Visual Learning for Hearing Impaired

As the awareness of the effectiveness of Visual Learning has grown, and the significant benefits of online educational video have become more widely accepted and understood, the availability and the amount of online educational video has started to increase.

However with the exception of one company, the needs of the hearing impaired child or student appear to have been largely ignored and forgotten.

While this may not have been deliberate, the fact remains that this has largely come about because the majority of so-called educational video available online, is film footage that was original recorded for other uses including general TV distribution, and was not developed specifically for the teaching of the school curriculum.

This means, simply because those videos may be of a general educational nature, does not mean that they adequately meet the requirements of the curriculum standards.

Zane Education however has taken a totally different approach, and as a result has a developed an online educational video library of over 1,500 online videos covering 11 school subjects and 240 topics specifically for the teaching of the curriculum.

They also have had the foresight to provide children with as many learning style options as possible, by adding subtitles to all of their videos.

In other words children with hearing impairments can now also enjoy the significant benefits of online educational video.

The issue of Dyslexia, there are those that would speculate that learning by using video rather than the use of textbooks, means that children’s reading skills will suffer.

Obviously with the addition of subtitles that is not necessarily the case. In fact a future article to be released in the next week will demonstrate and explain precisely, how video subtitles can be used to rapidly increase a child’s reading skills.

Research carried out by the Availll Institute over the last 5 years has demonstrated the link between the use of subtitles on video, and the improvement in children’s reading skills.

Unlike the child with special needs, the hearing impaired student will not require the attention of a parent, teacher or specialised tutor to make full use, and receive the full benefit’s from Zane Education’s comprehensive online educational video library.

They will be able to work on their on quite comfortably, and upon the completion of each topic, they will then be able to take full advantage of another of the significant features of Zane Education’s website.

Not only does Zane provide the use of educational video, they also support each of the 260 curriculum topics by providing online testing for each of those topics.

Interactive multiple-choice K12 curriculum quizzes containing a total of over 23,000 questions help to continue the learning process by revealing to the child not only whether their selected answer was correct or incorrect, in addition a further explanation is provided as to why the child’s answer was right or wrong. Hence the learning process continues.

So in many ways this approach to providing subtitles on each video removes virtually any distinction between the needs of the hearing impaired student and their peers, whether it is in the classroom or in the homeschool environment.

Dyslexia: Report on Perceived Link to Deaf Children with Cochlear Implants

Eight year-old Britan and her 10-year-old brother, Carson, have been going to the same summer camp for the past two years. For an entire day, they laugh, play games, eat pizza - and then chat with scientists who literally hang on every word they say.

That’s because Britan, who can hear normally, and Carson, who hears through cochlear implants – artificial ears for deaf people - are part of a study in the speech development laboratory at The Ohio State University Wexner Medical Center looking at the relationship between hearing and language skills.

Even though cochlear implants have significantly improved the communication abilities of children with hearing loss, many of these children still lag behind their peers in language and literacy development.

For nearly ten years, researchers at Ohio State have been following more than 100 children with normal hearing or hearing loss, some since birth, in order to help find answers that may lead to better implant designs and educational interventions.

Now, researchers say that a surprising picture is beginning to emerge from their studies that could change the way learning problems like dyslexia are detected and treated.

In "Measuring what matters: Effectively predicting language and literacy in children with cochlear implants," published in International Journal of Pediatric Otorhinolaryngology, the goal of Susan Nittrouer, director of Ohio State’s Speech Development Lab, was to evaluate how well various language measures typically used with very young children after they receive cochlear implants predict language and literacy skills as they enter school.

“We’re beginning to see similarities between the language problems of some children with cochlear implants and the language problems of some children with normal hearing who encounter barriers to language learning,” explained Susan Nittrouer.

“That’s enormously useful information because we know that the actual signal that children with cochlear implants get isn’t nearly as clear as the signal that normal hearing listeners get.

So if language and literacy problems in children with normal hearing are similar to those of deaf children with cochlear implants, maybe the difficulty rests with how they are processing the signal perceptually, even though they have normal sensitivity to sound. That would make sense since language was built on our perceptual capacities.”

