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Children's Hearing |
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Children have better hearing sensitivity than the accepted normal range for adults. The normal range of hearing for children is between -10dB to +15dB. It is not uncommon for children to have unrecognized hearing loss. Instead the teacher may tell the parents that the child is not "paying attention", or has "difficulty following directions", or the child is not learning as well as expected. Unfortunately, many children, especially with mild hearing losses, are misidentified as having ADD or ADHD. School hearing screening programs tend to use hearing testing equipment which is calibrated to adult hearing standards. Thus, many children are missed in school hearing screenings. This information from the Educational Audiology Association should be used as a guide to the educational ramifications of common levels of hearing loss in children. Normal Hearing - -10dB to +15dB The Child will detect the complete speech signal even at soft conversation levels. However, good hearing does not guarantee a good ability to discriminate speech sounds in the presence of background noise. Minimal Hearing Loss - 15dB to 25dB The child has difficulty "understanding" faint or distant speech but not in "hearing" speech. In other words, speech is very audible but it is not very intelligble. With a 15dB hearing loss, the student can miss 10% of the speech signal when the teacher is greater than 3 feet away and when the classroom is noisy. Child will be unable to tell short vowel sounds apart if presented in noise. Child will respond to own name accurately; but will not master pre-reading skills easily. Child may appear lost "in their own little world". Behaviors may mimic ADD or ADHD children. Child may speak very softly. Mild Hearing Loss - 26dB to 40dB Learning problems become apparent to teachers, but not hearing problems. Reading skills significantly impacted with the child unable to tell that certain consonant sounds are present. With 30dB hearing loss, child can miss 25 to 40% of the speech signal depending on the noise level in the classroom, the distance from the teacher, and the configuration of the hearing loss. Often confused with ADD and ADHD children, child has difficulty following directions, doesn't complete assignments, and difficulty sustaining attention to a teacher's oral presentations. The child will frequently ask for repetition of directions, may respond inappropriately, be impulsive and doesn't seem to listen. Child will respond to name when called; but may misunderstand directions. Self concept begins being affected. The child often does not know they can not hear well. School hearing screening programs often miss a child with this degree of hearing loss. Child may speak very softly. Barriers beginning to build with negative impact on self esteem as child is accused of "hearing when he or she wants to," "daydreaming," or "not paying attention." Child begins to lose ability for selective hearing and has increasing difficulty suppressing background noise which makes learning environment stressful. Parents notice child is more "hyper" or tired when they return from school. Research studies have shown that this degree of hearing loss affects one third of ALL children on any one school day with more being affected in K through 3rd grade, up to 50% of the children. These appalling facts are due to allergies, colds, and undetected permanent hearing loss. Moderate Hearing Loss - 41dB to 55dB Teachers and parents begin to realize a hearing problem is likely. The child will only understand conversational speech at a distance of 3 to 5 feet (face to face) only if structure and vocabulary are controlled. Without amplification the amount of speech signal missed can be 50% to 75% with a 40dB loss and 80% to 100% with a 50 dB loss. This level of hearing loss is often the maximum hearing loss due to colds, allergies, or ear infections. If hearing loss is from birth, child's speech is likely to be delayed or defective syntax, limited vocabulary, imperfect speech production and an atonal voice quality. Moderate to Severe Hearing Loss - 56dB to 70dB If the child has no amplification, conversation must be very loud to be understood. At 55dB hearing loss, the child can miss up to 100% speech information. Pre-reading skills impossible to master without special resource help. Child will have marked difficulty in school situations requiring verbal communication in both one-to-one and group situations. Child likely to have delayed language skills, syntax, reduced speech intelligibility and atonal voice quality. Child may be judged by peers and teachers as a less competent learner. Child is often a social outcast due to the difficulty to communicate easily. Self concept and feelings of rejection likely. Child lacks access to common information known easily by hearing peers such as names of school personnel. Severe Hearing Loss - 71dB to 90dB Without amplification, the child may hear loud voices about one foot from ear. When amplified optimally, children with hearing ability of 90dB or better should be able to identify environmental sounds and detect all the sounds of speech. Teachers and parents often investigate alternative methods of communication like sign language or cued speech to facilitate communication. Child may began choosing friends with like hearing impairments. Understanding speech when it is noisy becomes impossible. Child, with and without hearing aids, requires Assistive Listening Technology to combat normal classroom noise. Child has to be taught every bit of information likely learned by normal hearing peers effortlessly. In other words, child can not learn information by casually overhearing it. Ordinary information taken for granted by hearing peers, such as the "z" sound in the word "rose" is unknown to the child unless taught. Profound Hearing Loss - 91dB or more The child is aware of vibrations more than a tonal pattern. Speech is completely unintelligible. Child will respond on vision rather than hearing as a primary avenue for communication and learning. Detection of the speech signal is dependent upon loss configuration and use of amplification. In infants, speech and language will not develop spontaneously unless amplified before six months. Child, parents, and teachers seek alternative methods of communication. Teaching efforts are intensive, comprehensive, and unrelenting. Unilateral Hearing Loss - (Hearing loss in one ear only) The child will have difficulty understanding faint or distant (more than three feet) speech. The child will have difficulty localizing sounds and voices. The child will not be able to understand speech when it is noisy or reverberant. The child will miss learning opportunities which depend on "overhearing teacher's directions to another child". Child may be accused of selective hearing due to discrepancies in speech understanding in quiet versus noise. Child may have behavior problems due to fatigue, inattention, or frustrations. Child likely to fail a grade or two in school. Child misses most of group discussions. Child likely to pass most school hearing screenings. Educationally, child will require teaching efforts the same for a child with a moderate bilateral (both ears) hearing loss. Child does much better in an amplified classroom where the teacher's voice is slightly louder than the classroom environmental noise.
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