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Home - Popdhh.ca - Provincial Outreach Program - Deaf & Hard of Hearing

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We recognize there are many areas of your child's life that are impacted by their hearing loss. The Outreach Program strives to address, support and meet the unique communication and learning styles of your child. We will encourage them to become responsible contributing members of both the Deaf and hearing communities.

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Definition, Common Traits, Challenges, and Tips

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Definition, Common Traits, Challenges, and Tips

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Definition

Hearing impairment as a disability category is similar to the category of deafness, but it is not the same. The official definition of a hearing impairment by the Individuals with Disabilities Education Act (IDEA) is "an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but is not included under the definition of 'deafness.'" Thus, knowing the definition of deafness is necessary to understand what sort of disabilities are considered hearing impairments. A hearing loss above 90 decibels is generally considered deafness, which means that a hearing loss below 90 decibels is classified as a hearing impairment.

Common Traits

The National Dissemination Center for Children with Disabilities (NICHCY) explains that hearing loss falls into four subcategories: conductive, sensorineural, mixed and central. These identify the location in the body in which the hearing impairment occurs. Hearing aids and other sound amplifying assistive technologies (AT) often work for students with conductive hearing loss, as their impairments stem from the outer or middle ear. Such does not hold true with sensorineural, mixed and central hearing losses, as these impairments stem from the inner ear, the central nervous system or a combination of the two. Typically, hearing loss is categorized as slight, mild, moderate, severe or profound, depending on how well an individual can hear the frequencies that are commonly associated with speech.

Educational Challenges

Educational obstacles related to hearing impairments stem around communication. A student with a hearing impairment may experience difficulty in:

the subjects of grammar, spelling and vocabulary

taking notes while listening to lectures

participating in classroom discussions

watching educational videos

presenting oral reports

Underscoring the difficulty that students with hearing impairments may have in presenting oral reports are the potential language development problems linked to hearing impairments. Arizona's Department of Education's Parent Information Network notes that, "Since children with hearing impairments are unable to receive some sounds accurately, they often cannot articulate words clearly."

Tips for Teachers and Parents

The National Institute on Deafness and Other Communication Disorders (NIDCD) strongly endorses early intervention. This can limit communication hurdles. Typically, both oral (speech, lip reading and use of residual hearing) and manual (sign language) communication are used with and taught to children with hearing impairments. Voice and articulation training is often recommended to help students learn to form the sounds which they cannot hear.

Designating a note taker can allow a student with a hearing impairment to concentrate fully on listening to a lecture. A combination of traditional communication, lip reading, sign language and assistive technology can compensate for issues which make listening to lectures and participating in class discussions challenging. Children who read lips often need to sit close to the teacher, while those who use sign language may use an interpreter. Turning on captions during a video can reiterate what a student may pick up from his or her amplifying device.

Finally, it's important that parents and teachers don't underestimate a child's intelligence based on a hearing impairment. Arizona's Department of Education's Parent Information Network warns, "For most children with hearing impairments, language acquisition and language development are significantly delayed. As a result, some may incorrectly estimate the child's intelligence as low." Avoid this mistake!

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What is a Hearing Impairment? Special Education Guide

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Hearing impairment as a disability category is similar to the category of deafness, but it is not the same. The official definition of a hearing impairment by the Individuals with Disabilities Education Act (IDEA) is "an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but is not included under the definition of 'deafness.'" Thus, knowing the definition of deafness is necessary to understand what sort of disabilities are considered hearing impairments.

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Over 5% of the world's population - or 466 million people - has disabling hearing loss (432 million adults and 34 million children). It is estimated that by 2050 over 900 million people - or one in every ten people - will have disabling hearing loss.

Disabling hearing loss refers to hearing loss greater than 40 decibels (dB) in the better hearing ear in adults and a hearing loss greater than 30 dB in the better hearing ear in children. The majority of people with disabling hearing loss live in low- and middle-income countries.

Approximately one third of people over 65 years of age are affected by disabling hearing loss. The prevalence in this age group is greatest in South Asia, Asia Pacific and sub-Saharan Africa.

Hearing loss and deafness

A person who is not able to hear as well as someone with normal hearing - hearing thresholds of 25 dB or better in both ears - is said to have hearing loss. Hearing loss may be mild, moderate, severe, or profound. It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds.

'Hard of hearing' refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as well as captioning. People with more significant hearing losses may benefit from cochlear implants.

'Deaf' people mostly have profound hearing loss, which implies very little or no hearing. They often use sign language for communication.

Causes of hearing loss and deafness

The causes of hearing loss and deafness can be congenital or acquired.

Congenital causes

Congenital causes may lead to hearing loss being present at or acquired soon after birth. Hearing loss can be caused by hereditary and non-hereditary genetic factors or by certain complications during pregnancy and childbirth, including:

maternal rubella, syphilis or certain other infections during pregnancy;

low birth weight;

birth asphyxia (a lack of oxygen at the time of birth);

inappropriate use of particular drugs during pregnancy, such as aminoglycosides, cytotoxic drugs, antimalarial drugs, and diuretics;

severe jaundice in the neonatal period, which can damage the hearing nerve in a newborn infant.

Acquired causes

Acquired causes may lead to hearing loss at any age, such as:

infectious diseases including meningitis, measles and mumps;

chronic ear infections;

collection of fluid in the ear (otitis media);

use of certain medicines, such as those used in the treatment of neonatal infections, malaria, drug-resistant tuberculosis, and cancers;

injury to the head or ear;

excessive noise, including occupational noise such as that from machinery and explosions;

recreational exposure to loud sounds such as that from use of personal audio devices at high volumes and for prolonged periods of time and regular attendance at concerts, nightclubs, bars and sporting events;

ageing, in particular due to degeneration of sensory cells; and

wax or foreign bodies blocking the ear canal.

