Support Team for Deaf Children

Support Team for Deaf Children

 







Pupils supported by the team

Range of Services

Referrals to the team

Contact List

Main Index

Top Ten Tips

Guidance for teaching phonics

MSI - Multi-Sensory Impairment

Resources for Teachers of the Deaf

Early Years

 

 

 

 

Contact List 

 

 

Head of Sensory Service and Contact: Anne Lomas     
   
Assistant Head of Sensory Service Karen Turner
   
Sensory Service Business Manager Traci Wright
   
Team Leader Support Team for Deaf Children Sue Marsden
   
Early Years Co-ordinator      Michelle Audsley
   
Educational Audiologist Antony Limbert
   
Specialist Teachers of the Deaf Lucy Beech
  Poornima Chauhan   
  Alice Emsley
  Helen Lesak
  Bill Horton
  Ann Wilson
  Sandie Griffiths
   
Teacher for Children with Additional and Complex Needs Emma Kitching
   
Specialist Early Years Practitioners

Afza Jabeen

 

Penny McDermott

   
Educational Audiology Officer Melissa Crewe
   
Specialist Speech and Language Therapist Nichola Warin
   
Deaf Instructor Mary Robinson
   
Administrator Farakh Iqbal
   

 

Support Team for Deaf Children

Sensory Service
Department of Children's Services
SEN Services
Floor 7
Margaret McMillan Tower
Bradford

BD1 1NN

Tel: 01274 439500

 

 

 

 

 

 

Pupils supported by the team        

The Team supports the following deaf children from diagnosis (which can be as early as 6 weeks of age) to 19 years old:

  • Those with a sensori-neural loss who are hearing aid wearers
  • Those with a permanent bilateral hearing loss
  • Those with a permanent unilateral hearing loss
  • Those with Auditory Neuropathy Spectrum Disorder (ANSD)
  • Those with a diagnosis of Auditory Processing Disorder (APD)

 

Support is not provided for those with a temporary conductive hearing loss.

 

Range of Services

The Team provide qualified and experienced teachers of the deaf to work with both pre-school and school-aged deaf children/students and their families.

The aim of this support is to ensure that the individual needs of deaf children are met within the context of home and school. These needs are identified in partnership with the pupil, parents, teachers and other professionals.

The Team provides:

·         Support and information for families to enable them to make informed choices for their deaf children in relation to language development, communication options and educational pathways, etc

·         Support for pupils in mainstream and special schools to access the curriculum

·         Support and training to teaching staff and Teaching Assistants

·         Contribution to Stages of Assessment and IEP formulation

·         Speech audiometry and other assessments as necessary

·         Liaison with other agencies

·         Advice on classroom acoustics and the need for additional auditory equipment such as radio aids and soundfield systems

·         A teacher of the deaf and Specialist Practitioner who speak Panjabi/Urdu

·         Deaf Instructor support for pre-school deaf children

·         Parent-Toddler Groups that include courses for parents and carers

·         Deaf awareness and introductory sign language courses for parents and carers

·         Resources which include library, videos, DVDs, information booklets and leaflets

 

Referrals to the team

Referrals come direct to the Team from Local Health Trusts. For children identified through the Newborn Hearing Screening Programme the Early Years Co-ordinator or Head of Team attends the hospital clinics when the hearing loss is confirmed to parents. Schools with concerns about a pupil’s hearing are recommended to ask the family to take the child to the GP or ask the school nurse to see the child to determine whether a referral to an ENT consultant is necessary. It is through this route that pupils are referred to the Team. All referrals will normally receive a response within 10 working days and within 24 hours in the case of a pre-school child.

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Index  

The Support Team for Deaf Children 
Hearing Loss 
Hearing tests 
Hearing Aids 
Cochlear Implants 
Radio Aids 
Advice sheets for teachers and support staff 
Classroom Acoustics 
Soundfield Systems 
Organisations and useful publications 
Additional Resources

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Hearing Loss

How the ear works

The outer ear (pinna) collects sound waves and funnels them down the ear canal. These sound waves cause the eardrum to vibrate, and these vibrations are carried across the middle ear by the small bones (ossicles) to the oval window and into the cochlea. The cochlea is filled with fluid and contains thousands of tiny hair cells. The vibrations moving the membrane of the oval window cause a wave action in the cochlear fluid and, depending on the frequency of the vibrations, trigger movement of particular hair cells. The movement of the hair cells creates a small electrical charge which is carried along the auditory nerve to the brain where these signals are interpreted as sound.

