Sensorineural Hearing Impairment
Definition
What is sensorineural hearing impairment?
Sensorineural hearing impairment results from damage or lack of development to the tiny hair cells in the inner ear near the cochlea and auditory nerve.
There are two types of sensorineural hearing impairments: ski slop hearing loss and cookie bite hearing loss.
Ski slope hearing loss occurs when the person with a hearing impairment can hear without difficultly in a quiet room. But it is very difficult to hear in a noisy place - especially when there are a lot of people talking. Cookie bite hearing loss occurs when the person with a hearing impairment has problems hearing mid frequency sounds. It is less of a problem to hear high and low frequency sounds ("Sensorineural").
What is Noise Induced Hearing Loss?
Noise Induced Hearing Loss (NIHL) is a permanent hearing impairment resulting from prolonged exposure to high levels of noise ("Noise").
Sensorineural hearing impairment and NIHL are closely linked at they both are caused by some type of damage to the hair cells in the inner ear.
When does this hearing impairment manifest?
Sensorineural hearing impairment can manifest at any age. This hearing impairment can be genetic, developmental (occurring over many years), congenital (occurring from birth), or a sudden occurrence.
How it happens?
Causes of sensorineural hearing impairment:
-Exposure to loud noises over long periods or time or one exposure to a very loud sound (ex: Firecracker explosion)
-Exposure to diseases such as mumps, meningitis, or multiple sclerosis
-Using certain drugs such as aspirin, cisplatin, or quinine
-Using certain antibiotics such as gentamicin, or streptomycin
-May also occur if your mother has had rubella during pregnancy
-Born with a low birth weight
How common is it within schoolchildren?
Sensorineural hearing impairment occurs in
Noise induced hearing loss occurs in over 5 million school-age children.
boys have a higher occurrence of NIHL
According to Billings, "the incidence of severe to profound sensorineural hearing loss (SNHL) in cchildren is approximately 1:2000 at birth and 6:1000 by 18 years of age.
Treatment?
People with sensorineural hearing loss cannot regain their hearing, but most people find sensorineural hearing aids very helpful. A few cases of sensorineural hearing loss can be (partly) treated by means of an operation. (hear it.org)
Instructional Strategies
Instructional strategies for teachers:
- Use pictures/visual cues to reinforce communication, instructions, or vocabulary
- Repeat key points: rephrasing words as necessary
- Gain the students' attention & face the student before speaking to him/her
- Avoid walking and talking
- Make your voice consistently able to be heard
- Explain idioms, multiple meaning words, or any other vocabulary as much of the times these are learned by overhearing others use them in daily conversation
- Use the Frequency Modulated (FM) system, including pass the microphone around to students when talking
- Set up a signal so the student can let you know when he's struggling
- Monitor the child's fatigue level throughout the day
- Identify a buddy that can repeat a page number or simple instruction, but only as necessary
- Support better peer-to-peer communication by keeping the noise down.
- Help the student fit in - hearing devices are like little computers and high tech phones rolled into one
- Promote an atmosphere of acceptance and encouragement
- Be in contact with the person who specializes in working with students with hearing loss in your school/school district
("Inservicing")
Early intervention:
- Help your child stay on schedule with his or her speech, language, and communication skills
- Enhance your understanding of your child's hearing loss and special communication needs
- Support your family in a way that helps you feel confident in raising your child with hearing loss
- Keep track of your child's progress and help you to make decisions for intervention and education each step of the way as your child develops
- Infant testing - screening procedures that do not require the infant's cooperation ("Support")
Hearing habilitation services for children focus on:
- Adjusting to hearing loss
- Making the best use of hearing aids and cochlear implants
- Exploring hearing assistive technology systems that might help
- Learning to identify and distinguish sounds
- Enjoying the sounds of life ("Support")
Useful Websites
https://www.hear-it.org/Sensorineural-hearing-loss
https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/509386
http://successforkidswithhearingloss.com/for-professionals/inservicing-the-classroom-teacher/
https://www.asha.org/public/hearing/Support-Services-for-Children/
http://american-hearing.org/disorders/noise-induced-hearing-loss/
Research
Clason describes a specific drug cocktail that could be potentially used to treat hearing loss. Researchers from MIT, Brigham and Women’s Hospital, and Massachusetts Eye and Ear have been looking into the surprisingly similar characteristics of cochlea and the intestines. The researchers looked at how a drug cocktail would regenerate intestinal stem cells and replicated the process on cochlear cells from a mouse. This procedure worked, and the mouse’s cochlear cells produced hair cells. This study could ultimately help reverse sensorineural hearing loss.