With language development, timing is crucial. Most children with dyslexia, a language processing disorder that impacts somewhere between 5 to 20 percent of U.S. children, aren’t usually diagnosed until the third grade. By then, an important window of intervention opportunity has passed.

Ohio State has conducted multiple studies to pinpoint this critical window. Nittrouer’s team has been able to identify some accurate predictors of future language and literacy problems in children with hearing loss by the age of three.

“For example, a deficit in the early comprehension of spoken language is a strong predictor of later reading and writing problems,” said Nittrouer.

“Perhaps we’ll find that the measures of early language skill that we use with toddlers and preschoolers with hearing loss may actually identify children whose learning problems simply haven’t emerged yet. It would be ideal if we could step in earlier, and change the downstream impact.”

In an upcoming publication, Perspectives on Language Learning and Education, by the American Speech, Learning and Hearing Association, an article by Nittrouer suggests that some current theories of language development might need to be reconsidered, noting that the similarity of literacy problems in children with hearing loss and those with language deficits mandates taking a closer look at the role of perception in language development and new intervention approaches.

Read the full article here: HealthNewsDigest.com

In a second article published in Ear and Hearing, "Emergent Literacy in Kindergartners with Cochlear Implants" examined the early or emergent literacy of young cochlear implant recipients.

Hearing loss may change brain structure

"In the case of tinnitus, surprisingly, there were few changes to brain structure despite changes to function, suggesting that when sensory deprivation is accompanied by self-generated noise, it may be better at preserving neural tissue," says Fatima Husain.

Researchers used two different imaging modalities in studies of people with hearing loss, normal hearing, and those with hearing loss and tinnitus (ringing in the ears).

People in the hearing loss group showed structural changes in their brains.

“This suggests that functional changes due to sensory deprivation may result in long-term structural changes,” says Fatima Husain, a Beckman Institute faculty member at the University of Illinois.

The goal of the study was to investigate structural gray and white matter changes related to tinnitus and hearing loss and try to dissociate them from changes due only to hearing loss. (Credit: Fatima Husain)

“However, in the case of tinnitus, surprisingly, there were few changes to brain structure despite changes to function, suggesting that when sensory deprivation is accompanied by self-generated noise, it may be better at preserving neural tissue.”

Husain and her collaborators on the study measured neuroanatomical changes in gray and white matter in the brains of participants with only bilateral hearing loss (HL), participants who had HL and tinnitus (TIN), and a control group with normal hearing (NH) without tinnitus.

Their study, reported in the journal Brain Research, looked at neuroanatomical alterations associated with hearing loss and tinnitus.

Read the original study DOI: 10.1016/j.brainres.2010.10.095

The researchers used structural magnetic resonance imaging (MRI) scans and voxel-based morphometry (VBM) to examine changes in gray matter, and diffusion tensor imaging (DTI), to identify changes in white matter tract orientation.

While tinnitus is often accompanied by hearing loss, not everyone with hearing loss experiences tinnitus.

The goal of the study was to investigate structural gray and white matter changes related to tinnitus and hearing loss and try to dissociate them from changes due only to hearing loss.

“We observed that the HL group had the most profound changes in both white and gray matter relative to the other groups,” Husain says. The gray matter decreases seen in the HL group relative to the NH group were in the anterior cingulate, putamen, and middle frontal gyrus.

Two of these regions, the anterior cingulate and frontal cortex, were “also implicated in our companion study that studied functional response of the brain in the same group of subjects and points to involvement of the attention processing network.”

By dissociating the effect of tinnitus from hearing loss, the researchers concluded that “hearing loss rather than tinnitus had the greatest influence on gray and white matter alterations.”

Husain directs the Auditory Cognitive Neuroscience Lab in the Department of Speech and Hearing Science.

More news from the University of Illinois: http://www.beckman.illinois.edu/index.aspx

Hearing Disability Linked To Poor Touch Sensitivity

Touch and hearing are very distinct, but German scientists have found a possible genetic link between the two sensory systems.

Superficially, the two senses might seem worlds apart, but both rely on the ability to translate motions - vibrations in the ear and movement and pressure on the skin - into signals to the brain. A common set of molecules or mechanisms might be at work.

