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Aural Rehabilitation Aural rehabilitation when it concerns children has more habilitation character rather than rehabilitative. Rehabilitation presupposes the revival of certain skills. In case with children they do not have any skills to revive and they need assistance to adapt themselves in society with their aural impairments. The communication is the main activity of our social existence and the losses of hearing may cause various negative consequences of the child development. Apart from the medical issue the social rehabilitation plays an important role in the development of a child. A society pays special attention to the treatment and providing equal abilities to get education for handicapped children.
A number of legal acts were adopted to provide proper education for children with the hearing losses and prevent handicapped children from the possible discrimination. Following Acts were adopted to enable children with the hearing loss to enjoy their rights in a full scope: 1975, Public Law 94 - 142. This law promotes a free and appropriate public education (FAPE) for children ages 5 through 21 with disabilities. The Act mandates that the child must be placed in the least restrictive environment (LRE) to receive this education. This law states that related services should be provided for this education. These related services include: transportation, audiology, speech-language pathology, psychology, physical and occupational therapy, school health, early identification and assessment of disabilities, recreation, social work, parent counseling and training.
Public Law 99 - 457, Renamed Individuals with Disabilities Education Act (IDEA) in 1990 regulates the rights and procedures of the FAPE for children with disabilities as well as the rights of the parents to be involved into decision making. The Law mandates that FAPE should be available for the children from the age of 3 years beginning. Individualized Family Service Plan (IFSP) The IFSP is for children ages birth-to-three. The plan is developed with input from professionals (speech pathologist, audiologist, pediatrician, psychologist, physical therapist) as well as the parents, and is renewed annually.
Americans with Disabilities Act (ADA) This law, mandated in 1990, supports the equality of disabled people by prohibiting discrimination in the following areas: employment settings, state and local government agencies and public services as well as public accommodations (Shannon Esse, Linda Thibodeau, 2005). The loss of hearing can affect various sides of the children life. School performance, job productivity and emotional well being may be influenced by the hearing loss. The loss of hearing may cause the complex of inferiority and influence the mental and emotional state of the children. For the estimated 28 million children and adults in the United States who have a hearing loss, selecting the most suitable hearing aids can be the critical factor to enjoying life to its fullest (American Speech-Language-Hearing Association). The hearing aids may be classified into three groups.
The first group is In-the-canal and completely-in-the-canal aid. These aids are contained in a tiny case which is mounted inside the ear canal. Such aids are very suitable from the cosmetic point of view. They are not visible from outside. They offer some listening advantage. The next group of aids is the In-the-ear aids.
These aids are contained in the shell which fills in the outer part of the ear. Another group is behind the ears aids. All parts are contained in a small plastic case that rests behind the ear; the case is connected to an ear mold by a piece of clear tubing. This style is often chosen for young children for safety and growth reasons (American Speech-Language-Hearing Association).
It is worth noting that the hearing aids can not restore the hearing ability in the same way as glasses can not improve the vision characteristics. Hearing aids may only assist in perception of the sounds thus improving the adaptation to the social life. The proper development of hearing means for a child is of great importance. In a typical classroom, the child must overcome three main problems- reverberation, background noise and distance from the speaker (Patricia Trautwein, Ph. D, 1 / 3 / 2005). The psychological barriers contribute to the problem mentioned above when a child does not ask to repeat something in order not to attract attention of his classmates to his hearing impairment.
The reverberation can be reduced by removing noise sources. It is understandable but in condition of a typical classroom it is very difficult to fulfill. Additional noise may come from an outer source only. Stray noise is not a typical phenomenon for a classroom. If it occurs, it is most likely that the source can not be removed, for example the noise from the street. Regarding a child with the hearing losses they can only be place into the less noisy place of a classroom, for example far from the window.
The reverberation could be reduced by reducing areas of hard, sound-reflective surfaces. This measure is also difficult to implement while speaking of a regular classroom. If there is only one child or several children with hearing losses and the rest of a class are the children with the regular hearing it is most likely that administration finds such measure inappropriate regarding one child only. Besides, if children have their lessons in various class rooms it will be difficult to implement such measures in all the classrooms where a child with the hearing losses has his or her lessons. Another measure which can reduce reverberation is increasing areas of soft, sound-absorbing surfaces such as acoustic tile, carpet, bulletin boards, drapes, and tennis balls on chair and desk feet. Such measure could be provided partially.
Children may be placed in a preferential place in the classroom in order to reduce the distance between a teacher and a child. One of the most accepted techniques aimed to improve hearing abilities is a cochlear implant. Cochlear implants are utilized in the patient who cannot benefit from traditional hearing aids. The cochlear implant is a device used to bypass the nonfunctional inner ear and converts sound into electrical impulses that directly stimulate the cochlear nerve. The implant consists of an external portion comprised of a microphone, sound processor, and external coil and an internal portion that must be surgically implanted (Healthy Hearing, 2005). Cochlear implantation is a surgical procedure and is used when other aids are useless.
Cochlear implants are ultimate measures especially for children because they are connected with the surgery. Cochlear implants are used for the patients who are actually deaf. A cochlear implant is a small, complex electronic device that can provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. The implant is surgically placed under the skin behind the ear. An implant has four basic parts: a microphone, which picks up sound from the environment; an external speech processor, which selects and arranges sounds picked up by the microphone; a transmitter and receiver / stimulator , which receive signals from the speech processor and converts them into electric impulses; an electrode array implanted in the cochlea, which collects the impulses from the stimulator and sends them to the hearing nerve in the brain. The cochlea is the part of the internal ear that is responsible for hearing (Blue Cross Blue Shield of North California).
To enable children with the cochlear implants to hear the sounds FM system can be used. An FM system is composed of a teacher worn microphone / transmitter and a frequency tuned receiver coupled to the childs cochlear implant processor or a speaker positioned close to the child. Authorized FM transmission ranges vary from country to country. In the USA, FM transmission is limited to 72 - 76 MHz and 216 MHz. These systems do not interfere with the implant transmission frequency and therefore can be safely used by children with cochlear implants (Patricia Trautwein, Ph. D).
FM systems are very good to develop the childs learning skills. Certain requirements should be observed when they are used in the classroom to make the process more effective. The microphone should be passed to each speaker when there is a group discussion in the classroom. There are also some requirements connected with the technical issues of the TM systems which should be observed by a teacher who should remind children on certain procedures. One of important issues connected with cochlear implants, especially when patients are children is possible negative consequence of the cochlear implantation for the children health. The medical problem may transfer to a moral one.
Does good hearing worth of possible health danger as infection and even meningitis? In a 1984 News Magazine article, a well-known department head and pediatric otolaryngologist was interviewed on the topic of cochlear implants in children: "There is no moral justification for an invasive electrode for children. " Speaking for himself, he says he finds the cochlear implant a costly and 'cruel incentive', designed to appeal to conscientious parents who may seek any means that will enable their children to hear. "It's a toboggan ride for those parents, and at the end of the ride is only a deep depression and you may hurt the kid. " (Medical World News, June 11, 1984, p. 34). The doctors expressed apprehension of possible infection caused by the cochlear implants but the observations showed that the risk was not high because they had not seen otitis media progress to meningitis in the many thousands of stapedectomy patients, who had a wire running from the middle ear into the cochlea's oval window (WILLIAM F. HOUSE, D. D. S. , M.
D. ). Early identification and intervention plays an important role in the future development of a child. It is obvious that the sooner child starts adapting his impairment to the environment; the more comfortable he or she feels in this environment. Dr. Christine Yoshinaga-Itano, chair of the Communication Disorders and Speech Sciences Department at the University of Colorado in Boulder, states, "It's not that we " re fixing a delay, we seem to be preventing it from ever occurring. " Dr.
Yoshinaga-Itano and her colleagues have tracked children to age 3 and found that the data support the efficacy of early intervention and universal infant screening (DEVELOPMENTAL BENEFITS OF EARLY IDENTIFICATION). The development of the children with hearing losses depends upon their ability to communicate. The children who are born with hearing impairment need to pursue their coevals because they are from their birth are in unequal position with their coevals. A great deal of attention should be paid to the development of communication skills of the children with losses of hearing. Though language is communication means it should not be identified equal to speech.
Hearing is a way of learning language. If the hearing is impaired it should not mean that a child can not learn language. Hearing is only one of possible way of learning language as well as language is one of the ways of communication. As soon as hearing is impaired, the language should be transferred to a child by alternative means and techniques.
One thing is definite, if communication is included into a pyramid of the hierarchy of needs by Maslow, it will gain the top position among natural needs of a man. There may be various approaches to denoting the language but one thing is unchangeable, a child needs at least to get the mothers signals of her love. There are a lot of programs, approaches and techniques developing communication skills of deaf children. They maybe more or less effective, but they are nothing without the parents concern.
A newly born child learns the world to which he is a newcomer from his mother and father. It is up to parents to choose the appropriate techniques from their variety. Sometimes parents choose to combine the approaches in order to gain better results. There is no unique panacea and neither teacher no doctors are able to help a child getting the initial world perception. All approaches could be utilized and the only criterion of their effectiveness is their effect on a particular child. Teachers and educators are key professionals in adapting the child to the environment but they can not do anything effective without the active participation of the parents.
It is the parents involvement into programs that defines the effectiveness of the program. There are several techniques aimed to develop the communication skills of deaf children. First of all it is American Sign Language / English as a Second Language (ASL/ESL) (Bilingual-Bi cultural). This language is widely used among deaf people.
It is a manual language that differs from the spoken language because it is not based on English grammar / syntax. The main feature of such language is that it is based on the associative approach. Some linguists suggest using such approach for students. Such method is extremely effective for learning the foreign languages because manual gestures are the ultimate way of communication.
The oral form supports the manual gestures. It is worth noting that the children with hearing disabilities need to apply more energy to catch up with their coevals. As soon as they succeed to get the same knowledge as their schoolmates do; it means that they are far more hard working. The same learning process may be more difficult for children with the hearing impairment.
The assistance of parents, teachers and schoolmates should be substantial. Another program that develops communication skills of children is an auditory-verbal one. A program teaches a child to utilize and develop existing hearing skills. The participation of parents in such program should be everyday routine.
They need to develop hearing skills through everyday communication with a child, play etc. The primary goal of this program is to develop communication skills relying on aided hearing alone. A total communication is aimed to teach a child incorporating all possible means of communication, sign language, oral, finger spelling etc. An oral / auditory -oral program is objected to teach a child using the amplifying means supporting his hearing skills. The program is very important because it develops the communication skills necessary for integration into the hearing community. A cued speech program is objected to help a child in distinguishing the sounds by means of systems of eight hand shaped cues that represent different sounds of speech (Beginnings for Parents of Children Who are Deaf or Hard of Hearing, Inc).
The communication is the natural ability of the human being and the main part of the human activity. Hearing impairment does not mean the inability of communication. It is concern of society and a family to help a child with the hearing impairment to enjoy the life and interpersonal communication thus enabling him to understand that his hearing impairment is not an irresistible barrier to communication. Bibliography Shannon Esse, M. A, The University of Texas at Austin, And Linda Thibodeau, Ph. D. , The University of Texas at Dallas.
PEDIATRIC HEARING LOSS, available at web retrieved 16. 04. 2005 Hearing Aids, American Speech-Language-Hearing Association, available at web retrieved 16. 04. 2005 Patricia Trautwein, Ph. D. , FM Systems with Cochlear Implants, Audiology Online, available at web retrieved 16. 04. 2005 What are cochlear implants? Healthy Hearing, available at web retrieved 16. 04. 2005 Cochlear Implant, Corporate Medical Policy, Blue Cross Blue Shield of North California, available at web retrieved 16. 04. 2005 Medical World News, June 11, 1984, p. 34, quoted web retrieved 16. 04. 2005 WILLIAM F. HOUSE, D.
D. S. , M. D. , Cochlear Implants: My Perspective, available at web retrieved 16. 04. 2005 BEGINNINGS for Parents of Children Who are Deaf or Hard of Hearing, Inc Developmental Benefits of Early Identification, available at web retrieved 16. 04. 2005
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Research essay sample on Hearing Aids Communication Skills
