Test #2 - Culture Flashcards
Hearing world
Phrase for hearing people –> refers to spaces populated by hearing people
Terms for people who may not hear or speak
Deaf, deaf, DeafBlind, Hard-Of, Hearing, Late-deafned, Deaf mute
How many Americans have some difficulty hearing
48 Millions Americans have some sort of difficulty hearing
***Includes people born deaf or part of deaf culture
Who do you refer to about hearing loss
Audiologist - When confronted with Possibility of hearing loss - people tend to be referred to audiologist
Audiologist
Professional Who specializes in detecting hearing levels and proposing different types of Accommodations
- Prepares Audiogram + Gives label corresponding with hearing level indicated by audiogram
Field = Audiology
Purpose of Audiologist consultation
Measure degree + Type of hearing loss + configuration of hearing labels using a physical examination of the ear + tests of hearing and listening + Test middle ear function
Audiologist exam
Start = look at outer ear for evidence of malformations
THEN - use Otoscope )inserts in ear) to examine ear canal and eardrum (see if wax or objects blocking ear)
THEN - Do Pure-Tone Audiometry –> audiologist does a test of hearing tons
THEN - do Speech reception threshold
THEN - do Acoustic immittance test
Otoscope
Instrument that has a light and magnifying glass to look into ear
***Can look at condition of eardrum and note excess fluid
Pure Tone Audiometry
Overall: tests of hearing Tones
How is it done - Indiviudal goes into a soundproof room with headphones while the audiologist is ina dofferent room –> Audiologost turns on machin that emits pure tones at selected pitch or frequncies – Finds the lowest tone and frequencey individual responds to
- Audiologist turns on low sounds and increases the volume until the person is able to hear
Vary - sounds + pitch from low to high to determine hearing level in each ear
Measuring loudness
Loudness is measured in decibles
Speech Reception threshold
Overall - Testing level of speech that person can hear part of the time
Is a standardized list of phenotically balanced words - words are presented to person to asses the ability to recognize words across loudness levels
Acoustic Immittance test
Examines the function of outer and middle ear – can detect blockage in ear canal or fluid in middle ear or punctured ear drum
What is done after hearing tests are completed
After testing –> put the information on an audiogram
THEN recommendations are made for follow up testing or medical referrals
Audiogram
A chart that measures sound from 0-120 decibles and 125-800 cycles per sound for pitch
- Can be used for many reasons (Ex. Qualifying for the deaf olympics)
Circles = show hearing level of right ear
X = shows hearing level of left ear
Labels for hearing loss
***Based on the lowest level that you can hear
10-15 dB = normal
16-25 = slight hearing loss
41-55 = moderate hearing loss
56-70 = modertley severe hearing level
71 - 90 = sever hearing label
91+ = profound hearing levels
Hearing vs. Deaf people regarding audiologost
Hearing people may never see an audiologist/may never receive an audiogram BUT deaf people grow up seeing many audiologists/having stacks of audiograms
Word hearing Impaired
Audiologists + Speech Therapists often use Hearing impaired to describe all people with different types of hearing loss BUT this term is not embraced by deaf people
Pre vs. Post lingually deaf
Pre lingually deaf - Those who have not spoken or heard language before they became deaf (includes people born deaf)
Post lingually deaf = peolpe who speak and hear language before they became deaf (usally remeber what it is like to speak and hear before losing hearing)
Hard of Hearing
Refers to people who have slight to moderate hearing loss
Often use hearing aids + asisst devices –> this that are forms of amplifications
Why don’t amplification devices always work on HOH peolple
Before might be able to only hear high or low frequencies
Some people = can only hear low frequencies – can’t hear sounds b and d→ much of conversion has to be guesswork
OR
Can’t hear high frequencies – th or s sounds = hard to hear
People in deaf culture
Might have some hearing or HOH people who identify with deaf culture even if they do hear
Ability to hear vs. Ability to understand
Many people can’t separate someone’s ability to hear from ability to understand
Is lip reading effective?
