V-Connect Foundation: Info & Resources

Info & Resources

How does your ear work?

1. Ear canal 2. Eardrum 3-5. Ossicles 6. Oval window 7. Canal leading to the nose 8. Cochlea 9. Auditory nerve
How does the ear work?
The ear is made up of three main sections:
	The Outer Ear
	The Middle Ear
	The Inner Ear
Sounds from the outside world are picked up by the outer ear, which is made up of the pinna and the ear canal. As the sound waves enter the ear, the ear canal (1) serves to increase the loudness of those pitches that make it easier to understand speech. At the same time the ear canal protects another important part of the ear: the eardrum (2) - a flexible, circular membrane which vibrates when touched by sound waves.
The sound vibrations continue their journey into the middle ear, which contains three tiny bones called the ossicles(3-5), which are also known as the hammer, anvil and stirrup. These bones form the bridge from the eardrum into the inner ear. They increase and amplify the sound vibrations even more, before safely transmitting them on to the inner ear via the oval window.
The Inner Ear, or cochlea (8), resembles the circular shell of a snail, and houses a system of tubes which are filled with a watery fluid. As the sound waves pass through the oval window (6) the fluid begins to move, setting tiny hair cells in motion. In turn, these hairs transform the vibrations into electrical impulses that travel along the auditory nerve (9) to the brain itself. Exactly how the brain actually translates these nerve impulses remains a mystery.
Reference: http://www.ahschicago.com/hearing.asp
Hearing Health Checklist
Infants and Children
A child is more likely to be born with or develop a hearing loss if any of the following risk factors are present at birth:
	Admission to a NICU unit for greater than 48 hours
	Stigmata or evidence of a syndrome associated with a hearing loss
	Family history of hearing loss Craniofacial abnormalities such as ear pits or tags
	In utero infection such as CMV, rubella, toxoplasmosis, herpes
A child is at risk for developing a progressive or delayed onset hearing loss if any of the following risk factors are present as an infant:
	Parental or caregiver concern regarding hearing, speech, language and/or developmental delay.
	Family history of permanent childhood hearing loss.
	Stigmata or other findings associated with sensorineural or conducive hearing loss or eustachian tube dysfunction.
	Postnatal infections associated with sensorineural hearing loss including bacterial meningitis.
	In utero infections such as cytomeglovirus, herpes, rubella, syphilis and toxoplasmosis.
	Neonatal indicators-specificallly hyperbilirubinemia at a serum level requiring exchange transfusion, persistent pulmonary hypertension of the newborn associated with mechanical ventilation and conditions requiring the use of extracorporeal membrance oxygenation (ECMO).
	Syndromes associated with progressive hearing loss such as neurofibromatosis, osteopetrosis and Usher's syndrome.
	Head Trauma.
	Recurrent or persistent otitis media with effusion for at least 3 months.
Reference:
Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs
Joint Committee on Infant Hearing, American Journal of Audiology Vol. 9, 2000.
If any of the above risk factors apply to your child they should be assessed by an Audiologist.
About 50% of children with hearing loss do not have any of the above risk factors. Therefore it is important to observe the behaviour of your child in response to their environment:
If you answer YES to one or more of the following your child should be assessed by an Audiologist

Newborn (Birth to 6 Months)
	Does not startle, move, or cry to loud unexpected sounds.	YES NO
	Does not awaken to loud noises	YES NO
	Cannot be soothed by voice alone	YES NO
	Does not turn his/her head in the direction of your voice by 4-6 months	YES NO
Young Infant (6 through 12 months)
	Does not point to familiar persons or objects when asked	YES NO
	By 12 months does not understand simple phrases such as "wave bye-bye", " clap hands" by listening alone	YES NO
Infant (13 through 2 years)
	Is not alert to environmental sounds	YES NO
	Does not respond to sound and locate where sound is coming from	YES NO
	Cannot imitate and use simple words for familiar people and things around the home	YES NO
	Is not showing consistent growth in the understanding and the use of words to communicate	YES NO
	Two year old cannot repeat words or phrases and does not use short phrases when talking	YES NO
	Child does uses gestures only to communicate	YES NO
Child (Three Years and older)
	Speech is not like other children of similar age	YES NO
	Does not listen to TV at a normal volume	YES NO
	Seems unable to understand verbal questions or instructions	YES NO
Adults
Hearing Loss can develop at any time. Sudden changes in hearing are usually quite obvious, however, many hearing problems develop slowly over time and other people may be aware of a your hearing difficulties before you are.
If you answer YES to one or more of the following you should be assessed by an Audiologist
	Do you often need to ask people to repeat what they have said?	YES NO
	Do you typically have trouble understanding a conversation or mishear people in a group or in the presence of background noise?	YES NO
	Does it seem that people are regularly not speaking clearly or are 'mumbling'?	YES NO
	When watching television do you need to set the volume higher than other people to hear comfortably?	YES NO
	Do you become frustrated or even totally avoid some social occasions because there is too much noise or you cannot keep up with the conversation?	YES NO
	Can you become tired or stressed after you have been listening or in a conversation for an extended time period?	YES NO
	Do you find you need to be close to the speaker at meetings, seminars, restaurants or in religious services to understand?	YES NO
	Do you need to maintain eye contact or see people's faces to understand what they are saying?	YES NO
	Do you find it difficult to localize where sounds are coming from?	YES NO
Have your family or friends questioned whether you have a hearing problem?
Reference: http://www.audiology.org.nz/Public/HearingHealthChecklist.aspx
Hearing Aids
What are hearing aids?
Hearing aids are devices that amplify sound to make hearing easier for those with hearing difficulties.
How do hearing aids work?
Hearing aids are designed to compensate for hearing loss caused by parts of the hearing system that are not working effectively. Deficits may affect all sounds or be limited to specific sounds.
Modern electronic hearing aids use a microphone or an array of microphones to detect sounds. The sounds may be coded into a digital representation and are then filtered to best compensate for the hearing loss. Filtered sounds are then produced by a speaker and directed into the earcanal to enhance the sound sent to the eardrum and beyond.
What types of hearing loss are suitable for hearing aids?
Hearing aids are most effective at assisting mild, moderate or severe hearing loss caused by limitations in the transmission of sound through the eardrum and middle ear hearing bones (known as a conductive hearing loss) or reduced function of inner ear sensory cells called outer hair cells (known as a sensory hearing loss).
Hearing aids although usually useful are typically not as effective as cochlear implants for assisting very severe or profound hearing losses.
Hearing aids can also provide some benefit for hearing problems caused by damage to the hearing nerve or brain.
Do I need hearing aids?
Please visit our Hearing Health Checklist
What do hearing aids look like?
Hearing aids come in many different shapes, sizes and colours to suit different needs and preferences. Usually hearing aids can be designed to be smallest when they provide assistance for mild or moderate hearing loss.


