Conductive hearing loss and Aboriginal students

Transcription

1 Conductive hearing loss and Aboriginal students These notes were prepared by Dr Ann Galloway of Edith Cowan University for the Aboriginal Perspectives Across the Curriculum website. Conductive hearing loss as a result of otitis media is a very significant problem for many Aboriginal children. Otitis media middle ear disease - is also known by various more colloquial names such as glue ear, tropical ear, or runny ear. Causes Otitis media can occur as a result of factors such as colds, flu, chest infections, premature birth, and smoking around children. There is a high correlation between socio-economic factors and the incidence of otitis media (e.g., poor nutrition, overcrowded living conditions, lack of water for washing, lack of access to medical services). When a child gets an ear infection, fluid builds up in the ear canal, the ear becomes blocked, making hearing difficult, and preventing (accurate) transmission of incoming sounds. Cure Ear infections can often be cured with antibiotics, or sometimes surgery, but medicine cannot cure hearing loss that has already occurred, or its educational and social effects. Incidence of otitis media Otitis media is not unique to Aboriginal children; on average 30% of any children are likely to be affected by this disease. The incidence of otitis media in the Aboriginal population is much higher, occurs earlier, more frequently, and lasts longer than in the non-aboriginal population. At least 40% of Aboriginal children are likely to have been impacted by the disease and in more remote areas the proportion of children affected is often at least 70%, if not close to 100%. By adulthood hearing loss can be present in up to 70% of Aboriginal people (Australian Indigenous Health InfoNet). Consequences of otitis media hearing loss, which can range from mild to severe (0-60 decibels (db)):» 0-15dB is the normal threshold level for ears;» 25dB hearing loss is considered mild, but many common sounds will be missed;» with 30dB hearing loss - normal conversation sounds like a whisper; whispers cannot be heard;» with 60dB hearing loss normal conversation cannot be heard; a shouting voice would sound like normal conversation level (Morris, 1998). impaired language development:» three or more episodes of otitis media before the age of three years seriously hinders language development; a hearing loss within the first five years means that the child has missed out on much of his/her own language [which] makes literacy acquisition extremely difficult because the child does not have the basic framework of his/her language on which to build (Higgins, 1997);» fluctuating hearing loss, which results in inconsistent language input, so no adequate models of language are available to build on when learning written literacy;» ineffective language learning strategies;» difficulty discriminating sounds, especially similar sounds, or those not part of the child s home language repertoire (e.g., for many Aboriginal students /p/ /b/; /t/ /d/; /k/ /g/; /f/ /v/; /θ/ /ð/ ( th sound in thin and then respectively); /s/ /z/; and / / ( sh sound in ship) /ʒ/ ( sh sound in measure) will be difficult);» less proficiency at hearing word endings (in Standard Australian English word endings mark number, tense, and possession);» ogreater difficulties processing language, especially voiceless sounds and vowels, which are in the lower register ( soft ) and/or in unstressed positions in words;» delays in language comprehension and production. 1