Among children, chronic otitis media is a common cause of hearing loss.

Impact of hearing loss

Functional impact

One of the main impacts of hearing loss is on the individual's ability to communicate with others. Spoken language development is often delayed in children with unaddressed hearing loss.

Unaddressed hearing loss and ear diseases such as otitis media can have a significantly adverse effect on the academic performance of children. They often have increased rates of grade failure and greater need for education assistance. Access to suitable accommodations is important for optimal learning experiences but are not always available.

Social and emotional impact

Exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation, and frustration, particularly among older people with hearing loss.

Economic impact

WHO estimates that unaddressed hearing loss poses an annual global cost of US$ 750 billion. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs.

In developing countries, children with hearing loss and deafness rarely receive any schooling. Adults with hearing loss also have a much higher unemployment rate. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce.

Improving access to education and vocational rehabilitation services, and raising awareness especially among employers about the needs of people with hearing loss, will decrease unemployment rates for people with hearing loss.

Prevention

Overall, it is suggested that half of all cases of hearing loss can be prevented through public health measures.

In children under 15 years of age, 60% of hearing loss is attributable to preventable causes. This figure is higher in low- and middle-income countries (75%) as compared to high-income countries (49%). Overall, preventable causes of childhood hearing loss include:

Infections such as mumps, measles, rubella, meningitis, cytomegalovirus infections, and chronic otitis media (31%).

Complications at the time of birth, such as birth asphyxia, low birth weight, prematurity, and jaundice (17%).

Use of ototoxic medicines in expecting mothers and babies (4%).

Others (8%)

Some simple strategies for prevention of hearing loss include:

immunizing children against childhood diseases, including measles, meningitis, rubella and mumps;

immunizing adolescent girls and women of reproductive age against rubella before pregnancy;

preventing cytomegalovirus infections in expectant mothers through good hygiene; screening for and treating syphilis and other infections in pregnant women;

strengthening maternal and child health programmes, including promotion of safe childbirth;

following healthy ear care practices;

reducing exposure (both occupational and recreational) to loud sounds by raising awareness about the risks; developing and enforcing relevant legislation; and encouraging individuals to use personal protective devices such as earplugs and noise-cancelling earphones and headphones.

screening of children for otitis media, followed by appropriate medical or surgical interventions;

avoiding the use of particular drugs which may be harmful to hearing, unless prescribed and monitored by a qualified physician;

referring infants at high risk, such as those with a family history of deafness or those born with low birth weight, birth asphyxia, jaundice or meningitis, for early assessment of hearing, to ensure prompt diagnosis and appropriate management, as required;

Identification and management

Early detection and intervention are crucial to minimizing the impact of hearing loss on a child's development and educational achievements. In infants and young children with hearing loss, early identification and management through infant hearing screening programmes can improve the linguistic and educational outcomes for the child. Children with deafness should be given the opportunity to learn sign language along with their families.

Pre-school, school and occupational screening for ear diseases and hearing loss is an effective tool for early identification and management of hearing loss.

People with hearing loss can benefit from the use of hearing devices, such as hearing aids, cochlear implants, and other assistive devices. They may also benefit from speech therapy, aural rehabilitation and other related services. However, global production of hearing aids meets less than 10% of global need and less than 3% of developing countries' needs. The lack of availability of services for fitting and maintaining these devices, and the lack of batteries are also barriers in many low-income settings.

Making properly-fitted, affordable hearing aids and cochlear implants and providing accessible follow-up services in all parts of the world will benefit many people with hearing loss.

People who develop hearing loss can learn to communicate through development of lip-reading skills, use of written or printed text, and sign language. Teaching in sign language will benefit children with hearing loss, while provision of captioning and sign language interpretation on television will facilitate access to information.

Officially recognizing national sign languages and increasing the availability of sign language interpreters are important actions to improve access to sign language services. Encouraging organizations of people with hearing loss, parents and family support groups; and strengthening human rights legislation can also help ensure better inclusion for people with hearing loss.

WHO response

WHO assists Members States in developing programmes for ear and hearing care that are integrated into the primary health-care system of the country. WHO's work includes:

providing technical support to Member States in development and implementation of national plans for hearing care;

providing technical resources and guidance for training of health-care workers on hearing care;

developing and disseminating recommendations to address the major preventable causes of hearing loss;

undertaking advocacy to raise awareness about the prevalence, causes and impact of hearing loss as well as opportunities for prevention, identification and management;

developing and disseminating evidence-based tools for effective advocacy;

observing and promoting World Hearing Day as an annual advocacy event;

building partnerships to develop strong hearing care programmes, including initiatives for affordable hearing aids, cochlear implants and services;

collating data on deafness and hearing loss to demonstrate the scale and the impact of the problem;

promoting safe listening to reduce the risk of recreational noise-induced hearing loss through the WHO Make Listening Safe initiative; and

promoting social inclusion of people with disabilities, including people with hearing loss and deafness, for example, through community-based rehabilitation networks and programmes.

In 2017, the 70th World Health Assembly adopted a resolution on the prevention of deafness and hearing loss. This resolution calls upon Member States to integrate strategies for ear and hearing care within the framework of their primary health care systems, under the umbrella of universal health coverage. It also requests WHO to undertake a number of actions for promotion of ear and hearing care at global level, including many of those noted above.

(1) Disabling hearing loss refers to hearing loss greater than 40dB in the better hearing ear in adults and a hearing loss greater than 30dB in the better hearing ear in children.