To determine if touch sensitivity can be inherited genetically, Henning Frenzel of the Max-Delbruck Center for Molecular Medicine and his colleagues first examined 100 pairs of fraternal and identical twins in a study outlined in the journal PLoS Biology.

They tested the twins on two kinds of touch sensitivity traits: "vibration detection threshold," or how low a vibration the subject could detect with their pinky finger; and "tactile acuity," or the ability to distinguish between two pressure points on the skin that are very close together.

Since the identical twins are genetically identical and the fraternal twins share up to 50 percent of the same genes, any genetic effect on touch should be more pronounced in the former.

Next, Frenzel and his team calculated the heritability of the two traits, a figure that explains the degree to which genetic variation contributed to the variation in the traits seen in the subjects. On average, 28 percent of the differences in tactile acuity and 52 percent of the differences in vibration detection could be chalked up to genetic influence.

Second Experiment
In a second experiment, the scientists found that some - but not all - of a population of young people that were born deaf also had impaired tactile acuity. But since there are about 70 known genes that are involved in hearing impairment, the researchers wanted to focus on a smaller group of genes to test the link between hearing and touch impairment.

Third Experiment - Usher syndrome
The scientists next examined patients with Usher syndrome - a hereditary condition that causes both hearing and visual impairment. They zeroed in on USH2A, one of the nine known genes that, when mutated, cause Usher syndrome.

Of the Usher patients studied, the 19 individuals that had a mutation in USH2A had both impaired hearing and poor touch sensitivity. It's possible then, that this gene may play a role in both touch and sound.

"Our next task will be to investigate some of these other cases to see if they are also correlated with problems in touch," senior author Gary Lewin said in a statement Tuesday. "This will give us a better understanding of the genetic mechanisms that underlie both types of perception."

Listen up: Does Abnormality in auditory processing underlie dyslexia

People with dyslexia often struggle with the ability to accurately decode and identify what they read.

Although disrupted processing of speech sounds has been implicated in the underlying pathology of dyslexia, the basis of this disruption and how it interferes with reading comprehension has not been fully explained.

Now, new research published by Cell Press in the December 22 issue of the journal Neuron finds that a specific abnormality in the processing of auditory signals accounts for the main symptoms of dyslexia.

"It is widely agreed that for a majority of dyslexic children, the main cause is related to a deficit in the processing of speech sounds," explains senior study author, Dr. Anne-Lise Giraud and Franck Ramus from the Ecole Normale Supérieure in Paris, France.

"It is also well established that there are three main symptoms of this deficit:

• difficulty paying attention to individual speech sounds, 
• a limited ability to repeat a list of pseudowords or numbers, and 
• a slow performance when asked to name a series of pictures, colors, or numbers as quickly as possible.

However, the underlying basis of these symptoms has not been elucidated."

Dr. Giraud and colleagues examined whether an abnormality in the early steps of auditory processing in the brain, called "sampling," is linked with dyslexia by focusing on the idea that an anomaly in the initial processing of phonemes, the smallest units of sound that can be used to make a word, might have a direct impact on the processing of speech.

The researchers found that typical brain processing of auditory rhythms associated with phonemes was disrupted in the left auditory cortex of dyslexics and that this deficit correlated with measures of speech sound processing.

Further, dyslexics exhibited an enhanced response to high-frequency rhythms that indirectly interfered with verbal memory.

It is possible that this "oversampling" might result in a distortion of the representation of speech sounds.

"Our results suggest that the left auditory cortex of dyslexic people may be less responsive to modulations at very specific frequencies that are optimal for analysis of speech sounds and overly responsive to higher frequencies, which is potentially detrimental to their verbal short-term memory abilities," concludes Dr. Giraud.

"Taken together, our data suggest that the auditory cortex of dyslexic individuals is less fine-tuned to the specific needs of speech processing."

Why Current In-the-Ear Hearing Aids Fail

Hearing aids have improved greatly over recent years, but they continue to be a surprisingly frustrating experience for new wearers.

