• UNIT 2 LEARNERS WITH HEARING IMPAIRMENT

    Key Unit Competence: Apply suitable teaching methods, techniques and
    strategies to address the needs of learners with
    hearing difficulties

    INTRODUCTORY ACTIVITY


    Umutesi is a 7 years old girl who has just started Primary 1. She has a
    hearing loss resulting from repeated and severe ear infections throughout
    her early childhood. Her hearing loss is considered hard-of-hearing because
    she has some residual hearing and uses hearing aids. Umutesi’s language
    and speech skills are delayed because she could not hear adequately since
    early childhood. Umutesi is being assisted by an audiologist who ensures
    that her devices are in good working conditions, and she uses the devices in
    her schooling.
    1. What was the cause of hearing loss in Umutesi’s case?
    2. Discuss challenges or barriers Umutesi may face in school?
    3. What teachers can do to remove barriers Umutesi might face in her
    learning process.
    2.1. Definition, cause, and characteristics of Hearing Impairment
    ACTIVITY 2.1.

    –– How would you define Hearing Impairment?
    –– What could be the causes of Hearing Impairment?
    –– What could be the symptoms of a learner with Hearing
    Impairment?
    2.1.1. Definition of hearing difficulties
    Hearing Impairment signifies full or partial loss of the ability to detect or
    discriminate sounds due to an abnormality associated with the physiology,
    anatomy, or function of the ear. Hearing Impairment is an inability to hear well
    or not hearing at all.
    According to WHO census, (20 March 2019) Around 466 million people
    worldwide have hearing loss and 34 million of these are children. It is estimated
    that by 2050 over 900 million people will have disabling hearing loss.
    2.1.2. Causes of Hearing Impairment and deafness
    The main causes of Hearing Impairment include:
    • Hereditary factors: This is hearing loss or deafness that is inherited
    from parents or relatives
    • Prenatal factors:An expectant mother can be exposed to many different
    kinds of infection during pregnancy, such as rubella and influenza. Some
    of these infections are more damaging to the developing embryo than
    others. One of the most serious infections is rubella. Other infections
    contracted by the mother such as syphilis, may also cause Hearing
    Impairment in the developing embryo. Certain drugs such as quinine
    taken during pregnancy may also cause Hearing Impairment in a child.
    • Peri-natal factors: Hearing Impairment may occur just before, during
    or just after birth due to the lack of oxygen (anoxia).
    • Post-natal factors: Infectious diseases such as meningitis, measles and
    mumps can lead to Hearing Impairment, this can be during childhood
    or later in life. Discharge from ears is mainly as a result of chronic
    ear infections which may lead to hearing loss. In certain cases, this
    condition can also lead to serious and life-threatening complications,
    such as brain abscess and meningitis. Use of some drugs such as antimalaria
    drugs and certain antibiotic can damage the inner ear. Injuries
    to the skull are particularly serious as they may rupture the ear drum,
    dislocate the ossicles or affect the inner ear. Other causes that may lead
    to Hearing Impairment are exposure to excessive noise, old age and
    presences of foreign bodies in the external auditory canal.
    2.1.3. Characteristics of learners with Hearing Impairment
    Learners with Hearing Impairment generally show some specific behavioural
    characteristics:
    • Have difficult in hearing high pithed speech sounds such as: /s/, /f/,
    /z/, /t/, /k/, /t f/
    • Have difficult in understanding directions
    • Rely more on visual information processing
    • Have difficult in group discussions
    • Do not develop speech spontaneously
    • May not participate in useful conversation with others
    • Have inappropriate rhythm in speech and have poor articulation
    • Have a feeling of inferiority and may withdraw from the hearing
    community if misunderstand
    • May become aggressive or impulsive if not given appropriate support
    by the hearing
    • Ask repetition of what has been said
    • Cups the ear in the direction of sounds
    SELF-ASSESSMENT 2.1
    1. What is Hearing Impairment?
    2. Give 5 characteristics of a learners with Hearing Impairment
    3. Explain the causes of Hearing Impairment and deafness (in your

    own words)

    2.2. Classification and strategies to teach learners with
    Hearing Impairment
    ACTIVITY 2.2.
    – What is the classification of Hearing Impairment?
    – Explain the strategies of teaching learners with Hearing
    Impairment
    2.2.1. Classification of Hearing Impairment
    Hearing loss can be classified according to:
    • Severity
    • Age of onset
    • Part of the ear affected
    a. Classification according to severity:
    Some learners may only have slight or severe hearing loss. There are five major
    categories of hearing loss:
    1. Learners with slight hearing loss: These are learners who can follow
    normal conversation if there is no noise in the room but would need a
    preferential seating arrangement while facing the speaker. They may
    also have difficulty hearing faint or distant speech.
    2. Learners with mild hearing loss: Learners in this category may
    understand a conversation only at a distance of about one meter
    when the room is very quiet. They may miss as much as 50% of class
    discussion if voices are faint and may exhibit limited vocabulary and
    speech anomaly. In some cases, a child with mild hearing loss may not
    be able to make certain speech sounds that are high pitched such as /s/
    and /f/. Usually his/her main problem is that he/she mal-articulates or
    omits some sounds.
    3. Learners with moderate hearing loss: These learners may have
    difficulties hearing in all situations and:
    • Can only follow loud conversation;
    • Are deficient in language use and comprehension;
    • Are likely to have defective speech
    • Have limited vocabulary
    • Need the use of hearing aid and in some cases, speech training
    4. Learners with severe hearing loss: These learners may hear loud
    voices about 30 cm from ear. They may be able to identify environmental
    sounds and discriminate vowels but not all consonants.
    5. Learners with profound hearing loss: These learners may hear some
    loud sounds but are aware of vibrations more than tonal pattern .They rely
    on vision rather that hearing as the primary avenue of communication.
    They need hearing aids and sign language.
    b. Classification according to age of onset
    According to age of onset, Hearing Impairment is categorized into two: These
    are:
    Pre-lingual deafness: This refers to Hearing Impairment occurring prior to
    the age of two or before speech development.
    Post-lingual deafness: This refers to Hearing Impairment occurring at any age
    after speech has fully developed.
    c. Classification according to the part of the ear affected
    Before discussing this, we need to look at the anatomy of the ear. Functionally
    the ear is divide into three main parts. These are the outer ear, the middle and

    the inner ear as shown in figure below.

    There are four types of hearing loss according to the part of the ear affected.
    These are:
    • Conductive
    • Sensory-neural
    • Mixed
    • Auditory Neuropathy Spectrum Disorder
     Conductive hearing loss: This is when the damage or infection is either in
    the outer or the middle parts of the ear. This may result in mild or moderate
    hearing loss. Those with this type of hearing loss have residual hearing
    left and can hear and understand spoken language with the help of suitable
    hearing aids.
     Sensori-neural hearing loss: This is when the damage is in the inner ear.
    This may result in severe or profound hearing loss little residual hearing
    left. Children with this type of hearing loss usually do not acquire and use
    spoken language.
     Mixed hearing loss: This refers to a combination of both conductive and
    sensori-neural hearing loss this means that both the outer middle ear and
    the inner ear are affected at the same time. It should be noted that learners
    with Hearing Impairment can either be hard of hearing or deaf. Hard of
    hearing persons are able to use their hearing ability either with or without
    use of hearing aids. Speech and language skills are normally developed
    through the auditory channel. Deaf persons have a hearing loss that does
    not enable them to use hearing ability to understand speech even with the
    use of hearing aid. Such a learner uses vision as the primary modality for
    learning and communication.
     Auditory Neuropathy Spectrum Disorder: Hearing loss that occurs when
    sound enters the ear normally, but because of damage to the inner ear or the
    hearing nerve, sound isn’t organized in a way that the brain can understand.
    2.2.2. Strategies to teach learners with Hearing Impairment
    – Organize the classroom so that all the children are sitting in a U shape.
    This way the children can see each other, which will make it easier for
    children with Hearing Impairment to use sign language, read lips and
    understand mimics, thereby making it possible to participate more
    actively in discussions and classroom activities.
    – Spend some time giving face-to-face instruction, since group situations
    can be quite challenging for children with Hearing Impairment.
    – Look at the child (with Hearing Impairment) while speaking to her/
    him.
    – Speak slowly and clearly, but not too loud.
    – Use short, simple, and clear sentences.
    – Be consistent in the use of language.
    – Use clear mimics and gestures.
    – Ask the child (if s/he has an oral language) to repeat what s/he has
    understood.
    – Write down key words from the information given during the class and
    give it to the child at the end of every day.
    – Work together with an audiologist (if available) to teach and
    encourage the child to use her/his residual hearing to the maximum
    extent possible, even if the preferred means of communication is sign
    language.
    – Reduce all unnecessary noise, as multiple sources of sound will make it
    more difficult for the child to use her/his residual hearing. This is also
    important if the child is using a hearing aid.
    – If some of the classrooms in the school are noisier than others (e.g.
    noise from busy roads, airports or factories), the school should be
    flexible and move any classes with children with Hearing Impairment
    (as well as classes with children with Visual Impairment or other
    disabilities) to less noisy rooms.
    – Be flexible with time, as most of the children with Hearing Impairment
    (both deaf and hard of hearing) will struggle to understand everything
    that goes on in the classroom (as a result of their hearing loss).
    – Focus more on content than on grammar when assessing the writing of
    children who primarily use sign language for communication. Because
    the grammar of sign languages is very different from written languages
    – Please take into consideration that:
    – Facial hair (e.g. beards and moustaches) worn by male teachers may
    obscure leap reading and facial expressions.
    – Face covering – veils covering eyes, eyebrows, nose, mouth and cheeks
    (worn by some teachers and fellow learners), may obscure leap reading
    and facial expressions.
    The majority of children who are deaf (profound hearing loss) are born to hearing
    parents. The school should therefore attempt to provide instruction for parents on
    the implications of deafness within the family.
    A learner who is hard of hearing may also need more time to learn than other learners,
    as s/he will not always be able to hear the teacher’s voice and what other children
    talk about in the classroom. Therefore, much of the information given during

    the lessons will be lost.

    SELF-ASSESSMENT 2.2
    1. What is Hearing Impairment
    2. Hearing Impairment can be classified according to 3 elements.
    What are these elements?
    3. What are the four types of hearing loss according to the part of
    the ear affected?
    4. What are the five major categories of hearing loss
    5. Give 5 strategies to teach learners with Hearing Impairment
    SKILLS LAB
    Visit one classroom in a nearby primary school, observe all learners
    during lesson and break time. Identify those who might have Hearing
    Impairment. Based on 5 major categories of Hearing Impairment, assess
    these learners and classify them into 5 categories. Advise the teacher on
    teaching approaches or other reasonable accommodations to adopt in
    order to meet the learning needs of learners with Hearing Impairment
    in the classroom.
    END OF UNIT ASSESSMENT
    1. What is Hearing Impairment?
    2. Give 5 characteristics of a learners with Hearing Impairment
    3. Classify hearing loss according to severity, age of onset, and part
    of the ear affected

    4. What are the five major categories of Hearing Impairment?

    UNIT 1 LEARNERS WITH VISUAL IMPAIRMENTUNIT 3 LEARNERS WITH DEAF-BLINDNESS