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The Weber test – you put a vibrating tuning fork on the center of the head and ask the patient where they hear it best. Cyclocross started in Europe more than one hundred years ago when cyclist were looking for a way to stay fit in winter. Cyclocross requires the power of a sprinter, the speed and endurance of a time trialist, the bike-handling skills of a mountain biker and the tactics of a road racer. It is not surprising that cyclocross has become the fastest growing part of the sport of cycling in the U.S. Events foster a festive atmosphere and encourage everyone to have fun while racing as hard as possible.
Comments and Discussion:Have Your Say: Do you agree, disagree, want to discuss or add an opinion on this topic? In IDEA, a “hearing impairment” is described in educational terms as “an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance.” A hearing impairment may range from a mild loss to a severe loss. What then do these various definitions really mean for a learner, families, teachers, and others? Given the wide variety of ways in which deaf-blindness presents, it is helpful to think about four categories of deafblindness noted by Miles and Riggio (1999b) and Heller and Kennedy (1994). Since a learner with deafblindness has different access to learning experiences than do children who are typically developing, deafblindness has been described as a disability of information gathering (Gee, Alwell, Graham, & Goetz, 1994).
When sound is heard, a person is processing and interpreting a pattern of vibrating air molecules (Herer, Knightly, & Steinberg, 2002). With a mild hearing loss, most speech and conversations can be heard; however, sounds at a distance may be difficult to hear. Several terms used in educational settings include “deaf,” “hard of hearing,” and “hearing impaired.” Even among professionals in the fields of education and audiology, disagreement exists regarding the most appropriate definitions of these basic terms. As mentioned previously, the age of onset of a sensory impairment is of critical importance.
Common terms used in describing hearing loss are deaf, hard of hearing, and hearing impaired.
Common terms used in describing vision loss include low vision, light perception, or blindness.
Individuals wearing glasses or contacts probably are corrected for some of the most common disorders of visual acuity: hyperopia, myopia, and astigmatism. As previously mentioned, visual field loss or severe restriction constitues a visual impairment. Common disorders of the inner eye are retinitis pigmentosa, retinopathy of prematurity and retinal detachment.
Common causes of cortical visual impairment include asphyxia (the brain not getting enough oxygen), brain hemorrhage, infections of the central nervous system, and trauma to the brain (Roman-Lantzy, 2007). The type of eye condition impacts the visual information the learner receives and is able to process.
Cortical visual impairment is a condition in which the brain is not able to adequately interpret and use information sent by the eye, through the optic nerves.
Premature birth may result in retinopathy of prematurity, which can cause a variety of visual conditions, including blindness. Hearing loss is typically classified as one of three basic types: conductive, sensorineural, and mixed hearing loss. Sensorineural hearing loss may also occur due to abnormalities in the auditory cortex or brainstem.
A mixed hearing loss is present when the learner has both a conductive and sensorineural hearing loss. In addition to their function as the organs for hearing, the ears provide the sense of physical balance, or equilibrium. The ears and the eyes include components of the vestibular system, which helps maintain physical balance and body control. The following table provides additional details regarding some of the most common etiologies of deafblindness and sensory conditions frequently associated with these diagnoses. Causes of deafblindness may be hereditary or associated with prenatal, peri-natal, or post-natal conditions.
Premature infants are at a higher risk for having difficulties with vision and hearing, than are babies born at full-term. An accurate assessment of a learner’s vision and hearing is critical to determine the medical and educational interventions and instructional strategies needed for each learner.
Assessment information will help determine the educational programming and supports a learner needs. Given all the information you have processed previously in this module, it should be becoming apparent that the implications for teaching learners with deafblindness are numerous.
The best way to informally gauge a learner’s cognitive skills is by observing the way she “remembers”—that is, how she deals with and what she does with the sensory information she is able to process.
For a learner with deafblindness, neither assessment nor instructional design can be accomplished by one person or in isolation.
For additional implications and considerations see additional MAST modules on Deafblindness. Assessment information is obtained from parents, medical professionals, and educators observing and interacting with the learner in daily activities and environments. Functional vision and hearing assessments will address how the learner is currently using vision and hearing in daily activities and environments. Assessments will assist team members in planning educational interventions and instructional strategies. Collaboration among parents and professionals is critical to obtaining reliable assessment information and providing best practice educational strategies for learners with deafblindness.
The purpose of this research study is to find out more information about the various treatment options already available to patients with a large acoustic neuroma tumors. The auditory nerve (also called the eighth cranial nerve) connects the inner ear to the brain.
The current standard of practice in most cases is to attempt complete surgical removal of a large acoustic neuroma. After treatment of the of tumor, the study doctor will ask participants to visit the office for standard of care follow up exams at three months, six months, one year, and every year following up to five years.