Clearly, today’s hearing aids are tiny, nearly invisible in fact, and they amplify sound and are able to present a higher range of frequencies, but they have not yet completely solved the problem of amplifying the peripheral sounds we just don’t want, or don't need to hear.

For new wearers the crumpling of a paper bag on the other side of a room can sound like a jackhammer.

This is a huge challenge for technology because it is dependent on how the brain perceives sound and how we have learned to filter peripheral sound out of normal hearing. Andrew J. Oxenham is a psychologist and hearing expert at the University of Minnesota and an expert in psychoacoustics.

Oxenham explains: The ear works by analysing sound and breaking it into different frequencies and with many forms of hearing impairment it’s this frequency selectivity that is impaired.

What that means is that the ear doesn’t filter as well as it did before. So instead of having very sharp tuning to filter out different frequencies the filtering becomes much broader and there is no real way of compensating for that.

You can’t sharpen the filters or you can’t pre-process sound so it’s sharp. It’s like a broken TV set. You can process the signal going into the TV as much as you like but you still won’t get a clear picture of the output.

Recent hearing aids have made a lot of progress, like being able to present frequencies of up to 6000 Hz as opposed to limited frequencies up to about 4000 Hz, by using digital signal processing, and a lot more computing power on a lot smaller chip.

Another big leap forward has been made with directional hearing. They can focus the microphones toward the front and filter out a lot of the sound coming from the side and back. And although that is a fairly simple technique, it involves signal processing that wasn’t possible with earlier hearing aids.

Ambient or peripheral sound is horribly distracting for hearing aid wearers. A paper bag being crumpled across a room sounds screechingly loud.

This is common complaint of people who recently start wearing a hearing aid. Their hearing has deteriorated, often without them being completely aware of it, over a period of time.

When they are suddenly fitted with a hearing aid, they hear sounds they’ve got used to not hearing. The sounds are suddenly annoying and distracting. It’s a contrast effect.

It’s more to do with perception i.e the brain’s ability to analyse and prioritise different sounds.

It’s a complex interaction between the ear and the brain. The ear sends signals up to the brain; the brain does an awful lot of processing on top of that; then sends signals back down to the ear. These signals change the way the ear accepts input.

This is partly why hearing aids are not perfect because the hearing aid is not part of that natural feedback loop. There’s no way with current aids that the brain can interface with a hearing aid directly to change its characteristics.

Hearing Loops
To deal with background noise there are things called “hearing loops.”

These are systems that are set up within places like concert halls and churches that interface directly with the hearing aid. It’s like sending a radio signal to the hearing device.

The idea is that this hearing loop picks up the sound directly from the microphone in front of a speaker.

If you are in a conference and the speaker is talking into a microphone. Normally we hear the sound acoustically through the airwaves.

If you are wearing a regular hearing aid the microphone will pick up the sounds on the airwaves but that is together with all the background noise and reverberation in the room.

With a hearing loop it sends the signal directly from the microphone to the ear and bypasses all the acoustics in the building itself. So the ear is getting a much better, clearer and cleaner signal of what’s coming into the microphone.

Two hearing aids better than One?
It’s only recently that people have routinely been fitted with two hearing aids. Often people only got one.

Directional hearing and the way we localise sound: To know where the sound is coming from the brain compares the signals coming into the two ears. So if it’s slightly louder on one side then the brain knows the sound is coming from that side.

More importantly it’s the time of arrival difference between the two ears. If you think about a sound coming from the right. The sound will reach your right ear a little bit before it reaches your left ear.

Although we are talking about millionths of seconds, your brain needs two ears to make a distinction. If you only have one you lose that ability to localise sound and tell which direction it is coming from.

It’s also an important part of filtering out sound and noise. The brain can determine if there is speech right in front and background noise in back of and to the side. The brain can use those differences in localisation to help to make the speech more intelligible.

So the biggest technical challenge is developing hearing aids that can focus on what we really need and want to listen to. This is the current problem.

The Solution
We are hoping through even more sophisticated signal processing schemes that we’ll be able to work on artificial source segregation; i.e. analysing the signal that is coming in and figuring out what is speech and what isn’t, and only presenting to the ear the wanted signal.

