Learning Objective. To learn about current technological interventions that allow children with hearing loss to access auditory information

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2 Learning Objective To learn about current technological interventions that allow children with hearing loss to access auditory information in the educational environment.

3 Module Outline Goal: To improve each student s access to education through the use of technology Personal hearing technologies Classroom/group hearing devices How they work Limitations of these devices How to check and troubleshoot Additional classroom modifications

4 Hearing Technology: Personal Devices

5 Hearing Technology: Personal Devices

6 Hearing Technology: Personal Devices The most common personal hearing device is the hearing aid. Most school aged children will utilize a hearing aid that is worn behind the ear, commonly called a BTE (behind the ear) hearing aid.

7 BTE Hearing Aids & Ear Mold Ear Hook Ear Mold Tubing

8 Hearing Technology: Personal Devices Behind The Ear (BTE) Hearing Aids Ear Hook BTE Hearing Aid Ear Mold Image courtesy of Phonak, Inc.

9 Hearing Technology: Hearing Aid Styles Used mostly with adults Images courtesy of Phonak, Inc.

10 Hearing Technology: Hearing Aids Bone ConductionHearing Aids

11 Hearing Technology: Bone Conduction Aids BC Hearing Aids can be worn on a metal head band... or on a soft head band.

12 Hearing Technology: Implanted Devices

13 Hearing Technology: Cochlear Implants An internal receiver is surgically implanted behind the ear. The receiver has an electrode array that is inserted into the cochlea. Image courtesy of Cochlear Americas.

14 Hearing Technology: Cochlear Implants Processor External Stimulator Power Supply External Components of the Cochlear Implant: External device Sound dprocessor External Stimulator Power Supply Image courtesy of Cochlear Americas.

15 Hearing Technology: Cochlear Implants Internal lreceiver Internal Components of the Cochlear Implant: Internal Receiver Electrode Array Electrode Array Image courtesy of Cochlear Americas.

16 Hearing Technology: Cochlear Implants Currently three types have been approved for use in the USA by the Food and Drug Administration, manufactured by: Advanced Bionics Cochlear Americas MED EL Images courtesy of Advanced Bionics,

17 Hearing Technology: Other Implanted Devices Bone Anchored Hearing Devices are attached to the bone with an implanted titanium post. Image courtesy of Cochlear Americas.

18 Hearing Technology: Other Implanted Devices Bone Anchored Hearing Devices are used for ears with malformed outer and/or middle ears. Bone Anchored Devices are also used for children with hearing loss in one ear and normal hearing in the other ear.

19 Hearing Technology: Personal Devices Revisited

20 Classrooms Are Noisy Places Learning is an active and sometimes noisy process!

21 Additional Classroom Modifications Reduce internal noise Reduce external noise

22 Assistive Devices for Classroom Environments Personal FM Systems Body-Worn Devices Ear Level Devices Sound Field Systems

23 Body Worn Listening Devices FM Systems: The child wears a receiver The child wears a receiver that attaches that attaches to his hearing aids with a cord or cable. Image courtesy of Phonic Ear

24 Body Worn Listening Devices Student worn receiver, attached to a hearing aid Teacher worn transmitter and microphone Image courtesy of Phonic Ear.

25 Body Worn Listening Devices Direct Audio Input boots or shoes attach the stude t s pe so a ea g a ds to t e student s personal hearing aids to the FM receiver with a cord.

26 BTE FM Devices FM Receiver Images courtesy of Oticon and Phonak.

27 Portable and Wall-Mounted Sound Field Systems Two formats: FM Infrared aed Usually the speaker and the receiver are housed in one unit. The speaker/receiver unit has a handle for easy carrying. Image courtesy of Front Row Pro.

28 Mounted Sound Field Systems Many models are available. Infrared Sound Field System with Speakers, Receiver & Neck worn Transmitter FM Sound Field Speakers, Receiver & Transmitter with boom microphone Images courtesy of Front Row Pro.

29 Mounted Sound Field Systems Some systems have wallmounted speakers on the fill the entire classroom with sound.

30 Keep in mind p It is critical to provide visual and auditory access to information; all day, everyday!

31 But who s checking? Educate and empower parents, care givers, and teachers Provide necessary tools and skills Monitor in school settings Provide necessary time to complete lt checking routine

32 What do you need to know? Thestudent s s hearinglossdegree degree, type, etc. Type of student s personal hearing technology Type(s) of listening technology provided by the family or school for classroom use Name of the district contact that provides services to students who are deaf or hard of hearing

33 Knowledge is Powerful! Information about hearing aids, cochlear implants and group listening devices can be found online.

34 Checking and Troubleshooting Hearing Aids Basic Test Kit Basic materials needed: Listening stethoscope Battery tester Air blower (syringe) Wax removal tool

35 HA Total Looking/Listening g Check (TLLC) Daniel Ling COMPONENT LOOKING LISTENING Battery & Battery Voltage measured above 1.2. Compartment Compartment free of rust, corrosion or debris Molding & Tbi Tubing Free of wax & moisture, it not No feedback when canal bore is cracked or rough, no holes or tears in tubing, tubing is securely covered, sound is not weak or absent in the ear mold Ear Hook Microphone & Internal Components Free of wax & debris, filter in place (if present), not cracked, fits firmly to hearing aid (HA) No visible damage to microphone or case of the HA, controls are free of dirt & debris and move easily No feedback when hook opening is covered, sound is not weak or absent Six Sound Check is clear & free of distortion, sounds do not cut out when case is pressed, static is not present when controls are moved Feedback No visible damage to ear mold, Withvolume on full, cover canal tubing, ear hook, or HA opening of mold, hold aid near your ear. There should not be any feedback from the HA.

36 Checking Sound Quality: The Ling Six Sound Test An excellent way to quickly check the student s sound reception! Have the student repeat the following sounds: /a/ as in mama /i/ as in bee /m/ as in me / / as in shoe /u/ as in boot /s/ as in sew

37 Troubleshooting Hearing Aids (Patton, 2001) Problem Battery Ear Mold Tubing Hearing Aid (HA) Dead a) Wrong type a) Canal a) Tubing a) HA turned off b) Inserted incorrectly clogged with ear disconnected b) Moisture b) Corroded battery contacts c) Corroded wax blocking tube c) O/T/M switch in the T Weak a) Wrong type b) Weak a) Wax in canal opening c) Collapsed, clogged, or twisted a) Cracked, small hole b) Loosely attached c) Wrong type position ii d) Internal break in the microphone or other part a) Wrong power setting b) Microphone opening clogged c) Broken microphone d) Wrong tone setting e) Filter in ear hook clogged f) Internal problem

38 Troubleshooting Hearing Aids (Patton, 2001) Problem Battery Ear Mold Tubing Hearing Aid (HA) Feedback a) Wrong type a) Cracked or split b) Poor fit a) Cracked or small hole b) Loosely attached c) Wrong type Intermittent a) Corrosion a) Tubing bends or collapses when aid is moved a) Opening in ear hook b) Ear hook not firmly attached c) Internal problem a) Poor battery contact b) Internal connections broken or breaking Distortion a) Weak a) Wax in a) Clogged a) Microphone opening canal b) Moisture clogged or covered b) Defective microphone c) Incorrect tone setting d) Volume too high Static (Noise) a) Weak b) Corroded a) Internal problem b) Volume too high

39 Video: Total Looking/Listening g Check (TLC)

40 Use of the Ling Six Sound Check With a student: Sound Response /a/ (mama) /u// (boot) /i/ one six ten feet /m/ (me) / / (she) // /s/ (sew)

41 Sample Cochlear Implant User Guides Courtesy of Advanced Bionics Courtesy of Cochlear Americas

42 Video: Help Lights & LED Messages on p g g Cochlear Implants

43 Communication is Key!! DEVICE CHECK: Hearing Aids Cochlear Implants Information/Troubleshooting Name: DOB: Year: Audiologist: Phone: Device Make: Model: Serial Numbers Right: Left: Settings: Program: Right Left Volume: Right Left Other: Right Left Date Noted Changes Comments/Problems Observations

44 Video: Trouble Shooting a Cochlear Implant The following video shows s a classroom teacher troubleshooting with a kindergarten student who has difficulty hearing. This student uses two cochlear implants.

45 Video: Checking Cochlear Implant Batteries g p

46 Web Resources: Listening Technologies Websites provide useful information: