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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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