Transcript Learning to Listen Sounds

Educational Audiology
Audiologic Rehabilitation for Children and Educational Audiology
SPA 6581 – Spring 2015
Lecture Date: 03/24/15
Educational Audiology
The practice of audiology in educational or school settings
Topics
 Educational Audiology
Association
 Student Counseling and
Self-Advocacy
 Roles and Responsibilities
of Educational Audiologists
 Hearing Loss Prevention
 The Cross-Check Principle
in Educational Audiology
 Classroom Acoustics
 Case Management and
Habilitation
 Educational
Considerations for Students
Who Are Deaf and Hard of
Hearing
 Where Are We Headed?
Numbers…
State
2006-2007 Estimated
Population
# of Audiologists
Employed
Alabama
754,110
21
Arizona
1,076,801
63
Arkansas
461,752
4
Florida
2,669,242
60
Hawaii
184,996
0
Mississippi
507,977
1
Oklahoma
588,016
5
Rhode Island
159,214
0
Texas
4,240,524
40
EAA recommends target ratio of one full-time
educational audiologist for every 10,000 students
 What could influence the need for adjusting this ratio?
 Geographical coverage and Extensive travel time
 Number of students with hearing loss beyond the expected
prevalence
 Support: secretarial, scheduling, computer
 Time-intensive services
 Direct intervention
 Services to infants, toddlers, and students with multiple
disabilities
 Service provision to regional or self-contained programs
designed for multiple students who are DHH
Educational Audiology
Association
EAA
 International organization
 Audiologists and related professionals
 “The mission of the EAA is to act as the primary resource
and as an active advocate for its members through its
publications and products, continuing educational
activities, networking opportunities, and other
professional endeavors.”
Resources
 Educational Audiology Association: Educational
Audiologists and Cochlear Implants
 Educational Audiology Association: Minimum
Competencies for Educational Audiologists
 Educational Audiology Association: Recommended
Professional Practices for Educational Audiology
 Educational Audiology Association: Guidelines of the
Consensus Panel on Support Personnel in Audiology
Roles and Responsibilities of
Educational Audiologists
Roles of Educational Audiologists
 Vary depending on other services and personnel
available to assist children within the school system
 Educational audiologists are a member of the
educational team
 Traditional Audiological Activities
 Service Coordinator
 Instructional Team Member
 Consultant
Educational Audiologists as Service
Coordinators
 Service coordinator
 When a student with a hearing loss is not receiving any direct
special education services
 When a student with a hearing loss is receiving multiple special
education services
 Audiologist is the individual responsible for monitoring and
managing the educational program for the student, in order
to provide appropriate services and classroom
accommodations
 Routine diagnostic audiology services
 Works with general and special education teachers
 Works with student, parents, and other relevant individuals
Educational Audiologists as Service
Coordinators Continued
Service coordinator responsibilities (English, 1995):
 Prepare teachers and other
service provides to work with
students with hearing loss
 Ensure that all appropriate
services (e.g., SLP, OT, etc.)
are coordinated and
implemented in a timely
fashion
 Provide ongoing support to
teachers and other school
staff
 Monitor student progress
 Monitor student placement and
make recommendations for
review and further assessment if
needed
 Support transitions to other
grades, schools, and programs
 Maintain complete and
accurate information regarding
placement options within the
local education agency (LEA),
as well as those in the region
and state
Educational Audiologists as
Instructional Team Members
Audiologist provides
support to the:
“Support?”
 Special education teacher
 Assessment of the hearing loss
 General education
teacher
 Other related service
professionals
 Student
 Parents
 Understanding of the hearing
loss
 Management of amplification
and the student’s learning
environment to ensure
communication accessibility
 Direct habilitation
 In-service
 Consultation
Educational Audiologists as
Consultants
 May provide consultations to ALL teacher, includes those who may
not have children with identified hearing losses in their classrooms
 Teachers may request the following:
 Information about a child’s hearing sensitivity or auditory processing
ability
 Activities for improving their students’ listening skills
 Information about how to integrate and reinforce specific auditory skills
into the classroom curricula
 Classroom presentations related to the function of the ear, hearing loss,
hearing loss prevention, or deaf culture
 Information about classroom acoustics
 Assistance with the use of classroom amplification systems
 Suggestions for classroom accommodations for standardized testing, as
well as general instruction
Educational Audiologists in Schools
for the Deaf

Their role may be limited community support and collaborations rather than screening
and identification.


Schools for the deaf are typically structured around a Deaf culture environment


Why?
Requires a unique sensitivity to issues which may not be encountered in public school programs
Main goal?

Still maximizing audition and listening

These audiologists may have to be more creative in designing environments for students to use
and practice these skills

May have more of an opportunity to provide habilitation

What about all of the cochlear implant recipients?

Audiologists are a critical resource to help design communication strategies and structure learning
in the classroom to maximize outcomes for students
Responsibilities of Educational
Audiologists
Responsibilities may overlap with other school staff
(nurses, SLPs, counselors, teachers of the deaf)
 Identification
 Hearing loss prevention
 Assessment
 Counseling and guidance
 Habilitation
 Amplification, cochlear
implants, and other
assistive technology
Responsibilities of Educational
Audiologists
Identification
Assessment
 Collaborate with community
resources to promote awareness
of hearing loss, its implications,
and programs and services to
support children with hearing
loss and their families

Select and maintain audiometric
equipment

Provide comprehensive assessments

Analyze classroom noise and acoustics
 Establish, administer, and
coordinate programs to identify
disorders of hearing and
auditory processing

Assess central auditory function

Provide written & verbal interpretation of
assessment, functional implications, and
management recommendations

Make appropriate referral for further
audiological, communication,
educational, psychosocial, and medical
assessments
 Train and supervise auditory
support personnel
What is an Educationally
Significant Hearing Loss (ESHL)?
Any hearing loss that potentially interferes with access to classroom instruction &
impacts a child’s ability to communicate, learn, and develop peer relationships.
Responsibilities: Habilitation
 Recommend methods for improving acoustic accessibility in the learning
environment
 Plan and implement programs related to the care and use of amplification,
cochlear implants, and other technology
 Provide support and training to facilitate auditory skill development
 Develop and implement treatment plans to facilitate communication
competence using speechreading, auditory skill development, communication
repair strategies, and other visual support and technology
 Collaborate with other service providers in selection of appropriate materials
 Recommend classroom accommodations and instructional modifications to
facilitate access to the students’ communication and learning environments
 Serve as a member of the IFSP and IEP, and instructional teams responsible for
educational plans for children with hearing loss
Responsibilities
Hearing Loss
Prevention
 Establish, manage, and
implement hearing
conservation programs
within the school
environment
 Provide for education
about and access to
hearing protection devices
Amplification, CIs, etc.
 Evaluate, select, and fit HAT
 Ensure proper fit and
functioning of HAs, CIs,
BAHA, and HAT in the
educational environment
 Collaborate with CI centers
concerning the evaluation
and management of
students considering or using
cochlear implants
Responsibilities
 Counseling & Guidance
 Provide information related to the implications and impact
of hearing loss to families, caregivers, and students
 Provide support to students, parents, and caregivers related
tot eh educational and psychosocial aspects of hearing loss
 Provide information to assist students with hearing loss to
network with other students with and without hearing
difficulties
 Facilitate communication among families of children and
youth with hearing loss
 Make appropriate referrals to address counseling needs
beyond the student’s hearing loss
Ethical Considerations
 Compliance with federal and state laws, regulations, and policies
 Relations among private and educational audiologists related to
the dispensing and management of technology
 Issues of confidentiality
 Conflicts of interest
 Restrictions on information provided to families and caregivers
 Referral procedures
 Perceived pressures to compromise recommendations for or
against services and technology
Educational Audiology Service
Delivery Models
 School Based
 Contractual Agreement
 Combined School-Based & Contractual Agreement
 Telepractice
Educational Audiology Service
Delivery Models
School Based
 This model is effective only
if the audiologist’s
caseload is reasonable
Contractual
Agreement

May be less costly and the only
means of obtaining audiological
services in small or rural districts

Many districts limits services in their
contracts so that the majority of the
services related to the educational
support for students with hearing loss
are addressed minimally, if at all.
 Audiologists should emphasize to
administrators that a full range of
audiology services is required by
IDEA (2004).

May need to differentiate between
educational and clinical audiology
services
 Many districts assume that
the audiologist can
provide services to an
infinite number of students
School-Based vs. Contractual
Agreement Service Delivery Models
School-Based Audiology Services
Contracted Audiology Services
Direct employee
Contract employee
Relatively autonomous
Completely autonomous
Services are typically comprehensive based on
job description
Services may be limited by scope of contract
Peer of other school employees; perceived as
“insider” with increased opportunities for
collaboration
Considered an “outside expert”; collaboration
with teachers may be difficult
Caseload may be large
Caseload can be specified in contract
District typically purchases and maintains
audiological equipment
District not usually responsible for diagnostic
audiological equipment
Overall cost to district may be less per service
Lower capital outlay
Often less efficient in small, rural systems with
small student population unless part of a
regional cooperative
Higher cost per service
May be appropriate for small, rural systems
unless part of cooperative with greater number
of students
Educational vs. Clinical Audiology
Educational Audiology
Clinical Audiology
Identify hearing loss at earliest age
Identify hearing loss at earliest age
Diagnose hearing impairment
Diagnose hearing and balance impairment
Evaluate hearing abilities and skill development
to determine hearing function in various
communication and learning settings
Communicate with physicians, families, and
referral sources
Select, fit, verify, and validate hearing
technology for educational settings
Dispense and monitor appropriate amplification
for personal use
Identify audiological information for educational
implications
Identify appropriate instructional modifications
and accommodations
Consult with students, teachers, parents, and
other relevant staff regarding hearing and
amplification needs
Ensure that amplification is working properly in
schools
Provide or assist with (re)habilitative needs within
learning environment
Educational Audiology Service
Delivery Models
Combined School-Based &
Contractual Agreement
Telepractice
 This model can be useful
when the school-based
audiologist is not able to
provide services to all of the
students within the district or
when an audiologist with
specialized skills or
equipment is needed
 Relatively new
 Both audiologists must have:
 Clearly outlined
responsibilities
 Ability to collaborate to
eliminate duplication
 ASHA (2005), Audiologists
PROVIDING Clinical Services
Via Telepractice: Technical
Report (available from
www.asha.org/policy).
 Contracted arrangement
 CI mapping
 EDHI programs
Establishing and Expanding Educational
Audiology Services in Schools
 Reimbursement for Educational Audiology Services
 Dispensing Personal Hearing Instruments
 Cerumen Management
Reimbursement for Educational
Audiology Services
 A number of school systems have implemented third-party reimbursement from
Medicaid for audiology as a health related services provided to students under
IDEA (2004).
 Educational Audiologists must be certified as Medicaid providers
 Permitted by the guidelines from Centers for Medicare and Medicaid Services
(CMS)




Provided to Medicaid-eligible children
Medically necessary
Delivered and claimed in accordance with all other federal and state regulations
Included in the state Medicaid plan
 Each state has the authority to:




Determine the type, amount, duration, and scope of services
Determine state eligibility standards
Set rates of payments
Administer its own program
Training for Educational Audiologists
 Amplification
 Educational management
of children with hearing loss
 Mainstreaming
 Auditory (re)habilitation
 Working with special
populations
 Sign language
 counseling
 Educational referral, followup procedures, and special
education eligibility
requirements
 Evaluation of the need for,
selection, and maintenance
of personal FM and
classroom audio distribution
systems and other HAT used
in educational environments
 Structure of the learning
environment, including
classroom acoustics, and
implications for learning
Training for Educational Audiologists
 IFSP and IEP planning process
and procedures, including
interpretation of auditory
assessment results and their
implications, educational
options, and legal issues and
procedures
 Consultation and collaboration
with classroom teachers and
other professionals regarding the
relationship of hearing and
hearing loss to the development
of academic and psychosocial
skills
 Participation in team
management of
communication treatment
 Knowledge of the various
communication modes used by
individuals who are deaf and
hard of hearing
 Implementation of in-service
training for educational staff
and support personnel
 Knowledge of school systems,
multidisciplinary teams, and
community and professional
resources
Additional Readings
 ASHA: Guidelines for Audiology Service Provision In and
For Schools
 Suggested Discipline Responsibilities for Identification,
Evaluation, Referral, and Services for Children with
Hearing Loss
 Colorado Department of Education: Listening
Requirements for School Audiologists
 Standards of Practice for Audiology Services in the
Schools: Colorado Department of Education
Assessment: The Cross-Check
Principle in Educational
Audiology
Cross-Check Principle in Educational
Audiology
 Educational audiologists are seeing an increasing
number of children identified with hearing loss at very
young ages and with multiple learning challenges
 Jerger and Hayes (2006)
 Children should always be diagnosed using a test battery
 Not just a single measure
 Functional listening component of assessment battery often
falls under the scope of the educational audiologist
Assessment
 Basic Assessment of Hearing Loss
 Modifications for Special Populations
 Monitoring Hearing Sensitivity
 Additional Audiometric Information and Functional Hearing
Assessment
 Assessment of Educational Effects of Hearing Loss
 Communication of Assessment Results
 Personal Vulnerability and Safety
When standard instructions don’t
work…

Bright-colored soft toys, bubbles, or
stickers

Keep materials for activities not in use
within easy reach, but out of sight

Reinstruct, but remember not to ask…

If activity is too interesting to maintain
attention to the task, simplify it

Change response activity often:

Objects dropped or put into a
container may need to be out of
sight after the child’s response (lids)

Ask the child to count beeps

Turn over picture or playing cards for
each beep

Use a soft band for bone-conduction
testing

Park cars in a garage

Place simple puzzle pieces or pegs
in holes

Assemble Mr. Potato Head

Place blocks on board, or checkers
on checker board

Put coins in a bank

Place objects on matching pictures

Toss bean bag or small, light balls
into a box/basket

Put pop-beads together
Additional Audiometric Information
and Functional Hearing Assessment
 Speech Recognition for Sentences and Phrases
 Listening in Noise
 Speech Recognition with Visual Access
 The Functional Listening Evaluation
 Auditory and Listening Development Skills
Additional Audiometric Information
and Functional Hearing Assessment
Speech Recognition for
Sentences & Phrases
Listening in Noise

More realistic in terms of everyday
communication as compared with
word recognition
 Critical part of audiological
assessment

Most do not have normative data,
but provide us with information

Examples:
 Word Intelligibility by Picture
Identification Sentences
(4.5y+)
 Pediatric Speech Intelligibility
Test (3y+)
 Hearing in Noise Test for
Children
 Word recognition scores
obtained in quiet are not
reflective of children’s ability
to understand speech in
classroom
 Useful in alerting and
demonstrating to teachers
problems the child may
experience
Additional Audiometric Information
and Functional Hearing Assessment
Speech Recognition
with Visual Access
Auditory and Listening
Development Skills
 Most audiometric speech
tests are administered using
auditory input alone
 Some Tests of Auditory Skills:
 Early Speech Perception
Test (ESP)
 Functional Auditory
Performance Inventory
(FAPI)
 Auditory Perception Test
for the Hearing Impaired
(APT-HI)
 Cottage Acquisition
Scales for Listening,
Language, and Speech
(CASLLS)
 Can be used to determine if
the child relies on visual cues
 Can also be helpful to
determine if there is an
actual lack of
understanding, or if speech
production is actually
decreasing their auditory
only word recognition score
The Functional Listening Evaluation
 Need to document a student’s ability to hear in environments other
than the soundbooth
 The Functional Listening Evaluation (FLE)
 Developed by Johnson and Von Almen (1993) using a paradigm
suggested by Ying (1990) and Ross, Brackett, and Maxon (1991)
 Used to assess the effects of noise, distance, and visual access on a
students’ listening abilities
 Designed to evaluate students in their classrooms
 Due to room acoustics and individual classroom characteristics
 8 lists of words, phrases, or sentences are used in 8 conditions
 4 in quiet with close and distance proximities
 Auditory only and auditory + visual access
 Same 4 conditions are repeated with background noise present
 30 minutes to administer
Classroom Acoustics
Classroom Acoustics
Classroom Acoustics and At-Risk
Children
Children
Adults
 More vulnerable to the
effects of poor classroom
acoustics
 More mature and skillful
listeners who rely on their
language and life
experiences to assist with
auditory closure and
gaining meaning in less
than optimal acoustical
conditions
 More adversely affected
by noise and reverberation
as central auditory
pathways
(interhemispheric
organization & neural
synchrony) do not reach
maturity until adolesence
 Perform better during
complex listening tasks
Classroom Acoustics and At-Risk
Children
 In every classroom there are children who either have permanent
or fluctuating hearing loss or difficulty processing speech and
language, and the incidence is more prevalent with younger
children.
 Listening and learning are affected when students cannot hear
clearly. Skills involved in auditory processing and learning to read
are impacted.
 Listening and learning problems can be intensified because of
excessive noise and reverberation and the loss of intensity of the
teacher’s voice over distance or change in directionality.
 Improving classroom acoustics may require attention to
architectural design principles and elements; acoustical
modifications; and the use of hearing assistive technologies
Classroom Acoustics and At-Risk
Children
 At-Risk Populations for Learning in Poor Acoustical Environments:













