Theater Info
National Resources
MN Oral School Programs
Scholarships
Hearing Loss
[Auditory Devices]
Legislative Information
Board of Directors
Newsletters
Lending Library
| Auditory Devices and Assissted Listening Devices (ALD's)
(Much of the information on this page has been copied from the Oral Deaf Education website) School is primarily an auditory environment and, in a regular school, students are expected to spend the majority of their time listening in order to learn. The primary purpose of educational supports is to provide a student who is deaf or hard of hearing with access to this steady flow of auditory information. In addition, because access to auditory information may have been compromised throughout this student's life, supports are also meant to help fill in the gaps in background knowledge and language-based understanding, allowing the student the best chance of keeping up with his/her hearing peers.
The Americans with Disabilities Act (ADA) was developed in part to address the needs of a student with hearing loss. Knowledge of specific mandates within the ADA, particularly regarding the right to equal access to information in the classroom, provides an important resource for parents in advocating for support services on behalf of their child.
On this page you will find information on the following Auditory Devices:
Hearing AidsTop The hearing aid is the assistive device used by most deaf and hard of hearing children. In the event that the hearing aid provides less than beneficial auditory input for the development of spoken language, the cochlear implant may be used as an option. Many children who have received a cochlear implant continue to wear a hearing aid in the non-implanted ear.
There is a wide range of types of personal hearing aids. Parents, once the final diagnosis of a hearing loss has been made, are frequently already in contact with an otologist, a medical specialist concerned with ear problems and with an audiologist who specializes in the science of hearing. These professionals play critical roles with parents in decisions concerning the type of hearing aids and earmolds best suited for the individual child in order to provide the infant or child with the best possible acoustic message.
Knowledgeable professional assistance to parents is critical in view of the continuous technological advances in procedures in testing young children in the analysis of hearing aids and in fitting procedures. In some areas, where extensive otologic and audiological services may be lacking, the family pediatrician can be an important resource person for assisting and supporting parents in their search for appropriate professionals. Unfortunately parents have frequently reported that their pediatrician has been too slow in following up on parent concerns about a possible hearing loss in their baby and precious time can be lost. When and if this occurs, parents are faced with their first lesson in advocating for the child and need to become quite assertive.
Typically, unless otherwise indicated, most deaf and hard-of-hearing children are fitted with binaural (two) ear level hearing aids. Having two hearing aids allows the child to receive fuller quality auditory input, to localize the direction of speech, and to more quickly and accurately detect where a particular sound or conversation is coming from.
Another advantage of binaural hearing aids is the improved hearing in a noisy environment without increased stress on the child. Frequently, a child's hearing loss in one ear is not replicated in the other; two hearing aids, if correctly fitted, balance out these differences for improved listening. When one listens with two ears, environmental sounds and speech seem fuller and integration of bilateral listening is improved.
Just as a child with normal hearing constantly absorbs the field of language surrounding him and eventually begins the process of using spoken language, so does the deaf and hard-of-hearing child. Spoken language will develop and increase in stages similar (though at a slower pace) to his hearing counterparts if -- and only if -- quality sound is provided by the most appropriate hearing aids and earmolds. This comes along with intensive therapy by a competent teacher of the deaf and hard-of-hearing or speech/language therapist as well as the support and ongoing involvement of the child's parents. Starkey Financial HelpThe Hear Now Program of the Starkey Hearing Foundation offers help paying for hearing aids to people who meet financial qualifications. The program has provided over 47,247 hearing aids to 27,500 Americans since 1999. Applicants must meet the program’s financial criteria, complete the application process and be approved for hearing aids. Verification of the applicant’s financial situation and proof of a need for hearing aids are a part of the application process. Hear Now works with licensed practitioners who give of their time and talent to assist clients with the fitting and follow up processes. The applicant is responsible for the cost of the hearing evaluation and a nominal processing fee to the program. The recipient is also financially responsible for the cost of batteries and repairs. Once an application is approved, the aids are given to the applicant at no additional cost. To learn more about the Hear Now program, call 1-800- 328-8602 or see the website www.sotheworldmayhear.org. Cochlear ImplantsTop The first cochlear implant available to children was the 3M single channel device. No surgical procedure was available until the early 1980's for improving the listening of profoundly deaf children with a sensorineural hearing loss. The cochlear implant is an electronic device which requires electrodes to be surgically placed into the part of the inner ear known as the cochlea. These electrodes pass sound which is converted by another part of the device, the processor, into electrical impulses to the eighth auditory (VIII) nerve, where hearing takes place.
Since each newly-designed and manufactured implant is required by the Federal Drug Administration to undergo investigational trials, the first multi-channel implant, the Nucleus 22 with its twenty-two channels, was not made available for general use until 1990. Research comparing the 3M single-channel and this first multi-channel implant has been voluminous, the results indicate that profoundly deaf children using the multi-channel implant can receive auditory stimulation to an even greater degree than many hearing aid users.
Subsequent to the reported success of the Nucleus 22 multi-channel implant, other makes and models of implants have been designed and manufactured.
The cochlear implant is an exciting piece of technology that offers profoundly deaf children with the opportunity to access sound which otherwise would not be available to them with traditional hearing aids. Cochlear implants have the potential to help children acquire spoken communication when combined with an appropriate therapeutic approach that emphasizes the use of listening in the development of language. Most severe to profoundly deaf children who have received a cochlear implant at an early age and are enrolled in a program that focuses on the development of auditory skills have demonstrated excellent listening skills and a high level of spoken communication.
FM SystemsTop An FM system, a frequency-modulated radio transmission, is an assistive device that improves the speech-to-noise ratio in the environment. Any time a deaf or hard-of-hearing person is in an environment which has even everyday noises, there is a negative impact on quality listening. It can be a false assumption that the hearing aid(s) or a cochlear implant alone are adequate for good auditory reception unless the listener is in close proximity to the speaker.
Personal hearing aids and cochlear implants are most helpful in one-to-one communication situations, or in a group setting with ideal communication conditions. But there are three factors, which can limit their effectiveness in larger group situations or when communication conditions are less than ideal.
- Distance - The further away a speaker is from the listener, the weaker the signal will be, and the less effective the hearing device will be.
- Background Noise - Classrooms tend to be noisy places. When the background noise is as strong or stronger than the speaker's voice, it is much more difficult to understand what is being said.
- Reverberation - All sounds reverberate (or bounce off) surfaces within a room. If a classroom has hard walls and ceiling, no carpeting, and limited sound-absorbing materials on the walls, reverberation can create significant interference. Hearing aids will make all sound louder, not just the sounds that are important. Reverberation can mix with, and sometimes overpower, the sounds of speech, making it much more difficult to understand and follow what is being said.
An FM system may be recommended to resolve any or all of these conditons. The FM consists of a teacher microphone and transmitter, and a student receiver. It runs on either rechargeable or disposable batteries. Wearing the microphone about six inches away from the mouth, the speaker's voice is transmitted by one specific FM radio frequency to the student's receiver. The receiver works in conjunction with the hearing aid or cochlear implant to amplify the sound of the speaker's voice. No matter how far away the speaker stands, the signal arriving at the student's ears will be as strong as if the speaker were six inches away. And because the microphone is designed and positioned to pick up the speaker's voice, the voice will be a stronger signal than the background noise and reverberation.
For deaf and hard-of-hearing children in special classes and especially in the mainstream where the child cannot always be in close proximity to the speaker, the FM is a critical supplement to hearing aids and/or cochlear implant. One traditional recommendation for the mainstream is preferential seating, thought to provide the child with an improved listening environment. Research in acoustics and the speech signal has shown, however, that access to a clear and consistent speech message is not possible in the typical learning environment thus supporting the use of an FM system. This is not to negate preferential seating, which is also important in the mainstream, but to indicate that improved listening is basic to a child's success in being comfortable in the demands of the mainstream classroom.
Fortunately the FM system is not complicated for the child and is much like having a small, personal radio; there are no wires limiting a child's mobility; an accompanying transmitter microphone can be passed from teacher to teacher (or parent to parent), which can be clipped on a collar; distances up to 200 feet can separate the wearer and the speaker allowing the child to be "tuned in" for academic events as well as many other types of activities.
Because the auditory message received through personal hearing aids and cochlear implants is negatively impacted by distance, the FM system fills that "quiet spot". The situations made auditorily accessible to a child with an FM are as numerous as one's ingenuity - field trips, grocery shopping, museums, car rides, family biking, church services, etc. It is hoped that children are so determined to listen at all times that the FM will be as much a part of their getting ready for each day as are their hearing aids.
Presently no manufacturer has developed an FM system that has been widely used as a substitute for personal hearing aids. Research and development continue in this area. For now the hearing aid and the FM work in tandem in situations where this is appropriate and helpful.
