HEARING LOSS

HEARING LOSS

Hearing helps you:

1.      To understand what others are saying.

2.      Awareness to knowing where you are.

3.      To sense possibility of danger.

4.      In developing speech and language (babies and infants)

5.      To effectively interact (socialize with people).

6.      To perform better in school, at work etc.

7.      To be calm that the “world is still safe” stay connected to the world.

Hearing Loss

A.     In children

1.      Reduces or removes the opportunity to develop speech and language.

2.      Reduces academic (school) performance a school child

3.      Reduces interaction with peers.

4.      Denies the child opportunity to develop his/her potential to the fullest.

B.      Adults

1.      Reduced ability to participate in discussion

2.      Reduced job opportunities

3.      Difficult social interactions.

4.      Social isolation especially family.

5.      Loss of opportunity to develop a career of choice.

6.      Social stigma (too old, dumb etc.)

7.      Early loss of memory (dementia)

8.      Psychosocial disturbances e.g. stress, depression etc.

9.      Poor or no connection to the outside world.

RESULTS

Good hearing helps to improve quality of life.

Day to day challenges of people with hearing loss.

1.      Participating in group discussions.

2.      Lectures and presentations and classroom teaching.

3.      Religious services, concert, movies etc.

4.      Watching TV, listening to radio.

5.      Talking on phone.

6.      Knowing which direction sounds are coming from.

7.      Interpreting sound warnings correctly e.g. fire alarms.

8.      Fatigue and headaches.

WHY ARE MANY PEOPLE LIVING WITH HEARING IMPAIRMENT?

WHY ARE MANY PEOPLE LIVING WITH HEARING IMPAIRMENT?

1.      Do not know.

§  Young children may be labelled “naughty, disobedient; hears when he wants” etc.

§  Children may respond to speech sounds but yet miss important parts of speech e.g. words with /S/CH/

2.      Denial

§  Blaming others for “moving their lips” without producing sound.

§  Age phobia

§  Loss of opportunities if hearing loss is confirmed

3.      Underestimation of hearing loss

§  Hearing loss often develops gradually, may do adjust slow

§  The “lesser evil” choice – coping with some hearing loss rather than label of “incompetence or social stigma.

4.      Wrong advice from health professionals

§  Hearing with one ear is okay. You are even lucky!

5.      Others “experienced in coping” with hearing loss while not using devices

HEARING AIDS

When detected early can be treated in some conditions (those affecting the outer and middle part of the ear).

Those affecting the inner ear and nerves are managed using hearing devices (hearing aids).

The hearing aids make sounds louder and clearer so that a person hears others speaking almost as clearly as hearing people.

Children fitted with hearing aids beyond one year after birth are able to hear and thereafter learn speech and language!

Hearing aids are electronic devices made of technology that enables the person to effectively use the hearing that is still remaining however small.

Modern (digital) hearing aids have high technology to help children and adults.

Hearing aids require to be taken good care e.g. no contact with water (remove while bathing; while sleeping etc.).

Keep hearing aids clean and dry.

Learn how to put the battery and remove, how to manage switches on hearing aids and tubings.

IS YOUR CHILD HEARING WELL?

IS YOUR CHILD HEARING WELL?

“I think so”

“May be”

“Yes, why not?”

Do not take chances about good hearing in your child.

Hearing impairment in early child wood is the commonest cause for failure of a child to develop language.

Hearing screening test at the earliest age helps you to know if your child’s hearing is likely to be reduced.

Take your child to a clinic or audiology centre where a hearing screening test can be done.

Most Gertrude’s Satellite Clinics carry out hearing screening in the “well baby clinics”.

If you suspect your child is not hearing well, book an appointment to the Gertrude’s Paediatric Audiology Centre, Muthaiga.

MIDDLE EAR MEASUREMENTS IN CHILDREN

MIDDLE EAR MEASUREMENTS IN CHILDREN

1. INTRODUCTION

      Vital in Audiological evaluation

      Tympanometric and Acoustic reflexs

      Provide information about

1. Middle ear
2. Cochlea
3. Auditory nerve
4. Auditory brainstem
5. Focial nerve(cr nerve)

Cross check for other test eg behaviral,ABR

6< months use 1000 HZ (226HZ not accurate)

Otoscupy precedes tympanometric

Quantive description of tympamgram (description and shape)

Infant Acoustic stapedial refers tested using 1000HZ.

Acoustic reflects activator  stimuli for insects ear phones in 2cc cavity mg be reported in Dbhl.

Underestimated in infant ears

(ii) PROCEDURE

                        Biological chach of Tympammeter

                        Multiple frequencies probe tone generator

                        Rapid pressure sweet rate best for children (time span)

                       Seal should be hermetic

                      Straighten pinna gently

                     Most equipment have start pressure at +200dBa

                    Sweep pressure fm positive to negative

                    Negative to positive sweeps- increased completely

(iii) INTERPRETATION

 1.  Types A-normal

              B-Flat( Effusion perforation)

             C-Excessive Negative pressure

         As-Normal pressure peal

                 Abnormal shallow amphtude (Otosclerosis)

.Normal Limits

      Flat tympamgram,large canal volume (Vea>?cm3) =potent Eust tube or perforation

     Flat –Normal Ear canal Volume, or Low peal= One low peal

     Wide Typammetric width (  <0.2 mm nos) in 6-30 months.

    Peals y>0.3 mm hos, TW >235Db pa(Roushet al,1995) MEE

2. Acoustic Stapedial Reflects Tests

Follow tympammetry

Activator admittance  for 226 HZ probe tone 0.02 or 0.03 mm hos

In infants 226HZ-results in absent reflects in majority with 1000 Hz ready all report measurably remarks reflects.

ASR thresholds for children= adult values

(iv) NORMATIVE VALUES

1. TYMP         STATIC ADMITTANCE    Tympametric width  Canal Volume

Children  3-1o yr old          Y                              TW/GR                         Vea

                                             0.52                         80-15g                      0.3-0.9

                                                                                *60-150                   0.4-1

                    Fail <0.2 dapa

                             <0.3,+                                >160                           >1.0

                               (0-2-0.9)

ADULTS 18yrs       0.30-1.70                      51-114                   0.9-2.0

                               0.3dapa                            >115                      >2.0

                               <0.4+

                               0.3-1.4m                            50-110               0.6 to 1.5

2.ACOUSTIC REFLEXES

                            80-85 Dbhl IN 500 TO 4000 HZ

                             BBN is 10dB lower than tonal stimuli(Wilson Margolis, 1990)

How to make your conversation/Interaction better with a person using hearing Aids

Note: All people suffer from communication problems. They may not hear others properly even when their hearing is good. Reasons include:

1. Too many people speaking at the same time.
2. Distance between the speaker and person.
3. Listening in the presence of too much noise around you                                                                                                                                                                                                                      How to communicate better with a person with a hearing Aid

• Speak as naturally and clearly as possible. - Do not be too fast.                                                                                                                          - Do not shout.
• Get closer to the person. Make sure there is little or no noise around.
• Look at the person while speaking. Eyes help in 'hearing'. When someone looks at the speakers face, he can guess many words by looking at the lips. This helps to guess the words the person may have missed.
• Make sure the person knows first the topic you are going to discuss. Introduce the subject early.
• Repeat words or rephrase sentences. All people have problems hearing especially those people with hearing problems.
• Do not talk to the person for long. Listening is difficult especially for those with a hearing problem. Make hearing very comfortable.
• Listening is a skill to be learnt. Be patient with the person