Lip reading = usually infective because many sounds look the same on the lips
Example - ball vs. mall
Things that affect ability to hear
There are many external factors that affect ability to hear
Example - Bakcground noise + Revertbration (Many assistive devices can’t block revertbration)
Two catagories of hearing loss
- Congenital Loss –> Hearing loss before/at birth
- Acquired Loss –> Loss after birth
Two areas in the ear where hearing loss occurs
- Conductive loss – Issue in outter or middle ear
- Sensionueral Loss – Problems with inner ear or auditory never
Genetic causes of deafness
Gene mutations are cause of deafness in >50% of babies born deaf
Over 400 genes have been found to cause people to become deaf (genes can cause deafness during different times in lifecycle)
***Still trying to find all of the genes that cause people to become dead
Types of ‘deaf genes’
Non-syndormatic –> only cause people to become dead without any other physical changes (2/3 of deaf genes)
- Example – Connexin 26
Syndromic –> Affected person will ONLY be deaf if they also have additional conditions (1/3 of deaf genes)
- Example - Hunter syndrome (growth failure) + Usher syndrome (blindness) + Wardenbir Syndrome (Pigmenbtation)
Aquired Loss
Become deaf due to external factors (NOT GENES)
- Can develop during birth or any time in life
Examples - Meningitis + Menire Disease + Premature births + Fetal Alchol Syndrom + Elderly + Rubella (German Measles)
Rubella + Deafness
When have rubella = had explosion of deaf children –> NOW have rubella vaccine = the number of children getting rubella decreased = less deaf children
Most common cause for hearing loss in adulthood
Most common cause for hearing loss in adulthood = damage to hearing mechanism
Due to loud noises + drugs + aging + accidents + diseases
Conductive hearing loss
Hearing loss related to outer and middle ear
- Often outer/middle ear issues can be fixed
- Often temporary
Example - Ears that are not fully open + earwax + ear infections + physical injury
Sensorinuernal Loss
Limited to the cochlear in inner ear + connecting auditory nerve
- Cannot be repaired + usually permanent
Damage to cochlea = includes missing hair or disorder where sound is not carried from cochlea to auditory never
People = experience drastic changes in sensation of loudness
Cochlea
Transmits sound from middle ear to auditory nerve –> process includes 20,000 hairs inside the cochlea – sound moves through wavs of hair to nerve
Converts sounds to electrical impulses
Looks like snail + Size of pea
Relationship between deaf community and auditory technology
Complicated
Beleif about babies born with disabilities
For a long time there was a beleif that people born with disabikities were being punished or manifesting demonic orgins
- Babies born with disabilities (including deaf) were killed + abondoned + imprisoned
Old cured for deafness
Attempts to cure deaf people have existed for centuries (most cured only worsened the daamge)
Example - Use hot oil with boiled worms OR operation on tongue to speak (FAILED) OR shaking of head or forcing deaf people to screen so loud blood came out of mouth and ears
- Some doctors would strike head hard enough to fracture it (in hopes it would shake something loos)
Mircles cures cold by get-rich-quick medicine med included magnetic hats + bibrating machines + artifical eardrums + blowers + inhalers + massagers + oils
What happened after cruel medicine
Cruel medicine stopper but many deaf adults remember being forced to speak and lip read in school (if they tried to sign they were punished)
***Prohibition of deaf children from learning or using sign is still happening (BUT without physical punishment)
Logic behind avoiding using sign
If a deaf child doesn’t learn to sign = they will be less likely to speak and socialize with other deaf people = they can better integrate into the hearing world
Medical perspective
Utilizing auditory technology is the defauly to make deaf people into hearing people
Auditory technology over time
Auditory technology has evolved other time
Auditory technology history
Start = Ear trumpets
THEN - (1936) Hearing aids BY 1950s Hearing aides could be word by anyone
1960s-1980s - deaf children were required to wear body hearing aides at school
1984 - FDA aproval for cochlear implants for kids
1990 - Apprached cochlear implants for ages 2+
2002 - Approaved cochlear implants for 12 month old
Body Hearing Aids
Have a plastic tan case that was strppaed to chest or have a belt with cord attached to speaker system connected to a plastic ear model that fit ear canal
- Transmitted sounds at high levels that did not match audiograms
***Deaf children were often forced to wear them
Ear trumpets
Amplify sound by collecting sounds and funneling them into ear cannal
1980s cochlear implants
Although worked for some adults - others who had them in 80s/90s have traumatic stories
Side effects of early cochlear implants
Headaches + Virtogo
Children + Cochlear implants
Many children were forced to have surgery against their will OR without telling them they would have surgery –> trauama created atmosphere of distrust and resentment against new auditory innovations that involve surgery and speech training