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Over 5% of the world's population - or 466 million people - has disabling hearing loss (432 million adults and 34 million children). It is estimated that by 2050 over 900 million people - or one in every ten people - will have disabling hearing loss.

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A Silent World: A Hearing Impaired Life I The Feed

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Julia Gilchrist was born profoundly deaf in both ears. She tells The Feed about the alienating effect of disability. Facebook: https://www.facebook.com/SBS2Australia Twitter: https://twitter.com/sbs2 Tumblr: http://sbs2australia.tumblr.com/

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Students who are deaf or hard-of-hearing have a diagnosis, from an audiologist, which identifies the presence and degree of hearing loss. The Canadian Academy of Audiology defines hearing loss as mild (26-40 decibels), moderate (41-55 decibels), moderate to severe (56-70 decibels), severe (71-90 decibels) or profound (90+ decibels). The degree of hearing loss does not predetermine how students function in auditory, educational and social situations. Students with a moderate hearing loss may function as deaf, but with current technologies, students with severe to profound hearing loss may function as hard-of-hearing.

Meet with the student and parents prior to the school year to discuss how the school can support this student's needs related to hearing loss. This could include finding out about:

the student's strengths, interests, areas of need and method of communication

technology/equipment and support, including amplification

language development

deaf and hard-of-hearing specialist involvement

successful communication strategies used at home and in the community that could be used at school

monitoring and troubleshooting amplification.

Collaborate with the parents and student to consider if, and how, they would like to share specific information on hearing loss with peers.

Learn as much as you can about how hearing loss can affect learning and social and emotional well-being.

Reading, asking questions and talking to qualified professionals, such as an educational audiologist and a teacher with a specialized degree in the education of deaf and hard-of-hearing students will build your understanding and help you make decisions to support the student's success at school.

Access input from an audiologist to determine the appropriate communication technologies, such as a classroom sound field system or personal FM system.

Review recent assessments to identify possible delays and/or gaps in language development (e.g., extent of vocabulary development, appropriate use of vocabulary reading, writing).

Collaborate with the school, school jurisdictional team and community partners to identify and coordinate supports and services, such as a teacher with a specialized degree in the education of students with hearing loss.

Develop a system for sharing information with relevant staff members about the student's hearing loss and successful strategies.

Set up the classroom with attention to light source, room configuration and student placement. Consider sight lines (well-lit but free from glare) to the teacher, classmates and board.

Set up the classroom with attention to acoustics (e.g., reduce ambient noise from furnace fans, open windows, florescent lighting; reduce hard surfaces, such as floors and walls). As much as possible, place the student away from any remaining ambient noise.

Support daily use of the student's prescribed amplification.

Establish eye contact before speaking or signing directly to the student. If a sign language interpreter is required, talk with the interpreter about appropriate interaction practice.

Provide a variety of visual aids to support learning.

Allow extra time for the student to process and respond to information.

Use strategies to ensure that questions or discussion from peers is understood, such as repeating what is said, and using appropriate technology and/or planning with the interpreter.

Plan and provide consistent, targeted teaching in the chosen language(s) of instruction (e.g., American Sign Language [through an interpreter], and/or English and/or French).

Teach students how to recognize communication breakdowns and implement strategies to repair communication.

Provide assistive technology support, such as close captioning on DVD or Internet programs.

Use strategies to assist the student in accessing information in class, such as providing notes and/or a buddy system. Ask the student to demonstrate/verbalize understanding of concepts and language.

Check with the student to determine the need for rest breaks after long periods of speech reading or instruction in sign language.

Be aware of student-peer relationships and provide support and guidance, when necessary. Some students with hearing loss may be unaware or misunderstand incidental information and social nuances.

Promote social interaction and reduce isolation for students who use sign language by:

establishing a sign language instruction club for hearing peers, staff and, possibly, community members

providing opportunities and/or information to parents regarding opportunities to interact with other signing

students and adult role models via Skype or videoconferencing.

Provide communication support during extracurricular activities, field trips and assemblies.

Foster students' understanding of their interests, strengths and areas of need, and promote self-advocacy skills so students can ask for what they need.

1.

Do I need further conversations with the parents to better understand this student's strengths and needs?

Yes

No

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Students who are deaf or hard-of-hearing have a diagnosis, from an audiologist, which identifies the presence and degree of hearing loss. The Canadian Academy of Audiology defines hearing loss as mild (26-40 decibels), moderate (41-55 decibels), moderate to severe (56-70 decibels), severe (71-90 decibels) or profound (90+ decibels).

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Dear Hearing People - A Film by Sarah Snow & Jules Dameron

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Mild, Moderate, Severe, and Profound.

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Hearing Loss Simulator - Hear what hearing loss sounds like

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What are assistive devices?

The terms assistive device or assistive technology can refer to any device that helps a person with hearing loss or a voice, speech, or language disorder to communicate. These terms often refer to devices that help a person to hear and understand what is being said more clearly or to express thoughts more easily. With the development of digital and wireless technologies, more and more devices are becoming available to help people with hearing, voice, speech, and language disorders communicate more meaningfully and participate more fully in their daily lives.

What types of assistive devices are available?

Health professionals use a variety of names to describe assistive devices:

Assistive listening devices (ALDs) help amplify the sounds you want to hear, especially where there's a lot of background noise. ALDs can be used with a hearing aid or cochlear implant to help a wearer hear certain sounds better.

Augmentative and alternative communication (AAC) devices help people with communication disorders to express themselves. These devices can range from a simple picture board to a computer program that synthesizes speech from text.

Alerting devices connect to a doorbell, telephone, or alarm that emits a loud sound or blinking light to let someone with hearing loss know that an event is taking place.

What types of assistive listening devices are available?

