Understanding Hearing Loss: Types, Assessment & Treatment
Understanding Hearing Loss: Types, Assessment, and Treatment
Hearing impairment refers to quantitative alterations in the correct perception of hearing.
Deafness or Cofosis is the total loss of hearing. In this case, language is acquired through the visual pathway. Early diagnosis and proper rehabilitation are crucial to prevent the most significant consequence of childhood hearing loss: growing up without language.
Decreased hearing loss allows for the acquisition of spoken language through the auditory pathway.
Hearing Levels (Monfort and Juárez, 2001)
- Normal: The ability to discriminate any sound of speech and any combination thereof, regardless of its meaning (e.g., the ability to repeat any invented word).
- Residual: The ability to increase understanding by lip reading. The child is unable to discriminate any verbal message by listening alone, but comprehension improves with lip reading, and results are enhanced when using a hearing aid.
- Functionality: The ability to recognize and understand previously known verbal messages (but not new or invented words), especially with prior context.
Hearing Assessment
Technical Assessment of Conduct Evaluation
Observe the child’s behavioral reaction to an auditory stimulus.
Conditioned Response
- Game Audiometry: The measurement is transformed into a game, where the child presses a button after hearing sounds.
- Conventional Audiometry: After five years of age, in a soundproof chamber, the child receives sound stimuli through headphones.
- Evoked Response Audiometry: Auditory Evoked Potentials (AEP) are measured.
- Impedance: This assesses middle ear function. Children with risk factors for late-onset deafness should be identified and monitored.
Treatment
The role of parents is crucial. The family must become the primary source of psychological support and teaching for individuals with disabilities throughout their development, especially during early childhood. Parents and professionals should collaborate, as the outcome depends largely on the commitment and ability of everyone involved.
Rehabilitation Team
The rehabilitation team includes the family, hearing care professionals, speech therapists, social workers, doctors (ENT surgeons, prosthetists), and psychologists.
The differences between deaf children stimulated in their first years of life compared to those who start their education from 4 to 5 years of age are significant.
Early intervention encourages, promotes, and facilitates the overall intellectual development of the disabled child, providing a communication tool. The program should address all areas of development.
The basics of communication and language develop before three years of age. During this period, brain structures are ideally conditioned for such learning. Therefore, it is essential to act so the child acquires the greatest possible number of communicative and linguistic structures when they are biologically most prepared.
Audiology
Audiology focuses on communication processes, educating residual hearing, oral language learning, voice and speech training, and progressively improving the understanding and expression of the language used in the deaf child’s social environment. It also involves appropriate training for parents.
Methods of Communication
- Oral: Advocates for teaching oral language through the use of residual hearing, auditory discrimination training, and lip-reading training. Proponents believe that integration of the deaf depends on oral language proficiency, and any other system will hinder their learning.
- Sign Language (Manual): Believes that sign language is natural for the deaf. It has its own structure and follows the same developmental stages as spoken words. Children learning a sign system often show faster language, cognitive, and social development.
- Bimodal: Proposes that the child should communicate through sign language but must also learn spoken language to integrate into hearing society.