For more information, please contact Sireesha Pothukuchi BS CCRP, Regulatory Research Coordinator. Sensorineural hearing loss occurs from damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain. They might experience difficulties with hearing in areas that are noisy, and find it difficult to tell high-pitched sounds such as, 'th,' or, 's,' from one another. Some definitions are medically related, while others refer to the learner’s functioning in the environment.
The Individuals with Disabilities Education Improvement Act of 2004 (IDEA) describes visual impairment and blindness as having vision loss, even with correction, that “adversely affects the educational performance” of a learner (Individuals with Disabilities Education Improvement Act (IDEA), 2004). For people who can see and hear, the world extends outward as far as his or her eyes and ears can reach. Many children called deaf-blind have enough vision to be able to move about in their environments, recognize familiar people, see sign language at close distances, and perhaps read large print. A “congenital” impairment refers to a loss that is present at birth; an “adventitious” loss develops at some point after the peri-natal period. It is important to be able to understand a learner, design an appropriate educational program for her, assist families, and educate communities to embrace the talents and contributions which individuals with deafblindness offer.
The combination of these two sensory losses exponentially affects all aspects of learning and daily living.


Let’s further examine some terms used in the educational setting when referring to vision loss. Sound is measured in decibels (dB) (loudness or intensity) and hertz (Hz) (frequency or pitch).
With a moderate hearing loss, hearing normal conversation is difficult; therefore, learning to hear speech sounds at a young age, in order to develop clearly articulated speech is a challenge.
Scott Bradley (2007) of the University of Wisconsin has developed simulations to demonstrate severe to profound hearing loss. These occur when light rays entering the eye do not fall on the retina in a way that makes vision clear. When these muscles do not function normally, conditions such as strabismus, amblyopia, and nystagmus affect vision. The cornea (on the outer layer of the eye) helps refract, or bend, light rays entering the eye. Retinopathy of prematurity (ROP) occurs when there is abnormal blood vessel growth and development in the eye. Coloboma is caused when a child’s eye does not form properly during pregnancy so a gap, or cleft, exists in some part of the eye.
A conductive hearing loss occurs when sound cannot pass through the outer ear to the inner ear effectively. Auditory neuropathy spectrum disorder (ANSD) is believed to characterize approximately 10% of learners’ sensorineural hearing losses. A sense of balance helps us to know where we are in space, helps us stand, run, and walk without toppling over.
When both conductive and sensorineural hearing losses are present, the condition is referred to as a “mixed hearing loss”. In most states infants are screened for hearing impairments before leaving the hospital after birth. Assessing, determining interventions, and implementing best practice educational strategies needs to be done in a collaborative fashion. An acoustic neuroma is a type of benign (non-cancerous) brain tumor that grows in the middle ear. If the tumor grows large enough, it also may press on other nearby nerves and cause weakness, pain or tingling in the face. SRS is a way of treating many brain disorders with a precise delivery of a single high dose of radiation in a one-day session. Quite often the tumor is found to be attached to the facial nerve (nerve controlling facial expression) and the brainstem. The great majority of human sensorineural hearing loss is caused by abnormalities in the hair cells of the organ of Corti in the cochlea. People with SNHL may perceive other people's voices as sounding slurred or mumbled, and find it easier to hear men's voices than women's voices.
Some terms reflect the need for support for the individual’s unique learning characteristics. In this key piece of federal legislation, a visual impairment is determined by how the learner functions in the environment and not solely on the basis of a diagnosis or visual condition. Others have sufficient hearing to recognize familiar sounds, understand some speech, or develop speech themselves.
As might be expected, congenital sensory loss generally has a more pervasive effect on a child’s development and future learning than do adventitious sensory impairments. Some learners with vision loss retain the ability to determine that there is a source of light and from which direction it is coming. A person with a severe hearing loss will need an assistive hearing device, such as a hearing aid, in order to hear speech and conversation.
The age of the learner when he or she first experiences hearing loss or deafness is critical to an understanding of his or her possible exposure or non exposure to verbal speech communication. Damage or disorders affecting the macula of the eye cause impairments to the central field of vision. Strabismus occurs when there is a muscle imbalance and the eyes are not able to “look” at an object at the same time. When the fluid does not move correctly, increased pressure results.This pressure causes damage to the retina of the eye and the optic nerve.