 If any part of our hearing system is damaged our hearing will be affected, causing a temporary or permanent deafness.

 Types of deafness.

 Conductive deafness

This arises when there is a problem within the outer or middle ear, such that sound waves cannot effectively be conducted across them. The most common type of conductive deafness in young children is ‘glue ear’ (otitis media). This occurs when there is a build up of fluid within the middle ear as a result of the eustachian tube becoming blocked. The incidence of glue ear peaks at 2 and 5 years of age but these problems are generally resolved by the time a child is 7/8 years. In cases where individual occurrences are long-standing, grommets may be inserted into the eardrum to allow it to drain. Many conductive losses are temporary and for those that are not, surgical intervention or hearing aids might be necessary.

Ear Infections

Ear infections and language development

 Sensori-neural deafness

This is when there is a problem in the inner ear, generally because the hair cells in the cochlear are not functioning properly. The result is that sounds need to be louder before they can be perceived and are distorted. A sensori-neural loss is permanent. Because the damage is located inside the cochlear, a hearing aid can only do so much to help. Whilst an aid can make speech sounds louder they cannot make them clearer and speech will always be distorted to some extent.

 A child with a sensori-neural hearing loss can also have a conductive loss such as glue ear. In this case they have a mixed loss.

 For more information, download ‘Understanding Deafness’ from NDCS.

 

Auditory Processing Disorder (APD)

APD is a condition whereby a child, when tested, has hearing within normal limits and yet may struggle to understand speech, particularly in noisy conditions.

What are some of the symptoms of APD?
Children with APD can have difficulties:
     • Understanding when listening
     • Expressing themselves clearly using speech
     • Reading
     • Remembering instructions
     • Understanding spoken messages
     • Staying focussed
Some children with APD behave as if they cannot hear. Hearing, and listening,
in noisy places can be especially difficult for many children with APD.

Pupils with APD may benefit from the following:

  • being seated near the front of the class, close to the teacher
  • being able to see a speakers face clearly
  • instructions being given clearly, in smaller chunks and at a slower pace than normal
  • having background noise kept to a minimum
  • having written and other visual cues to support their hearing of speech
  • some pupils may benefit from a particular type of radio aid whereby the teacher wears a transmitter and their voice is transmitted directly to the pupils ear canal.

For more information please click on the link below:

Institute of Hearing Research leaflet on APD

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Hearing Tests

 There are a variety of hearing tests which can be used, depending on a child’s age and stage of development. Screening tests can be done with a new-born baby to see if it is likely there is a hearing loss. If there is no positive response they can be referred on to an audiologist who will carry out more detailed tests.

 Hearing tests are designed to give us, as far as possible, detailed information of the quietest sounds an individual can hear (their threshold of hearing), for each ear, across a range of frequencies important for speech.

 The most commonly used tests are detailed below.

 Otoacoustic emissions

This is commonly used as part of the newborn hearing screening programme. A healthy ear produces a faint response when stimulated with sound. This response can be recorded and lets the tester know if the baby needs to be referred for further assessment. Lack of a positive response can be due to birth fluid remaining in the ear canal or to high levels of background noise in the area where the baby is being tested.

 Auditory brainstem response

This is commonly used when there is no clear response using otoacoustic emissions. Children must be still and quiet whilst this test is carried out and for young babies it will be done whilst they are asleep. For older children, light sedation or a general anaesthetic are generally required. Three electrodes are placed on parts of the skull and sounds are introduced into the ear canal via headphones or insert earphones. The electrodes can detect a response to these sounds being sent through the cochlea and along the auditory nerve to the brain.

Visual response audiometry

This is suitable for children from approximately 6 – 30 months of age. Using an audiometer, sounds of different intensity (loudness) and frequencies (pitch) are played through insert earphones, headphones or speakers. When a sound is played the child is encouraged to turn their head to look at a visual ‘reward’. Once conditioned, the reward is delayed until the child turns in response to a sound, demonstrating that they have heard it.

