Espara, Desiree Dale N.

BEED-SPED 2

April 22, 2013 SPED 106-1:30-3:00-CP302

1. What is hearing impairment? How does deafness differ from the condition of hard of hearing? Individuals with hearing impairment are either deaf or hard of hearing. Students who are deaf do not have sufficient residual hearing to understand speech without special instruction and training. On the other hand, students who are hard of hearing have enough residual hearing to understand speech and learn in regular class without much difficulty. Hearing impairment or disability refers to the reduced function or loss of the normal function of the hearing mechanism. The impairment or disability limits the persons sensitivity to tasks like listening, understanding speech, and speaking in the same way those persons with normal hearing do. Thus, a person who is hard of hearing has a significant loss of hearing sensitivity but he or she can hear sounds, respond to speech and other auditory stimuli with or without the use of hearing aid. He or she is more like a hearing person than one who is deaf because both them use audition or listening to auditory stimuli in the environment, unlike a deaf person who relies more on visual stimuli. Therefore, Hearing impairment, or deafness, is when your hearing is affected by a condition or injury. Some people are born with a hearing loss while others may develop it as they get older. While some students who are hard of hearing may hear only specific frequencies or sounds within a certain volume range. They may rely heavily upon hearing aids and lip reading. Some students who are hard of hearing may never learn, or only occasionally use, sign language. Students who are hard of hearing may have speech impairments due to their inability to hear their own voices clearly. 2. Enumerate the causes or etiology of hearing impairment and discuss each briefly. Hearing impairments are attributed to genetic and heredity factors, infections, environmental and other traumatic factors. Some hearing impairments have unknown causes. Genetic and hereditary types of deafness occur in one out of one thousand live births. Causes are hereditary and chromosomal abnormalities. Infections such as maternal rubella, cytomegalovirus, hepatitis B virus, syphilis, mumps, and otitis media may occur during pregnancy or after birth. Adventitious hearing loss can be attributed to environmental factors such as excessive and constant exposure to very loud noises.

In the evaluation of children with unexplained Sensorineural Hearing Loss (SNHL) routine laboratory evaluation should be reconsidered given its low diagnostic yield. However, radiologic abnormalities of the inner ear are common. Identification of inner ear malformations has direct impact on management of these children, suggesting that all children should undergo radiologic imaging as an integral component of evaluation of SNHL .

3. What are the classifications of deafness? The affected part of the ear is one basis for classifying hearing impairment. A conductive hearing loss occurs in the outer and middle ear thereby blocking the passage of the acoustic energy. The blockage may be caused by abnormal growths or complications of the outer or middle ear. Impacted cerumen results from the excessive buildup of earwax in the auditory canal. Diseases of the middle ear can leave fluid or debris. Malformation, incomplete development, or abnormal growth and improper movement of the ossicular chains can cause conductive hearing loss. If the inner ear is intact, conductive hearing impairment can be corrected through surgical or medical treatment. A hearing aid is usually prescribed. A sensorineural hearing impairment occurs in the inner ear. The sensitive mechanisms and the auditory nerve may be damaged. A mixed hearing impairment results from a combination of both conductive and sensorineural hearing losses. Any dysfunction in the central auditory nervous system between the brain stem and the auditory cortex in the brain results in the central hearing disorder. Another basis for classifying hearing impairment is its being unilateral or present in one ear only, or bilateral or present in both ears. Sound is measured in decibels (dB) or units that describe its intensity, that is, its loudness or softness. We need to classify hearing aids in order for us to know the affected areas and so for us to give them an early intervention. 4. Enumerate the informal methods of evaluating hearing loss. Describe each method. Congenital or acquired hearing loss in infants and children has been linked with lifelong deficits in speech and language acquisition, poor academic performance, personal-social maladjustments, and emotional difficulties. Identification of hearing loss through neonatal hearing screening as well as objective hearing screening of all infants and children can prevent or reduce many of these adverse consequences. This report outlines the risk indicators for hearing loss, provides guidance for when and how to assess hearing loss, and addresses hearing referral resources for children of all ages. a. Whisper test Sit the child comfortably. Ask him or her to stick the tip of the forefinger in one ear. The tester sits behind the child where the uncovered ear is. b. Conversational live voice test Keeping the same position but facing the child, ask him or her to repeat words that contain high and low pitch consonants. c. Ball pen click test Use a retractable ball pen and place it one inch away from the ear. While the other ear is blocked by a finger, press the button of the ballpen down and release it. Do it only once. The child indicates that he or she hears the click by either raising one hand or acknowledging it with a yes or a nod. 2. Cognitive Assessment The assessment tools that measure intellectual capacity of children with hearing impairment do not rely primarily on verbal abilities.

