HI 2: Impact Flashcards
What is OME? Even tho 10-15% kids have MM HL, why do some go undetected?
OME (otitis media with effusion) is occurs in many pre-school/reception aged children. However, some children have it worse of then others and may have persistent bouts of hearing loss.
10-15% of children have mild to moderate, or unilateral deafness but are unlikely to use hearing aids. The hearing loss may fluctuate (with the coming and going of a hearing infection) and may be undetected by teachers or parents. This loss may be passed off as the child “not listening” (ie they are believed to be behaving poorly), or that behavioural problems are due to misunderstandings.
Where children are unwell, and miss school, it is difficult to differentiate between the effects of loss of hearing and missing lessons. - Lewis et al., 2015
What’s OME?
OME is, in simple terms, the build-up of non-pus liquid (or whatever) in the middle ear. It can be either mucoid or serous (pale yellow fluid). The middle ear also becomes inflamed, but there is no fever.
What are the effects of HL in childhood?
According to Haggard et al., (1993;2004) some children demonstrate no consequences provided if other factors are positive e.g. family history,
However, speech perception of high frequency (Hz) and low intensity (dB) consonants may be impacted with consequences for delays in • Phonology • Morphology • Comprehension • Literacy
Furthermore, some children may speak in a quiet voice, but perceive themselves to be speaking at a normal volume via bone conduction.
Lastly, it has been suggested that there is an increased risk for dysfluency as the physical illness puts the system under stress.
(also, noise +academic achievement)
Children with HI will exert greater listening effort which impacts academic performance. EXPLAIN.
Children with HI may need to exert greater listening effort.
* Their speech perception skills in noise and reverberation are still developing, so noise is more challenging to combat for a child w a HI. * Children are often required to attend to a teacher or other students, some of which who cannot be seen (maybe due to seating). This increases listening effort as the child can't use cues such as lip reading.
According to Bess et al. (1998) and Lieu et al. (2012), this greater listening effort can impact a child’s academic performance:
* The child uses few cognitive resources to understand and remember content - they are using resources to hear our for words (syntax?) rather than comprehending the meaning. * Overtime, this leads to deficits in academic performance in a variety of areas.
List intervention for OMEs
- Information can be gathered from organisations. Leaflets can be provided by Defeating Deafness, NDCS, AOHL.
- Antibiotics can be given to treat the bacterial infection.
- More invasive procedures can be used. Surgery can be used to insert grommets, or perform an adenoidectomy.
- Hearing aids are used, but usually after grommets are inserted 3 times.
- Certain diets can be used to reduce mucus production; e.g. dairy products may be avoided.
- Autoinflation (Perera et al., 2013) relieves the symptoms of OME by opening up the Eustachian tube to allow fluid to drain from the middle ear. It involves alternating nostril blowing through this balloon type device known as an ovovent.
Intervention for Mild-Moderate (MM)HL and unilateral deafness
- Management of the listening environment at home and school.
- Increasing the signal to noise ratio e.g. moving the child’s seating closer to the source (teacher).
- Hearing tactics.
• Monitoring hearing and communication development
Speech and language therapy: parent groups, language groups
Consequences of Severe-profound sensori-neural deafness
Impaired abilities in the following:
- Frequency resolution is how well the ear can tell apart two sounds that are similar in frequency. This can result in poor speech discrimination for consonants.
- Temporal resolution: The gaps between sounds can become blurred and obscure. Find it difficult to discriminate when sounds start and stop, word boundaries, and there may be very poor speech discrimination.
- Upward spread of masking: Low frequencies can be disruptive towards the higher frequency sounds. This excessive upward spread of masking is cause by SNHL. It can mean that speech sounds become muffled (?), and masked by noise such as background chatter.
- Auditory recruitment causes the perception of sound to be exaggerate. This may be due to neighbouring hair cells being able to pick up the frequencies of damaged cells, as well as their own. Additionally, some people have very restrictive dynamic ranges where loudness grows very quickly to uncomfortable levels.
- Poor sound localisation ie they find it difficult to find the location of a sound.
How are standard hearing aids checked?
- Ask the client to remove the hearing aid
- Visual check - any cracks, moisture or wax in the tubing?
- Battery check - is it switched on? What setting? Turn the volume up and listen for feedback.
- Sound quality check - turn the volume down, listen with a stetoclip.
Checking cochlear implants
- Visual check - check coils and cables for wear and tear.
- Daily battery check.
- Use a signal check device (avaliable from implant manufacturers) to check the transmitted signal - a light indicates that all systems are working.
Describe the The ling 6 sound test. What’s it for?
Speech perception testing
- A functional check of sound awareness/discrimination across the spectrum (250 - 8000 Hz) in a range of clients using amplification devices.
- 6 sounds are presented individually; their loudness and distance is maintained.
• Look for a response (awareness) or repetition (discrimination).
○ low-mid Hz m, a, u
○ mid-high Hz i, (sh), s
Connected discourse tracking (De Filippo & scott, 1978)
Checks text comprehension in older clients using a shadowing task:
• Tester reads a passage sentence by sentence.
• Client repeats what they hear.
• Use with/without speechreading.
• Provides information on how much language the client accesses, e.g. the number of words repeated, errors in sounds perceived.
Notes: most clients have some residual hearing which can be augmented by amplification and used to support spoken communication.
Tests for speech perception
Connected discourse tracking (De Filippo & scott, 1978)
The ling 6 sound test (Ling)
Why is being able to see the speaker important?
Speech perception is normally an audio-visual process
Ronnberg (1995): for a hearing person, seeing the speaker in a noisy environment
○ Is the equivalent to a 15dB increase in the signal to noise ratio
○ Keeps attention on the speech source
Is particularly helpful when material is difficult to understand (e.g. accents, foreign languages) or when listening conditions are poor
Why is being able to see the speaker important for DEAF PEOPLE?
- Vision provides cues on place of articulation.
- Hearing provides cues on voice and manner.
- Although only 30% of speech is understandable through vision alone, speech reading alongside residual hearing can maximise speech perception in a deaf person.
Optimal conditions for speechreading
• Optimal conditions for speechreading:
○ Face-to-face communication
○ Clear speech patterns
○ Good lighting
• Deaf adults signers are better speech readers than hearing adults (Mohammed et al., 2005).
