Hearing Impairments and Speech

Genetic causes of hearing impairment

• The narrow ear canals association with Down syndrome can make them prone to ear infections

• Cleft palate can expose areas to infection which can carry on to the ears

• RH incompatibility can cause high-frequency hearing loss even if the infant survives

Environmental factors (TORCHS)• TO is for

toxoplasmosis, from handling cat feces or undercooked lamb

• R is for rubella

• C is for Cytomegalalovirus, passed through the placenta to the child.

• HS is herpes simplex

Less-frequent causes of deafness

• Noise pollution. Stereos, particularly in automobiles; close exposure to gunfire; close exposure to jet engines or drag racers

• Meningitis• Otitis media• Asphyxia or lack of oxygen during

birthing

Factors affecting impact of hearing loss

• Prelinguistic or post?

• Unilateral or bilateral?

• Identified & taught sign language before 2 1/2 or after?

• Severity of loss

Indicators of hearing loss

• Physical problems associated with the ears

• Articulates poorly and omits consonant sounds (speech banana)

• Turns up volume on radio, TV, stereo• Requests repetitions; “huh?”• Unresponsive to normal voice• Reluctant to participate in oral activities

Special learning challenges for the hearing-

impaired• Multiple word meanings such as mole or

box• Syntax as it relates to word order: “The

parent spanked the child” as compared to “The child spanked the parent.”

• Figurative language such as “He’s one up on me” and “Give me some slack.”

• Idioms such as “He pulled himself up by his bootstraps”

Total Communication Method

• Combines finger spelling, speech reading, speech, and auditory amplification

• Most common method of classroom communication, followed by oral-aural

• Manual communication was not reported as a major mode of instruction in any school

Where do you seat the hearing impaired

• For unilateral losses, with the good ear towards you, the teacher

• For bilateral, second row, middle, rather than on the front

FM transmitters/receivers

• Student wears receiver with earphone• Teacher wears transmitter, microphone• Amplifies teacher’s voice without

amplifying all other classroom noise• Take it off when you aren’t using it! If

you don’t want to embarrass yourself.

Speech & Language Disorders

Definitions

• Communication is the exchange of thoughts, information, and ideas

• Speech is the systematic oral production of the words of a given language

• Audition is the thought transformed into words by a listener through hearing

• Language is an organized system of symbols that humans use to express and receive meaning.

Communication disorder

• Communication disorder is a broad term that includes both disorders in speech or language

Speech disorder

• A speech disorder is a disorder affecting articulation, voice, or fluency

Language disorder

• A language disorder is the impairment of deviant development of comprehension or use (or both) of a spoken, written, or other verbal symbol system.

• It could include reception (auditory)

What kinds of communication disorders

are there?

Glad you asked . . .

Disorders of Articulation--Phonology

• Substitutions--wight for right, toat for coat, wove for love, aminal for animal

• Distortions--brlu for blue, crat for cat• Omissions such as oke for poke, at for

hat, inging for singing• Addition of extra sounds such as

aluminininum for aluminum

Disorders of fluency and speech timing (stuttering)• Stuttering is characterized by repetitions

and prolongations of sound, syllables, or words, that interrupt the flow of speech.

• It is not know exactly what produces stuttering.

• Stutterers sometimes acquire secondary characteristics or tics such as stamping the foot or throwing the head around to get the sound out.

Language Disorders (1 of 3)

• Form of Language:• Phonology is the sound system of a

language and the rules that govern the sound combination. For instance, English has a ph blend but not a hp.

• Morphology is the system that governs the structure of words and the construction of word forms. “Unhappy” is a possible word but not “hapunpy”

Language disorders (2 of 3)

• Syntax is the system governing the order and combination of words to form sentences, and the relationships among the elements within a sentence.

• “He kissed her” does not mean the same things as “Her kissed him.”

• “The shooting of the hunters was awful” is nearly indeciferable because of the violation of syntax.

Language disorders (3 of 3)

• Semantics is the system that governs the meanings of words and sentences

• Pragmatics is the system that combines all of the language components into functional communication

Voice disorders

• Voice disorders are inappropriate variations in quality, pitch, or loudness

• Include breathiness, hoarseness, or harshness

• Vocal nodules can cause these

Laryngectomees

• More likely to be seen in parents than in children

• Result of the surgical removal of the larynx most usually due to cancer

• May use esophageal speech or assistive technology

• Recognize by gauze on throat

Assessment issues in speech

• Concomitant retardation or learning disability?

• Dialect?• Regionalisms?• Facial structure

such as cleft palate?

Service delivery models

• Inclusion. There is little reason to exclude the speech impaired student all day long from the classroom

• Consultative service• Itinerant service--pathologist comes to

classroom• Pull-out speech--child goes to “the

magic speech room” once a week• Intensive-cycle scheduling

Suggestions to improve student’s self-esteem

• Disregard moments of nonfluency• Show acceptance of what the child has

expressed rather than how he expressed it.

• Treat the stutterer like any other child• Acknowledge nonfluency without

labeling the child• Help the child feel in control of his/her

speech