Distinguishing between speech and noise
The assumption is that what you really want to listen to is speech, and so there are certain acoustical aspects of speech that we can recognise and there are certain acoustical aspects of noise that are different from speech.

So, we need to establish a suitable algorithm to be able to distinguish between speech and noise that will help you towards filtering the unwanted signal.

A more complete solutiion could mean that brain-computer interface may be part of the hearing aid systems of the future. Where the hearing aid is tapping into brain responses to pick up the specific signal the person wants to pay attention to.

This is an ongoing process with incremental steps and we will continue to see improvements over the next 15 years.

People With Dyslexia Have Difficulty Not Just Reading Words, But Recognizing Voices

While most people think of dyslexia as primarily a problem with reading, people with dyslexia seem to have trouble processing the spoken language, as well. A new study published last week Science found that people with dyslexia have a harder time recognizing voices than other people do.
How the Heck:

• Participants in the study–half of whom were dyslexic–watched and listened to cartoon characters on a computer. Each character had a distinct voice, and spoke either English, the participants’ native language, or Mandarin Chinese.
• The participants were then played a clip of each voice and asked to match it to the correct character.
• People without reading difficulties were better at recognizing voices speaking their native language. They could correctly pick out which character went with a voice about two-thirds of the time if the voice was speaking English, and only about half the time if it was speaking Mandarin.
• Dyslexics, on the other hand, showed no native language boost. It didn’t matter if a voice was speaking English or Mandarin: they correctly matched it with a character around half the time either way.

What’s the Context:

• Researchers are increasingly finding that reading problems, while the most well known feature of dyslexia, are just a part of what’s going on. People with dyslexia have difficulty in processing and combining the sounds of language—and, when reading, correctly linking them to letters on a page.
• This study underscores the idea that people with dyslexia have trouble processing phonemes, the units of sound that make up speech—and that differ slightly between different voices, helping us to recognize who’s talking.

The Future Holds:

• Understanding the mental roots of dyslexia could help researchers develop early interventions, helping children who have trouble processing language even before they start school.
• Since children start to recognize voices long before they learn to read, some variation on a voice-recognition test could help identify children who might develop dyslexia.

Reference: Tyler K. Perrachione, Stephanie N. Del Tufo, & John D. E. Gabrieli. “Human Voice Recognition Depends on Language Ability.” Science, July 29, 2011. DOI: 10.1126/science.1207327

Inclusivity Requires A Paradigm Shift

A billion is obviously an extremely large number of individuals, that have needs to be met.

In the Western world the populations are ageing, improvements in healthcare are helping people live longer – this means that the number of people who require assistance coping with age related conditions is only going to grow.

There are likely to be ever increasing numbers of people with poor vision, hearing loss, limited mobility and cognitive difficulties and we need to ensure that they are not excluded.

This is what is sometimes referred to as a Megatrend. Megatrends are great forces in societal development that will affect all areas – state, market and civil society – for many years to come.

Another Megatrend is the rapid growth and increased mobility of populations.

This will put a strain on all kinds of resources but from an inclusion point of view there is great deal of cross over with the needs of the disability community.

Economic migrants and refugees from war and famine will often face language barriers to inclusion in their new countries.

Couple this with the need to educate and raise literacy levels in the general population as a whole and you have a problem that is just too big for governments to ignore.

Read the remainder of this article here

Dyslexia: Recognising accents and voices can be difficult

People with dyslexia may not notice how people pronounce words differently, something that makes voice recognition possible, U.S. researchers say.

Tyler Perrachione, a doctoral candidate at the Massachusetts Institute of Technology, says even though all people who speak a language use the same words, they say those words just a little bit differently from one another -- what is called phonetics in linguistics.

Listeners are sensitive to phonetic differences as part of what makes a person's voice unique, but individuals with dyslexia have trouble recognizing phonetic differences, whether a person is speaking a familiar language or a foreign one, Perrachione says.

The MIT scientists trained people with and without dyslexia to recognize the voices of people speaking either the listeners' native language of English or an unfamiliar foreign language, Mandarin Chinese.

The neuroscientists found people with dyslexia were significantly worse at being able to consistently recognize the voices of the English speakers, but they were about the same as listeners without dyslexia at recognizing the Chinese voices. Both groups were very poor at recognizing voices speaking an unfamiliar language, Perrachione says.

