iii.

Lesson Proper
MODULE 8 DEAF AND HARD HEARING LEARNERS
VOCABULARY WORDS:
ASSISTIVE LISTENING DEVICE – are personal amplifiers designed to enhance sound levels
during in-person talks and small group conversations.
DEAFNESS – a hearing impairment that is so severe that the child is impaired in processing
linguistic information through hearing, with or without amplifications, that adversely affects a
child’s educational performance.
Hearing Impairment – is an impairment in hearing, whether permanent or fluctuating that
adversely affects a child’s educational performance but that is not included under the definition
of deafness.

DEFINITION
The Deaf community are "those deaf and hard-of-hearing individuals who share a
common language, common experiences and values and a common way of interacting with
each other and with hearing people" (NL Association of the Deaf, n.d.). They have a different
take when it comes to labelling. If an individual is totally deaf, it is fine with them to be called
"Deaf", especially those who have embraced deaf culture and communicate through sign
language. The term "deaf" (with small letter d) is usually used for those who are hard-of-hearing
with hearing aids or cochlear implants. However, the use of the term d/Deaf learners is more
inclusive and usually identifies both type of disability under hearing impairment.
In IDEA 2004, the term hearing impairment means "an impairment in hearing, whether
permanent or fluctuating, that adversely affects a child's educational performance but that is not
included under the definition of deafness in this section. (IDEA 20 U.S.C. $1401 [2004], 20
C.F.R. $300.8[c] [5]). There are two main categories of hearing impairment, Deafness and Hard-
of-Hearing. Deafness "means a hearing impairment that is so severe that the child is impaired in
processing linguistic information through hearing. with or without amplification, [and] that
adversely affects a child's educational performance." (IDEA 20 U.S.C. §1401 [2004], 20 C.F.R.
$300.8[c][3]). While Hard-of-hearing learners, with the use of hearing aid, has residual hearing
sufficient to enable successful processing of linguistic information through audition (Brill, et al,
1986). Also, a common term in deaf education is hearing loss, which means a loss in hearing,
whether permanent or fluctuating, that adversely affects a child's education performance but
that is not included under the definition of deafness in this section (PL 108-446, 20 U.S.C.
§1401 [2004], 20 CFR $300.8[c][5]).
The Deaf community embraces deaf culture that is achieved through socialization and
understanding that Deafness is "not a disability that needs to be fixed" but rather as an identity
that has a rich history, tradition, and language of its own (Obasi, 2008). There are factors to be
considered as á member of the Deaf community: (a) being deaf, (b) using sign language as a
means of communicating, and (c) attending residential school for the deaf The Deaf community
prefers the use of terms such as Teacher of the Deaf, School for the Deaf, and Deaf person
(which does not follow the first-person policy when it comes to labelling).
TYPES OF HEARING LOSS
A conductive hearing impairment is a condition when there is a disruption in the transmission
or sound in the middle or outer ear.
A sensorineural hearing impairment is characterized by issues with the inner ear or with the
connection to the brain.
A mixed hearing impairment refers to a condition when both types of hearing impairments,
conductive and sensorineural are present simultaneously.
CLASSIFICATION OF HEARING LOSS
Unilateral Hearing Loss – is a hearing loss on one side of the ear, either left or right.
Bilateral Hearing Loss – both ears have hearing loss.
CLASSIFICATION OF HEARING LOSS ACCORDING TO THE ONSET IN WHICH IT WAS
ACQUIRED
Congenital Hearing Loss – acquired at birth.
Acquired Hearing Loss – present after birth.
Pre-lingual Hearing Loss – acquired before the development of spoken language.
Post-lingual Hearing Loss – acquired after learning the spoken language.

CAUSES OF CONGENITAL HEARING LOSS

Genetics plays a crucial role in acquiring hearing loss. Genes that cause hearing loss
can comes both parents. It is possible that both parents may have recessive genes that cause
hearing loss but was passed down to their offspring as active otherwise called autosomal
recessive hearing loss. This happens when there is a history of the parent’s lineage on
hearing loss. While, on the other hand, if one of the parent’s manifest hearing losses and
passes it down to its offspring is what we call autosomal active hearing loss.
There are also other causes of congenital hearing loss such as maternal rubella, which
is an illness in infants that results from maternal infection with rubella virus during pregnancy.
Premature or early birth delivery and low birth rate can also cause hearing loss.
CAUSES OF ACQUIRED HEARING LOSS
Otitis Media is a middle ear infection, which may result in hearing loss that is permanent
or temporary. Otitis media is most common in young children but can occur at any age. Acute
Otitis Media (AOM) is a rapid-onset infection that results in inflammation, erythema, and
accumulation of fluid in the middle ear, located beneath the eardrum. This may result in fever,
ear discomfort and temporary hearing loss. Otitis media with effusion (OME), commonly referred
to as glue ear, is the accumulation of fluid in the middle ear without any accompanying infection.
This can result in impaired hearing and challenges in maintaining balance. Chronic suppurative
otitis media (CSOM) is persistent infection of the middle ear that can cause harm to the eardrum
and the small bones in the middle ear. This can result in permanent hearing impairment.
Another cause of hearing loss is meningitis, which is an inflammation of the meninges,
the protective membranes that surround the brain and spinal cords caused by a virus, bacteria,
fungi or parasites. This is the most leading type of cause of a post-lingual hearing loss (Heward
et al., 2018).
Excessive exposure to noise also leads to the degradation of one’s audition, Sound that
are amplified to 120 dB to 150 dB are already destructive to a typical person’s ears. Such as
noise-induced hearing loss becomes unnoticed, especially if an individual workspace is exposed
in a noisy as aircraft operators, sound operators, construction workers may acquire hearing loss
due to excessive exposure to noise.
IDENTIFICATION AND ASSESSMENT
Hearing loss is measured in terms of intensity or loudness of the sound produced
through decibels (dB). Intensity, refers to the amount of energy a sound has over an area. For
example, a sound produced in a small area has more intensity than in a larger area. This is why
small sounds like whispers or even our heartbeat can be heard in a small area compared to a
wide and noisy one. The higher the intensity of the sound, the louder it is. A 0 dB is the softest
level measured during the test, and 120 dB is the loudest level. A whisper typically has a sound
intensity of approximately 10 dB, while thunder has a sound intensity of around 100 decibels.
Listening to sounds beyond 85 dB will be painful for the ears that may lead to hearing loss if
prolonged. The threshold of pain is reached at 120 dB while the zero-decibel level is frequently
called the zero hearing-threshold level, or audiometric zero.
The pitch of the sound helps us identify between low and high sounds. Frequency,
which is expressed in hertz (Hz) units, is the quantity of vibrations a sound wave experiences in
a unit of time; a higher frequency corresponds to a lower pitch. Humans can normally hear
sounds between 20Hz and 20,000Hz (20kHz) (Clason, 2021). Frequencies in speech range
from 80 to 8,000 Hz, but most speech sounds have energy in the 500- to 2,000-Hz range.
Testing an individual's ear will vary depending on the type of assessment tool used to measure
the amount of decibels and hertz a person is able to hear.
Normal hearing 0-25 dBHL
Mild Loss 25-40 dBHL
Moderate Loss 40-55 dBHL
Moderate to Severe Loss 55-70 dBHL
Severe Loss 70-90 dBHL
Profound Loss 91 dBHL +
(dbHL decibels hearing level)
Source: How Hearing is Measured | Ear Associates & Rehabilitation Services of San Jose
California. (n.d.). [Link]
 Health Professional Role
Doctor/General Conducts a basic hearing screening to assess the condition of the
Practitioner ears.
Refers patients to the suitable healthcare specialists
Audiologist Expert in assessing and providing non-medical interver for
hearing loss:
 Conducts a comprehensive auditory examination
 Conducts a comprehensive diagnostic assessment
 Provides and customizes hearing aids
 Provides psychotherapy and auditory rehabilitation
services
 Provides guidance on the preservation of hearing and the
utilization of equipment that aid in hearing
Otolaryngologist A specialized physician who focuses on the medical and surgical
care of patients with diseases and disorders affecting the ear,
nose, throat (ENT), and other components in the head and neck
Source: Hearing Loss | Chapter 2: Definitions, ldentification, and Professionals / Trinity
University. (n.d.). https:/[Link]/sites/students-vision-hearing-loss/hearing-
loss/definitions-identifications-identifictaion-professionals#professionals
Pure Tone Audiometry
Pure-tone threshold audiometry or Pure-tone audiometry is a method of measuring an
individual's ability to hear specific pure tones that have been carefully calibrated. In other words,
it determines the type and severity of hearing loss by identifying which frequencies, an individual
has difficulty hearing. There are three main methods used: (a) manual audiometry, also called
conventional audiometry; (b) automatic audiometry, also known as Békésy audiometry; and (c)
computerized audiometry (Guidelines for Manual Pure-Tone Threshold Audiometry, 2005). The
examiner uses an audiometer, an electrical apparatus that produces pure tones at varying levels
of intensity and frequency. A majority of audiometers emit tones in 5-dB increments ranging from
0 to 120 dB. Each decibel level is delivered over several frequencies, often beginning with 125
Hz and progressing in octave intervals (doubling in frequency) up to 8,000 Hz. The child, who is
provided with sound input either through earbuds (air conduction) or through a bone vibrator
(bone conduction), is given instructions to press a button upon hearing a sound and release it
when there is no sound. In order to determine the hearing level on audiogram, the child must be
able to consistently detect a sound at that level at least 50% of the time. For instance, a child
with a hearing loss o1 60 decibels (dB) is unable to perceive a sound unless it reaches a
minimum volume of 60 dB. The results then are plotted in an audiogram.

Sample Audiogram
Source: [Link] clik-evoked waveforms and
Average hearing thresholds for younger and older [Link]
Speech Audiometry
Speech audiometry is a general term used to describe a collection of audiometric tests
using speech as the stimulus. Speech audiometry can be conducted by exposing the individual
to speech in both quiet conditions and in the presence of noise, such as speech babble or
speech noise. Audiologists employ speech audiometry to assess an individual's ability to
perceive and comprehend spoken language. The speech-reception threshold (SRT) refers to
the decibel level at which an individual is able to comprehend speech. An approach to quantify
the SRT involves administering a series of two-syllable syllables to the individual, evaluating
each ear independently. Audiologists commonly utilize the decibel threshold at which an
individual comprehends fifty percent of words as an approximation of the SRT.
Alternative Audiometric Techniques

 Play Audiometry. During play audiometry, the child is instructed to engage in

straightforward and specific tasks, such as retrieving a toy or placing a ball into a cup
whenever she detects the signal, which can be either pure tones or speech.
 Operant Conditioning Audiometry. In this assessment method, the child is rewarded with
a token or candy for pressing a button when a light and sound are presented together.
 Behavior Observation audiometry. A non-invasive assessment technique that involves
observing the child's responses to noises. An auditory stimulus is gradually intensified
until a consistent reaction, such as the movement of the head, blinking of the eyes, or
stopping of play, is consistently seen.
CHARACTERISTICS
The characteristics of learners with hearing impairment vary widely depending on the
case of their hearing loss. There are those learners who find amplification of sounds useful
for their residual hearing, while some prefer the use of visuals and sign language when
communicating. However, here are some of the characteristics that are common among
those with hearing impairment:

 May have difficulty with speech, reading, and writing due to the close relationship of
language and hearing.
 Fail or may take time to respond quickly with spoken or verbal instructions.
 May use hearing aids and/or amplification systems to enhance oral communication.
 May prefer to use visuals or American/Filipino Sign Language as their mode of
communication.
 Their expressive language may vary based on their experience and development.
 Have a large deficit in terms of academic abilities, especially reading and language
skills.
 In terms of social skills, Deaf learners find it hard to find someone who can make
conversations which sometimes lead to isolation.
EDUCATIONAL APPROACHES
Technology and Support
 Some learners with HI, especially those who are hard-of-hearing, use hearing assistive
technology (HAT) to support their audition and be able to understand the information that they
get from different settings. There are several HATS that teachers must be aware of and allow
students to use to enhance the learning experience of learners with HI.
Hearing Aid
The most common type of HAT is hearing aid. An ear-worn or behind the-ear electronic
gadget of compact size. It amplifies certain sounds to enhance the listening experience,
communication, and active engagement of individuals with hearing impairments in their daily
routines. People who wear hearing aids can hear better in both serene and loud environments.
This device comes in different shapes and sizes that has three parts: microphone, amplifier and
speaker.

Hearing Aid Hearing Aid

Source: [Link] Fidelity Hearing
Aid %288540158902%[Link]/640px-Vintage_Fidelity Hearing Aid %288540158902%[Link]
Cochlear Implants
A cochlear implant is a complex technological device that enhances hearing. It is a
viable alternative for those with profound hearing impairment caused by inner-ear damage, who
lack significant improvement in hearing with the use of hearing aids. A cochlear implant
circumvents impaired sections of the ear in order to transmit auditory impulses directly to the
hearing nerve. It utilizes a sound processor that is positioned behind the ear. The processor
records sound waves and transmits them to an implanted receiver located beneath the skin
behind the ear. The recipient transmits the impulses to electrodes that have been surgically
placed in the cochlea, the spiral-shaped structure in the inner ear. The signals elicit stimulation
of the auditory nerve, which subsequently transmits the signals to the brain. The brain
processes these impulses as auditory stimuli.
 Cochlear Implant
Source: [Link]
[Link]/640px-Cochlear [Link]
Assistive Listening Devices
Assistive Listening Devices (ALDs) are personal amplifiers designed to enhance sound
levels during in-person talks and small group conversations. These boxes are approximately the
dimensions of a deck of cards and are equipped with both a microphone and a listening wire.
Both the speaker and the listener utilize the same equipment.
Augmentative and Alternative Communication
Augmentative and alternative communication (AAC) devices offer alternative means of
communication for those who are unable to use spoken language due to profound hearing loss
or speech problems. Commonly used synonymously with the term speech-generating device
(SGD), augmentative and alternative communication (AAC) devices typically take the shape of a
tablet or laptop.
Alerting Devices
Alerting devices offer visual or tactile cues to enhance safety and awareness for those
with hearing impairments when significant sounds or alerts occur. Commonly referred to as
signalers or notification devices, these gadgets typically employ flashing lights and/or vibrations
to notify individuals of different noises in the surroundings.
Speech-to-Text Translation
Computer software or applications that use speech-to-text translation aids the learner
with HI to visually access class discussions and increase their understanding about the lesson.
It primarily converts a verbal input into a text for better comprehension and visualization.
Audio/Video Transcriptions
Transcriptions are an indispensable component of assistive technology, equipped
providing access to multimedia content and information that may have difficult to understand.
Today's technology such as televisions are with a device that will enable users to have captions
anywhere on their screens.
Teaching Approaches
Oral Approach
 Oral/Aural approach to deaf education excludes the use of sign language, speech
reading, or total communication. Instead, it emphasizes the development of receptive (hearing)
and expressive (spoken) language skills. Deaf or hard of hearing children receive instruction in
auditory oral techniques, utilizing their remaining hearing abilities in conjunction with hearing
aids and/or cochlear implants to facilitate their language and hearing growth. Advocates of the
oral approach recognize that teaching deaf children in speech is a challenging, rigorous, and
time-intensive task for the teacher, the parents, and, above all, the student. A child who
participates in a program with a focus on oral approach often employs several methods to
enhance their remaining hearing and develop the capacity to speak as clearly as possible.
Commonly employed methods of input include auditory, visual, and tactile modes. Considerable
emphasis is placed on amplification, auditory training (the art of active listening and acquiring
knowledge by attentive listening, rather than only developing the ability to hear sounds)
speechreading (the process of deciphering spoken words using body language, eye
movements, lip movements, and facial expressions.), cued speech (a visual communication
system consisting of hand signals that symbolize the 44 distinct speech sounds (phonemes)
used in the English language), the utilization of technological aids, and, most importantly, verbal
communication.