Several types of ALDs are available to improve sound transmission for people with hearing loss. Some are designed for large facilities such as classrooms, theaters, places of worship, and airports. Other types are intended for personal use in small settings and for one-on-one conversations. All can be used with or without hearing aids or a cochlear implant. ALD systems for large facilities include hearing loop systems, frequency-modulated (FM) systems, and infrared systems.

Hearing loop (or induction loop) systems use electromagnetic energy to transmit sound. A hearing loop system involves four parts:

A sound source, such as a public address system, microphone, or home TV or telephone

An amplifier

A thin loop of wire that encircles a room or branches out beneath carpeting

A receiver worn in the ears or as a headset

Amplified sound travels through the loop and creates an electromagnetic field that is picked up directly by a hearing loop receiver or a telecoil (see sidebar), a miniature wireless receiver that is built into many hearing aids and cochlear implants. To pick up the signal, a listener must be wearing the receiver and be within or near the loop. Because the sound is picked up directly by the receiver, the sound is much clearer, without as much of the competing background noise associated with many listening environments. Some loop systems are portable, making it possible for people with hearing loss to improve their listening environments, as needed, as they proceed with their daily activities. A hearing loop can be connected to a public address system, a television, or any other audio source. For those who don't have hearing aids with embedded telecoils, portable loop receivers are also available.

What's a telecoil?

A telecoil, also called a t-coil, is a coil of wire that is installed inside many hearing aids and cochlear implants to act as a miniature wireless receiver. It was originally designed to make sounds clearer to a listener over the telephone. It also is used with a variety of other assistive listening devices, such as hearing loop (or induction loop) systems, FM systems, infrared systems, and personal amplifiers.

The telecoil works by receiving an electromagnetic signal from the hearing loop and then turning it back into sound within the hearing aid or cochlear implant. This process eliminates much of the distracting background noise and delivers sound customized for one's own need. For people who are hard-of-hearing who do not have a telecoil-equipped hearing aid or cochlear implant, loop receivers with headsets can provide similar benefits but without the customized or "corrected sound" feature that matches one's hearing loss pattern.

Many cochlear implants have a telecoil built into the sound processor, or can use an external telecoil accessory with both hearing aid compatible telephones and public loop systems. A simple switch or programming maneuver performed by the user activates this function.

See the NIDCD fact sheet Hearing Aids for more information.

FM systems use radio signals to transmit amplified sounds. They are often used in classrooms, where the instructor wears a small microphone connected to a transmitter and the student wears the receiver, which is tuned to a specific frequency, or channel. People who have a telecoil inside their hearing aid or cochlear implant may also wear a wire around the neck (called a neckloop) or behind their aid or implant (called a silhouette inductor) to convert the signal into magnetic signals that can be picked up directly by the telecoil. FM systems can transmit signals up to 300 feet and are able to be used in many public places. However, because radio signals are able to penetrate walls, listeners in one room may need to listen to a different channel than those in another room to avoid receiving mixed signals. Personal FM systems operate in the same way as larger scale systems and can be used to help people with hearing loss to follow one-on-one conversations.

Infrared systems use infrared light to transmit sound. A transmitter converts sound into a light signal and beams it to a receiver that is worn by a listener. The receiver decodes the infrared signal back to sound. As with FM systems, people whose hearing aids or cochlear implants have a telecoil may also wear a neckloop or silhouette inductor to convert the infrared signal into a magnetic signal, which can be picked up through their telecoil. Unlike induction loop or FM systems, the infrared signal cannot pass through walls, making it particularly useful in courtrooms, where confidential information is often discussed, and in buildings where competing signals can be a problem, such as classrooms or movie theaters. However, infrared systems cannot be used in environments with too many competing light sources, such as outdoors or in strongly lit rooms.

Personal amplifiers are useful in places in which the above systems are unavailable or when watching TV, being outdoors, or traveling in a car. About the size of a cell phone, these devices increase sound levels and reduce background noise for a listener. Some have directional microphones that can be angled toward a speaker or other source of sound. As with other ALDs, the amplified sound can be picked up by a receiver that the listener is wearing, either as a headset or as earbuds.

What types of augmentative and alternative communication devices are available for communicating face-to-face?

The simplest AAC device is a picture board or touch screen that uses pictures or symbols of typical items and activities that make up a person's daily life. For example, a person might touch the image of a glass to ask for a drink. Many picture boards can be customized and expanded based on a person's age, education, occupation, and interests.

Keyboards, touch screens, and sometimes a person's limited speech may be used to communicate desired words. Some devices employ a text display. The display panel typically faces outward so that two people can exchange information while facing each other. Spelling and word prediction software can make it faster and easier to enter information.

Speech-generating devices go one step further by translating words or pictures into speech. Some models allow users to choose from several different voices, such as male or female, child or adult, and even some regional accents. Some devices employ a vocabulary of prerecorded words while others have an unlimited vocabulary, synthesizing speech as words are typed in. Software programs that convert personal computers into speaking devices are also available.

What augmentative and alternative communication devices are available for communicating by telephone?

For many years, people with hearing loss have used text telephone or telecommunications devices, called TTY or TDD machines, to communicate by phone. This same technology also benefits people with speech difficulties. A TTY machine consists of a typewriter keyboard that displays typed conversations onto a readout panel or printed on paper. Callers will either type messages to each other over the system or, if a call recipient does not have a TTY machine, use the national toll-free telecommunications relay service at 711 to communicate. (See Telecommunications Relay Services for more information.) Through the relay service, a communications assistant serves as a bridge between two callers, reading typed messages aloud to the person with hearing while transcribing what's spoken into type for the person with hearing loss.

