There are two types of hearing impairment or loss – conductive and sensori-neural. Some individuals suffer from both conditions at the same time.
Conductive hearing loss is commonly known as glue ear and is very common in young children after colds and/or earache. Most children outgrow this problem by the time they are seven years old.
Sensori-neural hearing loss is much less common than the conductive type. It’s caused by damage to the hearing mechanism itself – usually in the cochlea or along the nerve to the brain. Sensori-neural losses are found in four or five children per 1,000 with one or two of these cases being described as profound. This type of loss is permanent. It can range from mild to profound in degree and is unlikely to be corrected surgically, except in extreme cases by cochlea implants. Early diagnosis of this type of loss is crucial in order to cut down the long-term effects on the child’s language and speech development.
Most pupils with hearing impairment in mainstream education have a moderate to severe hearing loss. Some will have been equipped with a hearing aid and possibly with a box for the teacher to wear to conduct the sound more clearly.
Glue ear involves inflammation, either chronic or acute, and an accumulation of fluid in the middle ear. It can cause pain and hearing impairment. If it persists, an ear, nose and throat specialist will advise a simple operation to put in grommets to allow fluid to drain from the middle ear. A large number of primary school children suffer from glue ear, especially when colds, flu and other minor infections and childhood diseases are present.
The symptoms usually recur regularly, particularly when the child has had a cold or throat infection which has infected the ear. If the problem is considered to be severe then antibiotics will be prescribed and possibly decongestant nasal drops.
Otitis media is closely related to otitis externa (‘swimmer’s ear’), which is an inflammation of the canal joining the ear drum to the external ear, with similar effects.
If a pupil exhibits severe pain and distress at school and you suspect that it may be due to an ear infection, it is essential to speak to the pupil’s parents and advise an immediate visit to the doctor. If left untreated or not treated early enough, ear infections associated with glue ear can cause permanent deafness or mastoiditis.
Children with a hearing impairment may:
- rely on visual cues and lip-reading
- have some speech and language difficulties
- need ongoing support from a speech and language therapist
- need ongoing support from the local hearing impaired service
- need to wear a hearing aid
- have difficulties with hearing when there is background noise in the classroom
- misunderstand instructions and appear to copy others
- need to use some sign language
- have difficulty following audio or visual programmes.
A child who suffers with glue ear may:
- talk loudly and be unaware of the level of his voice
- have poor listening and attention skills
- experience difficulties with developing phonological skills
- often appear to be withdrawn or in a world of his own
- have difficulties interacting with more than one or two people at a time
- be unable to participate fully in group activities
- need to have the sound on the television or radio at a higher level
- need to have instructions repeated clearly and slowly
- find it difficult to participate in music or singing lessons
- put hands to his ears or head frequently (very young children may cry out with pain)
- have frequent ear, nose and throat infections.
- Always alert parents if you are concerned about a pupil’s hearing, as this is a medical condition and needs parental action. Within school it is important to support a child with glue ear by:
- speaking slowly and clearly, but not necessarily more loudly
- allowing him to sit where he can see your face
- making sure that you use the pupil’s name to attract his attention
- having a low level of background noise when you are giving direct teaching to his group
- providing opportunities for him to work with a partner rather than in a group.
In a mainstream school you may need to:
- seek the guidance and support of the hearing impaired service
- seek the guidance and support of the speech and language therapist
- ensure the pupil is seated where she can see the teacher clearly
- keep background noise to a minimum
- be familiar with the type of hearing aid the child is wearing
- speak clearly, but with no exaggeration of lip patterns
- simplify your statements and, if necessary, rephrase a sentence if it is obvious that the child has not understood
- use facial expressions to convey clues to what you are saying
- learn some basic sign language
- use Teletext subtitles when watching television programmes
- modify tasks to suit the learner’s language level
- teach other children ways to communicate with the hearing-impaired child.
Support Agencies and Links
British Association of Teachers of the Deaf: www.batod.org.uk
British Deaf Association: www.bda.org.uk
Deaf Action (Scotland): www.deafaction.org
Deaf Education through Listening and Talking: www.deafeducation.org.uk
National Deaf Children’s Society: www.ndcs.org.uk
RNID (Royal National Institute for Deaf People): www.rnid.org.uk