When a coloboma occurs in the iris, a learner may be sensitive to light since the amount of light entering the eye may not be adjusted properly by the iris opening and closing in a typical manner. The eye and optic nerves gather and send visual information properly to the brain, but the brain is not able to make sense of the information it receives. In a learner with ANSD, sounds are amplified satisfactorily in the cochlea, but the portion of the brainstem devoted to processing sounds does not respond normally. When the learner has a unilateral hearing loss, she has normal hearing in one ear and a hearing loss in the other. Parents and families of learners with deafblindness play a critical role in providing information and in implementing strategies over a long period of time. Although acoustic neuromas are not cancerous, they can become life threatening if they grow so large that they press on parts of the brain that control vital body functions such as breathing. Treatment involves the use of focused radiation beams delivered to a specific area of the brain to treat abnormalities, tumors or other functional disorders. In such cases the surgeons may decide to perform an incomplete or subtotal removal of the tumor. Catarrhalis — but CHRONIC OM pathogens are staph aureus and fungus -so tell me how many antibiotics it takes to cure a fungal infection? Let us look at some common definitions used when discussing the dual sensory impairment, deafblindness.
Thus, deafblindness requires its own interpretation and bank of considerations, when planning a learner’s educational program. If the child is profoundly deaf and totally blind, his or her experience of the world extends only as far as the fingertips can reach.
Low vision refers to a significant vision loss, but implies that the individual does still have some usable vision for daily life. Learners not having light perception are considered to have “total blindness” (Levack, Stone, & Bishop, 1991).
Listen to the samples of hearing loss simulated by the National Institute for Occupational Safety and Health. For instance, learners who are congenitally deaf will not hear spoken language and will not, therefore, learn a communication system based on oral language without intensive, ongoing intervention and supports. The peripheral field is what can be seen off to the sides of the body, while still looking straight ahead. If the cornea ruptures, blindness may result (Heller & Kennedy, 1994; Levack, Stone, & Bishop, 1991). Rods make it possible for a person to see in dim light, cones make it possible to see color and details.In retinitis pigmentosa, the rods and cones in the retina degenerate or lose their effectiveness to gather specific visual information. In CVI, the parts of the brain that process visual information are not functioning typically. If the external part of the ear is blocked by ear wax, fluid, or a tumor, a conductive hearing loss can result. This could be due to a problem “with the connection between the inner hair cells (of the cochlea) and the auditory nerve, or with the auditory nerve itself” (Morlet, 2010, p.2). Bilateral hearing loss means the loss occurs in both ears, though the sound intensities and frequencies heard in each ear may be the same or different (American Speech-Language-Hearing Association, 2010; Herer, Knight, & Steinberg, 2002).
The vestibular system sends messages to the brain about body movement from side to side and up and down.


In the case of hearing losses that develop later in life, assessments will be conducted by an audiologist to determine if the loss is conductive, sensorineural, or a mixed hearing loss.
If an acoustic neuroma is not diagnosed or treated, it can grow through the skull bones that make up the middle ear and press on important structures in the brain.
As someone who experiences these symptoms due to SNHL, the topic is one that is interesting.The Causes of Sensorineural Hearing LossThe inner portion of a person's ear contains tiny hair cells that are nerve endings.
Some of these definitions might seem very technical at first, but information included in this module should help make these seem less intimidating and more understandable.
A learner who becomes deaf later in childhood or adolescence will have experienced spoken language and will, therefore, be more likely to retain at least a degree of spoken language abilities.
Myopia, or nearsightedness, occurs when a learner can see things more clearly up close, but objects or images farther away are unclear. When glaucoma is untreated, blindness usually occurs (Levack, Stone, & Bishop, 1991; Miller, Menacker, & Batshaw, 2002). For example, cataracts on the outer part of the lens may result in difficulty discriminating colors. When outer rods are affected, a learner experiences peripheral field loss, or tunnel vision. The degree of vision loss depends on the location of the impairment within the brain, as well as the age of onset.
An impairment in the way a learner’s brain processes auditory stimuli can result in central auditory processing disorder (CAPD). In order to assess for intensity and frequency of sounds a learner hears, the audiologist will use a sound proof booth and a series of activities to chart an audiogram. A physical therapist, occupational therapist, and nurse are other professionals who may be included.
Total removal of such large tumors is associated with high rate of permanent paralysis of the facial nerve and high degrees of hearing loss.
The Arizona Center for the Blind and Visually Impaired (2008) provides a simulation of scotomas. Nystagmus is caused by involuntary eye movements, usually horizontally, though the eyes may also involuntarily move vertically, diagonally, and or circularly. Due to the degeneration of rods, some persons may have difficulty seeing objects and persons at night and in the periphery.
Cortical visual impairment may be mild to severe, and either temporary or permanent (Roman-Lantzy, 2007). Similarly to cortical vision impairment, in this condition it is the brain and NOT the sensory organ (in this case, the ear) that causes the impairment. Because they experience both vision and hearing losses, learners with deafblindness typically have difficulty learning gross motor skills and maintaining physical balance. More sophisticated, medical tests utilized to diagnose hearing loss include auditory brainstem response and otoacoustic emissions.
When the cones in the middle of the retina are affected, a learner has difficulty with central vision and seeing colors. This fluid does not allow the tympanic membrane, or ear drum, to move normally; it may cause the eardrum to rupture. The outer, middle, and inner ear components send auditory information properly to the brain, but the brain is not able to make sense of the information it receives. A teacher of the deaf and hard of hearing, in collaboration with others, may also conduct a “functional hearing assessment.” This, like the functional vision assessment, will provide information about what the student hears in common, everyday environments and how she uses the hearing she has.
Sensorineural hearing loss (SNHL) is caused by damage to these cells or nerve fibers in a person's inner ear.
As retinitis pigmentosa progresses, the learner will have difficulty with tasks such as reading and distinguishing details. Additional information will be gathered by a teacher of the visually impaired, with the help of parents and other educational team members.
At times, the hearing loss is caused by damage to the nerves that carry signals to the person's brain.Chart showing causes of acquired sensorineural hearing loss (SNHL) - Post to PinterestSNHL may also be present at the time a person is born referred to as, 'congenital,' although it is most often due to genetic syndromes, or infections the person's mother has passed onto their baby while still in the womb such as herpes, rubella, or toxoplasmosis. Below is a simulation of retinitis pigmentosa from the Arizona Center for the Blind and Visually Impaired (2008).
If otitis media occurs chronically, it may cause damage to the ear and result in a sensorineural hearing loss (Heller & Kennedy, 1994; Herer, Knightly, & Steinberg, 2002). This is called a “functional vision assessment.” During a functional vision assessment, information will be collected in regard to how the learner is able to use her vision in everyday activities. Some of the questions that will be addressed include: how close or far way to an object does the learner need to be for vision to be helpful? The medications are considered to be, 'ototoxic.' At this time there are greater than 200 known ototoxic medications, both over-the-counter and prescription, on the market.
A person's hearing and balance issues caused by these medications might at times be reversed when the medication therapy ends.
The health care professional will discuss the effects with the person and how the side-effects will affect their quality of life.The Effects of Ototoxic MedicationsOne of the first effects people tend to notice related to ototoxic medications and hearing loss involves tinnitus.
The hearing loss might go unnoticed until the person's ability to understand speech becomes affected, something this writer has personal experience with. Balance issues might also happen as a result of ototoxic medications; a person may experience a loss of balance and a feeling of being unsteady on their feet. At times these issues are temporary because the person's body may learn to adapt to a reduction in balance control - at other times not.The effects of ototoxic medications have the ability to affect a person's quality of life. An inability to hear conversations, or feeling a bit dizzy, may cause them to cease participation in their usual activities. The effects kind of sneak up on you and before you know it, there they are.Medications that are OtotoxicChart showing certain ototoxic medications - Post to PinterestMore than 200 medications and chemicals are known to cause hearing and balance issues. It is very important to discuss any effects you experience with your health care professional, as well as the potential for hearing or balance damage related to any medication you are taking. Treatment with a specific medication might provide you with your best hope for curing a life-threatening disease, or ending a life-threatening infection.Medications that are known to cause permanent damage include certain, 'aminoglycoside,' antibiotics such as gentamicin, as well as cancer chemotherapy medications such as carboplatin and cisplatin. Medications that are known to cause temporary damage include, 'salicylate,' pain relievers such as common aspirin, as well as, 'loop diuretics, and quinine.
In some instances, exposure to loud noise while a person is taking certain medications increases their damaging effects.At this time, research is being performed to develop ways to protect people from the ototoxic effects of medications, although there is no approved protective strategy.
It is important for you to monitor your hearing and balance before you start treatment with such a medication. Before beginning treatment, a baseline record of your hearing and balance should be recorded by an audiologist.
The baseline record should include an audio-logic hearing test that uses high-pitched testing, word recognition, as well as other types of testing if possible. I did not receive these types of testing until it was too late.The information can help you and your health care professional to make any important decisions to change or cease the ototoxic medication therapy before you hearing is permanently damaged. In instances when the medication cannot be changed or stopped, you and your audiologist might take steps to manage the effects of the hearing loss that results. During the course of ototoxic medication treatment, you should have periodic hearing tests as a part of the monitoring process, it will help you to report any hearing changes, balance issues, or ringing in the ears you experience.As for me, I now use hearing aids due to the hearing loss I experience. Balance issues are a part of life now for me, although a portion of the balance issues may be due to osteoarthritis. It is my belief that a combination of factors led to the hearing loss I experience, such as the use of heavy NSAID's, antibiotics for a life-threatening infection at one point in my life, and age-related factors.



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