Introduction

As a family with a child recently diagnosed with hearing loss...
you will find yourself faced with many challenging decisions about your child’s hearing impairment and treatment of their hearing loss. Perhaps one of the first challenges you may face is deciding what amplification system would be most appropriate for your child. This website is designed to give you some basic information about hearing loss. The effects of your child’s hearing loss on the sounds he is able to hear are discussed.

Possible amplification options are reviewed.  This website aims to serve as an initial aid as you embark on a new pathway with your child. We hope it provides you with some useful information and assists you in making the best decision for your child.

Types of Hearing Loss

1. Conductive Hearing Loss Any problem in the outer or middle ear ...

can block the normal sound path to the inner ear and cause a conductive hearing loss. Conductive losses are usually mild or moderate in degree, causing hearing loss of up to 50-60 decibels. This is often a temporary type of hearing loss such as caused by ear infection, blocked nose or a cold but in rare cases may get worse over time or even become permanent.

2. Sensorineural Hearing Loss

Any damage to the sensitive inner ear hair cells can lead to a sensorineural hearing loss. The degree of hearing loss can range from mild through moderate to a severe or profound hearing loss. This is a permanent type of hearing loss that will not get better but can sometimes get worse. It is possible for someone to have a conductive loss in addition to a sensorineural loss.


Degree of Hearing Loss

The chart below shows the loudness of different sounds around us...
The “banana” shape indicates the area where most speech sounds typically occur. The pictures show the loudness and pitch of some everyday sounds. You can draw your child’s audiogram on top of this chart to get an idea of what sounds your child can hear.

Aids for Listening

Simple communication begins even before we learn to speak...
through facial expressions, like a smile and later with simple signs and gestures. The goal of aids is to make speech sounds heard so that speech and spoken language can develop as normally as possible.

Hearing Aids

A hearing aid is a device that makes sounds louder and clearer...
for the wearer; the aim is to make all the sounds of speech clear enough to be heard. Hearing aids for young children may be worn behind the ear (BTE or post-aural), in the ear (ITE) or on the body. Most infants will be provided with a BTE aid. A microphone picks up sound, which is amplified then sent into the ear through a connecting tube and earmould. The earmould has to fit exactly to give the best possible sound quality, the shape of the ear will be copied by taking an impression which will be sent away for the mould to be made.

Cochlear Implants

A cochlear implant is an electronic device designed to help individuals...
with a very severe degree of hearing loss, who gain little or no benefit from hearing aids. Cochlear implant systems convert everyday sounds into coded electrical impulses. These electrical impulses stimulate the hearing nerve and the brain interprets them as sound. It consists of two parts: an internal implant that is put in place under surgery and an external part known as the speech processor. The speech processor can be worn behind the ear or on the body.

Approaches to Communication

We all communicate in different ways: with facial expressions...
gestures and body language as well as through speech and hearing. Each child is different and there are many different ways to help your child to communicate.  Your local teacher of the deaf or speech and language therapist will be able to discuss the options and give further advice.

Oral-Aural Communication

A method that emphasizes use of residual hearing and lip-reading...
to teach spoken language.

Auditory-Verbal

This is similar to the oral-aural approach, but lip-reading is not used. It is often referred to as “active listening.”

Sign Language

A visual and manual language using handshakes and the rest of the body, including the face, to convey words and concepts, e.g. British Sign Language (BSL). Sign language is an independent language with a specific vocabulary and grammatical structure.

Total Communication

A “habilitation” approach consisting of the integration of oral/aural and manual communication strategies. Although these are separate ways of communicating with your child, some people choose to use them in combination. Some parents may choose to talk to their child, whilst others use speech and sign. Some parents may be hearing impaired themselves, and may choose to communicate with their child using oral-aural communication or sign language. The mode of communication you use with your child may change over time, depending on their amplification, schooling and other factors. Ask your local professional about the different communication options and resources available.

Lip-reading, Eye Contact and Physical Contact

People with hearing loss come to rely to a greater extent on their other senses. Sight, touch and intuition are valuable communication tools. As hearing aid users make extensive use of lip-reading, either consciously or subconsciously, you should try to keep your whole face in clear view when speaking. When you address a hearing aid user, try to make eye contact and perhaps say the person’s name. If you know each other well, you can touch, for example, the person’s arm to catch his or her attention.

Distance
...

Another significant factor is distance. It is crucial that you are positioned...
close to the person you wish to speak with. The level of your voice is halved when the distance is doubled so even a small increase in distance may cause communication to fail.

It does not help to shout
...

Many people with normal hearing believe they have to shout to be...
understood by hearing impaired people. However, the hearing aid user’s main problem is usually not the volume of your voice, but the articulation of your words. So it is far more helpful to simply speak clearly and more slowly without exaggeration. In fact, shouting is usually as uncomfortable for a hearing aid user as it would be to someone with good hearing.

Some sounds are more difficult to hear than others

Hearing problems often manifest themselves as the inability to...
hear certain sounds, or the confusion of some sounds with others. People with a hearing loss may hear some of the words of a sentence, but fail to understand the spoken message. In such situations it can be a good idea to rephrase your sentences, as you might when communicating with someone from overseas who has not yet mastered your native language. It is important to remember that any kind of background noise makes it much more difficult for a hearing aid user to communicate. As people do not generally want to appear to be a nuisance by asking favors, it helps considerably if you can remember to switch off any sources of noise, such as the radio or television, before communicating with a hearing impaired person. Noisy children or parties, where everyone is speaking at the same time, are other situations where people with a hearing loss may give up communicating and appear to isolate themselves from events going on around them.

Psychological consequences of hearing loss

Some people can develop emotional or social difficulties due to their...
hearing loss. The inability to understand what is being said can lead to isolation, loneliness or depression. It can, therefore, mean a great deal if the people around them are supportive and encourage them to seek professional advice if necessary. Some people with  a hearing loss struggle with a feeling of embarrassment if they misunderstand what is being said, or respond inappropriately. Your support and understanding in such cases can make a big difference. People with hearing difficulties often spend a great deal of their energy just in concentrating on listening, which can lead to tiredness and stress. So it is important that others understand their situation.