Topof FormSUBMISSIONSHEET Matric No 15010628 Module Code S3203 Module Title HEARING IMPAIRMENTS Assignment Title ESSAY Module Co-ordinator KARAMOUZI ANNA Number of words used 16444 Date Due 29/1/2018 Date Submitted 29/1/2018 PLEASE NOTE: I confirm that I am aware of and haveread the University’s guidelines on plagiarism and collusion. Please tick ?By attaching this sheet to your work,you are confirming that the assignment is all your own work.I have read and understood all of theabove. Please tick ? a. It’sa fact that speech therapists have to know how to interpret achild’s/individual’s audiogram in terms of determining the degreeof his/her hearing loss, the comparison of the responses given toboth ears, the definition of the hearing loss’s type and site oflesion. Moreover, these data must be ascertained by the speechtherapist when he/she is going to take on the intervention and thesupport of a child or an individual with a hearing impairment, inorder to plan and organize the appropriate therapy. Specifically, according to child’saudiograms arise the following results: Right earAir-conductionAt 125Hz the child gave a positive responseat 60dB.
250Hz ? 70dB. 500Hz ? 80dB. 1000Hz ? 100dB. 2000Hz ? 90dB. 4000Hz ? 75dB.Left earAir-conductionAt 125Hz the child gave a positive responseat 60dB. 250Hz ? 65dB. 500Hz ? 80dB.
1000Hz ? 90dB. 2000Hz ? 100dB. 4000Hz ? 80dB. RightearBone-ConductionAt 250Hz the child gave a positive responseat 30dB. 500Hz ? 40dB. 1000Hz ? 60dB. 2000Hz ? 50dB. 4000Hz ? 40dB.
Leftear Bone-ConductionAt 500Hz the child gave a positive responseat 40dB. 1000Hz ? 50dB. 2000Hz ? 60dB. 4000Hz ? 40dB.
PURE TONE AVERAGE (PTA)For the right ear PTA = (80+100+90) = 270/3= 90dBFor the left ear PTA = (80+90+100) = 270/3= 90dB As a result, the child presents hearingloss in his/her right and left ear in 90dB which means that thedegree of his/her hearing loss is severe hearing loss (which includes70-90dB for both ears) (Papafragkou1996). As a consequence, a bilateral,cookie bite, Symmetrical hearing loss is ascertained throughaudiograms. In fact, both audiometric configurations lead to theconclusion that in this case there is a bilateral (hearing loss inboth ears) and also almost symmetrical hearing loss (similar degreeof hearing loss in both ears). Moreover, the image which is shapedfrom audiograms for both ears can be described as cookie biteconfiguration. In this case individuals/children present hearing lossin the mid frequency region. What is more, with regard to the type ofhearing loss there is a mixed hearing loss because the boneconduction is presented as better than the air conduction. Morespecific, bone conduction shows hearing loss and air conduction showseven greater hearing loss. Furthermore, concerning the site oflesion, there is both conductive and sensoryneuralpathology which means that the damage of the sensory mechanism islocated not only in the outer and/or middle ear but also in the innerear as well.
Therefore, two different damages have to be dealt with,in two different ways, as when the damage is found in the middle earin contrast with the case that the damage is in inner ear there isthe possibilityfor the child/individual to undergo surgery (Lampropoulou1999). b.Report(1)child 2.5 years old i) Since it has been ascertainedbased on PTA that there is a damage in the child’s middle ear thereis the posibilityto undergo surgery in order to cure the conductive hearing loss.Inthis case,after the surgical intervention,what still remains to be faced is the seusoryneural hearingloss.
Moreover, the prognosisabout his/her linguistic and academic development can be cosidered asgood because the child’s responses in term of frequence range up to4000Hz .However, the positive evolution of the child’s development depends and based not only onthe correct but also on the appropriate interversion and treatment.What is more ,the comprehensible speech will always be the basiculterioraim.ii) Furthermore, considering that thechild has a mixed hearing loss ,in case that surgery is impossible analternative intervention should be used by using another type of ahearing aid more simple and less intervening.Secondly ,as a nextstep,linguistic development has to be attended for six months.Afterthat ,the follow up of the child’s developing ability to hear alongwith the estimation of his/her functional hearing behavior willdefine whether the hearing aids amplification was a success or if theamplification of cochlear implants is regarded as a necessity for thechild’s own advantage (Kourbetis,Hatzopoulou2010) .iii) Additionally,the short term goalsthat have to be set for the child’s language development and speechin general include his/her vocabulary development and also thedevelopment of his/her communication skills.On the other hand,thelong term goal still remains the conquest of comprehensible speechfrom the child (Kourbetis,Hatzopoulou2010).