Just as choosing a hearing aid and/or a cochlear implant are an important and, at times, an overpowering decision, so is deciding on which of a number of different FM systems is most appropriate for a child. Most parents will need the expertise of an audiologist to assist them in learning not only the various brands, but also specific features of each. Also, the audiologist, experienced in working with children, can be supportive to both parents and children as adjustments are made to wearing and benefiting from the FM. In addition, the audiologist can provide constant encouragement and support for maximizing the auditory environment. Quality listening, besides making the process easier, is the basis for the development of spoken language.
FM Systems are provided under the IDEA law in the United States by the local school district for classroom use.
A note of caution: The FM System, like personal hearing aids, should only be used under the care and management of an educational audiologist. A school should never assign an FM System to a student without its being adjusted to that particular student's hearing loss first. Nor should anyone but an audiologist make adjustments to the settings. Using an FM system without this preliminary, professional adjustment, could further damage the student's hearing.
The Soundfield System is an alternative FM System, which eliminates the need for the student to wear an FM receiver. This is most effective for hearing aid users with more useful residual hearing or for students with a cochlear implant. Permanent loudspeakers are strategically positioned around the classroom so that the person wearing the microphone will be better heard by everyone. While this makes the speaker's voice louder and solves the issue of distance, it does not effectively reduce the background noise and reverberation still present in the room. For an older student who moves from classroom to classroom, a small, portable speaker system is available that can be placed on the student's desk.
Oral Transliterating / Oral InterpretingTop Assemblies, group discussions, videos, or inexpressive speakers can be particularly challenging for a student with hearing loss. For students who depend more on speechreading than on using their auditory potential, or for listening situations that may be particularly challenging, Oral Transliterating can be an effective support.
An Oral Transliterator is a person trained to convey verbally presented information between people who can hear and those who cannot. Supplemented by facial expression and natural gestures, but using no voice, the transliterator enunciates, repeats and/or rephrases a speaker's words so that the person with hearing loss receives the information as clearly as possible through speechreading. The transliterator usually sits between the speaker and the person who is speechreading so that the speechreader's focus can move back and forth between them easily. In cases where his/her speech is difficult for inexperienced listeners to understand or when communication has broken down, the student may request that the transliterator speak for him/her.
A transliterator is expected to adhere to a professional code of ethics, developed to ensure that the person with hearing loss will function as independently as possible; and that confidentiality will be honored for all persons in the communicative situation. There are training programs and workshops for preparing oral transliterators offered around the country.
Note-TakingTop A note-taker is a person who writes down the important information that is presented during a class for the student with hearing loss to use later in studying. This allows the student to devote full attention to processing and participating in the class without having to interrupt the access to information by writing things down. A note-taker can be either an adult or a peer. In either case, the note-taker needs a clear understanding of expectations, with occasional reviews of his/her work by the teacher to be sure the notes are adequate and appropriate. Because the relationship between the student and note-taker is based on a service, the choice of note-taker should not necessarily be based on friendship. Rather the note-taker should be selected based on note-taking skills, legibility, organization, and willingness to provide this service. It is worth noting that students at the top of the class may not be the best choice for note-taking, as they may not write many notes, or their notes may be particularly cryptic. Having more than one note-taker identified allows the responsibility to be shared, and offers an alternative if one of the note-takers is absent or unable to take the notes.
TutoringTop Hearing loss inhibits a student's access to information both formally - in the classroom, and informally - through hearing what is being conveyed all the time, all around. Thus, at any age, a student with hearing loss is apt to come to class with a less extensive background of information in any given subject, regardless of his level of intelligence. Because this student's language development is apt to be delayed, then understanding any new concepts will take more time. Processing new information may take extra time and careful instruction, making progress slower. There may be times when background information, reading comprehension, grammar, and/or vocabulary will need to be addressed.
When given an assignment to complete independently, hearing students usually have an assumed, age-appropriate understanding of the topic, and some idea of how to begin, how to proceed, and how to organize the process. This may not be the case for a student with hearing loss. Without the background and understanding of the topic, he/she may not even know how to begin. Being unable to begin independently becomes an obstacle that can lead not only to problems in time management, but can easily lead to serious frustration and discouragement.
Communication is a critical factor. The student and the person assisting him need to understand one another. Ideally then, they should have a period of time without distractions, without interruptions, and with time to ensure that the communication of ideas, questions and responses is clear and successful. This is not the kind of assistance that a classroom teacher can easily provide during, or even outside of, class on a consistent basis.