3. Assessment of Communication Abilities Assessment of speech and language abilities includes an analysis of the development of the form, content and use of language. Articulation, pitch, frequency and quality of voice are examined. 4. Social and Behavioral Assessment Hearing impairment brings about significant effects on social-emotional and personality development as a result of the restrictions in interactive experiences and communication activities with their age group. Linguistic difficulties oftentimes show in low self-concept and social-emotional maladjustment. Although the number of students with both learning disability and hearing impairment (LDHI) currently enrolled in secondary and postsecondary programs has not been precisely determined, it is clear that these students are currently receiving inadequate assessment and support in many institutions. The best route for serving these students would seem to be collaborative efforts between deaf educators and learning disabilities specialists, yet serious gaps exist between these two professions in regard to interpretation of laws governing special services, training of professionals, and locations of educational programs. The difficulties of developing collaborative work have been compounded by controversies within each field and the heterogeneity of the populations served by both disciplines. Those interested in creating good LDHI assessments should begin by considering the qualifications needed by those conducting evaluation procedures. The inadequacies of current formal assessment devices for this population need to be recognized; informal procedures, such as teacher observation and curriculum-based assessments, are still some of the best tools available for identification and educational planning. 5. Visit a special education class for students with hearing impairment. Talk to one of them by asking questions about their studies, things and activities they like and similar topics. What characteristics did you observe about the student? We are ask to visit a special education class to observe a student with hearing impairment, and since we still have the profile and document of Louiselle I choose to have an information concerning her activities and her studies. Name: Louiselle Tul-o Kimayong Gender: Female Birth date: June 06, 2000 Chronological Age: 12 years, 6 months & 4 days Grade Level: 3rd (elementary) Disability/ Impression: Hearing Impairment co-morbid: Mild Mental Retardation School: Sped Center (Military Cut-off, Baguio City) Parents: Father: Pablo G. Kimayong Mother: Carolyn T. Kimayong Home Address: # 182 Canablong St., Pob. West Lagawe, Ifugao City Address: # 5057, Purok 5 Kias, Baguio City

Our child that we had observed namely Louiselle T. Kimayong, aged 12 years, 8 months and 22 days old has Hearing Impairment and with comorbidity of Mild Mental Retardation. A hearing impairment can be described as a full or partial loss of the ability to detect or discriminate sounds around us. Common terms used instead of hearing impairment include hard of hearing and deafness. Louiselles case is full hearing impairment because even a single sound of footsteps she cant hear and recognize them. Her physical disability is caused by the suffering of her mother from toxic goiter and the taking of medicines. Some signs that a child has hearing impairment are: failure to startle at loud sounds, not turning toward the sound of a voice or imitating sounds after about 6 months of age, lack of babbling by 12 months of age, failure to respond to name by 12 months of age, not using single words by 18 months of age, failure to follow simple directions by 18 months of age. Her parents noticed these things when Louiselle was still young like she wouldnt turn her back when her name was called. And, hearing impairment that is present at birth is called congenital hearing impairment. And, its her case. On the first day of our observation Louiselle is a kind of shy and ashamed at our first interaction. However, she is sociable with her nieces. They are playing with each other and they enjoy more colouring and drawing. We used sign language to communicate with her. At first it is difficult interacting because we dont have a background in sign language but with the help of her sister-Liezel we are able to communicate well with each other. During the observation we give her simple activities to know where she is having a hard time. We gave her a memorization test, understanding instruction and math activities. In the memorization test we let her memorize the correct sequence of the four different colours f or 3 minutes. Louiselle wasnt able to pattern correctly the colours and this means that she has poor in retaining patterns. The second test is we let her understand a simple instruction which is In a sentence describe yourself and unfortunately she wasnt able again to understand the instruction, we had to sign language the meaning of the instruction but still she cant get the meaning because she doesnt know what describe means. The third activity that we had given to her is simple mathematics problems that encompass addition, subtraction, division and multiplication. She had easily solved the two to three digits numbers but she is having a hard time in division and multiplication especially the nos. that are more than three digits. Hearing impairment in children may delay development of language and cognitive skills, which may hinder progress in school. The extent of delay depends on the degree of hearing loss. In adults, hearing impairment often makes it difficult to obtain, perform, and keep jobs. And, when we checked her notebooks, activity papers and quizzes we had noticed that she has difficulty in language that includes construction of grammar and spelling. She sometimes writes wrong letters like rosarie (rosary) and glanbe (glance). Also her grammar, for instance her answers in a story based questions; she cannot understand the story thats why she cannot answer well the questions. She also shortcuts in relaying her messages through sign language and this also contributes to her wrong grammar. In addition to her math she still uses her fingers in counting and writing sticks.However, she can understand personal questions which are interpreted in sign language like what is your name? and how old are you? Hearing-impaired children and adults are often at risk of having social challenges and not being able to fit in with mainstream groups. This is because many of the needed communication skills are language-based, according to research conducted at the Washington University School of Medicine. But, when we went to her school which is the SPED CENTER to see how she is doing in school she was able to communicate with her classmates. She is also active in joining school programs like dance intermissions. Also, she joins regularly in their daily