iv) Moreover, the school placement that issuggested depends on the fulfillment of the goals that have been setin the beginning and also on whether or not the surgery hashappened.Specifically,if the child achieved to developed his/herlinguistic skills and his/her speech is comprehensible ,he/she shouldgo to normal school.Alternatively, if there was no surgicalintervention and/or the goals that were set weren’t reached by thechild ,then it will be better for the child to go to special schoolplacement for hard of hearing persons.In case that parents disagree with thisoption and they insist that their child should go to normal/typicalschool then,some changes in the classroom will have to be made inorder for the child to adjust the best way possible(Moores 1987). v) Therefore,there are a lot ofcommunication methods for hearing loss and deaf children .Speechtherapists must choose the appropriate approach to use for each caseso as to make the child’s language development easier (e.g. oralmethod,total communication and bilingual approach).
In addition , Oral method is used byspeech therapists in in order for the deaf children to understandspoken language and promote the lntelligible spoken language .By thismethod children are taught to maximize the use of their residualhearing through amplification (hearing aids or cochlear implants),to increase their residual hearing with speech lip-reading,to speak and finally to reinforceintelligibility.This method does not include the sign language.Theoral method also includes long training practice on speech productiveand listening skills and emphasizing on phonology.
Finally, no form ofsigning or finger spelling is allowed ( CDSS2013),(PENTA2012). What is more,Total’s method basic aim isto manage full communication in any way and stress the use of thevisual channelfor learning spoken and especially written language.In otherwords,this method is combined with the oral method by using signsand it also adjusts signs to spoken language structure.
Thus,Totalmethod involves all the options of language modes,child -derivedgestures,sign language ,speech ,lip-reading ,finger spelling,written languagereading and writing so as to transfer the information to deaf children .Notably,another characteristic of this method is that sign language is anartificial construction based on the grammatical structure of writtenlanguage (MDAAP2011). Last but not least,thebilingual method includes both the sign language of the deafcommunity and the written/spoken language of the hearing community.The goals of this approach are to develop a bilingual andbicultural identity and to take part in both hearing and deafcommunity.Such a program includes exposing and practicing in GSL andin modern Greek Language (written-spoken) ,and most importantly,lessons with well-adapted structure and realistic and interestinginput (DeafChildren Australia 2012). Specifically , in this case ,if the childaccept a surgical intervention the total method issuggested.Moreover,in the future the approach that the child prefers,likes and reacts better through this,will be more reinforced.
c.Report(2)child 10 years old I) The prognosis of this child is alsopositive and good for two reasons.Firstly,because the child is 10years old and he/she has already developed language and secondly,because his/her responses in terms of frequence range up to 4000Hz,so there is a hearing ability on a basic level which still exists.ii) ??reover,taking into account that the child’s hearing loss is mixed andsurgery is not an option,another way to cope with,it would be to usean alternative hearing aid,less intruding.What should be followednext is a six-month linguistic development.
As the child develops theability to hear ,combined with the assesment of his/her functionalhearing behaviour,will be critical and indicative of the extend towhich the amplification of the hearing aids had succeeded or if theamplification of cochlear implants is considered essential and morebeneficial for the child.iii) Thesort term goal that has to be set for the child is to maintainhis/her intelligibility, which includes all his/her communicationskills and the comprehensible speech. Moreover, the long-term goalmust be to help the child to continue his/her development inproportion to his/her age.iv) Furthermore, it is suggested a typicalschool placement for the child but some adjustments in the classroomare essential to be done. For example, the child should sit at thefirst desk in order to ensure better contact with the teacher.Another measure that should be taken for extra support is a specialeducator specialized in deaf children and if it’s possible to beexperienced in the lip-reading method so as to make the communicationeasier.
Finally, securing the child’spsychological support isrecommended for his/her smooth and normal development.v) Therefore, the most appropriateapproach that is advised for this child is the oral method andespecially the natural model of oral-multi-sensory approach because,the child has already developed language in that age. Specifically,multi-sensory approach constitutes an important piece of oral methodwhich is based on the use of all senses like residual hearing,tactile media, lip-reading and prosodic features of speech.Especially, the “Natural model” which is recommended in thiscase, according to Watson (1998), is aimed at reproducing for deafchildren those conditions that have been found to be helpful in hearing children. Additionally, the term”natural” points to stress how the language is acquired whenparticipating in meaningful conversations.Finally,using the right method in each case thechild’ssmoothlinguistic,academic and psychological development aresecured .