Hearing loss and Down syndrome

Hey guys,
     This semester I have been taking an aural rehabilitation class.  A part of this class is to do something interesting related to hearing or hearing loss.  I thought you guys would be interested in learning some interesting information regarding Down syndrome and hearing loss.  This information is intended for clinicians and students.  Attached is a worksheet for clients to work on during a hearing screening or evaluation. Hope you enjoy and learn something new!

What is the prevalence of people with Down syndrome having hearing loss? 
      People with Down syndrome tend to have more health problems than other people.  Specifically, there is a higher incidence of hearing problems in people with Down syndrome.  According to Down Syndrome Education Online, 80% of people with Down syndrome have hearing loss (2011).

How do people hear?
     The ear is divided into three parts leading to the brain. The ear is made up of the outer ear, the middle ear and the inner ear (ASHA, 2012).
     Sounds travel through the air in pressure waves.  As the sound hits the ear, it is transformed from acoustic energy to electrical energy.  It then travels to the ear drum and puts it in motion.  The eardrum then vibrates and then causes the bones of the ear or ossicles to move.  The movements of the ossicles allow for the vibrations to hit the oval window of the middle ear and inner ear.  Then the fluid in the middle ear goes into motion and the hair cells of the cochlea become stimulated.  Then the sound is transferred into nerve impulses and travels to the brain due to the auditory nerves functioning (Down Syndrome Education Online, 2011).

What is a hearing loss?
Three characteristics of hearing loss: type, degree, and configuration.

Type:
·         Conductive hearing loss- This type of hearing loss occurs in the outer ear and middle ear.  It can be treated with the help of a hearing aid.   
·         Sensory-neural hearing loss- This type of hearing loss occurs in the inner ear (cochlea).  It cannot be treated or corrected medically. This type of hearing loss is permanent.
·         Mixed hearing loss- This type of hearing loss occurs in the outer, middle, and inner ear. This hearing loss is a mixture of the previous two types of hearing loss. 

Degree of hearing loss refers to the severity of the hearing loss.

Degree of hearing loss	Hearing loss range (dB HL)
Normal	–10 to 15
Slight	16 to 25
Mild	26 to 40
Moderate	41 to 55
Moderately severe	56 to 70
Severe	71 to 90
Profound	91+

(ASHA, 2012)

Configuration
·         It is also known as the shape of the hearing loss.  It is the pattern of hearing loss across frequencies (ASHA, 2012).
*Note hearing loss is never measured in percent!

What is the most prevalent type of hearing loss in people with Down syndrome?
Conductive hearing loss is the most prevalent hearing loss among people with Down syndrome (Mazzoni, D.S., Ackley, R.S., & Nash, D.J., 1994).

What are some common hearing-related issues that people with Down syndrome experience?
     Abnormal ear formations are common in people with Down syndrome.  Most common, there is a congenital problem.  When the baby is developing there is a malformation of the middle ear ossicles (Mazzoni, D.S. et al, 1994).

      Wax can be a major problem if it interferes with hearing.  Ear wax can become hard and build up if it is not removed properly.  Wax accumulation is common in people with Down syndrome because of their ear canals are more narrow than others.
     Glue Ear is a common problem that can cause conductive hearing loss in people with Down syndrome.  It is a condition that the mucoid secretion builds up in the middle ear.  This build up affects hearing. It is a very sticky substance. 
     Middle ear infections are more common in people with Down syndrome due to glue ear and other factors.  In addition people with Down syndrome are more susceptible to infections (Down Syndrome Education Online, 2011).

     If hearing loss is not detected in people with Down syndrome, it can be very influential in their overall development.  Most importantly, hearing loss has a serious effect on people with Down syndrome’s cognitive abilities, language and auditory processing abilities, and overall IQ levels.  Many people with Down syndrome have hearing loss and it goes undetected. To prevent this from occurring a yearly hearing screening will eliminate this problem (Mazzoni, D.S. et al, 1994).
    
 If a person with Down syndrome experiences any of the previous information it is good to contact a local Audiologist for a screening.  Hearing screenings are quick and easy. All people need to receive a hearing screening if they have not had one recently.  If you live in Illinois, here is a list of certified Audiologists that work with clients with Down syndrome.

Resources

American Speech-Language-Hearing Association. (2012). Communication for a lifetime.

