Picture copyright Daniel East - from "Dave is Brave" www.learn2bebuddies.com.au“I’ve told him what to do a dozen times, but it goes in one ear and out the other!”
Have you ever heard that said? Well, it might be very near the truth.
But, despite what you might feel, a “good kick up the backside” is not the solution. We need to understand why our words have not stuck with the child.
What is involved in doing what you are told?
When you are told to do something you have to be able to hear, listen, interpret, remember and act on the instructions. If you have difficulties doing any one of these things you can seem “disobedient”.
In this post I want to talk about hearing.
I won’t give you a biology lesson on hearing here. You might want to visit the Mayo Clinic if you are interested in how the ear works. For now, I just want to point out some reasons why a child might not be able to hear you.
Conductive hearing loss (ASHA, 2009; Australian Hearing, 2009; Moore, 1997)
Children who have recurring ear infections such as Otitis media, or even a build up of wax in the ear will find it hard to hear clearly. For others the bone and cartilage structure may interfere with the movement of sound through the ear to the nervous system that processes the sounds.
Children with Down Syndrome are shown to be at increased risk of ear infections and conductive hearing loss because of their susceptibility to infections and the smaller ear canal (Moss, nd).
Indigenous Australians have also been shown to be at increased risk of conductive hearing loss (Coates et al).
For some children, the treatment might be through antibiotics or grommets (MyDr, 2008). For others, hearing aids may be used.
Sensorineural hearing loss (ASHA, 2009; Australian Hearing, 2009; Moore, 1997):
This is when the cochlea or the nerves that carry sound to the brain might be affected. The levels of hearing loss may differ, but generally sensorineural loss cannot be fully addressed even if the child is using hearing aids. For children whose cochlea is damaged, cochlea implants can be used. For others, communication will be through the use of sign language.
The levels of hearing loss are described as mild, moderate, severe and profound. If you want to know what a child might hear depending on the level of hearing loss they have been diagnosed with, visit ASHA and the Medical College of Wisconsin (they have a great picture that is easy to understand). The Warren Centre also has a good diagram of what sounds equate to different decibel levels (as seen in the ASHA description).
Disobedience or Distraction?
If a child has an ear infection such as Otitis Media they will struggle to hear you call their name in a noisy room or if their back is turned to you. So if they don’t respond, it is that they haven’t been able to pick out your voice from all the other noises going on around them.
If a child has a hearing aid or a cochlea implant, it doesn’t mean that they have perfect hearing. They will struggle to hear you in noisy rooms, or if there is something or someone making a noise closer to them than you.
You also need to remember that children with hearing impairments may have smaller vocabularies and may struggle with understanding how sentences are put together. This is because their learning of language is interrupted by what they can and can’t hear. This may mean they find it hard to pick out the important bits in your instruction.
For example, if you say "Julie, can you put your book away in your book tray, please?" the child
may know you have mentioned a book and a tray, but not make the connection between the two. So the child may be confused about what exactly you want them to do with the two objects.
In the next post I will talk about the difference between listening and hearing. Later I will also talk about some strategies and things to think about when giving instructions to a child who has a hearing impairment.
Australian Hearing (2008) Types of Hearing Loss. Retrieved 10th May, 2009 from: http://www.hearing.com.au/types-of-hearing-loss
American Speech-Language-Hearing Association. (2009). Type, Degree and Configuration of Hearing Loss. Retrieved 10th May, 2009 from: http://www.asha.org/public/hearing/disorders/types.htm
Coates, H.L., Morris, P.S., Leach. A.J., and Couzos, S. (2002). Otitis media in Aboriginal children: tackling a major health problem. Medical Journal of Australia 177 (4): 177-178 Retrieved from: http://www.mja.com.au/public/issues/177_04_190802/coa10271_fm.html
Mayo Clinic (2009). How do we Hear? Retrieved 10th May, 2009 from: http://www.mayoclinic.org/hearing-disorders/how.html
Moore, B.C.J. (1997). An Introduction to the Psychology of Hearing. SanDiego: Academic Press.
Moss, K. (nd). Hearing and Vision Loss Associated with Down Syndrome. Retrieved 10th May, 2009 from: http://www.deafblind.com/downmoss.html
My Dr (2008). Otitis Media in Children. Retrieved 10th May, 2009 from: http://www.mydr.com.au/kids-teens-health/otitis-media-in-children