morning exercises with her schoolmate with or without disabilities. She is not having a difficulty in expressing her feelings like using polite expressions such as sorry, thank you, and welcome. We went to visit her again to introduce another activities and to see if shes doing well. The first activity that we had is spelling by using scrabble tiles. First, we came up with set of words and we scramble the tiles of letters and we sign language its description, then we let her arrange the letters to form the correct word. And, the result was she got 5 out of 10. Second, we let her exercise her counting using coloured Popsicle sticks. Third, we taught her how to construct simple sentences correctly by a picture analysis wherein we show a flashcard of picture and it consist of words of a noun, adjective and verb that describes the picture. Then, we let her construct a sentence using the words in the flashcard. It is amusing to know that Louiselle can speak three words like Papa, Lola and Lolo. She can pronounce these words not very clear but at least she is able to utter words most particularly these words that are very overwhelming especially to her parents. Her fine and gross motor are very well. She performs well at school and at house.Louiselle is industrious and helpful in the household chores.She helps in cooking, cleaning, feeding the cats, washing dishes and clothes. She can also assist herself without the help of others like brushing her teeth, taking a bath and many more. She can also go by herself at her school from Kias to SPED CENTER and she can go home by herself. Louiselle is a responsible girl for she does her tasks in school such as assignments and homework. She knows to respect and obey other people especially her elders. Louiselle is fond of drawing and colouring and this is her past time when she is not doing something aside from watching television. We had also observed that she can understand the flow of story of the teleserye shes watching. We think that the facial expression of the characters help her to recognize the meaning of the drama also, trough lip reading she is able to understand the words that are uttered. In the activities that we have introduced to Louiselle tested her cognitive ability and she was able to participate in all the activities. She tried her best to finish all the activities with our assistance. After all the meetings that we had with Louiselle we had made a good relationship. She doesnt already feel annoyance and intimidation. Also, she communicates with us well. Sometimes we had difficulty in catching her attention but with the help of her sister that knows her more; we are able to get to know her better and making adjustments for her. Observing a child with hearing impairment is quite a difficult experience for us most especially when you dont know how to use sign language. Being there also gave us a very beautiful acquaintance because it made me realize how important to communicate with them. Even we cannot understand them through words but action really speaks louder than words.

References: http://www.nhs.uk/conditions/Hearing-impairment/Pages/Introduction.aspx. http://www.washington.edu/doit/Faculty/Strategies/Disability/Hearing/

http://onlinelibrary.wiley.com/doi/10.1097/00005537-20020100000001/abstract;jsessionid=5EB65C44574842DB6C794782EBCD387F.d04t03?denie dAccessCustomisedMessage=&userIsAuthenticated=false. http://pediatrics.aappublications.org/content/111/2/436.short. http://pediatrics.aappublications.org/content/111/2/436.short.

http://ldx.sagepub.com/content/24/7/391.short. http://www.who.int/mediacentre/factsheets/fs300/en/index.html http://www.marchofdimes.com/baby/birthdefects_hearing.html http://www.ehow.co.uk/about_5495528_activities-hearing-impaired-child.html

Galang (Respect) Sipag (Industry) Pagka-masinop (Frugality) Pagka-maalalahanin (Thoughtfulness) Bait (Kindness or good behavior) Pagiging maaasahan (Dependability) Pagka-masunurin (Obedience) Paninilbihan (Servitude) Spiritual Values

Takot sa Diyos (God-fearing) Pagkamadasalin (Piousness) Pagiging Pala-simba (Being a mass-goer) Dibosyon (Devotion) Bait (Kindness or good behavior) Moralidad (Proper morals) Relationship Values

Pakikipagkapwa-tao (Relationg to other people well) Utang na loob (returning a favor) Pakikisama (Being people oriented) May isang salita (Having a word of honor) Pagka-mapagkumbaba (Humility) Pagiging maaasahan (Dependability) Workplace Values

Sipag (Industry) Ayos na trabaho (Being organized) Pagka-masinop (Frugality) Pagka-matulungin (helpfulness) Kusa (Initiative) Pakikisama (Getting along well) Pagiging palangiti (Cheerfulness) Pagiging maparaasn (Resourcefulness) Pagiging maaasahan (Dependability) Dunong magisip (Ingenuity) Palabra de honor (Word of honor) Paninilbihan (Service) Integridad (Integrity) Community Values

Bayanihan (Cooperation) Paggalang sa batas (Respect for the Law) Pagka-mapagkawanggawa (Charity) Pakikiasama (Getting along well) Delcadeza (Probity) Linis ng pangalan (Clean reputation) Integridad (Integrity) Mroalidad (Proper Morals)