Hearing Impairment: Background, Anatomy, Pathophysiology. Assisting and educating parents.

It must be remembered that although most deaf children are otherwise healthy, a parent's response to having a child with hearing impairment is generally the same as that of a parent whose child has a physical disability or chronic medical condition. Some deaf children have both hearing loss and other disabilities or medical conditions. Help parents to identify available resources (such as those listed at the end of this section), or refer them to a social worker or counselor who can provide specialized assistance. In some states, social workers assigned to families with deaf or hard- of- hearing children are required to have a background in disabilities or hearing loss.

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Many states assign the next social worker available, in which case the worker has no more ability to determine the best form of communication, the best school environment, or the best resources than the primary care provider. The information available on the Internet may be selected strictly on geographic location, by the "number of hits" making the site appear at the top of the list, or by alphabet or the manner in which the resource is structured. If possible, the patient’s family should be directed towards people with expertise in the field and towards sources without obvious bias. Parents must understand that deafness is not an all- or- nothing categorization and that hard- of- hearing is not defined by the hearing loss being in the middle ranges (eg, 3.

B). Children with CHL are likely to develop good use of speech with appropriate amplification. Watch Demons Online Hoyts more. Children with SNHL are more variable. In SNHL, the nature of the sound may be distorted, which means that amplification of the deficit may not improve the child's language comprehension in any meaningful way. A helpful analogy is that of a radio signal that is mostly static; it remains unintelligible no matter how loud it is. Therefore, children with moderate SNHL (4. B) may have minimal benefit to improving language comprehension, although they may have good benefit from improved ability to hear environmental cues.

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Communication is the most important loss in deafness. Communication is necessary for socialization and integration into the family and into society.

All interventions must have the goal of optimizing the child's ability to successfully communicate and interact socially. Lip- reading (oralism) and sign language. Considerable debate continues regarding the choice of lip- reading (oralism) versus sign language. Watch Lee Evans Live: The Different Planet Tour Online Full Movie. Lip- reading may be taught alone or supplemented with cued speech. In the United States, sign language can be in the form of American Sign Language (ASL) or Signed English (SE) with Signing Exact English/Seeing Essential English (SEE, which is sometimes distinguished as Signing Exact English [SEE 1] and Seeing Essential English [SEE 2]).

PSE (Pidgin Signed English) is not used educationally, but functionally it combines the use of signs using an English- based grammar, but like any Pidgin language uses neither proper English grammar nor ASL grammar. Parents must be able and willing to accept and then participate in the language that they chose for their child. They should be vigilant and remember that school failures and behavior problems are not inherent to deafness but frequently result from a frustrated child who has no language, no ability to communicate, and no ability to connect with others. Advantages and disadvantages of lip- reading.

The greatest advantage of lip- reading is that parents and society are required to make only minimal adjustments for the deaf individual. Therefore, deaf children must learn to speak for themselves and understand the speech of others. The disadvantages are numerous. First, formal training can begin only at school age. Therefore, language acquisition is delayed beyond the optimal neurobiologic window for language acquisition, between approximately age 3- 5 years (although some evidence indicates it may be as young as 9- 1. Second, almost half of the consonants in English appear similar when spoken (eg, d- t, f- v, g- k, b- p- m). That is, they look identical on the lips but are distinguishable to hearing people when spoken.

Other sounds appear the same such as /ch/, /j/, and /sh/, making chew, Jew, and shoe indistinguishable from each other (this includes the "soft g" as in "George" and all variations of /sh/ as in fi sh, Charlotte, and na tion. Many vowel sounds appear similar, especially compared with their written equivalent. For example, the sound /oo/ may be written as “t o,” “ too,” “th rew,” “thr ough,” “d ue,” or “sh oe.”Lip- reading is hard to master and tiring to perform. To appreciate the difficulty, imagine reading this page with no spaces between the words and with only periods as punctuation. Then, imagine the text passing in front of you as if on an electronic billboard, and that every /p/ might be a /b/ or /m/, every /d/ could be a /t/, every /ch/ could be /j/ or /sh/, and so on. Fourth, lighting, distance, speech impediments, accents, and foreign objects or motion can make lip- reading more difficult (eg, faces silhouetted by light, food, pencils, fingers, mustaches, turning the head).

As a result, typical lip- readers understand only one third of a one- to- one conversation. The best lip- readers understand about two thirds.

In general, children with more hearing and better speech discrimination than others are most successful with lip- reading. Finally, the lip- reader cannot localize a speaker. During a one- to- one conversation between the lip- reader and one other person, there is only the one set of lips to watch.

Even a third person makes the conversation difficult because when the speaker’s lips stop moving, it could be a pause, or the other speaker has started speaking. The lip- reader must guess if he or she should continue to look at the speaker’s lips, risking missing the opening words of the second party (those which best set up context, for example agreement or disagreement with the first speaker).

To look at the other person’s lips risks missing the continued comments of the speaker. In a group setting, the lip- reader may miss several entire comments by the time his or her eyes identify the speaker. Having more hearing is helpful in group situations. Although hearing aids help to localize sound, they also amplify each voice equally, which may decrease the ability to accurately use the sounds that are heard. Watch Monte Carlo Online Forbes.