     Retrieved from http://www.asha.org/public/

Down Syndrome Education Online. (2011). An overview of the development of infants with
     Down syndrome (0-5 years). Down syndrome issues and information. Retrieved
     from http://www.down-syndrome.org/information/development/early/?page=6

Mazzoni, D.S., Ackley, R.S., & Nash, D.J. (1994). Abnormal pinna type and hearing
     loss correlations in Down's syndrome. Journal of Intellectual Disability Research. 38 (6),
     pp.549-60. Retrieved from http://ehis.ebscohost.com.proxy.lib.ilstu.edu/eds/
     detail?vid=7&hid=20&sid=79b69c8e-2987-4f76-88bc-d6a4c97fc8d1
     %40sessionmgr13&bdata=JnNp dGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3
     d%3d#db=cmedm&AN=7881226

Here is a worksheet to use with clients to learn about hearing. It is also a good tool to learn what they can and cannot hear in their environment.

Here are audiologists of Illinois who provide audiological services for people with Down syndrome.
Contact your local audiologist today and get a hearing screening.

A special thank you to Annie Farris for finding audiologists in Illinois!

Hope this was helpful!
xoxo,

SP Girl

An egg-cellent idea!

Hi,
Hope everyone had a wonderful Easter! Now that Easter is over the stores have all their Easter items on sale! Here is a good idea to use cheap artificial Easter eggs.

Materials you will need:
Artificial Easter eggs, permanent marker

Take an egg. Then using the marker write on both sides of the egg. You can write prefixes and suffices. This is also good to learn sounds. Any form of writing out words or sounds will make this activity fun and different for the client. You can separate the egg and have the client put the egg together to make words or have them already together and turn the egg for multiple sounds or words. Lastly, the client could also go on a hunt to look for the eggs throughout the room.

A special thanks to http://drjeanandfriends.blogspot.com/ for such a cute idea!
Hope you enjoy!

XOXO,
 SP Girl

Spring has Sprung!

      Happy Spring! Hope everyone is enjoying the nice weather! Here are some fun ideas that can be used inside or outside depending on the day you do your therapy. Since its been awhile since I've blogged I've decided to share three ideas I found on a Disney site called FamilyFun.go.com.

1.Adventure Waterscope

 Things you will need: can opener, coffee or large juice can, duct tape, plastic wrap, and a wide rubber band. (Possibly a bucket, water, and target words/objects)

    First use a can opener to cut both ends off the can. Cover the can's edges so they will not cut the client.  Next, stretch the plastic wrap over one end of the can.  Then secure it with the rubber band and duct tape. Dip the covered end into the water and peer inside. The waterscope can be used in the lake, pool, or bathtub.  If done in a clinic room fill a bucket with water. Place different plastic colorful objects in the bottom of the bucket. Have the client use the waterscope to look through the water to see the different objects. The main idea for this activity is to have the client say his or her target words. You could also laminate different words on paper if necessary.  Remember to have towels, because water can get messy sometimes.

http://familyfun.go.com/crafts/holiday-seasonal-crafts/spring-crafts-backyard-gardening/all-spring-crafts/magnifying-waterscope-848314/

2.Colorful nature hunt

Things you will need: Egg carton, paint, paint brush, water, paper towels, magnifying glass,

     Before therapy paint an egg carton with the colors of the small nature objects you have.  The main idea of this activity is to get the client to use the mangifying glass to look for different objects in the room or outside that match the color on the carton.  Encourage the client to look at the objects and discover new things. You want the client to be able to match the colors and say the objects found.

http://familyfun.go.com/crafts/holiday-seasonal-crafts/spring-crafts-backyard-gardening/all-spring-crafts/a-trail-tote-672562/

3. Flower Fairies

Things you will need: Colorful artificial flowers, scissors, red and pink markers, fine-tip black marker, drilled 16 mm round wooden bead, pipe cleaner for the body, wire cutters, yarn (about 4 feet), pipe cleaner for wings, and craft glue.

     First separate the flower and the stem from the artificial flowers.  Then using the marker, draw the face on the wooden bead (make sure the hole is on top of the bead).  Later bend the body pipe cleaner into thirds and use wire cutters to snip off a third.  Take the yarn and wrap it arround your hand to make a skein as such for the hair.

Then bend the longer piece of pipe cleaner in half and tuck the yarn in the fold. Thread both pipe cleaner ends through the bead head.

Later cut the two bends in the yarn to make the hair fall down on the bead.

Wrap the arms towards the middle of the body.

Then thread the legs through the flower petals and twist the legs so the petals are secured.

 

Place the wings on the back towards the middle of the body and twist them on in three parts.

This activity could be used as a reward in therapy as the client does a worksheet or structured actifity they get to complete the next part of the fairy.

http://familyfun.go.com/crafts/holiday-seasonal-crafts/spring-crafts-backyard-gardening/all-spring-crafts/flower-friends-667264/

I hope you enjoyed these cool Spring- filled activities. Have fun and enjoy!

xoxo,

SP Girl