Hearing disability

Sections Included:
1. Front Page
2. Introduction
3. Types
4. Characteristics
5. Challenges
6. Provinces and Educational Facilities
7. Steps taken by Government
8. Categories to Educational needs
9. Teaching Approaches

1. Hearing Impairment Inclusive Education (4.3)

2. Introduction Though there lies a difference between hearing impairment and deafness, they are more or less treated similarly for the purpose of deciding their disability category. According to the Individuals with Disabilities Education Act (IDEA), hearing impairment can be defined as ‘an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance but is not included under the definition of “deafness”. In order to comprehend this definition better, it is imperative to understand deafness so that there is a clarity about the type of disabilities that fall under the category of hearing impairment. A person suffering from a hearing loss above 90 decibels is termed as deaf. Thus, it can be said that a hearing loss below 90 decibels would be termed as hearing impairment.

3. Introduction The type of hearing loss is determined as per the location inside the ear where the hearing impairment occurs. Certain types of hearing loss may be encountered with the help of hearing aids. But the same may not hold true for all types of hearing loss. Hearing loss is classified as slight, mild, moderate, severe or profound, depending on how well an individual can hear the frequencies that are commonly associated with speech. Hearing impairment can cause many problems in the lives of the people suffering from it, especially in the lives of students who experience difficulties due to this impairment such as understanding the language subjects, taking important notes during lectures, taking part in discussions, comprehending educational videos, giving PowerPoint presentations, etc.

4. Introduction The American system of education is set up to meet disability requirements. It is a model based on shortfalls, planned to react when the student deviates or fails in a way that can be chased back indisputably to the condition that disables him or her. After ascertaining the shortfall, the system tries to make up for it through special education. Seeing the student’s shortfalls due to his or her disability, a need to incorporate specialized instructions in teaching was felt. Defining and determining the curriculum, teaching learning tools and mode of instruction for the specialized instruction should be a collective effort on part of the special educators, learner’s parents or guardians and others involved in the activity (for example speech-language pathologists, occupational therapists, parents, psychologists, interpreters, general educators, counsellors and other applicable representatives). This group would function as a team to create a document called the Individual Education Programme (IEP), which sets rolling the educational aims and objectives for learners, based on their special needs.

5. Introduction to Types of Hearing Impairment After getting a general overview of what hearing impairment is, the various types of hearing loss will be discussed. It is also important to understand the degree and descriptors associated with them. The three basic types of hearing loss are as follows: Conductive hearing loss Sensorineural hearing loss Mixed hearing loss

6. Conductive hearing loss It is a condition in which sound is not directed easily via the outer ear canal to the eardrum and the small bones (ossicles) of the middle ear. A person suffering from conductive hearing loss is able to hear soft sounds and encounters difficulty in hearing. This type of hearing loss is generally temporary and can normally be rectified through medical or surgical means.

7. Conductive hearing loss Conductive hearing loss could be caused due to the following reasons: • Accumulation of liquid in the middle ear due to common cold or an allergy • Malformation of the outer ear, ear canal, or middle ear • Accumulation of earwax • An infection in the ear • Water retention in the outer ear due to swimming, rafting, etc. • Malfunctioning of the Eustachian tube • Foreign body in the ear canal • Hole in the eardrum

8. Sensorineural hearing loss (SNHL): It occurs in cases of damage to the inner ear or to the nerves attaching the inner ear to the brain. Generally, this condition is beyond medical or surgical correction. This is the most common type of permanent hearing loss. A person suffering from SNHL is able to hear only faint sounds. An individual suffering from hearing impairment due to SNHL may hear unclear or muffled sound even when the sound is actually loud and clear.

9. Sensorineural hearing loss (SNHL): SNHL could be caused due to following reasons: • Ingestion of drugs which are harmful to hearing • Genetic or hereditary SNHL • SNHL due to increasing age • Some kind of an injury to the head • Problem with formation of the inner ear • Close and prolonged contact with loud noise

10. Mixed hearing loss: It is the result of combination of conductive hearing loss and sensorineural hearing loss. This condition occurs when there is a damage in the outer or middle ear along with a damage to the inner ear or the auditory nerve.

11. Degree of Hearing Loss Degree of hearing loss indicates the severity of the loss. The table below illustrates one of the normally used grouping systems. The numbers are demonstrative of an individual’s hearing loss range in decibels (dB HL). Degree of hearing Hearing loss range (dB HL) Normal 10 to 15 Slight 16 to 25 Mild 26 to 40 Moderate 41 to 55 Moderately severe 50 to 70 Severe 71 to 90

12. Other Descriptors Related with Hearing Loss Bilateral or unilateral hearing loss: The literal meaning of the word ‘bilateral’ is ‘effecting both sides’. Thus, a bilateral hearing loss means loss of hearing in both ears. Symmetrical or asymmetrical hearing loss: When a person experiences same degree of hearing loss in both ears, it is known as symmetrical hearing loss. Asymmetrical, on the other hand, means different degree of loss and configuration in each ear.

13. Other Descriptors Related with Hearing Loss Progressive or sudden hearing loss. In instances when a person loses his/her hearing power gradually over a period of time it is said to be a progressive hearing loss. On the other hand, quick and immediate hearing loss is termed as sudden hearing loss, which needs immediate medical attention in order to find out its cause and start the required treatment. Fluctuating or stable hearing loss. When the hearing capability varies at different times, it is called a fluctuating hearing loss. Whereas, in a stable hearing loss, condition of the child does not change over time and remains constant.

14. Characteristics Students with hearing impairment are often visual learners. Hearing impairment may be congenital or acquired; some may have complete hearing loss, may have residual hearing. Impact on learning will depend on the degree of the impairment and cause of hearing loss. Poor in reading heavy text and making inferences from text. Delay in linguistic growth, leading to lack of general vocabulary and technical vocabulary of mathematics and mathematical problems. Inadequate in distinguishing mathematical words while student is reading verbally. Limited use of cognitive strategies to select relevant information and approaches necessary for solving problems. Poor in solving problems that involve more than one dimension.

15. Challenges Problem in taking meaningful notes. Poor or unintelligible reading. Difficulty in understanding verbal questions. Poor Vocabulary. Problem in responding to oral tests. Difficulty in following verbal / group conversations. Problem in understanding abstract concepts and figurative language (like similes, metaphors and idioms). Problem in reading and learning spellings (because of difficulty in phonemic awareness and speech / sound discrimination).

16. Challenges Challenge in organizing or composing ideas. Deficits in communicating ideas due to restricted vocabulary. Problem in comprehending new vocabulary. Poor in discriminating difference between sounds and words. Problem in understanding / using phrases / words with multiple meanings, terminologies/technical terms, abstract concepts, facts, Challenge in forming connections between ideas or concepts Challenge in grammar usage and sentence construction. Poor in understanding of comparisons, cause effect relationships and chronology of events.

17. Provisions and Educational Facilities for Persons with Hearing Impairment Ali Yavar Jung National Institute for the Hearing Handicapped is an independent organization providing services to the hearing impaired in India. It began in 1983 under the aegis of Ministry of Social Justice and Empowerment, Government of India, to be of service to people suffering from hearing impairment. The organization and its centres located in different districts provide wideranging investigative, healing, scholastic and occupational services to people suffering from hearing and speech impairment. An interdisciplinary crew comprising audiologists, speech therapists, special teachers, psychologists, social workers, ENT (Ear, Nose and Throat) specialists, child specialists and neurologists are constantly attempting to retain a high standard of rehabilitation services.

18. Steps taken by the Government of India Numerous legislations have been passed by the Government of India on disability in the last ten years. Following are some of the prominent statutes: • Persons with Disability Act (1995): Hearing impairment has been included as a disability in the Persons with Disabilities Act, 1995. It also defines hearing impairment (vide supra). The Act undertakes the promotion and integration of learners with disabilities in regular schools. It includes a section allocated to condensed syllabus for children with disabilities and granting an allowance of a single language to the student suffering from hearing impairment.

19. Steps taken by the Government of India • National Programme for Prevention and Control of Deafness (2006): National Programme for Prevention and Control of Deafness was introduced with the long term aim of preventing and controlling major causes of hearing impairment and deafness. The initial project was concluded in 2008. According to a survey conducted by National Sample Survey Organization (NSSO), presently 291 people per one lakh in India suffer from severe to profound hearing loss (NSSO, 2001). A huge fraction of these are children between 0 to 14 years of age. These young Indians suffering from hearing impairment are a setback to the national productivity. To counter the problem of hearing impairment, it is imperative that rehabilitation and relief programmes reach all over the country, especially in the rural areas.

20. Catering to the Educational Needs of Hearing Impaired Children Before rendering support to hearing impaired children in a regular school environment, it is a good idea to assess the kind of support required which will help in eliminating potential obstructions to growth and development of the children. A precise and detailed knowledge of a learner’s requirements reinforces good preparation and development. A good assessment will entail:  Learner’s self-assessment of any support needs  Contemplation of support required to cater to any specific subject necessities  Incorporation of technology and communication in teaching  Participation of professionals, e.g. a teacher trained to teach students who are deaf  Parents’ opinions about suitable facilities  Use of expert evaluations  Data and information at all levels of accomplishment

21. Teaching Approaches with Regard to Hearing Impaired Learners Adoption of certain measures in imparting education to children with hearing disability can help speed up the process of special education. Some of these measures are as follows: Meeting specific requirements of individual learners Widespread use of visual aids Reading around the class by the teacher Making use of whiteboard and PowerPoint presentations Using videos/DVDs/online clips Helping children in taking notes Pre- and post-tutoring sessions for clarifications and doubt clearing Creation of small group for the purpose of teaching, assignments, projects, etc

22. Teaching Approaches with Regard to Hearing Impaired Learners Supporting language development Making demonstrations for better explanation Classroom displays for better perception and understanding Making efforts to reduce tiredness by giving short breaks Providing vocabulary and support hand-outs Checking and re-checking comprehension of the learner

23. Teaching Approaches with Regard to Hearing Impaired Learners Provide help and support during sports, swimming and other physical education activities Providing subject specific support to higher class students Making required changes in the syllabus Giving prepared notes to learners for better reception of teaching Making liberal use of mind maps to facilitate comprehension