10things About Hearing

10 Things You Should Know about Hearing
Loss: Orientation to Terminology and to the

Population
Dr. Susan Easterbrooks
Professor, GSU
Dr. Nanci Scheetz
Professor, VSU
I. How many school-aged children have a

hearing loss?
24th Annual Report to Congress on the
Implementation of IDEA (
http://www.ed.gov/about/reports/annual/osep/2002/index.html)
The 50 U.S. states, Puerto Rico, and the District of

Columbia, schools served the following numbers
during the school year 2000-2001.
Ages 3-5
Ages 6-21
8,243
70,662
What does this mean to you as a general education teacher?

Around the same year there were about 65,000,000 children in school,
or 1 per 1000. This means that most likely sometime during your years
of teaching, you WILL have at least one child with a hearing loss in
your class, or at least in your school building. Depending on the size of
your school/district/state, you may have several.
Hearing loss is a low incidence disability. Most children are educated
with 6 or fewer of their peers. Some attend schools for the deaf, where
there may be a dozen or more students of the same age, and many are
the sole student with a hearing loss in their county. Many counties share
the services of one teacher of the deaf.
II. What causes a hearing loss?
Prenatal
Genetics/heredity (most common prenatal cause)
Syndromes
Ototoxic agents
Perinatal
Prematurity/low birth weight
Birth trauma- low oxygen, severe jaundice, etc.
Viral infections (cytomegalovirus, congenital syphillis)
Postnatal
Meningitis (most common postnatal cause)
Significant ear infections and ototoxic agents
In about of the cases, the cause is unknown.
It is important to talk with someone

knowledgeable about causes of deafness
because different causes lead to different
problems for the child.
E.g., CMV- likelihood of additional disabilities
Genetics- likelihood of other members in the family
with hearing loss
III. What are some basic definitions that I need to

know?
IDEA 2007 defines hearing loss in this manner
An impairment in hearing, whether permanent or fluctuating, that
adversely affects a childs educational performance but that is not
included under the definition of deafness. Deafness means a
hearing impairment that is so severe that the child is impaired in
processing linguistic information through hearing with or without
amplification, that adversely affects a childs educational
performance.
In other words, a deaf child is one who cannot

understand spoken communication even with a
hearing aid. A hard of hearing child is one who can
hear spoken communication, but this does not
necessarily mean that he understands it.
Two misunderstood terms

Hearing impaired
Although this term is still used by the Fed, it is not
preferred by members of the Deaf community
Deaf and deaf

Deaf refers to an individual who identifies himself
as a member of the Deaf community
deaf with a small d refers to a designation on an
audiogram (described later)
IV. Are all children with hearing loss totally deaf?

In reality, most children with hearing loss can still hear
SOME information, but this is often more of a curse than
a blessing.
Because they can hear SOME things, most people
expect them to hear ALL things, and this is not what
happens.
For example, the child might hear you say ship, but
because he cant hear sh, he thinks you said chip. As
you can imagine, this will be a problem as the child is
learning to talk and to read.
Another way to define a hearing loss is

by degrees of loss
Typically these are:
0-15 dB
15-25
26-40
41-55
56-70
71-90
>90 dB
Normal
Minimal Hearing Loss
Mild Hearing Loss
Moderate Hearing Loss
Moderately Severe Loss
Severe Hearing Loss
Profound Hearing Loss
(Categories from the National Institutes of Health)

http://www.nih.gov/
V. What learning characteristics are associated with the

different degrees of hearing loss?
The tip sheet associated with this PowerPoint
presents the characteristics and needs of children with differing degrees of hearing loss.
0-15 dB
15-25
Normal
Minimal Hearing Loss
26-40
Some minor confusion of sounds
Mild Hearing Loss
May influence vocabulary and phonics

development
41-55
Moderate Hearing Loss
Definite influence on communication development

