SPED 537 ECSE Methods Multiple Disabilities Ch 6 & 7

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					SPED 537 ECSE Methods
Multiple Disabilities
Ch 6 & 7

     Deborah Chen, Ph.D.
   California State University,
            Northridge
          April 3-4 2006
Types of Hearing Loss
   Conductive
   Sensorineural
   Mixed
   Progressive
   Central auditory processing disorder
Intensity of Sound
   Decibel (dB)
   0 dB – softest sound
   25 dB – whisper
   50 dB – speech
   90 dB – food blender
   110 dB – rock concert
   140 dB - firecracker
Logarithmic Scale
   0 dB = softest sound heard
   20 dB = 10 x 10 louder than 0 dB
   20 dB hearing loss = hearing 100 times
    less than normal
Frequency of Sound
   Hertz or cps
   Low to high
   Vowels
   Consonants
   Voices
   Figure 1
Speech Banana
                   Figure 2

 Comparison of the Frequency and Intensity
of Various Environmental and Speech Sounds
Degree of Hearing Loss
   Mild: 15 – 30 dB
   Moderate : 30-50 dB
   Moderate-severe 50-70 dB
   Severe 70-90 dB
   Profound > 90dB
Causes of Hearing Loss in
Young Children

   40-60% genetic causes
   10% congenital infections
   10% meningitis
   17% NICU
   Rest unknown
Incidence of Hearing Loss
   30 infants born each day in US
   Hearing loss occurs 20 x more
    frequently than PKU (phenlyketonuria)
   1 in 1000 have severe-profound loss
   4-5 in 1000 have mild-moderate loss
Significance of Early Detection
   By 6 months > language outcomes than
    those detected later
   Average age of diagnosis 12-25 months
   Average age for detecting mild loss 5-6
    years
Newborn Screening
   Most hospitals screen “at risk”
   Identifies only 50 % children
   A.B. 2780 required all CCS approved
    hospitals to implement UNIVERSAL
    newborn hearing screening by 12/02
   400,000 (>70%) newborns in CA
http://www.dhs.ca.gov/pcfh/cms/NHSP
Universal Newborn Hearing
Screening
Costs $25-45 hospital-based screening.

Two electrophysiological tests:
 Screening auditory brainstem response

SABR
 Otoacoustic emissions

OEA
Impedance or Acoustic
Immitance Tests
   Tympanometry

   Acoustic Reflex
Behavioral Tests (Infants)
 Behavioral Observation Audiometry
(BOA)

 Visual Reinforcement Audiometry
(VRA)
Objective Tests
   Auditory Brainstem Response (ABR)
   Brainstem Evoked Response (BSER)
   Brainstem Auditory Evoked Response
    (BAER)

   Otoacoustic emissions (OAE)
Behavioral Tests
   Tangible Reinforcement Operant
    Conditioning (TROCA)
   Visual Reinforcement Operant
    Conditioning (VROCA)

   Conditioned Play Audiometry (CPA)
Audiogram

   Graph that shows:
    - hearing thresholds
    - at different frequencies
    - and loudness levels
    - by air conduction and
    - bone conduction
Audiogram
Provides information on:
 Type of hearing loss

 Degree of loss

 Slope of loss

 Sounds child can or cannot hear
     Figure 1
Pure Tone Audiogram
  Normal Hearing


                      Right
            Figure 2
      Pure Tone Audiogram
Moderate to moderate-severe SNHL




                            = air conduction

                            = bone conduction
          Figure 3
    Pure Tone Audiogram
Mild Conductive Hearing Loss
              Figure 4
Audiogram of a Moderate Hearing Loss
          Figure 5

      Illustration of
Sensorineural Hearing Loss
         Figure 6

     Illustration of
Conductive Hearing Loss
Degree of Hearing Loss
   Slight: may miss 10% speech when further
    than 3’ away
   Mild: may miss 25-40% speech
   Moderate: may miss 50-75%
   Moderate-Severe: may miss 100%
   Severe: Responds to loud sounds 1” away
   Profound: Relies on visual cues and vibrations

				
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