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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)

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Sped 537 ecse methods multiple disabilities ch 6 7

SPED 537 ECSE MethodsMultiple DisabilitiesCh 6 & 7

Deborah Chen, Ph.D.

California State University, Northridge

April 3-4 2006


Types of hearing loss
Types of Hearing Loss

  • Conductive

  • Sensorineural

  • Mixed

  • Progressive

  • Central auditory processing disorder


Intensity of sound
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
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
Frequency of Sound

  • Hertz or cps

  • Low to high

  • Vowels

  • Consonants

  • Voices


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 1

Speech Banana


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 2

Comparison of the Frequency and Intensity

of Various Environmental and Speech Sounds


Degree of hearing loss
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
Causes of Hearing Loss in Young Children

  • 40-60% genetic causes

  • 10% congenital infections

  • 10% meningitis

  • 17% NICU

  • Rest unknown


Incidence of hearing loss
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
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
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
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
Impedance or Acoustic Immitance Tests

  • Tympanometry

  • Acoustic Reflex


Behavioral tests infants
Behavioral Tests (Infants)

  • Behavioral Observation Audiometry

    (BOA)

  • Visual Reinforcement Audiometry

    (VRA)


Objective tests
Objective Tests

  • Auditory Brainstem Response (ABR)

  • Brainstem Evoked Response (BSER)

  • Brainstem Auditory Evoked Response (BAER)

  • Otoacoustic emissions (OAE)


Behavioral tests
Behavioral Tests

  • Tangible Reinforcement Operant Conditioning (TROCA)

  • Visual Reinforcement Operant Conditioning (VROCA)

  • Conditioned Play Audiometry (CPA)


Audiogram
Audiogram

  • Graph that shows:

    - hearing thresholds

    - at different frequencies

    - and loudness levels

    - by air conduction and

    - bone conduction


Audiogram1
Audiogram

Provides information on:

  • Type of hearing loss

  • Degree of loss

  • Slope of loss

  • Sounds child can or cannot hear


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 1

Pure Tone Audiogram

Normal Hearing

Right


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 2

Pure Tone Audiogram

Moderate to moderate-severe SNHL

= air conduction

= bone conduction


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 3

Pure Tone Audiogram

Mild Conductive Hearing Loss


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 4

Audiogram of a Moderate Hearing Loss


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 5

Illustration of

Sensorineural Hearing Loss


Sped 537 ecse methods multiple disabilities ch 6 7

Figure 6

Illustration of

Conductive Hearing Loss


Degree of hearing loss1
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