Deafness - SpeedyLook encyclopedia

The classification of deafnesses

Deafness of transmission Deafness is described as transmission when the outer ear or the middle ear is touched, and that the internal ear is intact. Among the main issues which frequently involve deafnesses of transmission, let us note:

the lack of mobility of the tympanum (the causes are multiples : séreuse Otitis or séro-mucous membrane, calcification, perforation, Cholestéatome…)
a problem on the chain ossiculaire (Ankylosis of the clamp or Otospongiose, luxation of an ossicle, lyses…)

Deafness of perception This deafness reaches the nervous Cochlée or ways post-cochléaires. The middle ear and external is valid. The deafness of perception meets in the cases:

of Presbyacusia
of catch of drugs Ototoxique S
of acute sound traumatisms (explosion type) or chronicles (professional exposure to the noise over long lives without protection): Barotraumatisme.
of tumor of the nervous ways (Neurinome generally)…
of Disease of Ménière
in certain cases of auto-immune Disease

; Mixed deafness Deafness is called mixed if it concerns a problem of transmission and perception.

; Central deafness Central deafness appears if the auditive surfaces of the brain are injured.

Diagnosis and degrees of deafness

Auditive perception is measured in Décibel S (and also in decibel HL, to see Audition).

Any feeling of abrupt auditive loss or in the hours which follow a damage to hearing (preferably in the 6 has 12 hours following this last): it is imperatively necessary to be presented to a service urgently as fast as possible so that an adapted treatment is applied such as for example: hémodilution, oxygenation hyperbare and vasodilators.

To determine the degree of deafness of a person, one bases oneself on the results of the best ear (that which has less hearing impairment). For this ear, one then makes the average of the losses for the frequencies of 500,1000 and 2000 Hertz. In lower part of 20dB of loss, hearing is regarded as normal. For the remainder, one refers to the classification established by the International office of Audio-Phonology (BIAP):

Loss of 20 with 40dB: Light deafness

40dB represents the sound volume of an informal talk. The normal word is perceived but certain phonetic elements escape the child. The weak voice is not correctly perceived. The child can present signs of fatigability, of carelessness, a certain blur of comprehension, articulatory difficulties. Above 30 dB of loss, if the child is constrained at the school, equipment is possible.

Loss of 40 with 70dB: Average deafness

60 dB represents the noise level of a sharp conversation. The word is perceived only if it is strong. The child presents important speech difficulties and articulation: it is lacunar comprehension. Between 55 and 70 dB of loss, the children perceive the strong voice without including/understanding the words: equipment and rehabilitation are then necessary.

Loss of 70 with 90dB: Severe deafness

80 dB represents the sound volume of a noisy street. Certain children hear the voice with strong intensity but do not include/understand the words. The amplification of the sounds is insufficient so that there is spontaneous development of understandable language. These children proceed by designation of the desired object. For these children, an equipment, a rehabilitation and the use of the labial reading are necessary.

Loss higher than 90dB: Major deafness

100 dB represents the noise of a power pick; 120dB that of an engine of plane to 10 meters. The child does not have any perception of the voice and any idea of the word. For a major deafness, one recomputes an average of the thresholds of frequencies 250,500,1000 and 2000 Hz, which makes it possible to distinguish 3 subcategories:

loss from 90 to 100 dB: major deafness first group
loss from 100 to 110 dB: major deafness second group
loss from 110 to 120 dB: major deafness third

group

For these children, an equipment, a rehabilitation and the use of the labial reading are necessary, as well as a more rigorous orthoepic follow-up still than for the severe deaf persons, because the recovery of auditive data is more difficult.

For the losses higher than 120 dB, one speaks about total deafness or cophose: no sound can be perceived without equipment, even if the person carries analogical or numerical prostheses. In the case of a deafness of perception due to a dysfunction of the cochlea, the implant cochléaire is often the most effective equipment to recover the maximum of auditive information.

NB: in general, more the hearing impairment is strong, more auditive recovery by the means of equipment and of rehabilitation is difficult, except for post-lingual deafnesses (occurred after the constitution of an auditive and linguistic zone in the brain)

Etiology of deafness

Congenital

The Surdité of genetic cause reaches approximately 1 over 2000 to 1 child over 1000. Many of these deafnesses will appear only at the end of several years even several tens of years. The viral infections or parasitic during the pregnancy like the Toxoplasmose, the Rubella and the disease of cytomegalic inclusions. This last disease is the most frequent infection in the expectant mother in Europe. It would reach up to 2 percent of the expectant mothers. Half of the fetuses of these women will be reached by the virus and 10% of the fetuses will develop at the end of a few years a deafness.