I'm not old, I don't need hearing aids!
A common misconception is that the use hearing aids is a sign of old age and should be avoided for as long as possible. This is unfortunate as:
	Hearing aids are used by people of all ages
	Studies of the appearance of adults with visible hearing aids shows that perceived age is not significantly increased
	Experiencing regular hearing difficulties (because hearing aids are not being used) can make people seem older!
Two ears (or two hearing aids) are best
Two ears are better than one! Being able to hear with both ears (binaural hearing) is at least as important as being able to see with both eyes.
If you only use one hearing aid when significant hearing loss is present in both ears there is a risk of auditory deprivation. This is when the brain gradually loses some of its ability to process information from the unaided ear because of a long term lack of sound stimulation. Using two hearing aids minimizes this risk.
Most hearing loss affects both ears therefore the majority of people with hearing loss are good candidates for two hearing aids. In New Zealand over 85% of suitable new hearing aid users opt for two hearing aids.


If cost is an important factor in your decision then it may be best to get two less costly hearing aids than one that has a higher price. Important benefits of binaural hearing (or use of two hearing aids) are:
	You get the best ability to determine where sounds are coming from
	Understanding speech in noisy surroundings is easier for you
	Your risk of auditory deprivation is greatly reduced
	The sound picture you experience will be fuller and more comfortable
Hearing Aid Technology
Digital Hearing Aids
	Over 90% of new hearing aids are digital
	Many use computer processing to reduce non-speech background noise
Directional Microphones
	Hearing aids with two microphone entry points or two or three microphones can be used to enhance sounds from particular directions.
	Directional microphones are typically used to help people concentrate their hearing on a particular conversation in the presence of background noise or when in a group of people.
A range of different hearing aid styles ands sizes are available with directional microphones
FM System
	Device that transmits sound wirelessly from a transmitter (placed near the source of the desired sound) to a receiver that passes the sound to the user often via hearing aids.
	Typically used to help hearing impaired children hear the teacher in a classroom environment or by hearing impaired adults in seminar or meeting situations.
Remote Controls

	Controls the specific functions of hearing aids such as adjusting the volume or changing to a different listening programme used for a different hearing environment.
Reference: http://www.audiology.org.nz/Public/HearingHealthChecklist.aspx
	Typically used to help hearing impaired children hear the teacher in a classroom environment or by hearing impaired adults in seminar or meeting situations.

Cochlear Implant:

What is a cochlear implant?

A cochlear implant is a routine medical option designed to help children and adults with at least a moderate-to-profound sloping hearing loss, to communicate more easily.

It is an alternative when traditional attempts to improve hearing ability, with powerful hearing aids, no longer provide assistance.

Unlike hearing aids, which amplify sound, a cochlear implant bypasses the damaged part of the ear and stimulates the hearing nerve directly.

A cochlear implant is designed to help children and adults communicate more easily with others and give you the confidence to live a full and rewarding life.

The Implant

The cochlear implant is the internal part of the system. It includes an electrode array which, when inserted into the cochlea, bypasses damaged hair cells and stimulates the hearing nerve directly.

The Speech Processor

The external speech processor analyses and digitizes sound into coded signals. These signals are transmitted through the implant to your hearing nerve so you can hear the sounds.

How are hearing aids different?

Hearing aids are designed to amplify sound. To a person with at least a moderate-to-profound sloping hearing loss, simple amplification may not be sufficient to hear, or may be distorted, as sound is still being delivered through the damaged part of the ear.

A cochlear implant doesn't simply make sounds louder - it bypasses the damaged part of the ear and sends sound directly to the auditory (hearing) nerve to provide a clearer understanding of sound and speech.

Reference: http://www.cochlear.com.au/Experience/581.asp

Recommended Book:

Recipes for Parenting:

Dr. Pervin Dadachanji has written a book "Recipes for Parenting" a guide for parents of 6 to 12 year olds which we recommend all parents to read, we have found it extremely informative & useful guide to have. It Price Rs. 195/-.

RECIPES FOR PARENTING, A GUIDE FOR PARENTS OF 6 TO 12 YEAR OLDS is a book on parenting techniques written by Dr. Pervin Dadachanji and edited by Meher Marfatia and published by Rupa. "Unfortunately children do not come with their own personal How To Operate manuals, so we either parent using trial-and -error methods or the same style of parenting on all kids. This does not work - even children with the same parents have different temperaments and need to be parented according to individual needs" notes the introduction to the book.

The book is divided into two sections.

The first part deals with basic techniques to shape child behaviour.

The second half deals with various issues like activities of daily living, family issues, social issues, school and homework etc. These are all in question answer format.