THE SIGNIFICANT IMPACTS OF A “TINY” HEARING LOSS Minimal and Mild Hearing Loss in School-Aged Children Maine Educational Center for the Deaf and Hard of Hearing © MECDHH 2017 THE SIGNIFICANT IMPACTS OF A “TINY” HEARING LOSS Presenters: Katherine Duncan, AuD Donna Casavant, MED, CAS [email protected] [email protected] © MECDHH 2017 OBJECTIVES • Define a minimal hearing loss. • Identify potential causes of minimal hearing loss. • Describe some educational, communication, and social impacts of minimal hearing loss. © MECDHH 2017 WHAT’S IN A WORD? © MECDHH 2017 WHAT IS MINIMAL HEARING LOSS? © MECDHH 2017 UNDERSTANDING AN AUDIOGRAM Increasing Pitch Low High Increasing Loudness Soft Loud Right Ear Inaccessible Left Ear Accessible Speech Sounds © MECDHH 2017 MINIMAL = SLIGHT + MILD • 16 - 40 dB HL range • At least one ear © MECDHH 2017 SLIGHT HEARING LOSS • 16-25 dB HL range • At least one ear • Individual thresholds or pure tone averages © MECDHH 2017 MILD HEARING LOSS • 26 - 40 dB HL range • At least one ear • Individual thresholds or pure tone averages © MECDHH 2017 IDENTIFICATION • Universal Newborn Hearing Screening • School-based screenings • Audiological follow-up © MECDHH 2017 WHY ARE MINIMAL HEARING LEVELS MISSED IN UNIVERSAL NEWBORN SCREENING PROCESS? • Limitations of audiometric equipment • No screening / lost to follow up © MECDHH 2017 LATE IDENTIFICATION • Progressive © MECDHH 2017 LATE IDENTIFICATION • Late onset © MECDHH 2017 TYPES OF MINIMAL HEARING LOSS Conductive Sensorineural • Outer ear • Inner ear * Canal * Cochlea * Ear drum * Auditory nerve • Middle ear * Ossicles (bones) Ø Stable * Eustachian tube Ø Progressive Ø Permanent Ø Infections Ø Perforations Ø Drainage Ø Fluctuating or Permanent © MECDHH 2017 COMMUNICATION IMPACT Access • Pace of conversation • Noise • Distance • Secondary conversations © MECDHH 2017 COMMUNICATION IMPACT Partial messages • Fragments • Misunderstanding • Misinterpretation • “Selective hearing” • Teacher’s perspective • Student’s perspective © MECDHH 2017 EDUCATIONAL IMPACT © MECDHH 2017 EDUCATIONAL IMPACT English • Letter / sound association • Unemphasized morphemes • Unemphasized words • Syntax © MECDHH 2017 EDUCATIONAL IMPACT Access • Listening in noise • Inconsistent access • Incomplete access • Listener fatigue © MECDHH 2017 EDUCATIONAL IMPACT Content • Vocabulary gaps • Misinterpretation • Misunderstanding © MECDHH 2017 SOCIAL IMPACT Isolation • Immaturity • Fast-paced conversations • Engagement • Inattention • Day dreaming • Reading social cues © MECDHH 2017 SOCIAL IMPACT Self-esteem • Emotions • Lack of participation • Misunderstanding • Misinterpretation • Self-confidence © MECDHH 2017 CONSIDERATIONS: AIDED OR UNAIDED • Audiometric configuration • Type • Stability © MECDHH 2017 CONSIDERATIONS: AIDED OR UNAIDED • Observed impact: • Speech / language development • Functional listening in the classroom • School and home listening needs © MECDHH 2017 CONSIDERATIONS: REMOTE MICROPHONE SYSTEM © MECDHH 2017 CONSIDERATIONS: SOUND FIELD SYSTEMS • Improved access to teacher’s voice • No personal equipment to wear © MECDHH 2017 CONSIDERATIONS: SOUND FIELD SYSTEMS © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: AUDITORY Listening Equipment • Personal amplification • RM / Sound Field • Listening checks © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: AUDITORY Environmental • Acoustic treatment: • Reduce background noise • Reduce reverberation • Strategic seating • Listening breaks © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: AUDITORY Teaching strategies • Repeat and rephrase • Minimize unnecessary talking • Introductory phrases • Highlighting © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: VISUAL