Speech trainning + Side effects
Some deaf people argue that time spent on speech training and rishs of side effects is not worth the efforts to hear and speak
Curreent Auditory innovations (overall)
Auditory innovations ate expeirncing rapid transformation and imporvments
- Fewer side effects + new experiences
Audiologosts + Speech therapists + teachers working with new technology to idenetofy hearing loss and developing hearing and speaking skills
NOW = have new hearing level screening laws + organizations are pushing to have hearing differences detected earlier to ensure full access to language earlier
Oral Rehabilitation
Developing hearing and speaking skills
How do parents not always know their child is deaf
Because there can be small signals and movements and reactions that send confusing signals to parents
Pre-early screening laws
Before early infant screening laws (1990) - deafness was not diagnosed until later in life
- Would find deafness when caregivers realized child wasn’t responding to noises or spoken commands
EVEN today - some deaf children are not identified until older (happens more often with progressive or conductive hearing loss)
Who might miss signals child is deaf
Parents + caregivers + pediatricians + Primary care doctors + nurses
Pediatricians + Primary care doctors + nurses – might miss because have limited expereince with deaf babies
Medical professional tranining in deaf culture
Medical professionals (including audiologist) do not have training related to deaf culture + the impact of early language deprivation + sign language BUT This is changing
- Articles have been written about importance of early identification
Importance of early exposure to sign language
Ensures that deaf infants are not deprived access to language –> if not given access early then deaf infants are at risk for cognitive + social + academic delays
Test given to New borns
New borns = given automated auditory brainstem response
Automated Auditory Brainstem Response
Records brain activity with babys response to sounds –> if baby does not register a resoonse in either ear they will be rested –> if they have the same result = go to audiologost for full testing THEN go to ENT to see if there are bigger medical problems underlying hearing loss –> ENT gives clearnce to go back to audiologost
Older audiology programs
Many audiologists graduated from older audiology programs which follwoed AGB – they often do not reccomend ASL or deaf culture (not treated equal to auitory devices + surgery + rehabillitation)
- Those audiologists often reccomend listening and spoken language programs for deaf infant
- Some audiologists + speech thearpists + medical professionals recomend not using sign + some require parents to sign a contract to prevent child from using sign
Claims about audiologists
Some in the deaf community claim that audiologosts collaborate with doctors + cochlear implant industry to supply pateints for profits
Listening and spoken language programs (LSL)
Tell parents not to use sign + encourages families to avoid contact with deaf community and deaf culture
- Only focuses on training kids to speak + read lips + hear
Rebranding of oralism + oral eduction (expludes ASL and deaf culture from childrens lives)
New generations of audiologists
Emerging generations of audiologists are more likley to introduce parents to different types of early dictation programs without exluding ASL or deaf culture
New programs for early childhood
ASL/English billuguil + bimodal programs for early childhood –> promote the use of ASL + inlcude teaching spoken english for kids who have some hearing
- Embraces multimodal + multiliguil forms of eduction (as opposed to LSL)
Sign for kids with no acess to sound
For kids who do not have access to sound - signing is the option that provides full access to language
Cochlear implants + hearing aids and hearing
Children ith cochlear implants or hearing aids may not fully hear english but may use devices to support spoken english development
Early signing
An increasing number of professions are supporting the idea if providing children with oppertunities to learn ASL as early as possible - this is the safest route to follow so child does not suffer langauge deperivaton
- Sign lagnguage has been found to support child’s learning of spoken language
Being able to speack vs. Being able to hear
Being able to speak and being able to hear are two different things - means that cochlear implants and hearing aids have limitation that can be remidied by providing acess to ASL
Texting
Started with sidekicks that deaf people used to communicate –> then hearing people wanted it – thats how we got texting (because of the deaf world)
Facetime
Also came becuase of deaf world
Gaulldete Football team
Someone on the other team new how to sign – so they huddled uo so no one could see the sign –> NOW all teams huddle
Football huddle came from deaf world
Signs in Baseball
Had a deaf baseball player – used sign to communicate - how got Safe and out signs etc.
