[MUSIC] There are a number of reasons for teachers of deaf children to understand hearing loss. Because without such specialist knowledge, you may not be able to provide optimal learning access to learning for these learners. Teachers are the professionals that have daily interaction with these children. Often spending more time with the children than their parents. Teachers may also be consulted for various reasons by other members of the child's rehabilitation team. In this video, I will describe how we hear, and how hearing status may be described and understood. Parents of children recently diagnosed with hearing loss may not understand everything that was explained to them by their audiologist. Often audiologist have no more than hour at a time with parents and it may be a few weeks until another appointment can be made. Parents may find it easier to access the teacher than to wait several weeks for the appointment with the audiologist. They may also feel more comfortable asking questions of someone they are more familiar with. Some parents may need help and guidance in accepting their child is deaf and that hearing loss is permanent. This is one of the reasons why it is useful for teachers to know how hearing works. Teachers need to understand how the individual's healing status may have affected their language acquisition, communication development in sign or spoken language, interaction with peers and the child's behavior, and performance in the classroom. This information is also necessary for planning each child's individual education plan, or IEP. Teachers may also need to help deaf children understand their own audiograms. So as to promote independence and allow children to be involved in those decisions around how to manage their residual hearing. It is often helpful to use a picture to explain hearing to parents and children. We start by identifying the outer, middle, and inner ear. And then explain that sound travels through the auditory system from the outer ear up the auditory pathway to the brain where we hear. Sound from the outer ear is converted to mechanical energy in the middle ear when the sound waves cause vibrations on the tiny bones. These vibrations then travel through the inner ear, or cochlear, where it is converted to neural energy. The neural energy then travels up the auditory nerve to the brain, where the sound is interpreted. From a medical and audiological perspective, there are three types of hearing loss, conductive, sensorineural, and mixed hearing loss. Traditionally type of hearing loss has been classified in terms of where along the auditory pathway the hearing loss originates. Conductive hearing loss occurs when the site of lesion is in the outer and/or middle ear. In this case, the auditory pathway is healthy from the inner ear up to the auditory cortex. Sensorineural hearing loss occurs when outer and middle ear are healthy, and the cochlear, the sensory part and/or the auditory pathway, neural part, may be the site of lesion. A mixed hearing loss is both conductive and sensorineural components. Audiologists classify hearing status by describing hearing thresholds. Hearing thresholds are the quietest levels that one can hear sound at 50% of the time. These hearing thresholds are recorded across a range of frequencies and intensity levels and are measured in decibels of hearing on an audiogram. Hearing thresholds are described in terms of laterality, symmetry, degree, configuration, and type. I will now briefly explain each of these terms. Laterality refers to one or both ears. Symmetry allows us to comment on clinical differences between ears. Degree refers to intensity ranges of normal, slight, mild, moderate, moderate-severe, severe and profound healing thresholds. Configuration refers to the shape of the graph. We find that certain shapes correspond to various causes of hearing loss. And type refers to the part of the auditory system where the hearing loss originates and this maybe conductive, sensorineural or mixed. The environmental audiogram is a useful tool to help parents understand what the child's residual hearing may be. Teachers can pluck the child's hearing thresholds on the environmental audio gram and then show parents that their child is able to hear those sounds below the line without amplification. This tool is also helpful as terms like mild or moderate hearing loss may be misleading to patients. Research has indicated that children with mild hearing loss can miss up to 50% of a classroom discussion, and miss out on incidental learning opportunities. Unmanaged mild and moderate hearing loss may result in children failing a grade. And they may present with immature behavior in the classroom. Children with severe hearing loss in the 70 to 90 decibel hearing loss range may detect speech and environmental sounds if they are provided with hearing aids. Children with profound hearing loss in the 90 DB HL plus range do not have any access to speech sounds and may hear some environmental sounds without hearing aids. Children with profound hearing loss will need language intervention to learn to communicate with others, whether in sign language or spoken language. When these children have not had early intervention services, one can expect significant delays in language, social, and academic skills. Language delays may result in children displaying negative behaviors, like tantrums in the classroom. Children with severe hearing loss and/or profound hearing loss may be able to access their residual hearing by using a hearing aid and FM systems. This allows them to participate in their sound environment, promotes awareness of sound and safety issues, and for some, allows them access to speech sounds. Children who are not able to use hearing aids successfully may be considered for cochlear implants if they meet the criteria for implantation. Children who use cochlear implants successfully are able to access speech sounds. And are likely to be placed in oral schools if they're able to use spoken language as the medium of instruction. When explaining the audiogram in the past, audiologists may not have considered the kinds of connotations that words like hearing loss may have. One could be inclined that if hearing's the yardstick, then having a hearing loss means the child is considered less than. This may also be interpreted as society thinks less of deaf or silent people. There is a suggestion that when counseling around hearing status, one could also consider advising families on deaf gain. This means that part of having a hearing loss, the child and their family has gained extended family in the deaf community. The child has also gained a new part of their identity as a deaf individual. They also gain a new language, sign language is considered a positive new way for the child and family to interact within the deaf community. We need to remember that understanding the audiogram and classifying hearing loss according to the presenting thresholds does not allow us to understand the whole picture for each child. What it does tell us is about the child's health condition, auditory functions and structures. But in order to understand the effects of the hearing loss on individual children, we need to understand how they experience the hearing loss in the context of their everyday lives. Consider how the hearing loss affects their everyday activities and interactions within their family and broader community. What are the physical, attitudinal, social, institutional, and environmental factors that the children you teach are faced with daily? To help parents understand hearing loss, we heed to help them to be aware of how these factors play a role in their children's lives. Our wish for deaf and hard of hearing children is that these children grow up to be independent and resilient adults who fulfill their potential. We want to foster and promote the idea that the deaf and hard of hearing child can do anything except hear as well as their peers. Teachers have an important role to play in helping children and their parents understand that they are not the audiograms. [MUSIC]