Teaching Strategies • Use of technology • Use of visual supports • Enhance speech reading conditions • Captions © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: VISUAL Environmental • Reduce visual distractions • Lighting • Room design modifications • Strategic seating • Watching breaks © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: ACADEMIC Supplementary • Teacher notes • Guided notes • Captions • Other © MECDHH 2017 ACCOMMODATIONS TO CONSIDER: ACADEMIC Teaching Strategies • Pre-teach / Preview • Sequential presentation • Repeat or rephrase • Extra processing time • Frequent check for understanding © MECDHH 2017 ACCOMMODATIONS TO CONSIDER Social • Quiet lunch • Social group / recreational • Meeting opportunities © MECDHH 2017 ACCOMMODATIONS TO CONSIDER Self-Advocacy • Maintain personal devices • Learning needs advocacy • Repair communication breakdowns • Ask clarifying questions © MECDHH 2017 STILL THINK IT’S MINIMAL? © MECDHH 2017 ANY QUESTIONS OR COMMENTS? © MECDHH 2017 THE SIGNIFICANT IMPACTS OF A “TINY” HEARING LOSS Thank you for joining us! Katherine Duncan, AuD Donna Casavant, MED, CAS [email protected] [email protected] © MECDHH 2017 REFERENCES • https://www.researchgate.net/profile/John_Clark12/publication/16145943_Uses_and_abus es_of_hearing_loss_classification/links/53da93270cf2e38c6337e92c.pdf • http://hearinghealthmatters.org/hearingandkids/2014/mild-hearing-loss-mild-problem/ • http://successforkidswithhearingloss.com/relationship-hl-listen-learn/ • http://www.hearingreview.com/2014/04/may-mild-slight-minimal-insignificant/ • http://www.classroomhearing.org/acoustics.html • http://jeissonmanchego2126.pbworks.com/w/page/54622486/Acoustic%20vocabulary • http://toonoisyapp.com/ • http://rockstarmathteacher.blogspot.com/2014/09/my-interactive-math-notebooks-and.html • http://home.d47.org/wes/kmdunham/self-advocacy-for-students/ © MECDHH 2017 IMAGE CREDITS • https://ahearingloss.com/tag/audiogram-2/ • https://www.health.qld.gov.au/rbwh/services/newborn_hearing • https://hearingresources.com/pediatric-audiology/ • http://successforkidswithhearingloss.com/resources-for-professionals/child-hearing-screening/ • https://entcare.wordpress.com/tag/hearing-loss-in-children/ • http://www.hodgsonfitness.com/negative/ • http://www.shareyouressays.com/121068/essay-on-ear-the-organ-of-hearing-830-words • https://www.dreamstime.com/royalty-free-stock-image-sad-girl-feeling-excluded-group-playing-kids- image31664876 • http://feedyoursoul.com/2014/08/06/the-gift-of-confusion/ • https://thebahablog.com/tag/hearing-aids/page/2/ • https://www.emaze.com/@ACWRIOFT/Race-and-Ethnicity © MECDHH 2017 IMAGE CREDITS • https://www.nytimes.com/2016/02/07/education/edlife/in-oakland-building-boys-into-men.html?_r=0 • http://www.workinsports.com/blog/how-to-ask-questions-that-will-always-inspire-thoughtful-answers/ • https://thecornerstoneforteachers.com/classroom-seating-arrangements/ • https://www.lightspeed-tek.com/ • http://www.cochlear.com/wps/wcm/connect/us/home/baha5/index.html?utm_campaign=Baha_- _Brand&utm_source=google&utm_medium=cpc&utm_term=%2Bbaha%20hearing%20implant&utm_ content=baha_cochlear&gclid=CjwKEAjwwcjGBRDj- P7TwcinyBkSJADymblTpaZ8kR3G73iMzhjnuw_k_t2ii3IpGyeDUIQBQyNZYhoCzUfw_wcB • https://readingagency.org.uk/news/blog/10th-birthday-party-speech.html • http://hearalberta.ca/sign-up-for-classes/speechreading-lipreading-classes/ • https://www.dreamstime.com/stock-photo-cute-toddler-playing-teacher-role-game-her-toy-happy- little-girl-holding-magnetic-board-colored-magnetic-letters-written-x-image79544410 • http://www.eslweb.org/resources/index.php?topic=1835.0 • https://www.123rf.com/photo_31009696_tired-student-boy-sleeping-in-classroom.html © MECDHH 2017.