Galladete helments
Have visor that can show plays in the helmet
Instant messaging
Ties to TTY
Hearing aids
External devices
Most = come with a mold that is inserted into the ear and connects to a device that lies behind the ear
Contains: Microphone + Amplifier + Speaker
How to hearing aids work
used to amplify sounds and channel sound into inner ear
Digital hearing aids
Can reduce environmental sounds and focus on amplifying human voices
Effectiveness of hearing aids
Effectivness depends on person’s residual hearing
IF there is not much hearing left then hearing aid may not be usful
***In profoundly deaf people = turn amplification higher –> can cause squeeling + whisting
Deaf people + hearing aids
Many memebers of deaf community wear hearing aids – provide different benefits
Benefits: Acess to envirnmental sounds + speech + music
Some deaf people wear hearing aids when with hearing family and remove them in daily life OR wearing only at work when communicating with hearing
Cost of hearing aids
$1000 - $6000 (often not included in health care)
How do hearing people hear sounds
Sound goes through ear to auditory never (connected to inner ear) –> Nerve transmitts the sound (now electrical impulses) to the brain – brain interprets sound
Sensorineuonal hearing loss
Cochlea in inner ear doesn’t work – means that when sound goes through ear it does not go to auditory nerve
How do cochlear implants work
Have internal coil which is surgically implants into the cochea and attached to audiotory nerve
Implant has electrodes that allw external sounds to skip cochlea and be converted to electrical impulses that can go through nerve to brain
Imlpant = connects external sounds with nerve through device that is behind ear
***Implants do NOT amplyfy sound – transmitt sound to nerve
Take implant on/off
Device is attatched to magnet that is inserted behind the skull – device attarcts to magnet = can take on/off
Implants + residual hearing
Implants do NOT depend on the amount of hearing person has left
Who are candidates for implants
Deaf people = usually better candidates for implants as long as nerve works
Doctors usually don’t recommend for Hard-of hearing people in both ears - reccoemnd in one ear with worse hearing loss
What happens when implant cochlea implant
Can get rid of any hearing individual has left – when coil goes through cochlea if its too rigid it can damage hairs in cochlea
Criteria for sucessful Cochear implants
- Profound sensineuronal hearing loss
- Need ability to complete brain imaging appointmens (CT and MRI)
- Functional Auditory nerve
- Good speech and comprehension skills
- Evidence of limited benefit from hearing aid
- Vaccinated against infections
- Cleared for surgery
- Fincial position to cover costs
- Enjoy socializeing with hearing/non-signing people
- Acess to transprotation for long term follow uo appointments and care
- Under 18 = need tp be enrolled in educational program that supports listening and speaking
- Realistic expectations about results
- Support of freinds + family
Steps after get implant
Need to train brains to relearn or MAP impulses so the brain can interpret impulses
- Takes time to make connection between sound and brains interpretation
Impulses = different from the sounds they are used to hearing
Mapping
Programing electrical impluses in process to make sure person hears at appropriate level and can be interpreted
***Not shiny and perfect like videos
Cost of cochlear implants
Including surgery + device + rehab = $100,000 (some are covered by insurance)
Cochlear implant shelf life
5-10 years – need multiple surgeries to replace
Cochlear implant controversy
Given deaf community past with doctors + audiologist – there are doubts and reistence towards implant technology
People can’t fathom putting people through elective procedure that could have serious conseqeunces (escpially young children who don’t understand potential consequences)
Old side effects of implants
1980s - 2000s –> has reprots of partial facial paralysis + tics + dizzyness + vertigo + death (usually because infection)
Past = people had bigger scars (now smaller)
FDA + implants
FDA increased requirments to be able to get implants (protect pateints) + lowered age to 12 months old
National Associtiaon of Deaf (NAD) opinion on Implants
1993 - NAD discouraged cochlear implants in kids BUT the bumber of kids getting implants continued to increase
THEn revised statment to encourage acces to ASL espcially for kids with implants
Inacurate concerns about implants
There have been inaccurant concerns about implants that impeded ability to have consructuve dialog about implants
Example - can’ts wim or go on roller coasters or play sprots or drive hybrd cars or go scuba diving or was through TSA –> ALL not true
Life with implants
May have some lifestyle changes
Examples:
1. Implants are not always water proof
2. Cam interact with theft detection systems + metal detectors + radio transmitters + static electricity
3. Communicate with doctirs if need MRI
Complaints about current implants
Some freustrations after receiving implants:
1. Inability to upgrade implant
2. Implant damage
3. Unavalibity of replacments
4. infections
5. Implant failure
6. Skin irritation
7. dependecey on batteries + dependcy on audiologost to help with programing device
***Demagnetized implants sometimes need to be replaced
Characterization of deaf genes
Only a few dozen of the 400 genes for deafness have been characterized
***Size and complexity of these genes makes testing difficult
Tests for deaf genes
Tests are available for a few common forms of deafness (Example connexin 26 protein form GJB2 gene)
Connexin 26 gene
Whether a person is deaf because of Connexin 26 depends on parents
The tendencey of deaf people to marry other deaf people results in increase in frequencey of kids who are deaf due to connexin 26 protein BUT based on the ways in which most genes for deafness are transmitted there is no gaurentee that the child will be deaf
Purposes of genetic testing
- Diagnostic testing – Determine the genetoc statsus of deaf child or adult (now stard of care)
- Carrier tetsing - find which relatives varry gene for deafmess
- Prenatal testing - find genetic status of fetus
- Genetic testing can be used tp test embyroes with days of egg fertalization –> IVF allows parents to sleect deisred genetic outcome
- Might test to find chances of having deaf child
- Diagnostic testing can be identified in terms of knowing genetic infleunces related to preventing or prepaing to deal with complex medical conditions associtaed with syndromatic defaness
Deaf people + genetic testing
Most deaf people are resistant to genetic testing – beleive they do more harm than good
- Those who prefer to have deaf children most likely feel that their child will have a better chance of being a full participant in deaf culture
- Mostly hearing parents consider prenatal diagnosis for genetoc deafness
Hearing vs. Deaf parents
Hearing and deaf parents think differently – hearing people see deafness as medical issue to be tearted but culturally deaf people feel deafness is not a medical probelm
Genetic controversy
There are social and psycological implications related to knowing more about genetic inheritance and choices about human characteristics
Affect of prenatal testing
Process of prenatal testing creates oppertunity to decide how acceptible it is to have babies with disabilities
- If one accepts prenatal tetsing to see child’s chance of having disbaility then challenges the typical perspective that people with disabilities are entittled to be born and treated equally
People making uncommon reproductive choices
When people decide on reproductive choices that are not common other people may become upset
Example:
1. To increase the chances of having a deaf bay a deaf-lesbian couple visited a sperm bank and were informed that potential donors were eliminated if there was a possibility the child could be deaf → instead they asked a deaf friend to be a donor
- Society’s reaction – public opinion ranged from supported to oppositional
2. In England people who prefer to have deaf children are not allowed to select embryos carrying the connexin 26 mutations
Deaf visual things in House
- Lights on door bells + fire alarm + if have baby can set lights up for that (or have a monitor)
- Can have a pager like thing (tell you if door bell is ringing etc.)
Concept for Or
Becomes which
Example - You like chocolate vanila THEN which sign?