 Pure tone audiometry

This is the gold standard of hearing tests as it can give us all the information we need about a child’s or adult’s hearing. It can be used with children as young as three years of age. Young children are encouraged to perform an action when they hear a sound (e.g. put a man in a boat) whilst older children and adults will be asked to press a button. Wearing insert earphones or headphones, air conduction testing is carried out which shows the status of the whole hearing system i.e. outer, middle and inner ear. Using bone conduction, where a vibrator is placed on the mastoid bone behind the ear, the inner ear alone is tested. Any difference between the results of these two tests can show whether a hearing loss is conductive, sensori-neural or mixed.

 Audiograms

An audiogram is a graph showing an individuals threshold of hearing. Along the X axis are the frequencies tested, from low to high, and along the Y axis the intensity of the sounds, generally from -10 to 120. Frequencies are measured in Hertz (Hz) and intensities (on an audiogram) in decibels of hearing loss (dBHL). Normal hearing is between 0 and 20dBHL, where 0dBHL is the average quietest sound which can be heard by young healthy adults with good hearing. Results for the right ear are marked with a red circle and those for the left with a blue cross. Bone conduction results are marked with a triangle.

 An audiogram showing normal hearing is reproduced below.

 

Degrees of hearing loss

If a child or adult is diagnosed with a hearing loss, the degree of that loss is classified as mild, moderate, severe or profound. The degree is calculated by taking the average of the threshold levels obtained at 250, 500, 1000, 2000 and 4000Hz in the better ear. Many children have a hearing loss in one ear and normal hearing in the other, in which case they are classified as having a unilateral hearing loss.

Examples of audiograms showing different degrees of hearing loss are shown below.

  A moderate hearing loss                                    A severe hearing loss

 

                                            A profound hearing loss

This link will allow you to listen to a variety of hearing loss simulations.

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Hearing Aids

  

Most children who are diagnosed with a hearing loss are issued with hearing aids by their Local Health Trust. These are generally post aural (behind-the-ear) hearing aids though some may need bone anchored (Baha) hearing aids.

Post aural hearing aids

      

These are digital aids which can be programmed to match the level of hearing loss in each ear. Hearing aids for the right ear are marked with a red spot and those for the left with a blue spot. It is very important that these are worn in the correct ear.

 Pupils requiring hearing aids have impressions of their ears taken in the hospital and these are used to make individual earmoulds. As a child grows, so their ears get larger and they will need new moulds making. For very young babies and toddlers new moulds may be needed every four to six weeks. For older children new moulds will be required less often. Exposure to the sun makes the moulds and tubing become hard and yellowed, necessitating new moulds. Staff from the Support Team for Deaf Children cannot repair hearing aids or make new earmoulds. The responsibility for these lies with the parents. If a pupil’s hearing aids are broken, or they are whistling because the moulds are too small, you should contact the parents and ask them to visit the hospital as soon as possible.

 Modern hearing aids can have more than one programme: e.g. a start-up programme for 3600 listening in everyday general situations; a listening-in-noise programme where the hearing aid uses directional microphones, picking up sounds from the front but limiting the amplification of sounds from behind the wearer; a programme for listening to music etc. These additional programmes can be added as the hearing aid wearer becomes able to select the most appropriate programme for a particular situation.

As good as modern hearing aids are, they do have limitations. They are designed for hearing speech when in 1:1 or small group situations. The microphones are effective within a radius of two metres. Beyond that distance their ability to amplify sounds is greatly reduced. In addition, hearing aids will amplify all sounds picked up by the microphones, not just speech. They therefore make all background noises louder, and the wearer can still have difficulty perceiving and understanding the different sounds of speech. Pupils with hearing aids may therefore benefit from the use of a radio aid when they are a distance from the speaker.