Cued Speech
Source: [Link]

Total Communication/Simultaneous Communication

Total communication encompasses both an educational philosophy and a method of
communication. Advocates employ diverse modes of communication to teach students with
hearing impairment in the English language. Advocates of this approach, often known as
"SimCom," argue that presenting English language through both spoken words and manual
communication (such as signing and fingerspelling) allows youngsters to employ one or both
forms of communication (Hawkins & Brawner, 1997). Total Communication employs a diverse
range of techniques, including sign language (a language system that uses visual-manual
modality to convey meaning), spoken language, auditory perception, fingerspelling, gestures,
facial expressions, and lipreading. These approaches are used in a flexible manner, adapting to
the specific needs and preferences of the deaf child. The premise of this approach is that deaf
children have the ability to acquire excellent communication skills through the utilization of any
available tools. The goal is to enhance language acquisition by employing the most efficient
approach tailored to each child's needs (National Deaf Children's Society, 2024).
Bicultural-Bilingual Approach
While there are various versions of the bicultural-bilingual approach, majority of them
consist of three key elements (Schirmer, 2001):
1. American Sign Language (ASL) is regarded as the principal language, whereas English is
regarded as the subordinate language.
2. Individuals who are hearing impaired play a significant part in the advancement of the
program and its educational framework.
3. The program incorporates education on Deaf culture.
For deaf students, bilingual education can be organized in two ways: either by first
learning American Sign Language (ASL) and then English, or by teaching both languages
simultaneously.

American Sign Language

Source: [Link] [Link]
Accommodations
Consider the following accommodations for use in instruction with students who has
hearing impairment:

 When giving verbal instruction to students, make sure that you are facing them as others
may try to lip read what you are saying.
 It would be beneficial for them if the teacher would write or post the instructions on the
board.
 Teachers must speak clearly and use simple words without exaggeration.
  Develop a signal system for the class (e.g. the use of sign language when going to the
rest room or raising two fingers for those who would like to ask a question).
 Voice modulation will be useful for them but the use of audio amplification devices for the
class instruction would be even better.
 The adaptation of visual cues, picture supported texts, written notes, outlines, and
diagrams helps the students to visualize and comprehend the topic.
 Pair learners with hearing impairment with hearing learners for peer tutoring.
 Use captioned versions of streamed video/film or provide a printed copy of the material.
 Write important information on the bulletin boards. Keep the reminders readable and
direct.

Let's Explore More

Learn more about teaching strategies for the hearing impaired on the following websites.
* Center for Hearing and Communication ([Link] org/post/tips-for-teachers-of-
students-with-hearing-loss)
* Instructional Strategies for Students who are Deaf and Hard of Hearing
([Link] deaf-hard-of-hearing)
* Australian Disability Clearinghouse on Education and Training
([Link]
PLACEMENT OPTIONS
Residential Schools
One of the placement options for Deaf learners is by attending residential schools.
School for the Deaf can be an effective institution for them to develop their communication and
language skills while learning together with his/her deaf classmates. Residential schools also
offer specialized instructions and programs that would fit based on the unique learning style and
need of Deaf students.
Inclusive Classroom
While it is undeniable that there are some barriers for Deaf children when enrolled in a
regular class, the benefit of socializing and exposure to hearing individuals remains critical. It is
important, however, that the school must hire an interpreter for a class with Deaf learners to
accommodate the lesson for better understanding.
Reference: Gil Jr. T. O. (2024). Foundations of Special and inclusive Education. LORIMAR
Publishing.