With today's new electronic communication devices, however, TTY machines have almost become a thing of the past. People can place phone calls through the telecommunications relay service using almost any device with a keypad, including a laptop, personal digital assistant, and cell phone. Text messaging has also become a popular method of communication, skipping the relay service altogether.

Another system uses voice recognition software and an extensive library of video clips depicting American Sign Language to translate a signer's words into text or computer-generated speech in real time. It is also able to translate spoken words back into sign language or text.

Finally, for people with mild to moderate hearing loss, captioned telephones allow you to carry on a spoken conversation, while providing a transcript of the other person's words on a readout panel or computer screen as back-up.

What types of alerting devices are available?

Alerting or alarm devices use sound, light, vibrations, or a combination of these techniques to let someone know when a particular event is occurring. Clocks and wake-up alarm systems allow a person to choose to wake up to flashing lights, horns, or a gentle shaking.

Visual alert signalers monitor a variety of household devices and other sounds, such as doorbells and telephones. When the phone rings, the visual alert signaler will be activated and will vibrate or flash a light to let people know. In addition, remote receivers placed around the house can alert a person from any room. Portable vibrating pagers can let parents and caretakers know when a baby is crying. Some baby monitoring devices analyze a baby's cry and light up a picture to indicate if the baby sounds hungry, bored, or sleepy.

What research is being conducted on assistive technology?

The National Institute on Deafness and Other Communication Disorders (NIDCD) funds research into several areas of assistive technology, such as those described below.

Improved devices for people with hearing loss
NIDCD-funded researchers are developing devices that help people with varying degrees of hearing loss communicate with others. One team has developed a portable device in which two or more users type messages to each other that can be displayed simultaneously in real time. Another team is designing an ALD that amplifies and enhances speech for a group of individuals who are conversing in a noisy environment.

Improved devices for nonspeaking people

More natural synthesized speech
NIDCD-sponsored scientists are also developing a personalized text-to-speech synthesis system that synthesizes speech that is more intelligible and natural sounding to be incorporated in speech-generating devices. Individuals who are at risk of losing their speaking ability can prerecord their own speech, which is then converted into their personal synthetic voice.

Brain-computer interface research
A relatively new and exciting area of study is called brain-computer interface research. NIDCD-funded scientists are studying how neural signals in a person's brain can be translated by a computer to help someone communicate. For example, people with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease) or brainstem stroke lose their ability to move their arms, legs, or body. They can also become locked-in, where they are not able to express words, even though they are able to think and reason normally. By implanting electrodes on the brain's motor cortex, some researchers are studying how a person who is locked-in can control communication software and type out words simply by imagining the movement of his or her hand. Other researchers are attempting to develop a prosthetic device that will be able to translate a person's thoughts into synthesized words and sentences. Another group is developing a wireless device that monitors brain activity that is triggered by visual stimulation. In this way, people who are locked-in can call for help during an emergency by staring at a designated spot on the device

Where can I get more information?

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on assistive devices:

For more information, contact us at:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: nidcdinfo@nidcd.nih.gov

NIH Publication No. 11-7672
December 2011

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Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders

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What are assistive devices? The terms assistive device or assistive technology can refer to any device that helps a person with hearing loss or a voice, speech, or language disorder to communicate.

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Hearing Aids, Cochlear Implants, and Other Devices | Canadian Academy of Audiology

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Should I get a hearing aid? Are hearing aids expensive? What is a cochlear implant? How does a cochlear implant work? Do you feel that people are mumbling?

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Members of the Deaf community in America use a different language-literally. Not only does their language-American Sign Language (ASL)-connect them to others who are Deaf, it also serves as a membership card into a linguistic subculture of our society that not everyone is privileged to enjoy.

Breaking down stigmas

Rich communication doesn't have to be
verbal.

One of the ways the Deaf distinguish themselves as a culture is by capitalizing the word Deaf and working to change mainstream America's attitude. The Deaf culture doesn't believe in using the word "disabled" because that word makes implies "less than"-as though they are lacking something. By removing the label, they are also removing any stigma that might be attached.

"It's about perspective," Deaf advocate Eileen O'Banion said. "When you are Deaf, you see the world in a different way. You communicate differently. You seek out others who are Deaf because they understand you. You don't believe you have a disability-and you don't want to be fixed."

In fact, some advocates even speak about "Deaf gain," a communication advantage afforded to those who must use means other than verbal language. The idea is that deaf people have more meaningful and intentional connection because they cannot hear.

Tough choices around cochlear implants

Meghan Watt lost her hearing after contracting HIB meningitis at the age of two. A conversation with a middle high school teacher piqued her interest in cochlear implant (CI) surgery, even though she admits she wasn't always keen on the idea. Today, she has bilateral cochlear implants.

Meghan is aware there is controversy among certain factions of the Deaf community regarding cochlear implants and is comfortable with the choices she's made. "Some don't approve of CIs and that's that," she explained matter-of-factly. "If they're happy being Deaf, that's great. That's their decision. I like being able to hear what's going on around me."

Some members of the Deaf community are opposed to cochlear implant surgery-especially for infants who are born without hearing. They believe every person deserves the right to choose for themselves whether they want to remain Deaf and encourage parents to begin teaching ASL as the baby's first language. Some activists believe learning language and cognitive development through ASL is a basic human right that should be protected and that choosing cochlear implants steers families away from learning ASL and embracing Deaf culture.

Audism and oralism

Nine out of 10 Deaf infants are born to hearing parents. Many of those parents choose cochlear implant surgery as soon as they are medically able because it helps their child with speech development.

But the Deaf culture believes mainstream hearing America puts too much emphasis on the spoken word. They maintain ASL is a complete language, even though they don't produce words with their mouths and voices.