Neither is resource room tutoring the best answer, since typically a resource room teacher needs to divide her time simultaneously among several different students who may have very different needs and demands. If a student with hearing loss has to compete with others for the teacher's assistance, the result will invariably and unavoidably be inadequate.
A tutor needs to be a knowledgeable person, who can give a period of concentrated attention to the student on a consistent, daily basis. This means the student can begin to synthesize what he learns in class with what is reinforced in the tutorial, in order to acquire a basic understanding and maintain his standing in the mainstream class. If one considers the nature and extent of this language-based disability; the extent to which language is the basis for all learning; and the extent to which school is an auditory environment; then one-to-one tutoring for a student with a significant hearing loss should be considered fundamental to a successful mainstreaming program.
CaptioningTop Captioning is a system that allows a speaker's words to be displayed in the form of typed words on a TV set or a computer screen. There are a number of different uses for captioning today.
Closed Captioning: Today the law requires that television and film producers arrange to have captions electronically embedded in many programs prior to their being seen on television. TV sets manufactured after July 1993 have a decoding chip built into them so that the embedded captions can be displayed on the screen as the closed-captioned program or video proceeds. This means that a student with hearing loss, depending on his/her reading skills, can now have access to the same information available to hearing peers during a video presentation. Parents are encouraged to request, through the student's IEP, that only captioned media will be used throughout the student's educational career. As with other supports, captioning can also be helpful to people without hearing loss, such as students who are learning to read, students from other countries who are learning English, and students who have reading problems.
Real-Time Captioning: Often referred to as CART (computer assisted real-time transcription) or R.T.C. (real-time captioning), many live programs on television, testimony in court rooms, and a growing number of live lectures are now making use of this captioning system. With real-time captioning, a stenographer, or court reporter, with special training, sits in the classroom and records everything that is being said. Simultaneously, the student is able to view what is being said on a laptop computer screen or television monitor. Real-time captioning in the classroom is still new and quite expensive because it requires a specially trained court reporter and technical equipment. Where it has been used, students have reported positive results.
Remote Real-Time Captioning: A variation of CART requires the student's computer to be hooked into a modem and telephone line that accesses a stenographer at another location. The speaker uses a special wireless microphone that transmits the voice to a receiver, and then through the modem and telephone line to the stenographer. The stenographer listens and records the information, which is then transmitted back to the student's computer screen almost instantly. This is a less expensive alternative to having the real-time captioner in the classroom, but requires any classroom being used to have a telephone jack capable of transmitting information through the special modem.
Voice to Text: The latest technology is a system whereby a computer program translates a speaker's voice directly into captions. The systems currently on the market, however, are not yet sufficiently robust to function successfully in the typical classroom. Their day will undoubtedly come. In the meantime, however, oral transliterating and real-time captioning are the best options for providing moment-to-moment information. Despite the costs to school systems, parents should be encouraged to request oral transliterating and/or real-time captioning in their child's IEP, particularly for middle and secondary students. The specific choice of service should be weighed carefully depending on the needs and interests of the particular student, because some students prefer one system over the other.
Telecommunication DevicesTop TTY is an acronym for a TeleTYpe machine. Another acronym, TDD, stands for Telecommunication Device for the Deaf. Still another is TT, meaning Text Telephone. All three of these refer to the same thing: a device that allows a person who is deaf or hard-of-hearing to use the telephone. By connecting a regular telephone to a TTY, a person is able to type messages on a small keyboard and send them to another TTY, where the message will appear in print on a small screen. When the person at the other end responds with another TTY, that message appears in print on the first caller's small TTY screen. There will need to be a TTY at both ends of the connection for this to work. To call a person who does not have access to a TTY, there is the telephone relay system. Through this system, a relay operator with a TTY, can translate the spoken message of a hearing person into a TTY message for a person who is deaf and vice versa. The number of your local relay service can be found in your local telephone book.
Communicating by telephone is just as important for a student with hearing loss as it is for one who hears. Making arrangements, checking on homework, and organizing social activities are much easier using the phone.
Previously, students were dependent on parents or siblings to make their personal phone calls. With a TTY, a student can now talk to friends, order pizza, or call an emergency number to get help. Parents, who are often concerned about the social life of their deaf and hard-of-hearing youngsters, report that this technology makes a real difference in the quality of their children's lives.
|
