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Hearing and visual impairment
Hearing and Visual Impairment

Presented by:

APS Healthcare

Southwestern PA Health Care Quality Unit



Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented.

Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies.

Note of clarification
Note of Clarification

While mental retardation (MR) is still recognized as a clinical diagnosis, in an effort to support the work of self-advocates, the APS SW PA HCQU will be using the terms intellectual and/or developmental disability (I/DD) to replace mental retardation (MR) when feasible.


Upon completion of the session the participant will:

  • 1. Recall causes of hearing and visual impairments

  • 2. Identify symptoms of hearing deficiency and visual difficulties

  • 3. Recognize ways to support an individual with hearing or visual impairments

It s about communication

Hearing impairment and individuals with i dd
Hearing Impairment and Individuals with I/DD

  • Increased incidence

  • Age related hearing impairment

  • Serious problem

  • Early detection

Causes of hearing impairment
Causes of Hearing Impairment

  • Blockage of External Auditory Canal

  • Otosclerosis

  • Inheritance

  • Aging

  • Noise Exposure

  • Disease/Infection

  • Medications

  • Trauma

Types of hearing impairment
Types of Hearing Impairment

  • Partial/Total

  • Unilateral/Bilateral

  • Congenital/Acquired

  • Conductive/Sensorineural

Signs of hearing impairment
Signs of Hearing Impairment

  • Speaking in loud monotonous tone

  • Habitually asking “what?” or to repeat

  • Failing to follow directions

  • Turning head toward sound

  • Cupping ear

  • Inappropriate comments to conversation

Signs of hearing impairment1
Signs of Hearing Impairment

  • Withdrawal

  • Inattentiveness

  • Facial expressions indicating difficulty understanding

  • Complaining that people mumble

  • Difficulty hearing on phone

  • Only hearing part of conversations

  • Turning up volume of TV/radio

Additional signs in people with i dd
Additional Signs In People with I/DD

  • Confusion

  • Disruptive or inappropriate behavior

  • Self injurious behavior (head banging)


  • Otoscopy

  • Audiometry

  • Conditioned Play Audiometry

  • Behavioral Observation Audiometry

  • Impedance Testing/Tympanometry


  • Removal of blockage

  • Assistive devices

  • Surgery

    • Stapedectomy

    • Cochlear Implant

  • Sign language

  • Hearing aids

  • Facts about hearing aids
    Facts about Hearing Aids

    • Amplify ALL sounds

    • Help with conductive hearing loss

    • Do not help with sensorineural hearing loss

    • Must be placed correctly for optimal performance

    • Must be cared for properly

    Communication tips
    Communication Tips

    • Face the person when speaking

    • Do not raise your voice

    • Speak slowly and distinctly

    • Get their attention

    • Stand near them

    • Do not stand in front of a window

    • Do not cover your mouth

    • Minimize background noise

    More communication tips
    More Communication Tips

    • Do not talk while chewing, eating, smoking

    • Use gestures

    • Rephrase

    • Do not rush

    • Have individuals repeat important information back to you

    • Include in conversations

    • Arrange room so all are visible to one another

    • Make sure hearing aid is in and working


    • Minimize excessive, prolonged noise exposure

    • Treat ear infections promptly and completely

    • Be aware of medications toxic to the ears

    • See physician if a problem is suspected

    Visual impairment
    Visual Impairment

    • Eyesight cannot be corrected to a “normal” level

    • Loss of vision that makes it difficult or impossible to do the daily tasks of living without specialized adaptations

    The normal eye
    The Normal Eye

    • Sclera

    • Cornea

    • Iris

    • Pupil

    • Lens

    • Retina

    • Optic Nerve

    Visual impairment and people with i dd
    Visual Impairment and People with I/DD

    • Development is slower

    • Learning process is more difficult

    • Must use other senses to compensate

    Visual classifications
    Visual Classifications

    • Normal Vision

    • Low Vision

    • Legal Blindness

    • Blindness


    • Congenital

    • Genetic

    • Trauma

    • Detached Retina

    • Infection

    • Tumors

    • Poisons

    • Diseases

    Signs of vision loss
    Signs of Vision Loss

    • Changes in reading habits

    • Sitting unusually close to TV

    • Change in ability to recognize familiar faces or changes in appearance

    • Changes in grooming habits

    Signs of vision loss1
    Signs of Vision Loss

    • Changes in orientation

    • Increased confusion

    • Difficulty locating or recognizing “small” objects

    • Changes in eating habits and table manners

    Diagnosis visual examination
    Diagnosis: Visual Examination

    • Difficulty reading

    • Blurred/Double vision

    • Halos /Spots

    • Pain in the eyes

    • Loss of peripheral vision

    • Sudden loss of vision

    • Difficulty focusing on near or far objects

    • Difficulty seeing at night/adjusting to changes in light

    Visual exam what to take
    Visual Exam - What To Take

    • Glasses or contact lenses

    • List of visual changes

    • Date and results of last visual exam

    • List of current medications

    • Personal history

    • Family history

    Treatment interventions
    Treatment Interventions

    • Braille

    • Guide dogs

    • Large print and audio books

    • Magnifiers

    • Talking devices

    • Computers

    Support tips
    Support Tips

    • Lighting

      • Provide plenty of floor and table lamps

      • Place mirrors so they do not reflect light

      • Aim light at work they are performing

      • Adjustable blinds

      • Sheer curtains

    Support tips1
    Support Tips

    • Furniture/Flooring

      • Textured but not patterned upholstery

      • Brightly colored accessories

      • Replace worn carpet

      • Remove area rugs

      • Do not wax floors

      • Remove obstacles from walkways

    Support tips2
    Support Tips

    • Color Contrast

      • Doors

      • Steps

      • Landings

  • Texture Contrast

    • Sidewalks

    • Traffic

  • Support tips3
    Support Tips

    • Ask before doing

    • When walking, allow them to hold your elbow

    • Announce arrival and departure

    • Respect the job of a guide dog

    • Doors fully opened or closed

    • Identify paper money as to denomination

    • Arrange food in clockwise pattern

    Support tips4
    Support Tips

    • Do not avoid word/phrases

    • Describe new environments

    • Do not rearrange furniture

    • Do not shout

    • Explain what you are doing


    • Regular eye exams

    • Sunglasses with UV protection

    • Protective eyewear

    • Antioxidants

    In summary
    In Summary…

    • Regular examinations

    • Early detection and treatment


    • Diseases of the Eye and Ear. Retrieved from the World Wide Web: http://mayoclinic.com

    • Self Help for Hard of Hearing People. Retrieved from World Wide Web: http://www.shhh.org

    • Eye Diseases. Retrieved from World Wide Web: http://www.nlm.nih.gov/medlineplus/eyediseases

    • Hearing diseases and Deafness. Retrieved from World Wide Web: http://www.nidcd.nih.gov/health/hearing


    • Hearing and Visual Impairment. Retrieved from the World Wide Web: http://www.aadb.org (American Association of the Deaf-Blind)

    • Hearing Deficits. Retrieved from the World Wide Web: http://www.nad.org (Nat’l Association of the Deaf)

    • Inherited Eye Diseases. Retrieved April 7, 2009 from World Wide Web: http://myclevelandclinic.org

    To register for future trainings,orfor more information on this or any other physical or behavioral health topic, please visit our website at www.hcqu.apshealthcare.com


    Please take a few moments to complete the evaluation found in the back of your packets.

    Thank You!

    5/09 JM