By Nwadinobi V.N. (Mrs)
Introduction and definition:
The ear is the part of the body that is used for hearing. Information about the world is
acquired through hearing. Anybody that hears nothing around him, no matter how loud the
sound is should be seen as having ear problem. It is a condition or rather an impairment
which is a physical, observable condition of tissue that can affect the function of the organ
system of which that tissue is a part. Hearing impairment is a disability that can affect the
effective functioning of the total personality no matter the period of onset (Okeke, 2001).
Among the earliest attempt to define hearing impaired was the one made by the committee of
Nomenclature of the conference of Executives of American schools for the deaf (1938)
which says that the deaf are those people in whom the sense of hearing is non-functioning for
the ordinary purpose of life. According to them also, the hard-of-hearing can be defined as
those in whom the sense of hearing although defective is functional with or without a hearing
aid. The committee went on to categdrize the deaf into two, thus:
i. The congenially deaf (people that become deaf from birth)
ii. The adventurously deaf (people who though were not born deaf, still became deaf
later in life, due to some accident or illness). Ross (1972) expressed that hearing impaired is
the generic term that include both the hard of hearing (partially hearing) and deaf. These two
terms came up because of newer diagnostic and testing method, persons classified as deaf
have been classified as hard-of-hearing.. The hard-of-hearing are those who can benefit
maximally from auditory training and from wearing hearing aids. This then enables them to
acquire speech and language naturally. The deaf are set of people whose sense of hearing is
completely lost as a result of damage in the auditory channel, thus such people's sense of
hearing are rendered in-active and non-functional with or without hearing aids for the day-to-
day life purposes.
Hearing impaired include both the hard-of-hearing (partially hearing) and the deaf.
The two describe the degree of impairment. The hard of hearing refers to those whose
hearing loss in the pre-lingual period or later is not of sufficient severity to preclude the
development of some spoken language, and those who have normal hearing in the pre-lingual
period but acquire hearing loss later. The category of their impairment is not as severe as that
of the deaf. Bryan (1975) observed that it is well documented that deaf children are worse
than hard-of-hearing and normal hearing children in arithmetic problems involving reading
skills. Proper diagnosis is therefore important for proper categorization and eventual
realization of the fullest potentials of hearing impaired children.
CAUSES OF HEARING IMPAIRMENT
There are a number of factors that can cause both conductive and hearing impairment. Okeke
(2001) identifies 13 causes of hearing impairment thus:
1. Hardened wax or external object blocking the external auditory canal.
2. Inflammation of the middle ear (ottitis media).
3. Infection of the middle ear such as sinuses, adenoids, tonsils.
4. Heredity, e.g otosclerosis, which is a hereditary condition that stiffens the small bones
of the middle ear.
5. Infections such as German measles (rubella), small pox, mumps, influenza, cerebro
spinal meningitis, maternal syphilis,
6. Drvga, poisons, e.g carbon monoxide, quinine taken by expectant mothers.
7. Birth injuries such as prematurity, prolonged labour, difficult birth, anoxia (lack of
8. Pathological conditions of the foetus, erythroblastosis fetalis
9. Development anomalies.
10. Lack of the right vitamins (avitaminosis)
11. Noise and blast
12. Accident in the form of head injuries.
13. Brain tumors or abscess caused by condition such as birth injuries, degeneration of
circulatory structures (Mba, 1995).
Some of the causes above occur before birth like the maternal rubella, that is the German
measles that attacks pregnant mothers. Others occur during birth such as pre-maturity,
prolonged labour, difficult birth, anoxia (oxygen insufficiency) etc. Most causes of
hearing impairment occur after birth like Hardening of wax in the canal leading to the Ear
Drum which blocks sound waves from entering the middle ear, and through to the inner
CHARACTERISTICS OF CHILDREN WITH HEARING IMPAIRMENT
Hearing impairment is a handicapping condition that affects the normal functioning of the
child. The condition impedes their educational achievement no matter the degree of
impairment. Ernbrey (1971) who studies the effect of a mild hearing loss on educational
achievement found out that the mild hearing impaired subject did not achieve at the same
level as their normal*hearing children. The observable signs by which the hearing
impaired could be identified include the following:
- Articulation of certain speech sounds correctly often eludes the child.
- The child finds it difficult to write down dictations.
- The individual fails to respond to or confuse verbal directions.
- Complains of a buzzing or ringing sound in the ear.
- Fails to respond when called from a distance.
- Complains of discharge from the ears.
- Speaks in an abnormally low, high or loud voice.
- The child responds only when he/she sees the speakers face or gesture. The
individual has frequent colds and hay fever.