Some activists talk about audism-an attitude of superiority based on an ability to hear-and oralism-advocacy or use of the oral method of teaching Deaf students to speak. Audism and oralism, activists maintain, degrade ASL and interfere with the Deaf person's ability to develop speech and listening skills.

"Deaf culture is important because it allows individuals to be who they are," O'Banion explained, "and live in a way that is unique to them. There's more to a person than whether or not they can hear, so don't just focus on their ears."

American Sign Language (ASL)

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), ASL is a complete, complex language consisting of signs made by the hands, facial expressions and body language. The National Association of the Deaf (NAD) calls ASL the "backbone of the American Deaf culture."

"Many who are not familiar with ASL think it's English and hand gestures," O'Banion said. "It's not. Signing is different between countries and regions, much like the spoken word is different between countries and regions."

While the origins of sign language are not clear, most agree that it began almost 200 years ago and has been evolving ever since. Like modern language, sign language has different accents, rhythms, rules for pronunciation, word order and grammar. The language is so complex, some members of Deaf culture say they can identify when a person learned ASL simply by observing the way they sign.

How to communicate with a Deaf person

Fortunately, you don't need to know ASL in order to know how to communicate with a Deaf person. According to a tip sheet developed by the Rochester Institute of Technology, one of the country's premiere learning institutions for the Deaf, there are five guidelines to remember when communicating with the Deaf.

1. Acknowledge the fact that your first attempts to communicate will feel awkward and uncomfortable. This will pass as your interaction progresses.

2. It's OK to use paper and pen. In fact, the Deaf person will appreciate your efforts even more if you use a combination of communication methods, such as hand gestures, facial expressions and the written word.

3. Take the time to communicate and connect. Deaf people consider communication an investment of time and effort. Slow down, take your time and ask for clarification if you need it.

4. Understand that Deaf people listen with their eyes. Vision is the most useful tool they have to communicate and receive information. For this reason, only speak when you have eye contact, even if they are using an interpreter. Maintaining eye contact is a sign of respect.

5. Use the beginning and ending of a conversation as an opportunity to make physical and visual contact with the Deaf person, especially if they have been using an interpreter during your conversation. Smile, shake hands, touch their arm (if appropriate) and make eye contact.

More: Top universities for Deaf students

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Deaf culture and community: Why it is important

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Members of the Deaf community in America use a different language-literally. Not only does their language-American Sign Language (ASL)-connect them to others who are Deaf, it also serves as a membership card into a linguistic subculture of our society that not everyone is privileged to enjoy.

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What is American Sign Language?

American Sign Language (ASL) is a complete, natural language that has the same linguistic properties as spoken languages, with grammar that differs from English. ASL is expressed by movements of the hands and face. It is the primary language of many North Americans who are deaf and hard of hearing and is used by some hearing people as well.

Is sign language the same in other countries?

There is no universal sign language. Different sign languages are used in different countries or regions. For example, British Sign Language (BSL) is a different language from ASL, and Americans who know ASL may not understand BSL. Some countries adopt features of ASL in their sign languages.

Where did ASL originate?

No person or committee invented ASL. The exact beginnings of ASL are not clear, but some suggest that it arose more than 200 years ago from the intermixing of local sign languages and French Sign Language (LSF, or Langue des Signes Française). Today's ASL includes some elements of LSF plus the original local sign languages; over time, these have melded and changed into a rich, complex, and mature language. Modern ASL and modern LSF are distinct languages. While they still contain some similar signs, they can no longer be understood by each other's users.

How does ASL compare with spoken language?

ASL is a language completely separate and distinct from English. It contains all the fundamental features of language, with its own rules for pronunciation, word formation, and word order. While every language has ways of signaling different functions, such as asking a question rather than making a statement, languages differ in how this is done. For example, English speakers may ask a question by raising the pitch of their voices and by adjusting word order; ASL users ask a question by raising their eyebrows, widening their eyes, and tilting their bodies forward.

Just as with other languages, specific ways of expressing ideas in ASL vary as much as ASL users themselves. In addition to individual differences in expression, ASL has regional accents and dialects; just as certain English words are spoken differently in different parts of the country, ASL has regional variations in the rhythm of signing, pronunciation, slang, and signs used. Other sociological factors, including age and gender, can affect ASL usage and contribute to its variety, just as with spoken languages.

Fingerspelling is part of ASL and is used to spell out English words. In the fingerspelled alphabet, each letter corresponds to a distinct handshape. Fingerspelling is often used for proper names or to indicate the English word for something.

How do most children learn ASL?

Parents are often the source of a child's early acquisition of language, but for children who are deaf, additional people may be models for language acquisition. A deaf child born to parents who are deaf and who already use ASL will begin to acquire ASL as naturally as a hearing child picks up spoken language from hearing parents. However, for a deaf child with hearing parents who have no prior experience with ASL, language may be acquired differently. In fact, 9 out of 10 children who are born deaf are born to parents who hear. Some hearing parents choose to introduce sign language to their deaf children. Hearing parents who choose to have their child learn sign language often learn it along with their child. Children who are deaf and have hearing parents often learn sign language through deaf peers and become fluent.

Why emphasize early language learning?

Parents should expose a deaf or hard-of-hearing child to language (spoken or signed) as soon as possible. The earlier a child is exposed to and begins to acquire language, the better that child's language, cognitive, and social development will become. Research suggests that the first few years of life are the most crucial to a child's development of language skills, and even the early months of life can be important for establishing successful communication with caregivers. Thanks to screening programs in place at almost all hospitals in the United States and its territories, newborn babies are tested for hearing before they leave the hospital. If a baby has hearing loss, this screening gives parents an opportunity to learn about communication options. Parents can then start their child's language learning process during this important early stage of development.