Inserting a new battery

 

Bone Anchored Hearing Aids BAHAs

         

A boneanchored hearing aid is an implanted hearing aid that transmits sound via bone conduction, bypassing the ear canal and middle ear. Sound is conducted through the skull to stimulate the cochlea directly. Conventional bone anchored devices consist of a titanium implant, an external abutment and a detachable sound processor. A different type uses an implanted magnet with a magnetic detachable sound processor. They are suitable for those with a conductive hearing loss, some of those with a mixed hearing loss, and those with a unilateral hearing loss.

Bone anchored hearing aids can be worn attached to a softband (headband) which is suitable for children to benefit from the hearing aid without the need for surgery, or for an individual to trial a bone anchored hearing aid prior to surgery.

There are three suppliers of bone anchored devices in the UK: Cochlear Europe, Oticon Medical and Sophono.

 Models of hearing aids used in Bradford

 

Audio Input Shoes for Bradford Hearing Aids

Attaching audio input shoe to Eterna

 

Removing audio input shoe from Eterna

 

Naida Hearing Aids

Nios Hearing Aids

Cochlear Divino

Cochlear Intenso

Cochlear BP100

Checking a Hearing Aid

Hearing aid maintenance equipment for schools

Inserting An Earmould

Connecting to computers

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Cochlear Implants

What is a cochlear implant?

A cochlear implant is a special type of hearing aid, providing a sensation of hearing for deaf children and adults. They are suitable for children who have a permanent, severe to profound hearing loss, who even with modern, powerful hearing aids are unable to hear the full range of speech sounds. 

Traditional hearing aids work by amplifying sounds in the outer ear and sending these sounds through to the cochlea. Vibrations set up within the cochlea generate a series of small electrical impulses which travel via the auditory nerve to the brain. Cochlear implants provide a sensation of hearing by changing sounds into an electrical signal and sending this to a series of electrodes implanted within the cochlea, stimulating the auditory nerve and sending the signal on to the brain.

What does one look like?

A cochlear implant has two major parts; one external and one surgically implanted in the skull. The external part comprises a microphone, speech processor, lead and transmitting coil. The internal part consists of a receiver and an electrode array which is placed inside the cochlea.

 

When are children implanted?

Research has shown that the earlier a child is implanted, often now between the ages of 1 and 2 years, the greater the benefit. Bilateral implants are now becoming increasingly common.

Implant centres

Implants are carried out by regional cochlear implant centres, staffed by surgeons, audiological scientists, teachers of the deaf and speech and language therapists. The implant team will assess children to see if they meet audiological and personal criteria which might include some or all of the following:

  • They have a permanent severe to profound hearing loss
  • They are unlikely to benefit from the use of traditional hearing aids
  • There are no contra-indications for surgery
  • The child has established good hearing aid use which suggests they will wear the implant
  • The child is able to co-operate in testing, allowing the implant to be ‘mapped’ (tuned in)
  • Parents and local professionals are willing and able to support the child in the use of the implant

What is the process?

A child is assessed at an implant centre and if a cochlear implant is agreed the child requires surgery for the internal parts to be implanted. After approximately four weeks, allowing time for the wound to heal, the child returns to the implant centre for it to be ‘switched on’. Mapping (or tuning) the implant requires the child to be able to respond when a sound is ‘heard’. The audiological scientist will seek to establish a ‘map’ whereby, for each of the active electrodes, a threshold and comfort level are established. A threshold level is the lowest electrical level which results in the child being aware of a sound and the comfort level the highest electrical level which results in a sound being heard as loud but not uncomfortably so. This ‘map’ will be refined over successive visits to the centre as the child becomes more familiar with the implant and his/her awareness of a range of sounds.

Yorkshire Cochlear Implant Service

Basic Guide to Operating Nucleus Freedom Processor

Troubleshooting the Freedom Processor

British Cochlear Implant Group

Handbook for Educators Med-El

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 Radio Aids (FM systems)

  

Listening in school can be problematic as hearing aids are not designed for that situation. There are three major issues:

  • The distance between the pupil and the teacher (hearing aids are only effective up to 2 metres)
  • Hearing aids pick up and amplify those sounds which are closest to them, which is not necessarily the teacher’s voice
  • High levels of background noise and/or reverberation make it more difficult for a pupil to hear and concentrate on what the teacher is saying

 Radio aids help to alleviate these problems as they allow the pupil to hear the teacher’s voice as if they were standing next to them.