- The child bends forward so as to hear or understand what is said to him.
- Asks the speaker to repeat sentences or words.
- When called from a distance the child fails to respond.
- Gives wrong answers to simple questions.
- Often times the child dodges situations that may require him listen or talk to
- The individual is insensitive to sound.
- Rubs the ears frequently or turning to one direction as if trying to locate a sound.
- The individual has frequent ear aches and running ears.
- The child often screams to express pleasure, annoyance or need.
- The child is Withdrawn and does not mingle readily with classmates and
TYPES OF HEARING IMPAIRMENT
The ear is divided into three major parts - the outer, the middle and inner ear. The outer
ear picks or collects energy, the middle ear transmits the energy which is then converted
into nerve impulses in the inner ear.
Generally, we have the following types of hearing impairments thus:
1. Conductive hearing impairment
2. Sensori-nueral hearing impairment
3. Central hearing impairment
4. Mixed hearing impairment.
Details of these are presented below:
The conductive hearing impairment: occurs as a result of obstruction to the passage of
sound waves through the external canal or by way of the ossicular chain through the middle
ear. It does not affect the inner ear. In this case therefore if sound vibrations can be
transmitted in anyway directly to the inner ear without having to pass through the middle ear,
the child hears. The person suffering from conductive hearing loss can be helped through
surgery or through wearing bone conduction hearing aids behind the ears.
Sensori-nueral hearing impairment; is prevalent among children. This is associated with
the inner ear because it is damage to or degeneration of the sensory structure of the inner ear
that causes it. Those who suffer from this hearing loss are unable to hear most frequencies in
the human voice in most cases.
Central hearing impairment; Cerebral cortex is the part of the brain where the sensation of
sound is produced and interpreted meaningfully. Therefore if there is interference with the
pathway through which nerve fibres proceed from the brain stem to the temporal lobes of the
cerebral cortex it results to central hearing loss. In other words an error in the auditory center
in the brain causes central deafness.
Mixed, hearing impairment: is the combination of conductive and sensorinueral hearing
loss. An individual here has outer-or middle and inner ear problem combined. Mixed hearing
deafness; are often difficult to diagnose and treat because there are problems of both
conduction and processing of sound.
PROBLEMS OF HEARING IMPAIRMENT
Hearing impairment is a challenging condition as pointed out earlier, therefore a hearing
impaired child or person is bound I have some problems. These problems range, from
language difficulty, social and emotional problems, thinking difficulty, to academic
1. Language difficulty - Severe hearing loss could deprive the affected person of the natural
ability to acquire verbal language which could impede development. Bakare (1979)
expressed that perception is the first major process in the cognitive processes and that the
defects in the hearing organ of the deaf create a deficit in the development continuum of
language skills. In the past, it is common to pass a deaf person for deaf and dumb meaning
that he/she could neither here nor talk. Today researches are beginning to reveal the
complexity of the relationship' between the two (hearing and speaking).
2. Social and emotional problems: The social integration of hearing impaired students with
the classroom generally depends on whether or not their hearing peers perceived them good
enough to make effective member of a discussion group or project group. (Northcott 1973).
Socially the hearing impaired child is bound to be less mature than the hearing child of the
same age because of certain frustrating problems he is subjected to like poor language
development. Studies have shown that the hearing impaired manifest a great degree of
emotional maladjustment than their normal peers. They are often emotionally insecure in
their relationship with others as in most cases they are not sure of being understood by other
people when they use sign language (Obikeze' and Ofojebe 2000).
3. Thinking and academic achievement: The hearing impaired children due to lack of
auditory experience have their intellectual development defective when compared with the
hearing children. Okeke (2001) argued that if the children's hearing impairment is not
ameliorated, poor or lack of complex and abstract reasoning will Pose a serious threat to the
child's academic aspirations. In other words language disabilities resulting from deafness"
directly interfere with intellectual performance and indirectly affect thinking by obstructing
normal patterns of cognitive stimulation and interpersonal communication and
MANAGEMENT AND INTERVENTION PROCEDURES OF HEARING
For the hearing impaired child to benefit maximally from special education programmes,
there is need for proper management of his challenged state. Obikeze and Ofojebe (2000)
identified ten measures for the management and control of hearing impairment in
children. These are as follows:
1. The use of new drugs in treating infections of the ear, nose and throat.
2. Surgical treatment where possible
3. Use of improved hearing test techniques and equipment for diagnostic purposes.
4. Use of improved hearing aids such as ear trumpets.
5. Giving of better prenatal care to expectant mothers.
6. Availability of good medical and nursing care during the period of delivery and
control of accidents and possible brain injury during and immediately after.
