1. Lecture 5
Deaf & Hard of
Hearing
Ching-fen Hsu
2013/10/18

2. A Given Gift
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The process of hearing is remarkable
Being able to hear
Turn sounds into meaning
With hearing learning is possible
About thoughts, ideas, feelings of others
By listening to others
Through exchanging knowledge expanded,
ideas shared, emotion expressed,
workplaces/social settings functioned

3. Dorothy Brett
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Born in noble British family
Partially deaf entire life
Slade Art College in London
Bloomsbury Group member
Horizon broadened by Virginia
Woolf & John Maynard Keynes
• 1924 followed D.H. Lawrence to
new Mexico
• Remained staying in US

4. Historical Context
• 1520-1584 Pedro Ponce de Leon: Spanish monk, 1st
teacher of Deaf students---successful teaching Deaf to
read/write/speak
• 1600s William Holder & John Wallis instituted
educational programs in England for Deaf---writing &
manual communication teaching method
• 1700s school for Deaf established: Henry Baker in
England & Thomas Braidwood in Edinburgh & Abbe
Charles Michel de l’Epee in France & Samuel Heinicke
in Germany & Thomas Hopkins Gallaudet in US (with
Laurent Clerc)
• 1817 1st Deaf school in Hartford in Connecticut (manual
communication, Martha’s vineyard children there)

5. Debate on Teaching Method
• Laurent Clerc (Deaf Frenchman): father of Deaf
education in US
• Hundred years’ war: oral communication vs.
manual communication teaching method debate
• Edward Gallaudet: strongly supported manual
approach & separate center schools
• Alexander Graham Bell: sign language foster
segregation/ legislation should ban two Deaf
persons married each other/ Deaf should not teach
• Advances in battery design make great impact on
their lives of hearing loss
• World War II battery-operated hearing aid possible

6. Challenges for Hearing Loss
• Several groups could be divided:
(1)Mild to moderate hearing loss people profit
from hearing aids
= not qualify to receive SE
= does assistive devices fully compensate
disabilities?
(2)Using oral language in learning &
communication
(3)Using sign language
= separate from hearing society
= ASL becomes a debate
(4)Colorful sign language life

7. Gallaudet University & Laurent Clerc
National Deaf Education Center
• Dr. Mason Cogswell & Thomas Hopkins
Gallaudet were neighbors in
Connecticut
• Mason sent Thomas to Europe for
learning SE of Deaf
• 1856 Amos Kendall donated estate for
elementary school of Deaf
• I King Jordan: president of university
• Pioneers in Deaf culture/community
movement
• National centers: host social activities,
sporting events, competitions
• http://clerccenter.gallaudet.edu

8. Defined Terminologies

9. Process of Hearing

10. Structure of Human Ears
• Pinna: outer structure of the ear
• Eardrum: vibrates with presence of sound waves &
stimulates the ossicles of middle ear
• Ossicles: three tiny bones in middle ear for passing
info to cochlea
• Eustachian tube: equalize pressure on both sides of
eardrum
• Cochlea: structure for containing hearing organs
• Hair cells: part of cochlea for responding to different
frequencies of sounds & producing electrochemical
signals sent on to brain
• Otoacoustic emissions (OAEs): low level of sound
produced when hair cells vibrates in inner ear

11. Conductive Hearing Loss
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one type of hearing impairment
blockage/damage to outer/middle ear
prevent sound waves from traveling to inner ear
cause mild to moderate hearing disability
temporary experience in our lives (airplane)
20% elementary students & 80% children bet
kindergarten & fifth grade
• able to be corrected with hearing aids & surgery
& medical techniques (cleanup ear infection)

12. Sensorineural Hearing
Loss
• Hearing impairment due to damage to
inner ear/auditory nerve
• Nerve deafness
• Difficult to correct
• Patients can hear different frequencies at
different intensity levels
• Their hearing losses are not flat/even
• Less common type in young children

13. Age of Onset
• Congenital hearing loss: at/before birth
• Acquired hearing loss: after birth
• Onset vs. oral language development
(1) Prelingually deaf: become deaf before they learn
to speak & understand language
born deaf/lose hearing during infancy
95% children & youth (1:10 one deaf parent)
severely influence communication & learning
mainly learn sign language
(2) Postlingually deaf: profound hearing loss after
speech development/ able to have oral
communication ability

14. Degree of Hearing Loss
• Mild (21-40dB): only soft speech/sound at a
distance difficult to hear
• Moderate (41-55dB): typical conversational
speech is hard to follow
• Moderately severe (56-70dB): only loud speech
can be heard
• Severe (71-90dB): even loud speech is hard to
understand
• Profound (91dB+): considered “deaf” assistive
listening devices needed
• Residual hearing