2 poor listening skills problems with attention and distraction reduced mathematical skills reduced scores on intelligence tests behavioural problems diminished social skills leading to ostracism by peers early school dropout and poor employment prospects due to limited education The consequences of otitis media can be life long, so it is important that teachers be aware of the language skills and knowledge that are needed for success in written literacy, especially given the integral part that written materials play in mainstream learning. This knowledge will help teachers to be able to identify gaps in students learning and provide the basis for remediation. The information given here is a general outline of otitis media and its consequences for language and literacy development. The following references will provide further information: Aboriginal Curriculum Unit, Board of Studies, NSW. (1995). Aboriginal literacy resource kit. North Sydney, NSW: Board of Studies, NSW. Australian Indigenous Health InfoNet. Ear conditions. Available: Department of Education. (2002). Do you hear what I hear? Living and learning with conductive hearing loss/otitis media. East Perth, WA: Department of Education. Higgins, A. H. (1997). Addressing the health and educational consequences of otitis media among rural school-aged children. Townsville, Qld: Australian Rural Research Association. Available: arera/otitis/contents.html Howard, D. (1991). Mild hearing loss and Aboriginal children s learning. The Aboriginal Child at School 19(1), Kindig, J. S. & Richards, H. C. (2000). Otitis media: Precursor of delayed reading. Journal of Pediatric Psychology, 25(1), Lowell, A., Budukulawuy, Gurimangu, Maypilama, & Nyomba. (1995). Communication and learning in an Aboriginal school: The influence of conductive hearing loss. The Aboriginal Child at School, 23(4), 1-7. Lowell, A. (1993). Otitis media and Aboriginal children: The influence of conductive hearing loss in the classroom. Ngoonjook, 8, Morris, P. (1998).The diagnosis and treatment of middle ear diseases in high risk populations: a user s guide. Aboriginal and Islander Health Worker Journal 22(3), Nienhuys, T. & Burnip, L. (1988). Conductive hearing loss and the Aboriginal child at school. Australian Teacher of the Deaf, 29, Walker, N. & Wigglesworth, G. (2001). The effect of conductive hearing loss on phonological awareness, reading and spelling of urban Aboriginal students. Australian and New Zealand Journal of Audiology, 23(1), Wallace, I. F. & Hooper, S. R. (1997). Otitis media and its impact on cognitive, academic and behavioral outcomes. In J. E. Roberts & I. F. Wallace (Eds), Otitis media in young children (pp ). Baltimore: Paul H. Brookes Publishing Co. Yonowitz, L., Yonowitz, A. Nienhuys, T., & Boswell, J. (1995). MLD evidence of auditory processing factors as a possible barrier to literacy for Australian Aboriginal children. The Australian Journal of Education of the Deaf, 1(1),

3 Effective teaching strategies for students with conductive hearing loss The strategies that have been found to be effective in improving educational outcomes for students with conductive hearing loss are basic good teaching practices for any group of students. The following summarises the main strategies Modifying the physical environment within and outside the classroom to maximise listening and learning to ensure that: external noise is minimised/absent environmental noise from equipment is minimised lighting is adequate; no fluorescent lights flickering rubber tips are put on desks and chairs soft furnishings (e.g., carpet on floor; walls covered with artwork) are installed to reduce noise sound field amplification (if available) is functioning correctly regular maintenance of equipment is arranged a variety of teaching methods is used, e.g.» explicit teaching» whole group» one-on-one» small group» peer, scaffolding» hands on learning» educational games, especially language games» AIEO/ATA expertise is utilised» the classroom environment is print-rich Organise students to maximise listening by: seating children with hearing difficulties close to the speaker waiting for silence before speaking ensuring students are paying attention ensuring students know how to show they are listening negotiating culturally appropriate listening behaviours positioning students in a close group when giving instructions (e.g., on the mat) facing the class when giving instructions speaking clearly ensuring the speaker s mouth is visible to assist lip reading establishing a buddy system so designated students help each other using peer tutoring using small group work pre-teaching key words and concepts re-instructing using routines Increase student awareness of hearing problems and consequences for learning/classroom interaction by: focusing on hearing and ear health in health and/or science lessons discussing the problems that children with CHL face discussing ways students can reduce noise in the classroom and assist children with CHL using the children s section of the Do you hear what I hear? CD with the class using the Breathe, Blow, Cough (BBC) routine daily 3

4 Develop the types of language skills that underlie written literacy: phonological awareness skills (production and reception of the sounds of the language):» discriminating listening» rhyme/rhythm» syllable segmentation» production and reception of sounds (individual and blends) in all word positions» knowledge of letter names and sounds» explicit instruction in the physical production of sounds text level skills (production and reception of different types of oral and written texts)» vocabulary» meaning of words and concepts» specificity in language use (e.g., positional (use of prepositions); descriptive (use of adjectives, adverbs))» sentence structure» sequencing, structure and language of different genres of texts» language that encourages thinking, expresses the relations between objects, (e.g., reasons/explanations; cause/ effect; prediction/justification; speculation/ possibility; similarity/difference; comparison/contrasts; problem/ solution/explanation) world semantic knowledge» build on existing world knowledge» develop new world knowledge» develop metalinguistic skills» way language works» knowledge of concepts Link sounds to written language by: creating and maintaining a print-rich environment developing concepts of print developing students knowledge of differences between consonants and vowels developing students knowledge of the difference between letter names and letters sounds helping students understand there is no one-to-one sound/symbol correspondence Identify possible areas of problem in oral language by: checking school records re ear health being alert for anecdotal evidence (e.g., from caregivers) using a screening tool taping and analysing students oral language to assist with identifying areas of problem analysing written language for error patterns Factors that influence the efficacy of these strategies: teacher interaction with students (e.g., compatibility of interaction style with Indigenous styles, evidenced in aspects such as question forms used, responses to unsolicited student initiations) scaffolding of children s language (e.g., expansions and repetitions; clarificatory questions; inclusiveness) explicitness of teaching 4