Young children (<15 years old)
Conductive hearing loss
History of recurrent otitis media
Language or articulation disorder
Learning disability or dyslexia
English as a second language (ESL)
Auditory processing deficit
Minimal bilateral sensorineural hearing loss
Unilateral sensorineural hearing loss
Developmental delays
Attention deficits
Cochlear implants
Auditory neuropathy spectrum disorder (ANSD)
Properties of Classroom Acoustics
Noise

Any auditory disturbance that
interferes with what a listener wants or
needs to hear

Internal building noise, classroom
noise, external building noise

3 variables that contribute to speech
masking by noise are:
 Long-term acoustical spectrum
of the noise (masking
consonants?)
 Average noise intensity relative to
the intensity of speech
 Fluctuation of noise intensity over
time
Signal-to-Noise Ratio
(SNR)
 Relationship of the intensity of
the following:
 Auditory signal (i.e.,
teacher’s voice, etc.)
 Background noise
 Young listeners need a quieter
listening environment
 Goal for SNR without hearing loss
= +15 dB or more
 Goal for SNR with hearing loss =
even more!
Properties of Classroom Acoustics
Reverberation

Occurs when sound persists in a
classroom as a result of repeated
reflection from surfaces in or
surrounding the enclosed space

Warning signs:
 Hard ceilings without acoustical
tiles
 High ceilings greater than 10 feet
 Painting ceiling tiles (reduce
absorption)
 Hard surface flooring
 Lack of sound absorption
materials
 Irregularly shaped classroom
Inverse Square Law &
Critical Distance
 The distance from the sound
source has a significant
effect on the SNR. The direct
sound level decreases in
linear proportional to the
distance between the talker
and the listener
 6 dB decrease in sound
pressure level (SPL) occurs
with each successive
doubling of distance from
the sound source
Classroom Acoustical Standards
 ANSI/ASA S12.60-2002, Acoustical Performance Criteria, Design Requirements and
Guidelines for Schools (June 26, 2002)
 Revision in 2010
 Purpose = to assist school planning and design professionals in providing learning
environments that allow for good speech communication between teachers and
students in classrooms and other learning spaces without the use of electronic
amplification systems.
 Standard is voluntary, unless referenced by state code, ordinance or regulation
 Looks at:







Background Noise Considerations
Instructional Equipment Noise
Heating, Ventilation, and AC (HVAC), Building Services, and Utility Noise
Reverberation Time
Noise Isolation Design Requirements
Classroom Audio Distribution systems
Conformance and Tolerance Verification
Which states have adopted the
standard?
 http://www.access-board.gov/acoustic/index.htm
 New Hampshire Department of Education
 New Jersey School Construction Board
 State of Connecticut
 Ohio School Facility Commission
 New York City Public Schools
 Arlington County (VA) Public Schools
Classroom Acoustics Resolutions and
Guidelines
 AAA and ASHA both have developed position
statements on classroom acoustics
 Roles of audiologists and acoustical consultants
 U.S. Green Building Council (2009)
 Classroom acoustics is a national agenda item for this
council
Measuring Classroom Acoustics
 Classrooms of the 21st century are dynamic with active
learning environments where the acoustical parameters
change by time, the specific learning activity, and other
factors (Smaldino, Crandell, & Kreisman, 2005).
 Specific Procedures to be used in measuring classroom
acoustics:





Classroom Observation
Measuring background noise levels in dBA
Measuring or estimating reverberation time
Measuring or estimating the SNR
Estimation of the critical distance
Measuring Classroom Acoustics
Classroom
Observation Tools
Classroom and Student
Observation and Assessment
Tools

Children’s Auditory Perception of Speech
(CHAPS)

Children’s Realistic Index of Speech
Perception (CRISP)

Evaluation of Classroom Listening Behaviors
(ECLB)
 Classroom Acoustical Screening
Survey Worksheet

Fisher’s Auditory Problems Checklist
 Modeling Classroom Acoustics

Listening and Learning Observation
 Subjective Assessment of
Classroom Acoustics

Listening Environment Profile

Scale of Classroom Listening Behaviors

Screening Instrument for Target Educational
 Classroom Acoustical
Modification Efficacy Scale I
(CES-I)
 Classroom Acoustics
Documentation Form
Role of the Educational Audiologist in
Classroom Acoustics
 Advocacy
 Acting as an information resource
 Performing observations and acoustical measurements in
classrooms and other learning spaces
 Collaboration with educational facility planning teams
 Ensuring acoustical access for special populations
 Conducting efficacy measurements to determine the need
for and benefits from acoustic treatments and
modifications, as well as, HAT
Case Management and
Habilitation
Case Management and Habilitation
 Planning Case Management and Habilitation
 Implementing Audiological Habilitation
 Services for Special Populations
 Inclusions
Planning Case Management and
Habilitation
 Service coordination for students with hearing
impairment
 Implies communication and collaboration with more than
one service or service provider
 Clarification of the needs and services for the student
with hearing loss
 Identification of currently available school personnel
 Arrangements for effective collaboration among service
providers
 Development and implementation of a written
communication system
Implementing Audiological
Habilitation

Primary role of educational audiologist in habilitation is to facilitate optimal access to and use of
auditory input during the learning process

Direct







Indirect







Management of amplification
Development of auditory skills
Speechreading
Communication repair training
Management of environmental barriers to communication
Counseling
Classroom audio distribution systems and other HAT
Teacher collaboration
Selection of classrooms and teachers
Selection of auditory curricula and materials
Facilitation of auditory skill development
Information concerning student hearing loss and auditory function
Combination
Services for Special Populations
 Unilateral, minimal, or high-frequency losses
 Students with fluctuating hearing problems
 APDs
 ANSD
 Children with multiple learning challenges
 Four areas:




Amplification and other technology recommendations
Strategies for classroom management
Development of auditory goals and objectives
Monitoring student progress and auditory function
Categories of School Accommodations and
Modifications for Children with Listening Difficulties
 Amplification
 Assistive technology devices
 Communication
 Instruction
 Physical environment
 Curricula
 Evaluation
Student Counseling and SelfAdvocacy
“One of the most difficult facts that
students with hearing loss will face is
that their hearing loss never goes
away.” Karen Anderson
Counseling Students with Hearing Loss
 Service is typically overlooked or referred to another member of the
team
 Teachers are often unaware of student feelings about the impact
of the hearing loss on relationships with peers
 May not always refer the student for counseling
 By providing information and support in the early years, many
adolescent frustrations can be lessened or even avoided
 Enabling vs. Empowering
 Remember back to “Family-Centered AR”
 Tell them where to sit vs. teaching them variables to consider when
choosing where to sit
Hearing Loss Prevention
Planning a Hearing Loss Prevention
Program

Ongoing Programming




Curricular Interface




All materials should be reviewed by the teachers before use
Ensures developmental appropriateness of the materials and increases teacher support
Targeting the School Environment

Focus on noise produced within the school environment at each educational level

Noise levels in class have ranged from 85 to 115 dB, up to 128 dB in a woodworking class
Noise Criteria Standards