The finding, published in Science, reaffirms the theory that the underlying deficit in dyslexia isn't about the act of reading per se, but instead involves difficulty with how sounds of spoken language are heard and processed in the dyslexic brain.

Listen Up! ADHD, Dyslexia and Hearing loss!

There are many possible interventions that can occur when a child performs poorly in school, but one that can be easily overlooked is a hearing check.

Yet a growing body of research indicates hearing loss--even a minimal amount--can have a dramatic effect on everything from attention and behaviour to academic performance.

At the same time, data indicates, and experts in the field believe, that the introduction of sound reinforcement and sound amplification systems can help with this problem.

Normal hearing for children is 15 decibel hearing level(dB HL)or better at all frequencies with normal middle ear function. Anything less can place a child at risk in the academic setting.

There are approximately 46 million K-12 students in the United States; more than 9 million--about 20 percent of them--have some type and degree of hearing loss.

Based on the number of audiologists employed by school districts to manage students with hearing loss, less than 1 percent of these children with hearing problems are receiving professional help through their schools.

Of course, it's possible that not nearly all those students need professional help with their hearing loss. In fact, many times the loss is not even noticeable by most observers, and the same loss likely would not affect the behavior of adults.

However, for a child trying to integrate new information, even "minimal" hearing loss can have a huge impact on learning.

"The issue that needs to be addressed is hearing clearly for effective teaching and learning," says David H. Parish, president and CEO of Woodbury, MN-based Calypso Systems, a manufacturer of integrated classroom products, including classroom acoustic systems. He stresses that children who have trouble hearing what is going on in the classroom may perform below standards both academically and behaviourally.

"Studies show that children who fail basic hearing tests have to repeat a grade at 10 times the rate of those who pass them," says Parish. "That statistic clearly demonstrates that the ability to hear--especially at younger ages when language skills are not as advanced or for those learning English as a second language--is critical for good academic outcomes."

Loud and Clear
The Acoustical Society of America, in conjunction with the American National Standards Institute, has published standards that define, for classrooms, the acoustical standards necessary for effective teaching and learning environments.

The key standard is signal-to-noise ratio. The "signal" is the teacher's voice or the audio of media employed in instruction. "Noise" is everything else that makes it more difficult to hear the signal: students' chatter, the fish tank, street noise, HVAC systems, and so on.

"The signal needs to be sufficiently greater than noise to be heard and understood, and very often that is not the case," says Parish.

Another eye-opening statistic in this context: Roughly 72 percent of all children referred to special education courses also fail a basic hearing test. "Why does this happen?" asks Parish. "Which is the cause and which is the effect here?"

According to Parish, these children are more easily distracted, which makes it more likely that they will be disruptive in the classroom. As a result, they often move into special education programs.

This raises the question: Could schools reduce the number of referrals into special education through the introduction of sound reinforcement and sound amplification systems? Studies suggest the answer may be "yes."

According to research compiled by Pamela Millett, assistant professor and educational audiologist at York University in Toronto, a number of studies show decreases in special education referral rates following installation of sound field acoustic systems across school districts.

For example, in the Oconto Falls School District (WI), special education referral rates fell from an average of 7.72 percent between 1989 and 1998 to 4.6 percent between 1998 and 2000, when sound field amplification systems were installed in all classrooms in the district from kindergarten to grade 5. This is a reduction of more than 40 percent.

Dyslexia makes voices hard to discern, study finds

People with dyslexia struggle to recognise familiar voices, scientists suggest.

The finding is the first tentative evidence that small sounds in the human voice that vary between people are difficult for dyslexics to hear.

Writing in the journal Science, the scientists say that many people could have some degree of "voice blindness".

By studying it, scientists hope to better understand how the human brain has evolved to recognise speech.

Humans rely on small sounds called phonemes to tell one person from another.

As we first try to form the word dog, for example, phonemes are the "duh"-"og"-"guh" sounds that our parents prompt us to make.

But as we master the ability to read, we become less reliant on recognising these sounds to read, and eventually stop noticing them.