7. Regular medical and health care in infancy and during the school years.
8. Firm control of contagious diseases via vaccination and immunization.
9. Prompt treatment of colds and coughs in children.
10. Prompt treatment of middle ear infection such as otosclepsis
Strategies and programmes for educating the Hearing impaired
It is often difficult to mainstream the hearing impaired but when they are
mainstreamed, such students need sign language interpreters in the classroom as well as
supplementary resources assistance.
Teaching the hearing impaired will definitely pose a problem to the teacher
because deafness being a serious sensory deprivation is noted to hinder the afflicted
person's development generally and their academic achievement in particular. Thus Alade
and Abosi /1991) found out that hearing impairment has adverse effects on academic
achievement but the magnitude of such adverse effects depends on the degree of hearing
loss. For effective teaching and learning therefore the hearing impaired needs appropriate
methods that could facilitate the acquisition of language as well as social and emotional
adjustment. These methods include:
1. Auditory method: - This method involves teaching hearing impaired children to
recognize sounds. It emphasizes the development of listening skills. It is a situation
whereby the hearing impaired is constantly exposed to sound and language in their
environment together with the provision of some kind of hearing aids for amplification.
2. The oral method:- Here gestures and signs are not allowed. The oral method rather
uses speech, lip reading and auditory training to teach. Stressing assisting the hearing
impaired to acquire communication skills and de-emphasizing gestures and signs is
necessary and central in the education of hearing impaired. Special educators also place
emphasis in the development of early meaningful communication in the management
of hearing impaired individuals.
3. Rochester method:- This method emphasizes reading and writing. Rochester method
combines the oral method and finger spelling or writing in the air technique.
4- Neo-oralism:- The central task of this method is to give tools of communication
especially expressive communication at an early to change youngster who are passive
into being active and therefore develop an initiative in learning. The method, like Rochester
method makes use of finger spelling. If the young deaf child masters finger spelling, the
language mastery process becomes easy like that of the hard-of-hearing child.
5. Simultaneous total communication method:- This approach involves using oral
communication audition, finger spelling, signs, gestures, dramatization reading, pencil and
pen writing and drawing. All the sense modalities are used in the this method.
Idowu (2004) writing on what the teacher should do to educate the hearing impaired or the
deaf stated the following:
1. Learning by deaf children is visually oriented. What they can see is important to them
and not what they are supposed to hear. So, the teacher should therefore make use of the
black board, pictures, diagrams etc.
2. Making use of concrete objects creates and sustains interest in the lesson.
3. The concept of over-learning is very important in working with deaf children. A single
idea or concept should be presented in a variety of ways, and by using more than one sense
4. Every subject on the time - table could provide an opportunity for teaching language, or
some form of communication skills. He added that teachers should seek co-operation of the
home of the child and ensure that he/she is accepted, loved and encouraged by his/her parents
1 a. What do you understand by hearing impairment? b. List about ten signs of hearing
2a. What are the causes of hearing impairment? b. Write short notes on
i. the partially sighted
ii. the congenitally deaf
iii. the adventurously deaf
3. The hearing impaired is faced with some problems. Comment on this statement.
4a. Mention four major types of hearing impairment
b. Explain fully the management and intervention of the hearing impaired child.
c. How can the classroom teacher help the hearing impaired.
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academic achievement of the deaf in E.D Ozoji, J.U. Umuolu, S.O Olaniyan (eds).
Contemporary issues in mainstreaming the exceptional child in Nigeria's 63-3-4
system of education. Jos: Ehindero Press.
Bakare, C.G.M (1979). The cumulative cognitive deficit syndrome in African children. An
inaugural lecture" delivered at the university of Ibadan.
Bryan, T.H and Bryan, J.H (1975). Understanding learning disabilities New York Alfred
publishing Co. IncEmbey, T.e (1971). A study of the effect of mild hearing loss on
education achievement (Doctoral thesis, university of Tulsa,) DissertationAbstracts
Idowu, A.I (2004) Guidance and counseling in Education, llorin. Indemac Ltd. Mba,'P.O.
(1995). Fundamentals of special education and vocational rehabilitation Ibadan;
North Cott, W.H (ed) (1973). The hearing impaired child In a regular classroom,
Washington DC. A.G Bell Association.
Obikeze, NJ and Ofojebe C.C. (2000). Issues in Special Education. Onitsha; Onwubiko
print & pack Ltd.
Okeke, B.A (2001). Essentials of Special Education Nsukka, Afro Orbis publication Ltd.
Ross, A.O. (1972). The Exceptional child in the family. New York; Grune and Stratton.