Make sure to design it with objectives related to general education
Consider how much class time the program will take
Teacher Involvement



Introduction
Activities that can be done by the teacher, para, or students
Designing a curricular sequence from preschool to highschool
OSHA: 90dBA for 8 hours (older) and NIOSH: 85 dBA for 8 hours (newer)
Permissible noise exposure criteria for children over a lifetime are unknown, more conservative damage-risk are warranted
Architectural Information
Hearing Loss Prevention Curricula
 Preschool Hearing Loss Prevention Program
 Elementary Hearing Loss Prevention Program
 Middle School Hearing Loss Prevention Program
 High School Hearing Loss Prevention Program
Preschool Hearing Loss Prevention
Program
 Outcome: Early awareness
of need to protect ears
and hearing
 Objective
 We hear with our ears
 We need to take care
of our ears
 Loud sound can hurt
our ears
 Content
 Location and # of ears
 Sources of sound; loud
vs. soft
 Causes of damaging
noise (toys, etc.)
 Ways to avoid noise
damage
Elementary Hearing Loss Prevention
Program
 Outcome: Increased
awareness of hearing
process and danger of loud
noise exposure
 Objective
 Interface with school’s
curricular objectives on
hearing (one of 5 senses)
 Loud noises can damage
hearing
 We can help protect our
ears from loud noises
 Content
 How the ear transmits
sound
 Damage to the ear
cannot be seen but can
be temporary or
permanent
 Causes of damaging
noise
 Some rooms and
locations are noisier than
others
 Ways to avoid noise
damage
Middle School Hearing Loss
Prevention Program
 Outcome: Understanding of the
implications of damaging noise
exposure and need for active
use of ear protection in specific
situations
 Objective
 The inner ear is susceptible to
permanent damage from
noise
 Specific strategies can
prevent this noise damage
from occurring or from
increasing
 Content
 How the ear works and what
part is damaged by noise
exposure
 Noise damage can be
permanent but can be
prevented; increased loss
can also be prevented if a
problem already exists
 Sources of damaging noise
exposure
 Ways to prevent damage
from noise
 Symptoms of excessive noise
levels
 Different surfaces reflect or
absorb sound waves
High School Hearing Loss Prevention
Program
 Outcome: knowledge necessary
for prevention of hearing loss
caused by occupational and
recreational noise
 Objective
 Damaging noise levels can
occur in the workplace
 Laws requiring employers to
protect employees from
noise-induced hearing loss
 You can take precautions to
prevent noise-induced
hearing loss from
recreational sources
 Content
 Interface with vocational
and health curricula
 Expanded information
regarding anatomy of the
ear with specific attention to
cochlea and cochlear
damage
 Audiogram and
configuration associated
with noise-induced hearing
loss
 Sources and levels for
damage from noise
exposure
 Etc.
Numbers…
State
2006-2007 Estimated
Population
# of Audiologists
Employed
Alabama
754,110
21
Arizona
1,076,801
63
Arkansas
461,752
4
Florida
2,669,242
60
Hawaii
184,996
0
Mississippi
507,977
1
Oklahoma
588,016
5
Rhode Island
159,214
0
Texas
4,240,524
40
References

Cole, E. B., & Flexer, C. (2007). Children with hearing loss: Developing listening and
talking birth to six. San Diego, CA: Plural Publishing, Inc.

Deconde Johnson, C., & Seaton, J. B. (2012). Educational audiology handbook. (2nd
ed.). Clifton Park, NY: Delmar Cengage Learning.

Educational Audiology Association. (2012). Educational audiology association. Retrieved
from http://www.edaud.org/

Educational Audiology Association. (2012). Position statements. Retrieved from
http://www.edaud.org/displaycommon.cfm?an=1&subarticlenbr=4

Ling, D. (2002). Speech and the hearing-impaired child: Theory and practice. (2nd ed.).
Washington, DC: Alexander Graham Bell Association for the Deaf and Hard of Hearing.

Ling, D., & Ling, A. H. (1978, 1980, 1985). Aural habilitation: The foundations of verbal
learning in hearing-impaired children. (3rd ed.). Washington, DC: AG Bell Association for
the Deaf, Inc.