WWU Darling AR 2010 midterm packet #2

Hard of Hearing
deaf/Deaf
Deafened

mild --> severe hearing loss

audiologically deaf
-bilateral/profound HL
-even w/ hearing aids, speech is not perceived by auditory channel alon

culturally deaf
-identify with deaf culture
-does not depend upon degree of HL

HL that occurs after completion of education (late teens and beyond)

congenital, acquired
sudden, progressive

exogenous vs endogenous
site of lesion/disorder
type (conductive, sensory-neural, mixed)

Direct- reduced access to speech signal
Indirect- speech delays (grammar, syntax, speech, vocab)

Consequences in relation to:
Academics (reading, comprehension)
Social/emotional
Vocational
Family interaction

Children with HL perceived themselves as less socially accepted than did their peers with normal hearing
23 HOH kids ages 6-12 compared to age-matched cohort of 23 NH kids.

Asked 1200 kids w/ mild HL "During the past month, how often have you felt badly about yourself?"
Result: kids w/ mild HL have significantly higher rate of low self esteem than kids w/ NH.

On a rating scale of intelligence, personality, attractiveness and capability, when showed pictures of people wearing visible hearing aids respondents scored them lower in nearly every category
THE HEARING AID EFFECT

results of an old 1977 study showing that people judge those with HL as less intelligent, attractive, capable or personable.

Much less so.
This is one rationale for early inclusion, so that rapport can be developed before such notions come to be.

True
(learning card!)

False

Hearing loss--> lg. deficits (esp affective vocab)
Lg deficits --> limited experience in self expression
Limited experience in self-expression --> delay in awareness of their own or others emotions.

Shock
Denial
Depression
Acceptance

90%

False.
There is no set time.

Change in:
hearing status, amplification, educational placement, communication modality
Starting school
Adolescence
Starting work
Dating

blocking their efforts to help
being foolish or stubborn

Be sympathetic
Don't overwhelm them w. info or jargon
Provide info in unbiased manner
LISTEN
Support decisions without judgement
Professionals can add to anxiety by emphasizing issues that are not parental priorities immediately after Dx

Mother-child interaction is more rigid
Moms use more directive lg.
Parents may stop talking to their child =(
Without intervention, the above can impact parent-child attachment

Fewer opportunities to access social language.
Limited communication skills = poor social competence

Limits ability:
to think independently
for self control
to understand/verbalize feelings, motivations, needs of self/others
to be flexible and tolerate frustration
to rely on/be relied upon by others
to maintain healthy relationships

True.
Wouldn't mention wearing hearing aids.
Didn't want to be teased by peers
Many reported spending most of their time alone

Delayed due to prolonged dependence & low self-confidence
Difficulty developing internal locus of control
Experiences isolation
More behavioral adjustment problems than NH peers
Subject to fewer demands & more parental intervention when frustrated
Less opportunity to use coping skills

Assign responsibilities to increase self-confidence.
Realistically accept child's strengths and weaknesses.

b. A hearing impaired child w. age appropriate language is more likely to interact with typically developing peers than with hearing impaired children with language delays.

No older HI mentors
No HI peers to share experiences with
NH kids are unfamiliar with HL

Singles the child out as different
Can be a source of derision
If used incorrectly, can interfere w. communication

singles child out as different
may miss social opportunities

Source of derision
NH children may stop trying
HI children may stop trying

may lead to com. breakdown
may cause kid to remove self from groups

No contact w. typical speech/language models
No need to make an effort to establish social skills

No contact w. peers who are unlike themselves
No contact w. adults who are not understanding of their problems.
No preparation for the "hearing world"

feel like "outsiders"
require teacher mediation in classroom interactions
shy, withdrawn, poorly motivated, dependent
aggressive and uncooperative
behave immaturely
strong desire to please

False, silly.
ALL teenagers experience that crap.
Whew! So glad I don't have to re-live that nightmare!!

Less emotionally bonded to friends
Friendships higher in aggression
Preferred spending time w. other teens w. HL
Many reject amplification & struggle w. acceptance of HL
HI girls act out physically instead of verbally as is the norm

c. self advocacy

b. just over 30%

How family copes w. HL & immersion
-some view it as medical issue
-some view it from religious perspective
-adherence to management plan may be culturally bound
-families seek id, eval and management services based on cultural views

d. both a. and b.
differences in perspectives on time
and
differences in priorities (other factors may supersede tx priority)

NH sib gets less attention from family
family discussions center on HL sib
parents more lenient w. HL sib
NH sib assigned tasks to help HL sib
success of NH sib expected therefore not praised as highly as HL sib
NH sib = caretaker role
NH sib uncomfortable providing bridge to social world for HL sib

Families w. high stress = high incidence of child abuse
Lg. deficits can cause difficulty in understanding what is happening during sexual encounters
May be unable to understand innuendo
May be overly eager to please others
May find it difficult to communication concerns about a situation

medication
NIHL
hereditary HL
TBI
surgery

Direct - reduced access to the acoustic cues of speech
Indirect - difficulty w. communicative exchange
Which leads to:
social/emotional consequences
vocational deficits
family interaction deficits

7 years

"Not my fault" aka "He talks like he has marbles in his mouth!"
develop avoidance techniques (stop answering the phone)
pretend they heard what was said
deny difficulty

20%
The other 80% state cost and cosmetics as their reasons for not getting them

False
The $600-$5000 expense is not typically covered

the Granny study =)
2 age matched groups of women, one group fitted w. hearing aids.
Subjects interacted w. one another and rated each other on attractiveness, friendliness, confidence and intelligence.
Group w. hearing aids displayed less of the above because of projected self image.

HI adult: What did you say?
NH adult: nothing, it's not important.

frustration
isolation
resentment
paranoia
spouse/family/friends become impatient w. repeating and clarifying which leads to MORE isolation

c. elation

talking on the phone
talking or answering "for" the person
translating for them
explaining what was missed
covering for them when com. was missed.

False
Greater problems before, fewer problems after.

Opt out of activities (too stressful)
Misunderstandings common
Blame communication partner
Avoidance techniques develop
Make excuses about losing interest in activities
Withdrawal leads to depression
Failure to make connection between all the above and HL

c. ability to operate a motor vehicle.
All others are considered adverse affects of adult onset/acquired HL