15. Causes
(1) Heredity/genetics: most common cause of deafness in
children, congenital/ sensorineural
(2) Meningitis: 2nd most common cause, CNS disease,
affect meninges (coverings for brain/spinal cord),
mostly come from bacterial infections, postnatal
deafness, acquired profound sensorineural hearing
loss
(3) Otitis media: middle ear infection, fluid accumulation
behind eardrum, corrected with antibiotics, frequency &
duration of infection matter, permanent conductive
hearing loss, damaged eardrum, mild to moderate
hearing loss, hearing aids work
(4) Noise: >105dB/ hour is unsafe (rock concert 125dB)

16. Prevalence
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Hearing loss is associated with age
> 65y have hearing problem
1:3 in 65y population
25% use hearing aids
1:1000 babies is profoundly deaf
2-3:1000 hearing loss
Number underestimated for hearing loss
could be a characteristic of other
syndrome (DS)

17. Prevention
• Avoid German measles
• Major cause of deafness
in newborns
• 1972 accounted for 11%
• 1998 1% for
immunizations
• Avoid dangerous E over
85 dB
• Wear earplugs
Decibel Levels of Noise in US E

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Hearing Aid
Amplification of sounds in E
Most commonly used device
From hearing trumpet to today’s hearing aid
Eliminate need for SE
Profit from general education classes
(1) Behind the ear (BTE)
(2) In the ear (ITE)
(3) In the canal (ITC)
(4) Completely in the canal (CIC)
• Digital hearing aids:
reduce background noise/ amplify sounds according to
individuals’ hearing profiles
• Disposables for keeping clean/preventing damaged

19. Hearing Aid Photo

20. Cochlear Implant

21. FM Transmission Device
• Frequency modulated
• Overcome distance &
noise problem
• wireless microphones
clipped to shirt &
receivers small enough
attached to hearing aids
• Background noise
reduced
• Greater freedom for
teachers/ students

22. Audio Loop
• Listening device directs sound from the
source directly to listener’s ear through
specially designed hearing aid/ earphone
• Used in lecture/ concert hall
• Sound travels through radio waves/ wire
connection
• Inexpensive
• Easy to install in rooms up to 100 seats
• Wire picks up audio signal from amplifier
& transmit to electrical current with a
magnetic field within the area encircled
by the wire
• User receivers convert the magnetic
energy back into sound

23. What’s on the Horizon?
• Blue Cross Insurance Company reimburses implanted
hearing aids surgery
• Middle-ear bones vibrate & transmit sound into inner
ear
• 85% improvement in hearing
• Do not amplify distracting background noise
• Animals can regenerate hair cells automatically &
regain hearing ability
• Humans cannot
• 80% hearing loss results from damaged hair cells in
inner ear
• Regenerating hair cells is possible in humans, but the
challenging is the number of cells

24. Auditory Assessment
• pure sounds generated by
audiometer
• Sound waves of specific frequencies
at combinations of Hertz (Hz) &
decibels (dB) & pitch & loudness
• Separate testing for L & R ear
• Audiogram: a grid/ graph
• Scores below 0dB has hearing loss
• Air conduction audiometer method
• Bone conduction audiometer method

25. • Travis’s hearing
diagram
• Conductive hearing
loss
• Mild range of 40 dB
• Bone conduction test
closes to 0 dB
• A hearing aid is
needed

26. • Heather’s
audiogram
• Sensorineural
hearing loss
• 30 dB hearing
loss
• Mild hearing
loss with a
hearing aid on
• Speech banana:
speech sounds
range

27. Early Intervention
• Early intervention is very important at four aspects:
(1)Early identification allows children to be fitted with
hearing aids (4 weeks old)/ cochlea implants (1y)
(2)Early intervention (>6 months) pays off in reading
achievement & speech abilities in later years
(3)Preschool programs help develop language
(4)Early intervention programs help families better
understand & meet special needs
• Deaf children with deaf parents develop well at
reading > Deaf children with hearing parents
• Sign language becomes their native language

28. Communication First
• Dina The Deaf Dinosaur
• Importance of learning ASL
• Note culture differences & family
experiences
• Early identification & early
intervention must go hand in hand

30. Tips for Classroom
Management
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Place Ss as close to the speaker as possible
Face Ss when talking
Reduce background noise as much as possible
Do not stand with direct light behind you
For class discussions, make sure Ss know who is
about to speak & ensure seeing faces in talking
• In discussions, arrange Ss’ chairs in a circle

31. Review Objectives
After this course, you should be able to….
• Explain variables that must be considered when
planning instruction for students with hearing problems
• List and explain the major causes of hearing loss
• Describe and justify universal hearing screening of
newborns
• Discuss the concept of Deaf culture, list examples or
signs of Deaf culture, and describe its importance to
the Deaf
• List the major types of assistive technology specifically
designed for people with hearing problems, and
provide examples for each

32. Hands Are Bridges

33. Questions?