What research does the NIDCD support on ASL and other sign languages?

The NIDCD supports research on ASL, including its acquisition and characterization. Funded research includes studies to understand sign language's grammar, acquisition, and development, and use of sign language when spoken language access is compromised by trauma or degenerative disease, or when speech is difficult to acquire due to early hearing loss or injury to the nervous system.

Study of sign language can also help scientists understand the neurobiology of language development. In one study, researchers reported that the building of complex phrases, whether signed or spoken, engaged the same brain areas. Better understanding of the neurobiology of language could provide a translational foundation for treating injury to the language system, for employing signs or gestures in therapy for children or adults, and for diagnosing language impairment in individuals who are deaf.

The NIDCD is also funding research on sign languages created among small communities of people with little to no outside influence. Emerging sign languages can be used to model the essential elements and organization of natural language and to learn about the complex interplay between natural human language abilities, language environment, and language learning outcomes. Visit the NIH Clinical Research Trials and You website to read about these and other clinical trials that are recruiting volunteers.

Where can I find additional information about American Sign Language?

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

For more information, contact us at:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: nidcdinfo@nidcd.nih.gov

NIH Publication No. 11-4756
March 2019

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American Sign Language (ASL) is a complete, natural language that has the same linguistic properties as spoken languages, with grammar that differs from English.

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Imagine trying to learn a lesson in a classroom trapped inside of a clear sound-proof box. The only way you can gather information is visually and you will be tested on what you've learned - or were supposed to have learned - at the end of the day. Seems a bit unfair, doesn't it?

The only way you can gather information is visually and you will be tested on what you've learned - or were supposed to have learned - at the end of the day. Seems a bit unfair, doesn't it?

This could be anything from the basic ABC's to complex mathematical equations - deaf and hard-of-hearing students face many challenges in their day-to-day lives. So much so that their challenges in the classroom are all too often over-looked.

With that being the case, here are 10 challenges that deaf and hard-of-hearing students face in the classroom, along with guidelines for teachers on how to mitigate them:

Also, we recommend not placing a deaf or hard-of-hearing student near the A/C unit in a portable building or near a window. Hearing aids can pick up and amplify all outside sounds - making it impossible to understand what is happening inside of the classroom if you place a student by a window. Be mindful that if there is carpet in the room-it helps with the distinction of sounds versus hardwood floors, allowing sounds to bounce around and become overwhelming.

To minimize this educational gap, teachers could present the directions of tasks in an assortment of ways to be positive that the deaf student will comprehend and complete tasks properly. It is important to not assume that because a student can hear sound and voices, that he or she can distinguish speech and process acoustical language.

This lack of engagement and attention often wears on the child, making them tired and can cause headaches. When arranging seating charts, keep in mind that it is best to incorporate deaf students into smaller groups. This will help the child relax and focus on their school work rather than unwanted, distracting social interactions.

These are only 10 of the many challenges that deaf and hard-of-hearing students face in the classroom, and we hope it helps open conversations in your school and district about taking a few additional steps to assist deaf students in the classroom. By acknowledging the challenges deaf students are facing and implementing strategies to alleviate those learning barriers, teachers create a learning environment that will benefit all students every day.

For more, see:

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10 Challenges Deaf Students Face in the Classroom

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Imagine trying to learn a lesson in a classroom trapped inside of a clear sound-proof box. The only way you can gather information is visually and you will be tested on what you've learned - or were supposed to have learned - at the end of the day.

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http://www.lynnterry.tv/299/deaf/ A bit of truth and a bit of humor about being partially deaf and how it affects me (and the people around me) in everyday life...

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Assistance Dogs International : Hearing Dogs

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Hearing Dogs assist deaf and hard of hearing individuals by alerting them to a variety of household sounds such as a door knock or doorbell, alarm clock, oven buzzer, telephone, baby cry, name call or smoke alarm. Dogs are trained to make physical contact and lead their deaf partners to the source of the sound.

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APPLICANT FAQ

What types of dogs does PAWS use?
How does PAWS get the dogs they train to be Assistance Dogs?
Can PAWS train a client's own dog to be their Assistance Dog?
Can a PAWS Dog alert me to oncoming seizures or provide support while I'm walking?
What tasks are PAWS Dogs trained to do?
What tasks are PAWS Dogs NOT trained to do?
Who is eligible to apply for a PAWS Dog?
What are the age requirements to apply?
How much does it cost?
How long is the application process?
I completed the application process, but haven't been matched to a dog yet. Why?
What if I have other pets in my home?
How old are the dogs when the clients receive them?
What are the responsibilities of the client who receives a PAWS Assistance Dog?
Can Assistance Dogs live in apartments and go in public places?

What types of dogs does PAWS use?

PAWS Service Dogs, Seizure Response Dogs and Service Dogs for Children with Autism are primarily Labrador Retrievers, Golden Retrievers and crosses of the two breeds. PAWS Hearing Dogs may be Retrievers or small breed dogs. Occasionally, PAWS has Poodles or Poodle mixes reserved for clients in need of a hypo-allergenic dog. All dogs must pass specialized health and temperament screenings to be accepted into training.

How does PAWS get the dogs they train to be Assistance Dogs?

Some of our dogs are donated by private individuals or breeders, while others come from our own strategic breeding program. PAWS makes every attempt to rescue dogs from animal shelters for training when qualified dogs are available.

Can PAWS train a client's own dog to be their Assistance Dog?

Due to the highly specialized nature of Assistance Dog work, we do not consider a client's own dog for training.

Can a PAWS Dog alert me to oncoming seizures or provide support while I'm walking?

