Monday, March 2, 2015

Hearing Impairment

Hearing Impairment

Hearing Impairment affects nearly 50 million people in the United States alone. Hearing Impairment affects not only conversation, but enjoyment of music, tv, and other entertainment options. Grandparents can no longer hear their children laugh, husbands have difficulty talking to their wives on the telephone, children cannot hear their teacher, and music is harder to enjoy.

There isn't anything a therapist or medical professional can do to cure hearing impairment, however there are many things conversation partners and therapists can do to help those with hearing problems listen, understand, and better comprehend what is going on around them. An audiologist will be able to additionally assist a person suffering from hearing impairment with hearing aids, cochlear implants, and other hearing related medical advice.

Types of Hearing Loss
  • Conductive- this type of hearing loss is caused by a problem with the ear's ability to conduct sound.  Causes of conductive hearing loss may be an ear infection in which middle ear fluid presses against the ear drum (typmanic membrane) and does not allow it to move, causing a loss of hearing. Similar problems could be caused by impacted ear wax, allergies, poor eustacian tube function, swimmer's ear, malformations, and multiple other causes. Oftentimes, but not always, conductive hearing loss can be fixed with tubes, removal of wax, antibiotics which stop an infection, and other medical management.
  • Sensorineural- this type of hearing loss is caused by a problem with the ear nerves or with the nerves that transmit sound information to the brain. Possible causes include loud noise exposure (so turn down your TV!), illnesses, aging, trauma, and ototoxic drugs. 
  • Mixed- this is a mixture of both conductive and sensorineural hearing loss.  So, for example, if your Grandfather who has lost some hearing due to aging and working on a tractor also has a lot of ear wax, he may have both types of hearing loss or "mixed" hearing loss.
Degree of Hearing Loss
 
Hearing is measured in decibels, abbreviated to dB.  You want to be able to hear all frequencies (low and high sounds) at 0 decibels for a perfectly normal hearing test.   As that decibel number rises there are different degrees of hearing loss. 
  • Normal:-10-15dB
  • Slight Hearing Loss: 15-25
  • Mild Hearing Loss: 26-40
  • Moderate Hearing Loss: 41-55
  • Moderately Severe Hearing Loss: 56-70
  • Severe Hearing Loss: 71-90
  • Profound Hearing Loss: 91+
Configuration of Hearing Loss
 
The configuration of hearing loss is the shape of the hearing loss.  This would mostly consist of a description about what the hearing loss looks like.  There are 4 configurations:
  • Bilateral vs Unilateral: Bilateral hearing loss is a loss in both ears.  Unilateral hearing loss is a loss in a single ear.
  • Symmetrical vs Asymmetrical: Symmetrical hearing loss would be the same severity of loss in both ears. Asymmetrical would be a different severity in each ear.
  • Progressive vs Sudden: Progressive hearing loss occurs over a period of time (like a loss due to aging). Sudden hearing loss occurs very quickly (like a loss due to a severe illness or a very loud noise).
  • Fluctuating vs Stable: A fluctuating loss changes over time, sometimes better and sometimes worse (for example, a conductive loss due to ear infections will be worse during an infection and better after the infection is gone). Stable hearing loss would remain the same over time.
Development and Hearing Loss

Hearing is an essential part of developing typical speech, language, and communication skills. If you cannot hear a word, it will be extremely difficult to learn that word. As such, the earlier a hearing impairment occurs in a child the more significantly their development will be impacted by that loss.  Early intervention is crucial for children who may have a hearing loss to ensure that they are given all the help they need to develop speech and language milestones. According to the American Speech Language Hearing Association, hearing loss affects children in four major ways:
  1. "It causes delay in the development of receptive and expressive communication skills (speech and language).
  2. The language deficit causes learning problems that result in reduced academic achievement.
  3. Communication difficulties often lead to social isolation and poor self-concept.
  4. It may have an impact on vocational choices."
If you think your child may be experiencing a hearing loss, please take your child to a trusted pediatrician or audiologist to have their hearing tested so that should intervention be required, it can be started as early as possible. "Recent research indicates that children identified with a hearing loss who begin services early may be able to develop language (spoken and/or signed) on a par with their hearing peers. If a hearing loss is detected in your child, early family-centered intervention is recommended to promote language (speech and/or signed depending on family choices) and cognitive development."

What can I do to help someone with a Hearing Impairment?

  • Reduce auditory distractions- when at a restaurant, you can ask that the music be turned down, at home or in the car, turn off the tv or radio while talking
  • Turn up the lights- turn lights and lamps on so the person has the ability to see your face and put together context clues from facial expressions
  • Frequently check for understanding- make sure they are listening and understanding by asking questions and listening for more than just, "mmhmm"
  • Repeat or rephrase information as needed
  • Enhance speech reading conditions- don't chew gum, put your hands or objects over your mouth and face, make sure to face the person head on when talking
  • Obtain the person's full attention prior to speaking
  • Clearly enunciate speech- Don't talk with your mouth full!
  • Turn closed captioning on the television

References
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