Acoustic “Barrier-Free” state is quite important for people suffering from hearing impairment for maintaining their quality of life. Poor speech discrimination leads to poor speech communication. Here, in this paper, the barrier-free state for hearing impaired people, especially, those with senile deterioration of the hearing acuity with poor speech discrimination is discussed. Hearing aids, cochlear implants, etc., are strong tools in respect of a medically oriented approach to preventing removing the barrier against people suffering from hearing impairment. It is not the aim of this paper to discuss these medical equipments, but the so-called “assistive products” which are thought to be effective as a more sophisticated way towards achieving the barrier-free state for people with moderate hearing impairment. Our objective is to understand updated information about the assistive products and provide adequate advice to these patients to achieve better speech communication.
Frequency selectivity and otoacoustic emission (OAE) testing are commonly used for the assessment of basilar membrane vibration and integrity of the outer hair cells in the inner ear. In this study, we investigated the relationship between the frequency selectivity profiles (psychophysical properties) and OAEs (objective parameters) in patients with sensorineural hearing loss. We found a positive correlation between these measures, which suggested that they could be used for non-invasive determinations of the inner ear function. Our research showed that frequency selectivity testing was useful for quantitative assessment of the auditory responses in the low frequency range, as well as the audiological characteristics of individuals with moderate to severe hearing impairment, in whom OAE testing is not appropriate. However, frequency selectivity testing is not suitable for infants, patients with functional hearing disabilities, and subjects in whom subjective audiometry cannot be satisfactorily performed.
In this study, we compared language development between two congenitally profoundly-hearing-impaired children who received hearing aids at school entry and higher grades. They had much the same hearing level and aided hearing threshold level, and received speech and language training from the same age. At school entry, they showed little differences in auditory function, communication media or language skill. After they entered elementary school, one of them continued, and in the other, school was interrupted to allow for speech and language training. At higher grades, they showed some differences in speech perception ability, communication media, verbal IQ score, vocabulary age, reading comprehension, writing ability and articulatory ability. In the child who continued to receive speech and language training in speech clinic, the reading comprehension and writing ability were delayed until middle grades. Therefore, we provided primary training for enhancing vocabulary, grammar, reading and writing abilities until middle grades and concentrated training for advancement of reading comprehension and writing ability from the fourth grade. As a result, the child showed normal range of reading comprehension and writing ability by the sixth grade. The results led to the following suggestions about speech and language training for school-aged congenitally profoundly-hearing-impaired children. 1) For enhancing reading comprehension, complementation of the formation of representation and inference ability is needed for the fourth and upper grades. 2) Reading written sentences aloud is effective to promote reading comprehension and writing ability. 3) For improvement of the auditory and articulatory abilities, it was effective to continue auditory and articulatory training until middle grades.
A questionnaire about speech discrimination tests for children with hearing aids in Japanese schools for the deaf was performed. There were responses from 86 schools. Speech perception was assessed in the preschool department in 83% of the schools and in the elementary school department in 75% of the schools. A percent increase in the number of assessments was observed as compared to the investigation performed five years ago. Although the assessment of monosyllables and words intelligibility increased, assessment of sentences was low. There were many opinions on the difficulties in applying adult-oriented speech perception assessment to children, in combining test batteries, and in explaining the test methodologies.
The regulations for health and medical professional qualifications have changed relative to those in 2001. This study (2010) compared the current working situation of 56 deaf and hard-of-hearing health and medical professionals with the study in 2002, by analysis of the differences of the working environment. The study revealed a major increase of job opportunities and the type of work available in health and medical professions. Among those who were working in the medical institutions, only 57.9% of them had a hearing level above 80dBHL. Thus, the effect of hearing ability on job opportunities was not significant. The ratio of experienced career change by hearing disability turnover was not improved compared to the past study. Also limitation of the working environment in incorporating the concept of “reasonable accommodation” to the deaf and hard-of-hearing people was understood, and the deaf and hard-of-hearing support system is apparently immature. In comparing and referring to the existing examples in other countries, we also discussed about the building of a possible support system in the job aid structure.
ICT (Information and Communication Technology) was used to develop a distance support program website for hearing impaired children and their families. This website was assessed by the parents of hearing impaired children and Speech Language Hearing Therapists (ST) who were involved with education or audiology of hearing impaired children. The evaluators accessed the website to assess the understandability of each of the contents of the website, usability of downloads and links, and usefulness of the movie contents, parental guidance, and the distance support program overall. The results showed that the parents of the hearing impaired children provided answers in the affirmative for 48 out of the 53 questions and the STs provided answers in the affirmative for 47 out of the 53 questions. Although the users need to have some knowledge of the ICTs in order to use this website and it is necessary to consider the effectiveness of this website along with normal face-to-face individual language therapy, our results suggested that this website can be useful to support hearing impaired children and their parents who live in remote places or abroad.