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a fact that speech therapists have to know how to interpret a
child’s/individual’s audiogram in terms of determining the degree
of his/her hearing loss, the comparison of the responses given to
both ears, the definition of the hearing loss’s type and site of
lesion. Moreover, these data must be ascertained by the speech
therapist when he/she is going to take on the intervention and the
support of a child or an individual with a hearing impairment, in
order to plan and organize the appropriate therapy.
Specifically, according to child’s
audiograms arise the following results:
At 125Hz the child gave a positive response
250Hz ? 70dB.
500Hz ? 80dB.
1000Hz ? 100dB.
2000Hz ? 90dB.
4000Hz ? 75dB.
At 125Hz the child gave a positive response
250Hz ? 65dB.
500Hz ? 80dB.
1000Hz ? 90dB.
2000Hz ? 100dB.
4000Hz ? 80dB.
At 250Hz the child gave a positive response
500Hz ? 40dB.
1000Hz ? 60dB.
2000Hz ? 50dB.
4000Hz ? 40dB.
At 500Hz the child gave a positive response
1000Hz ? 50dB.
2000Hz ? 60dB.
4000Hz ? 40dB.
PURE TONE AVERAGE (PTA)
For the right ear PTA = (80+100+90) = 270/3
For the left ear PTA = (80+90+100) = 270/3
As a result, the child presents hearing
loss in his/her right and left ear in 90dB which means that the
degree of his/her hearing loss is severe hearing loss (which includes
70-90dB for both ears) (Papafragkou
As a consequence, a bilateral,
cookie bite, Symmetrical hearing loss is ascertained through
audiograms. In fact, both audiometric configurations lead to the
conclusion that in this case there is a bilateral (hearing loss in
both ears) and also almost symmetrical hearing loss (similar degree
of hearing loss in both ears). Moreover, the image which is shaped
from audiograms for both ears can be described as cookie bite
configuration. In this case individuals/children present hearing loss
in the mid frequency region. What is more, with regard to the type of
hearing loss there is a mixed hearing loss because the bone
conduction is presented as better than the air conduction. More
specific, bone conduction shows hearing loss and air conduction shows
even greater hearing loss. Furthermore, concerning the site of
lesion, there is both conductive and sensoryneural
pathology which means that the damage of the sensory mechanism is
located not only in the outer and/or middle ear but also in the inner
ear as well. Therefore, two different damages have to be dealt with,
in two different ways, as when the damage is found in the middle ear
in contrast with the case that the damage is in inner ear there is
for the child/individual to undergo surgery (Lampropoulou
child 2.5 years old
i) Since it has been ascertained
based on PTA that there is a damage in the child’s middle ear there
is the posibility
to undergo surgery in order to cure the conductive hearing loss.In
,after the surgical intervention
,what still remains to be faced is the seusoryneural hearing
loss.Moreover, the prognosis
about his/her linguistic and academic development can be cosidered as
good because the child’s responses in term of frequence range up to
4000Hz .However, the positive
evolution of the child’s development depends and based not only on
the correct but also on the appropriate interversion and treatment
.What is more ,the comprehensible speech will always be the basic
ii) Furthermore, considering that the
child has a mixed hearing loss ,in case that surgery is impossible an
alternative intervention should be used by using another type of a
hearing aid more simple and less intervening.Secondly ,as a next
step,linguistic development has to be attended for six months.After
that ,the follow up of the child’s developing ability to hear along
with the estimation of his/her functional hearing behavior will
define whether the hearing aids amplification was a success or if the
amplification of cochlear implants is regarded as a necessity for the
child’s own advantage (Kourbetis,Hatzopoulou
iii) Additionally,the short term goals
that have to be set for the child’s language development and speech
in general include his/her vocabulary development and also the
development of his/her communication skills.On the other hand,the
long term goal still remains the conquest of comprehensible speech
from the child (Kourbetis,Hatzopoulou
iv) Moreover, the school placement that is
suggested depends on the fulfillment of the goals that have been set
in the beginning and also on whether or not the surgery has
happened.Specifically,if the child achieved to developed his/her
linguistic skills and his/her speech is comprehensible ,he/she should
go to normal school.Alternatively, if there was no surgical
intervention and/or the goals that were set weren’t reached by the
child ,then it will be better for the child to go to special school
placement for hard of hearing persons.
In case that parents disagree with this
option and they insist that their child should go to normal/typical
school then,some changes in the classroom will have to be made in
order for the child to adjust the best way possible
v) Therefore,there are a lot of
communication methods for hearing loss and deaf children .Speech
therapists must choose the appropriate approach to use for each case
so as to make the child’s language development easier (e.g. oral
method,total communication and bilingual approach).
In addition , Oral method is used by
speech therapists in in order for the deaf children to understand
spoken language and promote the lntelligible spoken language .By this
method children are taught to maximize the use of their residual
hearing through amplification (hearing aids or cochlear implants
),to increase their residual hearing with speech lip-reading
,to speak and finally to reinforce
intelligibility.This method does not include the sign language.The
oral method also includes long training practice on speech productive
and listening skills and emphasizing on phonology.Finally, no form of
signing or finger spelling is allowed
What is more,Total’s method basic aim is
to manage full communication in any way and stress the use of the
for learning spoken and especially written language.In other
words,this method is combined with the oral method by using signs
and it also adjusts signs to spoken language structure.Thus,Total
method involves all the options of language modes,child -derived
,sign language ,speech ,lip-reading ,finger spelling,written language
writing so as to transfer the information to deaf children .Notably
,another characteristic of this method is that sign language is an
artificial construction based on the grammatical structure of written
Last but not least,the
bilingual method includes both the sign language of the deaf
community and the written/spoken language of the hearing community
.The goals of this approach are to develop a bilingual and
bicultural identity and to take part in both hearing and deaf
community.Such a program includes exposing and practicing in GSL and
in modern Greek Language (written-spoken) ,and most importantly
,lessons with well-adapted structure and realistic and interesting
Specifically , in this case ,if the child
accept a surgical intervention the total method is
suggested.Moreover,in the future the approach that the child prefers
,likes and reacts better through this,will be more reinforced.
child 10 years old
I) The prognosis of this child is also
positive and good for two reasons.Firstly,because the child is 10
years 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.
taking into account that the child’s hearing loss is mixed and
surgery is not an option,another way to cope with,it would be to use
an alternative hearing aid,less intruding.What should be followed
next is a six-month linguistic development.As the child develops the
ability to hear ,combined with the assesment of his/her functional
hearing behaviour,will be critical and indicative of the extend to
which the amplification of the hearing aids had succeeded or if the
amplification of cochlear implants is considered essential and more
beneficial for the child.
sort term goal that has to be set for the child is to maintain
his/her intelligibility, which includes all his/her communication
skills and the comprehensible speech. Moreover, the long-term goal
must be to help the child to continue his/her development in
proportion to his/her age.
iv) Furthermore, it is suggested a typical
school placement for the child but some adjustments in the classroom
are essential to be done. For example, the child should sit at the
first desk in order to ensure better contact with the teacher.
Another measure that should be taken for extra support is a special
educator specialized in deaf children and if it’s possible to be
experienced in the lip-reading method so as to make the communication
easier. Finally, securing the child’s
psychological support is
recommended for his/her smooth and normal development.
v) Therefore, the most appropriate
approach that is advised for this child is the oral method and
especially 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 method
which 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 this
case, according to Watson (1998), is aimed at reproducing for deaf
children those conditions that have been found to be helpful in
hearing children. Additionally, the term
“natural” points to stress how the language is acquired when
participating in meaningful conversations.
using the right method in each case the
academic and psychological development are