Hearing impairment
| Hearing impairment | |
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| The International Symbol for Deafness | |
| ICD-10 | H90-H91 |
| ICD-9 | 389 |
| DiseasesDB | 19942 |
| MeSH | D034381 |
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Hearing impairment Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hearing impairment On the Web |
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American Roentgen Ray Society Images of Hearing impairment |
Synonyms and keywords: Hearing loss
Categories of hearing impairment
Hearing loss is categorized by its severity and by the age of onset. Two persons with the same severity of hearing loss will experience it quite differently if it occurs early or late in life. Furthermore, a loss can occur on only one side (unilateral) or on both (bilateral).
Types
As discussed above, there are three major types of hearing loss: neural/sensorineural, conductive, or a combination of both. Treatment depends upon the type of hearing loss that is present.
Social impact
Pre-lingual impairment
See also: Prelingual deafness
In children, hearing loss can lead to social isolation for several reasons. First, the child experiences delayed social development that is in large part tied to delayed language acquisition. It is also directly tied to their inability to pick up auditory social cues. This can result in a deaf person becoming generally irritable. A child who uses sign language, or identifies with the deaf sub-culture does not generally experience this isolation, particularly if he/she attends a school for the deaf, but may conversely experience isolation from his parents if they do not know sign language. A child who is exclusively or predominantly oral (using speech for communication) can experience social isolation from his or her hearing peers, particularly if no one takes the time to explicitly teach her social skills that other children acquire independently by virtue of having normal hearing. Finally, a child who has a severe impairment and uses some sign language may be rejected by his or her deaf peers, because of an understandable hesitation in abandoning the use of existent verbal and speech-reading skills. Some in the deaf community can view this as a rejection of their own culture and its mores, and therefore will reject the individual preemptively.
Post-lingual impairment
Those who lose their hearing later in life, such as in late adolescence or adulthood, face their own challenges. For example, they must adjust to living with the adaptations that make it possible for them to live independently. They may have to adapt to using hearing aids or a cochlear implant, develop speech-reading skills, and/or learn sign language. The affected person may need to use a TTY (teletype), interpreter, or relay service to communicate over the telephone. Loneliness and depression can arise as a result of isolation (from the inability to communicate with friends and loved ones) and difficulty in accepting their disability. The challenge is made greater by the need for those around them to adapt to the person's hearing loss.
Many relationships have suffered because of the anger that occurs when there is general miscommunication between family members. Generally, it's not only the person with a hearing disability that feels isolated, but others around them who feel they are not being "heard" or paid attention to, especially when the hearing loss has been gradual. Many people opt not to choose hearing aids for fear of looking old, since hearing loss is usually associated with old age, which equals ineffectiveness in some societies. Family members then feel as if their hearing loss partner doesn't care about them enough to make changes to reduce their disability and make it easier to communicate.
Medical treatments
Approaches
Cleaning of ear canal (usually occurs during physical exam) to remove cerumen or a foreign body can restore hearing.
In addition to hearing aids there exist cochlear implants of increasing complexity and effectiveness. These are useful in treating the mild to profound hearing impairment when the onset follows the acquisitions of language and in some cases in children whose hearing loss came before language was acquired. Recent research shows variations in effacacy but some promising studies[1] show that if implanted at a very young age, some profoundly impaired children can acquire effective hearing and speech.
Ear protection can be used for the prevention of additional hearing loss.
Surgery and Device Based Therapies:
- Myringotomy and tube placement (middle ear effusions)
- Hearing aids
- Middle ear implantable devices
- Cochlear implants
- Reconstructive middle ear surgery (including stapedectomy and tympanoplasty)
Views of treatments
There is controversy in the culturally deaf community as to whether cochlear implants address wellness concerns, the overall health and psycho-emotional well-being of prelingually deaf children at all.
Gene therapy
In 2005, there was success of the regrowth of cochlea cells in test subjects by a research team led by Dr. Yehoash Raphael from the University of Michigan. This study was conducted using guinea pigs as test subjects. [2] It is important to note however, that the regrowth of cochlear hair cells does not imply the restoration of hearing sensitivity as the sensory cells may or may not make connections with neurons that carry the signals from hair cells to the brain.
A team led by Dr. Stefan Heller from Stanford University are pioneering stem cell research in the prospect of regrowth in cochlea cells.[3]
Resources
Many different assistive technologies, such as hearing aids, are available to people who are hearing impaired. People with cochlear implants, hearing aids, or neither of these two devices also use additional communication devices to reduce the interference of background sounds, or to mediate the problems of distance from sound and poor sound quality caused by reverberation and poor acoustic materials of walls, floors and hard furniture. Three types of wireless, one-way wireless exist along with hard-wired devices. A wireless device used by people who use their residual hearing has two main components. One component sends the sound out to the listener, but is not directly connected to the listener with the hearing loss. The second component of the wireless system, the receiver, detects the sound and sends the sound to the ear of the person with the hearing loss. The three types of wireless devices are the FM system, the audio induction loop and the infra red system. Each system has advantages and benefits for particular uses. The FM system can easily operate in many environments with battery power. It is thus mobile and does not usually require a sound expert for it to work properly. The listener with the hearing loss carries a receiver and an earpiece. Another wireless system is the audio induction loop which permits the listener with hearing loss to be free of wearing a receiver provided that the listener has a hearing aid or cochlear implant processor with an accessory called a "telecoil". If the listener doesn't have a t-coil or telecoil, then she must carry a receiver with an earpiece. The third kind of wireless device for people with hearing loss is the infra red (IR) device which also requires a receiver to be worn by the listener. Usually the emitter for the IR device, that is, the component that sends out the signal, uses an AC adaptor. The advantage of the IR wireless system, is that people in adjoining rooms cannot listen in on conversations, and thus it is confidential and necessary for situations where privacy and confidentialitiy are required or chosen. Another way to achieve confidentiality is to use a hardwired amplifier which sends out no signal beyond the earpiece that is plugged directly into the amplifier. That amplifier of the hardwired device also has a microphone inside of it or plugged into it.
- Hearing dogs, a category of assistance dogs, are trained to help those with hearing impairments.
- The advent of the internet's World Wide Web and closed captioning has given the hearing impaired unprecedented access to information. Electronic mail and online chat have reduced the need for deaf and hard of hearing people to use a third-party Telecommunications Relay Service in order to communicate with the hearing and other hearing impaired people.
Bibliography
- United States Environmental Protection Agency press release, April 2, 1974
References
See also
- Audism, discrimination against Deaf and hard-of-hearing people
- Auditory brainstem response (ABR) test
- Deaf culture
- Hearing loss with craniofacial syndromes
- King-Kopetzky syndrome
- Models of deafness for a comparison of the medical, disability and cultural models of deafness.
- Mondini Dysplasia
- Noise induced hearing loss
- Noise pollution
- Post-lingual hearing impairment
- Pre-lingual deafness
- Tinnitus
- Unilateral hearing loss
Quotations
- "Blindness cuts you off from things; deafness cuts you off from people." — Helen Keller
- "What matters deafness of the ear, when the mind hears. The one true deafness, the incurable deafness, is that of the mind." — Victor Hugo
- "Deaf people can do anything except hear." — I. King Jordan
External links
- World Health Organization fact sheet on deafness and hearing impairment
- National Association of the Deaf. The NAD protects deaf and hard of hearing civil rights.
- International Federation of Hard Of Hearing Young People
- Hard of Hearing Advocates Non-profit foundation dedicated to helping those with hearing loss
- Inside Deaf Culture Website
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