Clason, Debbie. "New Drug Cocktail May Be Future Treatment for Sensorineural Hearing Loss." Healthy Hearing. N.p., 18 Apr. 2017. Web. 24 Oct. 2017. <https://www.healthyhearing.com/report/52745-New-drug-cocktail-may-be-future-treatment-for-sensorineural-hearing-loss>.
This stem cell therapy article starts off by asking the questions: “What if doctors could grow a new working inner ear from a person’s own skin cells? Or repair the damaged inner eat from within?” These questions provide researchers a base to follow in researching whether or not stem cell therapy is something that the future can look forward to. One approach that researchers have thought of is to surgically place stem cells within the cochlea. This method creates hair like cells that are similar to those originally found in the middle ear from induced pluripotent stem cells (adult cells). Using adult cells is just one way to produce these hair like cells, as embryonic stem cell-based approaches could work also.
"Stem Cell Therapy." Stanford Initiative to Cure Hearing Loss. N.p., n.d. Web. 24 Oct. 2017. <https://hearinglosscure.stanford.edu/research/stem-cell-therapy/>.
Khetrapal discusses the two most popular research, based on gene therapy and stem cells. Gene therapy was first experimented on a guinea pig in 2005, which turned out to be a success in reproducing the hair cells that recorded sound. Again, in 2008, this experiment was done with mice, and again proved to work. Later research has reported that Columbia University is conducting one of the world’s first gene therapy trial for a man who has hearing loss. On the other hand, stem cell research has focused their attention on whether or not stem cells can reconnect the inner ear to the brain. In a 2012 experiment, some transplanted cells, in gerbils, had grown projections that formed connections to the brain stem. This said, gene therapy and stem cell research could potentially work in the future.
Khetrapal, Afsaneh. "Hearing Loss Research." News-Medical.net. N.p., 18 May 2017. Web. 24 Oct. 2017. <https://www.news-medical.net/health/Hearing-Loss-Research.aspx>.
This ongoing study in Australia zones in on children with hearing loss. The study called Longitudinal Outcomes of Children with Hearing Impairment (LOCHI), began the assessment process when children with a hearing loss were 6 and 12 months. These children had the procedures to either have hearing aids or cochlear implants done at the very early ages of 6 or 12 months. After some time with intervention and special services, the same children were reassessed at ages 3, 5, and 9 years. Even though the same children are planning to receive an assessment at age 15 and 22, the study has already concluded that early detection, early intervention, and fitting of hearing aids or cochlear implants are key for child development.
Packer, Lisa. "Australian Study Highlights Impact of Early Intervention for Children with Hearing Loss." Healthy Hearing. N.p., 28 Apr. 2016. Web. 24 Oct. 2017. <https://www.healthyhearing.com/report/52644-Australian-study-highlights-impact-of-early-intervention-for-children-with-hearing-loss>.
This study assesses Migrant, American Indian, and Early Head Start programs transitioning children from subjective hearing screening techniques to objective screening practices. One of the main practices that was implemented during the assessment was an otoacoustic emmisions (OAE) testing. This test is incredible as a small probe, that fits into a child ear, is placed in the ear canal and transmits a quiet tone or clicking sound into the ear. Depending on if the ear is healthy or not, the results will differ. However, in a healthy ear, the sound in the ear will travel to the hair cells and they will produce an “echo” back to the probe. If this happens, the screening unit will read “pass.” This use of technology along with hearing screenings allow for data collection. In conjunction with data collection, conducting periodic hearing screenings throughout early childhood were also discussed.