Need support.
56-70
Moderately Severe Loss
Cannot access spoken communication without

amplification and modifications
71-90
Severe Hearing Loss
May not be able to access spoken communication

even with amplification. May need alternative
communication options. Require significant
instructional assistance.
Tips
Tips
and
and
Facts
Facts
VI. What is an audiogram, and why is it

important?
An audiogram is a graphic representation of a
persons hearing or auditory responses (another
word is thresholds or the softest sound
detected 50 percent of the time).
Across the horizontal plane of an audiogram are
frequencies in Hertz (Hz), or pitch information of
the sounds presented during a hearing evaluation.
On the vertical plane of the audiogram are labels for
loudness, measured in decibels (dB)
For more information on reading an audiogram, consult your schools

audiologist or teacher of the deaf, or go to
http://clerccenter.gallaudet.edu/SupportServices/series/5002.html
Why do we need to look at a childs audiogram?
We make decisions about surgery,

communication options, auditory training, and
speech approaches based on the audiogram.
It is also important so that parents know what to
expect their child to respond to in the
environment.
VII. What is the Speech Banana and what does it

tell me?
The audiogram to the
right demonstrates
different sounds and
where they would be
represented on an
audiogram. The yellow,
banana-shaped figure
represents all the
sounds that make up
the human voice when
speaking at normal
conversational levels.
Interpretation
This represents the

hearing of an individual
with normal hearing in
the low frequencies
sloping to a severe high
frequency hearing loss
in the left ear ( blue
Xs)and a moderate to
severe hearing loss in
the right ear(red Os).
Results
The listener is able to hear all the
low and mid speech sounds but is
not able to hear the high pitch
speech sounds in the left ear. The
listener is not able to hear any
normal speech sounds in the right
ear. This person would rely on the
left ear for speech understanding
and would experience difficulty
hearing in noisy environments.
For additional examples, go to:
http://www.hearingresearch.org/Dr.Ro
ss/Audiogram/Audiogram.htm
VIII. What does in mean when some says that the

deaf/hard of hearing population is
heterogeneous?
The population of children with hearing loss is not a
homogeneous population. Every child is different.
What you do for one child may be totally ineffective with

another because there are so many differences to
consider.
These include:
Deaf or hard of hearing (degree of hearing loss)

Additional learning disorders or not
Early identification and intervention or not
Early, appropriate amplification
Presence or absence of another deaf person in the
home
Home language
Age at which child began schooling and number of
years in school.
IX. There are many different ways we can increase

the likeliness that a child has access to sound.
Although these will be described in greater detail

in an upcoming PowerPoint, here are some
commonly used listening devices:
Sound field amplification system

Individual aids (digital and programmable)
Group amplification systems
Cochlear implants
X. Ways to communicate visually

with a child who is deaf
There are many different ways we can represent
English
Signed English, Signing Exact English, Cued Speech,
Fingerspelling, etc.
American Sign Language is its own unique language,

separate from signed version of English, and separate
from signed forms from other countries.
These will be described in greater detail in a later
PowerPoint presentation in this series.
References and Resources
http://www.ed.gov/about/reports/annual/osep/2002/index.html
Location of the 24th Annual Report to Congress on the Implementation of
IDEA.
http://clerccenter.gallaudet.edu/InfoToGo/index.html
This site have hundreds of fact sheets and other resources on deafness.
http://www.listen-up.org/htm/toc.htm
This site has hundreds of resources and suggestions and was developed by
teachers and parents.
http://www.deafed.net
This site was developed by folks in teacher preparation. Along with the
PowerPoint presentations in this series, you will find lots of teaching suggestions.

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10 Things You Should Know about Hearing

Loss: Orientation to Terminology and to the

I. How many school-aged children have a

The 50 U.S. states, Puerto Rico, and the District of

What does this mean to you as a general education teacher?

II. What causes a hearing loss?

In about of the cases, the cause is unknown.

It is important to talk with someone

III. What are some basic definitions that I need to

In other words, a deaf child is one who cannot

Two misunderstood terms

Deaf and deaf

IV. Are all children with hearing loss totally deaf?

Another way to define a hearing loss is

(Categories from the National Institutes of Health)

V. What learning characteristics are associated with the

Some minor confusion of sounds

Mild Hearing Loss

May influence vocabulary and phonics

Moderate Hearing Loss

Definite influence on communication development

Moderately Severe Loss

Cannot access spoken communication without

Severe Hearing Loss

May not be able to access spoken communication

VI. What is an audiogram, and why is it

For more information on reading an audiogram, consult your schools

Why do we need to look at a childs audiogram?

We make decisions about surgery,

VII. What is the Speech Banana and what does it

This represents the

VIII. What does in mean when some says that the

What you do for one child may be totally ineffective with

Deaf or hard of hearing (degree of hearing loss)

IX. There are many different ways we can increase

Although these will be described in greater detail

Sound field amplification system

X. Ways to communicate visually

American Sign Language is its own unique language,

References and Resources

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