
for Teachers of Learners who are Deafblind
of this module, Learners Who are Deaf or Hard of Hearing,
you will have:
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