Eiserman, William D., and Lenore Shisler. Screening for Hearing Loss in Early Childhood Programs. N.p.: Elsevier Inc, 2007. PDF. <https://www.infanthearing.org/ncham/publications/2007ECRQHeadstartArticle.pdf>
Other
- According to Eiserman "To put the incidence of congenital hearing loss in context, consider that in a representative sample of 10,000 newborns from the general population, 30 will have congenital hearing loss, but only 11 will have Down Syndrome, 5 will have Spina Bifida, and one will have PKU.”
- Hearing aids or cochlear implants allow most students to perceive speech occurring within a distance of 3-6 feet ("Inservicing").
Hearing aids and/or cochlear implants do not restore normal hearing.
- According to Lurie Children's hostital, syndromes associated with sensorineural hearing loss that occur on a genetic basis include: Waardenburg's, Jervell, and Lange-Nielson, Pandred's and Usher's.
-Low birth weight is the most common risk for SNHL in the NICU population while excessive noise exposure is the most common cause of hearing loss (Billings).
- Is it recommended to have repeated testing every 6-12 months for several years in order to look for the onset of a delayed sensorineural hearing loss (Lurie).
 |  |  |  |
|---|
 |  |  |  |  |
|---|
Resources
Eiserman, William D., and Lenore Shisler. Screening for Hearing Loss in Early Childhood Programs. N.p.: Elsevier Inc, 2007. PDF. <https://www.infanthearing.org/ncham/publications/2007ECRQHeadstartArticle.pdf>
Billings, Kathleet R., and Margaret A. Kenna. "Causes of Pediatric Sensorineural Hearing Loss." Archives of Otolaryngology–
Head & Neck Surgery. American Medical Association, 01 May 1999. Web. 24 Oct. 2017. <https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/509386>.
Clason, Debbie. "New Drug Cocktail May Be Future Treatment for Sensorineural Hearing Loss." Healthy Hearing. N.p., 18 Apr.
2017. Web. 24 Oct. 2017. <https://www.healthyhearing.com/report/52745-New-drug-cocktail-may-be-future-treatment-for-sensorineural-hearing-loss>.
Eiserman, William D., and Lenore Shisler. Screening for Hearing Loss in Early Childhood Programs. N.p.: Elsevier Inc, 2007.
PDF.
"Inservicing the Classroom Teacher." Supporting Success For Children With Hearing Loss. N.p., 2017. Web. 24 Oct. 2017.
<http://successforkidswithhearingloss.com/for-professionals/inservicing-the-classroom-teacher/>.
Khetrapal, Afsaneh. "Hearing Loss Research." News-Medical.net. N.p., 18 May 2017. Web. 24 Oct. 2017. <https://www.news-
medical.net/health/Hearing-Loss-Research.aspx>.
"Noise Induced Hearing Loss." American Hearing Research Foundation. N.p., Oct. 2012. Web. 24 Oct. 2017. <http://american-
hearing.org/disorders/noise-induced-hearing-loss/>.
Packer, Lisa. "Australian Study Highlights Impact of Early Intervention for Children with Hearing Loss." Healthy Hearing. N.p.,
28 Apr. 2016. Web. 24 Oct. 2017. <https://www.healthyhearing.com/report/52644-Australian-study-highlights-impact-of-early-intervention-for-children-with-hearing-loss>.
"Sensorineural Hearing Loss – Causes and Treatments." Hear-it.org. N.p., n.d. Web. 24 Oct. 2017. <https://www.hear-
it.org/Sensorineural-hearing-loss>.
"Sensorineural Hearing Loss." Lurie Children's. Ann & Robert H. Lurie Children’s Hospital of Chicago, 2017. Web. 24 Oct. 2017.
<https://www.luriechildrens.org/en-us/care-services/specialties-services/otolaryngology/diagnosis-treatments/hearing-loss/Pages/sensorineural-hearing-loss.aspx>.
"Stem Cell Therapy." Stanford Initiative to Cure Hearing Loss. N.p., n.d. Web. 24 Oct. 2017.
<https://hearinglosscure.stanford.edu/research/stem-cell-therapy/>.
"Support Services for Children." American Speech-Language-Hearing Association. ASHA, 2017. Web. 24 Oct. 2017.
<https://www.asha.org/public/hearing/Support-Services-for-Children/>.