5 Some of the strategies listed here are presented in the Department of Education publication Do you hear what I hear? Living and learning with otitis media/conductive hearing loss. Others have been included as a result of input from teachers who participated in the research project Teaching Indigenous students with conductive hearing loss in remote and urban schools in Western Australia. This research project was conducted by Edith Cowan University under the leadership of Professor Gary Partington, and funded by an Australian Research Council [SPIRT] Grant and industry partners the Department of Education and Training, Catholic Education Office, and Association of Independent Schools. The information given here is a general outline of good teaching strategies when working with students with conductive hearing loss. The following references will provide further information: Aboriginal Curriculum Unit, Board of Studies, NSW. (1995). Aboriginal literacy resource kit. North Sydney, NSW: Board of Studies, NSW. Beresford, Q. & Partington, G. (Eds). (2003). Reform and resistance in Aboriginal education: The Australian experience. Crawley, WA: University of Western Australia Press. Berry, R. & Hudson, J. (1997). Making the jump. Broome, WA: Catholic Education Commission of Western Australia. Berry, R. & Hudson, J. (1998). The FELIKS approach: A bi-dialectal approach to Indigenous education [Video]. Broome, WA: Catholic Education Commission of Western Australia. Catholic Education Office of Western Australia. (2002). Eli the Dragonfly. Broome, WA: Catholic Education Office. Department of Education. (2002). Do you hear what I hear? Living and learning with otitis media/conductive hearing loss. East Perth, WA: Department of Education. Education Department of Western Australia. (1997). First steps series. Port Melbourne, Vic: Rigby Heinemann. [previously published by AddisonWesley Longman] Education Department of Western Australia. (1998). Time for talk. Perth, Western Australia: Education Department of Western Australia. Ford, L. (1993). Teaching Aboriginal learners with hearing difficulties and special communication needs. Ngoonjook, 8, Higgins, A. H. (1997). Addressing the health and educational consequences of otitis media among rural school-aged children. Townsville, Qld: Australian Rural Research Association. Available: arera/otitis/contents.html Howard, D. (2003). The ear troubles kit. Nightcliff, NT: Phoenix Consulting. Howard, D. (1992). Knowing who may have a hearing loss: A simple speech reception game for use by teachers and parents. The Aboriginal Child at School, 19(1), Howard, D. (1991). Mild hearing loss and Aboriginal children s learning. The Aboriginal Child at School 19(1), Hughes, P. (2001). What works Best practice in Indigenous literacy education. Newsletter of the Australian Literacy Educators Association, June Love, E. & Reilly. S. (1995). A sound way. South Melbourne: Longman. Lowell, A., Budukulawuy, Gurimangu, Maypilama, & Nyomba. (1995). Communication and learning in an Aboriginal school: The influence of conductive hearing loss. The Aboriginal Child at School 23(4), 1-7. Lowell, A. (1993). Otitis media and Aboriginal children: The influence of conductive hearing loss in the classroom. Ngoonjook, 8, Murdoch, K. (2002). Classroom connections: Strategies for integrated learning. South Yarra, Vic: Eleanor Curtain Publishing. Partington, G. (1998). (Ed.). Perspectives on Aboriginal and Torres Strait Islander education. Katoomba, NSW: Social Science Press. Passy, J. (1990, 2002). Cued articulation. Hawthorn, Vic: ACER. Passy, J. (1990, 2002). Cued vowels. Hawthorn, Vic: ACER. 5

6 Websites Research projects addressing educational implications of hearing loss: Teaching Indigenous students with conductive hearing loss in remote and urban schools in Western Australia [the Conductive Hearing Loss Research Project]: Addressing the health and educational consequences of otitis media among young rural school-aged children: Teaching ideas and other information: