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Special Education
Notes
The cochlea has approximately 30,000 hearing nerve endings (hair cells).
10.5.3 Central Hearing Loss
In central hearing loss, the problem lies in the central nervous system, at some point within the brain.
Interpreting speech is a complex task. Some people can hear perfectly well but have trouble interpreting
or understanding what is being said. Although information about central hearing loss is accumulating,
it remains somewhat a mystery in otology (the medical specialty of ear medicine and surgery).
A condition called central auditory processing impairment frequently leads people to think they
have hearing loss when their hearing is actually normal. Despite the fact that this problem is extremely
common and present in many highly successful people, it is actually classified as a learning disability.
Basically, the problem involves a person's inability to filter out competing auditory signals. People
with central auditory processing impairments have difficulties that include:
• Problems "hearing" when there are several conversations going on
• Inability to read or study with the radio or television on
• Problems reading if someone turns on a vacuum cleaner or air conditioner near them
• Generally missing the first sentence from people talking to them if they are involved in an
auditory attention task (such as watching television)
Although such people (and their families and friends) frequently suspect that they have a hearing
loss, the function of the ears is usually normal, and routine hearing tests are normal. Naturally,
people with this condition may also develop hearing loss from other causes, and this can make it
even more difficult for them to function under everyday circumstances.
There is no good treatment for central auditory processing impairments other than educating the
person, family, and friends, and trying to control the environment. This is especially important for
children, whose grades may go from F to A if they are provided with a silent place in which to do
their homework.
The test necessary to diagnose central hearing impairment must be designed to assess
a person's ability to handle complex information. Most of the tests now available
were not created specifically for this purpose. It requires a very experienced and
almost intuitive judgment on the physician's part to make an accurate diagnosis.
10.5.4 Functional Hearing Loss
Functional hearing loss involves a psychological or emotional problem, rather than physical damage
to the hearing pathway. Individuals with this type of hearing loss do not seem to hear or respond;
yet, in reality, they have normal hearing.
The most important challenge for physicians is to classify this condition properly. It may be difficult
to determine the specific emotional cause, but if the classification is made accurately, the proper
therapy can begin.
Too often, a functional hearing loss is not recognized, and individuals receive useless treatments for
prolonged periods. In turn, this process may aggravate the emotional element and cause the condition
to become more resistant to treatment.
10.5.5 Mixed Hearing Loss
Frequently, a person experiences two or more types of hearing impairment, and this is called mixed
hearing loss. This term is used only when both conductive and sensorineural hearing losses are
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