We do not train dogs to predict seizures, only to respond to a seizure that is happening. PAWS does not train dogs to provide weight-bearing support while walking, but may train a dog to counter-balance for a client needing mobility assistance.

What tasks are PAWS Dogs trained to do?

PAWS Dogs have over 40 tasks they could be trained in, including retrieving and delivering dropped items, tugging to remove items of clothing and opening doors. Service Dogs may pull a lightweight manual wheelchair or turn lights on and off. Hearing Dogs primarily alert and orient clients to common sounds. Seizure Response Dogs respond to a client's seizure by summoning help or providing stimulation. Service Dogs for Children with Autism act as a constant companion to a child to help them improve social, communication and life skills.

What tasks are PAWS Dogs NOT trained to do?

We do not train Guide Dogs for people who are blind, for diabetic alert/response, to anticipate or detect medical symptoms, for the primary benefit of emotional comfort, to recognize and/or manage undesirable human behavior, to provide supervision, navigation, or safety from environmental hazards, to respond aggressively, to provide personal protection or to assist with the management of mental illness (such as PTSD, etc.) as a primary condition.

Who is eligible to apply for a PAWS Dog?

People with a physical disability, hearing impairment, seizure disorder or a child with autism who can demonstrate that an Assistance Dog will enhance their independence or their quality of life are qualified to apply. PAWS can only accept a limited number of applications per year from individuals who live in areas serviced by a PAWS Field Representative. Although many individuals with disabilities are eligible and in need of an Assistance Dog, PAWS will determine and select individuals where the tasks provided by PAWS' highly trained dogs will be of the greatest benefit.

What are the age requirements to apply?

Individuals applying for a Service or Seizure Response Dog must be at least 14 years old with age appropriate cognitive ability. Those applying for a Hearing Dog must be 18 years or older. Families applying for a Service Dog for Children with Autism must have a child with autism between 4-12 years old: application must be received by 7th birthday; Needs Assessment completed by 9th birthday; placement prior to 12th birthday.

How much does it cost?

The dog is provided at no cost to the client. However, PAWS needs to raise $30,000 to cover the cost of breeding, care, customized training and continued support of each team. The significant majority of funds raised by PAWS come from individual donors. PAWS also receives support from businesses, foundations and community groups (eg: AMVETS and AMVETS Auxiliaries, Lions and Lionesses, Order of the Eastern Star).

PAWS promotes a "pay it forward" culture. Once a client achieves certification, we encourage them to consider hosting a Personal Campaign to benefit another client still waiting for a PAWS Dog. We are happy to work with certified clients willing to fundraise on PAWS' behalf, and have the tools to make it easy.

Accepted clients in the waiting pool for a PAWS Dog who wish to host a Personal Campaign for PAWS may do so. However, it is not a requirement to receive a PAWS Dog, nor will it help a waiting client get a dog more quickly.

For more information on giving to PAWS, click here.

How long is the application process?

From the time an application is received to the completion of the in-home Needs Assessment can be as long as 24 months. If a client is accepted into the program after the Needs Assessment, they will go into the pool of all clients waiting to be paired with a PAWS Dog. For all clients in the "waiting pool", the search to find an appropriate dog begins right away. However, depending on the individual needs of the client, and the individual qualities of the dogs in training available, it may take another 1-4 years to find the right match.

I completed the application process, but haven't been matched to a dog yet. Why?

Finding the right dog to match your specific needs, personality and environment is not an exact science. Many factors are taken into consideration, with the ultimate goal being to find the best dog to meet your unique needs. Also, not every dog successfully completes training; sometimes we must start the matching process over.

What if I have other pets in my home?

PAWS does place an Assistance Dog in homes that have cats, birds or other small caged pets. Effective September 1, 2012, no PAWS Assistance Dog will be placed in a home with any other dog, unless it is a retired PAWS Dog or working Assistance Dog from an Assistance Dogs International or International Guide Dog Federation-accredited agency for someone else in the household. It has been our experience that other dogs in the home can interfere with the bonding and training process of the Assistance Dog Team.

How old are the dogs when the clients receive them?

Typically, dogs are approximately 18-24 months old.

What are the responsibilities of the client who receives a PAWS Assistance Dog?

Clients must be able to follow through with the in-home and public (if applicable) training process with their local PAWS Field Representative. Clients must be committed to maintaining the dog's training throughout the lifetime of the team and to providing for the well-being of the dog (veterinary care, proper grooming, exercise, etc.). It is advisable to research yearly veterinary, grooming and feeding costs in your specific area prior to applying for an Assistance Dog. Paws With A Cause provides ongoing training support for its teams.

Can Assistance Dogs live in apartments and go in public places?

Yes. The Americans with Disabilities Act guarantees the right of a person with a qualifying disability to be accompanied by their individually trained Assistance Animal in public venues. The Fair Housing Act allows for trained Assistance Animals in apartments or other no-pet housing at no additional cost to the person with a disability. More information can be found at www.ada.gov and www.usdoj.gov/crt/housing/title8.php

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HEARING DOGS PAWS Hearing Dogs are custom-trained to assist people who are deaf or hard of hearing by physically alerting their partner to common sounds such as a smoke alarm, doorbell, alarm clock, telephone ring or child's cry. A Hearing Dog...

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Understanding the Hearing Impaired (Helping #4)

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Understanding the hearing impaired is the first step towards effectively interacting with these individuals.Watch More Health Videos at Health Guru: http://www.healthguru.com/?YT

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About UDL When applied to learning, Universal Design becomes a framework for teaching and learning that addresses the widest possible variety of learning needs, styles, and preferences. It recognizes that each of us has preferred modes of receiving and processing information or demonstrating knowledge and abilities.