Despite ignoring them, however, phonemes remain important for voice recognition.

The tiny inflections in the way people pronounce phonemes gives a listener cues to tell one voice from another.

Because people who suffer from dyslexia are known to struggle with phonemes when reading, a US-based team of scientists wondered whether they might also struggle hearing them in people's voices.

Listen well
To investigate, the team grouped 30 people of similar age, education and IQ into two camps: those with and without a history of dyslexia.

The subjects then went through a training period to learn to associate 10 different voices - half speaking English and half speaking Chinese - with 10 computer-generated avatars.

The subjects were then later quizzed on how many of those voices they could match to the avatars.

Non-dyslexics outperformed people with a history of dyslexia by 40% when listening to English.

However, this advantage disappeared when the groups were listening to Chinese.

read more of the article here: BBC News - Dyslexia makes voices hard to discern, study finds

Total Hearing Aid Implant

A University of Southampton diagram of the UK's first totally implanted hearing aid.

The Otologics 'Carina' middle ear implant device consists of a rechargeable battery, a signal processor and a microphone which are all implanted under the skin.

Picture: University of Southampton

Children with hearing loss in one ear fall behind in language skills

By the time they reach school age, one in 20 children have hearing loss in one ear. This one impediment can raise significant hurdles for these children, because the loss of hearing in one ear hurts their ability to comprehend and use language.

"For many years, paediatricians and educators thought that as long as children have one normal hearing ear, their speech and language would develop normally," says Judith E. C. Lieu, MD, a Washington University ear, nose and throat specialist at St. Louis Children's Hospital.

"But then a few studies began suggesting these children might have problems in school. Now our study has shown that on average, children with hearing loss in one ear have poorer oral language scores than children with hearing in both ears," Lieu says.

Hearing loss in one ear can stem from congenital abnormalities in the ear, head trauma or infections such as meningitis. Children with hearing loss in one ear may go undetected because they can appear to have normal hearing. Their difficulty hearing may be mistaken simply for lack of attention or selective hearing, says Lieu, assistant professor of otolaryngology.

Even children with recognised 'one-side hearing loss' often aren't fitted with hearing aids and often don't receive accommodations for their impediment.

The researchers studied 74 six- to 12-year-old children with hearing loss in one ear. Each was matched with a sibling with normal hearing so that the researchers could minimise the possible effects of environmental and genetic factors on the children's language skills. The children were tested with the Oral and Written Language Scales (OWLS), a widely used tool to assess language comprehension and expression.

An average OWLS score is 100, and hearing loss in one ear caused, on average, a 10-point drop in scores. The oral composite score, which reflects both children's ability to understand what is said to them and their ability to respond or express themselves, averaged 90 in children with hearing loss in one ear.

Lieu says that the study demonstrated the strongest effect from hearing loss in one ear in children who are living below the poverty level or with mothers who have little education. Poverty levels and maternal education levels are well-established influences on language skills, and hearing loss in one ear may increase that effect.

"This study should raise awareness that if children with hearing loss in one ear are having difficulties in speech or reading in school, their hearing may be part of the problem," Lieu says. "Parents, educators and paediatricians shouldn't assume that having hearing in one ear means children won't need additional assistance."

The study does not address which possible solutions will be most effective for overcoming the decrease in language skills seen in the children with hearing loss in one ear, but Lieu suggests that studies could be done to see if hearing aids or amplification systems in the classroom will help.

In addition, having an educational audiologist as part of an individualised educational plan also might be beneficial.

"The effect of hearing loss in one ear may be subtle," Lieu says. "These children may shun large group situations because the noise overwhelms them, and they have a hard time understanding speech. They could have difficulties playing team sports because they can't localise sound as well as others and therefore, can't tell who is calling to them or from which direction.

"For them, listening takes a lot more work, and they may have to put in extra effort," Lieu says. "We don't know yet if the hearing loss ultimately affects their overall educational achievement and eventually, even which occupations they choose."

Clearly there is still much to discover with this study but it does re-enforce the need to check the hearing of children who are having learning difficulties or are not socialising as well as they might.

Link: http://www.medicine.wustl.edu