Problems Quick Links
Summary  •  Poor Acoustics  •  Hearing Problems
Immature Auditory Capabilities  •  At-Risk Students

Problems: Hearing Problems

All children experience hearing difficulties as a result of their environment and those caused by their own immature auditory capabilities. Every child is denied acoustic accessibility every day because of the combination of these two issues in the classroom. But successful auditory learning is dependent on two factors: the environment and the hearing ability of the child. In addition to immature auditory closure, a large percentage of the K-12 student population is further at risk with a permanent or temporary hearing problem that is exacerbated under the poor classroom acoustical conditions.

A recent study in The Journal of the American Medical Association showed that 14.9 percent (or approximately 8 million) of school-aged children have some degree of hearing loss. ⁱ This is a permanent hearing loss that if correctly identified, should receive some technological (such as personal FM system) and educational assistance through the Special Education public school program. Recent estimates suggest that another 10 million school-age children exhibit some degree of a sensorineural hearing loss (SNHL), meaning that they have greater difficulty understanding speech in noise or reverberation than do normal hearing children. ⁱⁱ These children obviously have problems understanding speech in the typical noisy classroom environment.

But these are not the only children in our classrooms who suffer a physically related hearing loss. There are those that suffer a temporary hearing loss due the ear infections which are very prevalent amongst the elementary school-aged children. The most common causes of hearing problems in children are conductive hearing losses caused by Otitis media. Otitis media (more commonly referred to as a middle ear infection) can be caused by viruses, bacteria, or fungi creating a build-up of fluid in the area behind the eardrum referred to as the middle ear. This space is typically air-filled keeping it very arid and dry. There are times when the middle ear can contain a fluid that never causes inflammation. In these cases there will be no symptoms. "Sometimes, weeks or months may pass before a parent realizes that the child has an infection or fluid build-up. However, the effects on hearing and listening will be the same as if the fluid was inflamed."ⁱⁱⁱ "Many hearing impaired students with good compensatory skills and normal learning ability are often disabled more by the learning environment than by their hearing loss." ^iv

When the middle ear is filled with fluid, it prevents sound transmission of the sound vibrations from the eardrum to the inner ear, resulting in a mild to moderate temporary hearing loss. ^v Few educators and parents realize the impact that one middle ear infection can have on a child’s ability to hear and process what they hear in the classroom. Furthermore they do not realize the duration of that impairment which puts their child at academic risk for learning. According to Dr. Vincent Carrasco, M.D., fluid can remain trapped in the middle ear for 3-6 weeks before it is cleared, even after a week of antibiotics. ^vi

To put this in perspective, imagine that a child has fluid beginning to build-up in the middle ear. Two weeks later, inflammation begins to develop, causing the child pain. The parent immediately takes the child to the doctor who diagnoses the problem as a middle ear infection. The child begins taking an antibiotic. It is now three weeks after the fluid first began to build-up, one week after beginning the antibiotic. It will take another three to six weeks before the fluid is cleared. Therefore, this child will have fluid in the inner ear for a total of 6 to 9 weeks, impairing that child’s listening and learning abilities. That child may only miss one or two days of school attendance, but he will likely be missing out on learning for 6 to 9 weeks, or approximately 16-25% of the academic year.

How significant is that fluid build-up? Plug your ears with your fingers and listen to someone talk, in order to find out. This is how voices sound to children with fluid in their middle ear. Speech sounds that are received by the middle ear have different pitches, low frequencies for vowels, high frequencies for consonants. When the middle ear fills with fluid, the low frequencies can pass through while the high frequencies cannot because there is not enough energy to transmit these sounds. As a result, a child may not be hearing sounds of s, f, th, sh and others. ^vii This can result in problems with speech, language and learning. We just gave an example of a child with one ear infection during the course of the school year. Imagine if that child has recurring or chronic ear infections throughout the year. This could have a significant effect on the auditory processing skills placing this child in the same risk category as those defined under the category of “Learning Disabled.” It would not be uncommon for a child with chronic infections to encounter significant speech and reading difficulties (due to problems learning phonics.) “Children with auditory processing problems as a result of chronic ear infections will not “outgrow” these problems and will require therapeutic intervention to correct the underlying weaknesses with the auditory processing system that are causing learning problems.” ^viii

You can see the devastating effects that an ear infection has on learning, but just how prevalent are these infections amongst the school population? A federally funded research project referred to as the MARRS project (Mainstream Amplification Resource Room Study) identified that 43% of students had minimal hearing loss on any given day. This staggering figure is attributed to research suggesting that approximately 10-15% of all elementary school children are experiencing mild hearing losses associated with OME at any given time. ^ix Therefore another significant subset of our student population is suffering from acoustical depravity in classrooms where noise obliterates their speech perception abilities. This has been confirmed by research from Crandell and Flannagan (1999) who determined that in noise, children with a conductive hearing loss caused by OME scored only 54% on speech-perception tests. Gravel and Wallace (1992) found this consistent with their research that showed OME-positive children exhibited considerably greater difficulties understanding speech in a noisy environment than did the OME-negative group. Specifically, children with a positive history of OME require a significantly greater SNR (by 2.9 dB) than did the OME negative children to reach equivalent performance levels. ^x