 A radio aid consists of two parts

  • A transmitter worn by the speaker (generally the teacher)
  • A receiver worn by the pupil

 The teacher’s voice is transmitted via radio waves directly to the pupil’s hearing aid(s) on a specific frequency. It is important that if two or more pupils are using a radio aid in different classrooms that they are each on a different frequency. If there are occasions when pupils need to be on the same frequency, for example for an assembly, then the radio aids can be set up to allow frequencies to be changed by the pupil or their teacher.

 Transmitters need an aerial to send the signal. This may be incorporated into the microphone lead or it may be a separate wire which hangs down from the transmitter. It is important that these are fully unwound in order for the signal to be effective.

 Many receivers now are very small and attach to the bottom of the hearing aid via an audio input shoe. Each type of hearing aid has its own unique audio input shoe. As the receiver is very small it does not have its own battery source but draws from the hearing aid battery. The hearing aid batteries will therefore not last as long as when no radio aid is used.

Attaching audio input shoe to Eterna

Removing audio input shoe from Eterna

Fitting a shoe and receiver

 

 It is important that the radio aid is effectively managed by the teacher.

  • It should be switched ON whenever the pupil is being taught, either as part of the whole class or in a small group.
  • It should be switched OFF whenever the teacher is not speaking to the pupil directly or as part of a group.
  • Leaving the transmitter switched on inappropriately means that the pupil is constantly being distracted by the teacher talking to others.

Connecting the radio aid to other equipment

It is possible to connect an audio lead to the transmitter. The other end of the lead can then be plugged into any device with a headphone socket e.g. a computer, keyboard or cd player. This allows the pupil to hear a much better quality sound.

Radio aid models issued by STDC

              

          

 

            

        MLxi BAHA

Wearing EasyLink & ZoomLink transmitters

Inspiro

            User Guide

Wearing an Inspiro transmitter

EduLink

            EduLink User Guide

         

          Radio Aid loan form for Schools

          NDCS Radio Aid Guide

          NDCS Radio Aid factsheet

          NDCS Quality Standards for FM

          Otto Discovers FM

 

 

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 Advice sheets for teachers and support staff

Advice for pupils with a mild hearing loss

Advice for pupils with a conductive hearing loss

Advice for pupils with a mixed hearing loss

Advice for pupils with a unilateral hearing loss in their right ear

Advcie for pupils with a unilateral hearing loss in their left ear

Advice for pupils who wear hearing aids

Advice for pupils who use a radio aid

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Classroom Acoustics

Classroom Acoustics: A Brief Guide

Information on Classroom Acoustics to Support Quality First Teaching

Pupil Interview and Noise Survey for School Staff

NDCS Acoustic Toolkit - Introduction

NDCS Acoustic Toolkit - Schools Noise Survey

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Soundfield Systems

  What is a soundfield system?

It is basically a low powered public address system. It comprises a microphone connected to a radio transmitter, an amplifier and a number of loudspeakers (generally 4) placed around the room. The speaker’s voice (usually the teacher’s) is amplified and fed through the loudspeakers. The teacher is able to talk at a normal conversational level, yet their voice is heard at a constant level by all pupils in the class, irrespective of where they are sitting. Soundfield systems are used widely throughout the United States, and are increasingly finding favour in this country. A number of schools in Bradford have installed such systems and are pleased with the results.

 

Why are these necessary?

There are mainly three reasons why we might experience difficulty in hearing a speaker.

  1. Speaker-listener distance. The level of a teacher’s voice (or any source of sound) decreases as we move further away. Pupils near the front may be able to hear comfortably but not so those at the back of the class. Teachers can only compensate for this by raising the level of their voice. As teachers move around the room pupils will find it easier/harder to hear.
  2. Reverberation times. Many classrooms have very poor acoustics. Hard floors, large area of glass, high ceilings and few soft furnishings lead to high reverberation times (echo). This affects our ability to understand speech.
  3. Signal-noise ratio. Levels of background ‘noise’ (anything that stops or interferes with being able to hear a particular sound clearly) tend to be high. Such noise can be from within the classroom, from adjacent halls/corridors and/or environmental noise outside.

 

What are the benefits?

A soundfield system can help in reducing the effects of the three factors highlighted above, though if the acoustics in a classroom are particularly bad this should be treated first before installing a soundfield system..

For the teacher: Research shows that a soundfield system greatly reduces the amount of vocal effort required to make him/herself heard over the level of background noise. This leads to a subsequent reduction in the frequency and severity of voice/throat problems and therefore time off. Teaching unions have recognised vocal strain as a problem for teachers generally.

For the pupils: ALL pupils will benefit. Research has shown benefits for the following groups of pupils:

  • Children with a hearing loss, particularly those with a conductive loss.
  • Children with Attention Deficit Hyperactivity Disorder (ADHD).
  • Children with Central Auditory Processing Disorder (CAPD).
  • Children for whom English is an additional language.
  • Younger children who are still developing language.
  • Children with ‘glue ear’ or some level of hearing loss.

 

Many people have reported that the use of a soundfield system has led to a reduction in overall noise levels in the classroom which can to some extent alleviate poor acoustic conditions.

 

Where can I get more information?

Please see the websites listed below. These include a number of companies who produce soundfield systems.

If you would like to discuss the use of these systems, please contact Sue Marsden, Head of Team, Support Team for Deaf  Children, Future House, Bolling Road, Bradford, BD4 7EB.

Tel: (01274) 385833 or email sue.marsden@bradford.gov.uk

 Links to companies providing soundfield systems:

P C Werth

www.soundfields.co.uk/index/asp

Connevans

Aviro

Lightspeed

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Organisations and Useful Publications

National Deaf Childrens Society

The NDCS provide support and information for deaf pupils, their parents/carers and for professionals working with deaf babies, children and young people in homes and schools.

 

Membership is free to all those listed above and you can join quickly and easily online - just click on the link above. Once you are a member there are a wide variety of publications which you can order or download. Some of those which may e useful are listed below. 

Auditory neuropathy

Bone anchored hearing aids

Bullying and deaf children

Cochlear implants: a guide for families

Deaf children with additional needs

Deaf friendly nurseries and pre-schools

Deaf friendly schools

Deaf friendly teachers training pack

Deaf friendly teaching

Down’s syndrome and childhood deafness

Glue ear: a guide for parents

Hearing aids

Individual education plans

Mild deafness

Playtime and deaf children

Radio aids

Starting school

Starting secondary school

Tips for communicating with deaf children

Understanding deafness

Unilateral deafness

 

              RNID

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Additional Resources

              Ling 6 Sounds

The Ling 6 sounds are a quick and easy way to check that a child's hearing aids or cochlear implant are working. The sounds have been chosen because they span the frequency range important for speech. With your mouth hidden (to prevent lip-reading) you make the sounds in a random order and the child is required to point to the correct picture. Children can learn how to do this in a short time and it can then be used for daily checks. It is necessary to establish a baseline of which sounds a child is able to hear. If, on later testing, a child is unable to correctly identify a sound which previously they had shown they could, then it is possible that the aid is faulty. Older pupils can be asked to repeat the sound rather than point to the picture.

 

 Resources for Teachers of the Deaf

Audiology handbook

 Hearing aid list and audio shoes

 Eterna hearing aids

Naida and Nathos hearing aids

Nios hearing aids

Audio input shoes for hearing aids

Inserting an earmould

Radio aid frequencies 

Compatability of radio aid frequencies

Cost of radio aids

Using FM Successware

FM Advantage

 STDC Assessments booklet

 Functional Listening Evaluation

 Pre School SIFTER

 Ptre School SIFTER Manual

 Secondary SIFTER

 Secondary SIFTER Manual

 LIFE UK

LIFE UK Version A

LIFE scoresheet

LIFE Pre-teacher appraisal

LIFE Post-teacher appraisal

 Merklein

Merklein scoresheet

BKB sentence lists

MJ word lists

MJS lists

Assessments booklet

Audiogram of familiar sounds

 

 

 

Early Years

Advice for settings working with young children who have a hearing loss: Early Years Support Ideas


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