Among the deaf newborns, the proportion of left-handeds person is higher than the average. Thus, according to a study, the proportion of left-handed deaf children exceeds 20% whereas it is of 10% in the children not having deafness.

Postnatal

The diseases as the Méningite can cause a deafness.

Deafness can be caused by accident: important wound with the ear or damage due to the breath of an explosion. It can also be caused by an exposure to too intense sounds without adequate protections (auditive Barotraumatisme).

Certain people were not born deaf but gradually become it into growing old; it is what is called the Presbyacousie.

By sound traumatism

The Bruit involves a deafness by destruction of the Internal ear which occurs in the form of accident following a sound of very strong intensity, or gradually by exposure prolonged to too intense noises (with a correlation between the duration and the noise level). The mechanism is the irreversible progressive destruction of the ciliées cells of the body of Corti for of which first touched cells those of the perception of the sounds of frequency 4000 Hz what explains the clinical evolution and the need, envisaged by the legislation of a regular monitoring by audiograms of paid which work with the noise.

The evolution passes by a stage of auditive tiredness with an auditive loss in the 4000 transitory Hz which appears with the exposure and disappears at rest. Then this auditive deficit becomes permanent and final in the form of a Scotome localized on the frequency of the 4000 Hz without the person not being able to realize it because the frequencies of the word, known as " conversationnelles" are from 500 to 2000 Hz. A third phase marks the beginning of the embarrassment with difficulties of comprehension when the scotome extends and touches the 2000 Hz. The evolution is continued by a agravation of the auditive loss, without the lowest frequencies being touched.

Deafness is recognized (in France) like Occupational disease in table n°42 of the general scheme of the social security and in table n°46 of the agricultural mode, in both cases supplied of a restrictive list of work likely to cause recognized deafness and with a minimum time of exposure of 1 year (reduced to 30 days for noise exposure violent one in the settling of the engines, engines and thermal engines). The declaration and measurements must be made after 3 weeks of suspension of noise exposure professional and before 1 year.

The auditive loss must be higher or equal to 35 dB on the best ear, deficit confirmed by a Audiométrie tonal and vocal realized three weeks at one year after the suspension of noise exposure organic (this average audiometric deficit of 35 dB is calculated while dividing by 10 the sum of the deficits measured on frequencies 500,1000,2000 and 4000 Hz, respectively balanced by coefficients 2,4,3 and 1).

Whereas only approximately 750 professional deafnesses are declared and recognized each year in France, the epidemiological investigations practiced by the company doctors in Europe as in Quebec show an attack much more important: in France, the Summer investigation gave 27% of employees subjected to an excessive noise and another investigation locates at 21,3% is 13,5 million paid which presents an auditive deficit of to the noise.

The sound traumatism can act like agent worsening in the event of catch of drugs potentially ototoxic

Medicamentous ototoxicity

Very many drugs can cause often irreversible lesions at the level of the nervous structures of the ear involving a fall, sometimes severe, auditive capacities. This toxicity depends on the amount and of the duration of the treatments and it is variable from one subject to another; it is worsened by a bad elimination of the accused product (impaired renal function for example).

Antibiotiques of the family of the Aminoside S. This effect ototoxic can occur after parenteral administration (intravenous or intramuscular), oral, local or by aerosols.
Antibiotic of the family of the Macrolide S (érythromycine) when they are managed by intravenous way: usually reversible hearing impairment is frequently associated with acouphenes.
Vancomycine with strong amounts, it is responsible for a generally irreversible auditive loss.
Salicylated and others anti-inflammatory drugs not stéroïdiens taken with strong amount and over one long life: Acetylsalicylic acid (aspirine), Phenylbutazone and its derivatives, Diclofénac, Ibuprofène, Indométacine…
Diurétiques (furosémide, acid ethacrinic, bumétanide) with amount-dependant, usually reversible ototoxicity with the stop of the treatment.
Chemotherapy: Cisplatine, Vincristine, nitrogenized mustards, Vinblastine, Carboplatine, Bléomycine has an important ototoxicity.
Antipaludéens: Quinine and Chloroquine is ototoxic if the duration of the treatment exceeds several months.
Others médicaments' more rarement' : antiarythmic béta-blocking (Propranolol, metoprolol), Carbamazépine, Acid valproïque, anti-ulcerous drugs (Cimétidine, Oméprazole), certain morphine opiates, antidepressants tricyclic, IMAO, anxiolytic (family of the Benzodiazepine S).

Communication

Normally, a deaf person of birth has his own language, however in order to communicate with people not knowing this specific language, it is necessary to choose other possibilities. These possibilities are not exclusive. A deaf person can express himself by the language of the signs and/or the oral examination, to know " to see on the lèvres" and being equipped with an auditive apparatus at the same time. With good knowledge that a deaf and a deaf do not give themselves at all the same significance in spite of what one believes still nowadays because of the auditive assistances. A deaf installed is not inevitably a deaf person because he speaks well: it has evil to include/understand because it reads on the lips, especially because it does not know all the vocabularies. It can be very well tired with its or its interlocutors, who speak to him quickly or move all the time. A deaf installed is not inevitably either a " become sourd" following an accident or anything.

the acouphenes are harmful effects which often accompany deafness. The acouphenes often génent the communication going even until causing a fold of the person. people suffering from acouphenes (or comparable: Hyperacusia, Hypersonie, Sonophonie, etc…) often find themselves in situation of avoidance: that wants to say that the people try to organize their life to avoid having to undergo noise pollutions which are likely to accentuate their acouphenes. It is a vicious circle which makes that the individuals find themselves sometimes isolated and cannot have one normal social life often any more. That is even more difficult when it is necessary to reconcile personal life, health issues and professional life.

As personal example having had " amongst other things " to undergo Hyperacusia with sounds having sometimes 10 times their normal value, it is almost impossible not to lose the head. But with a " good diagnostique" , an adapted treatment and time it happens that one can improve his situation. It is advised to contact associations which are often very qualified to help in the steps.

Acouphènes
Hyperacusia

Language

The languages of the signs are visual and gestural, and nonsound Langues like the other languages. They are not mimes; they employ signs and have an elaborate grammar which is clean for them. It is necessary that the interlocutor understands also the language of the signs so that the Deaf person can communicate with him. Certain families improvise also signs, but they do not form part of the language of the signs. Contrary to a very widespread idea, this one is not universal: each country has its own language of the signs and certain areas have even their patois. However, certain signs are common to several countries, and that can allow Deaf persons, however originating in very different countries, to quickly communicate between them grace of the very iconized signs. The language of the signs has existed in France for more than two centuries. There exist interpreters in language of the signs. As opposed to what believe the vast majority of people, the language of the signs is not the natural language of the deaf persons; it is only the oldest means of communication worked out by the latter between them. Nowadays, the adoption or not of the language of the signs as native tongue of the child is function of the choice of rehabilitation of the parents and the professionals of deafness, and does not raise of a determinism which only supposed forever. A deaf person can think, write and communicate in any language as well as one hearing.

The French signed uses the signs of language (LSF or LSQ, which have their own syntax) while preserving the syntax of the French language. They are especially the oralized deaf persons who have French as native tongue who uses it without referring to the deaf culture.

The labial Lecture makes it possible to the deaf person to include/understand a oralisant interlocutor, but does not allow him to perceive the entirety of the message. It is estimated that 30 % only of the message “is read” on the lips, the remainder being interpreted by the deaf person according to the context (mental substitution), which often gives place to misunderstandings. For example, certain sounds resemble each other enormously on the lips like baba , dad and mama . Phonemes are invisible on the lips like /r/ and /k/ and are thus difficult to perceive. There exist even deaf jokes drawing started from these confusions like better calves for “better wishes”…

The supplemented spoken language (LPC) is resulting from the Cued Speech American, that is to say literally “coded word”). LPC is a complement with the labial reading which allows the deaf child a reception at 100% of the oral message. It thus gives access to the French language under conditions comparable with those of a hearing child. It is a very effective tool for the training of the reading and the writing, because it allows a total autonomy of the deaf person vis-a-vis the written support. LPC is very easy to learn (a score of hours to acquire the whole of the keys); he asks then a regular practice. It is desirable to use it in family (parents, phratry, grandparents, cousins…). The family choices can be relayed within the school framework, since professional coders and coders in LPC are authorized - within the framework of the law of February 11th, 2005 on the handicap to intervene in class. Their presence makes it possible to the deaf pupils to profit from the entirety of the course exempted by the professor, of the interventions of the pupils and the environment of class: various noises, jokes, uproar… The life of the class is restored as a whole and thus allows the integration and the participation of the deaf pupil within the group. LPC exists in France since about thirty years. Association for the promotion of the Supplemented Spoken French language (ALPC) exemption information and formations for the parents and the professionals, in particular the speech therapists (or logopèdes) and specialized educators.

Technology

The Appareillage (Audioprothèse) makes it possible to the deaf people to better hear and to the deep deaf persons to have sound reference marks. It is used more by the people who become deaf into growing old. Many hearing parents deaf children choose also this option. All the deaf persons do not carry apparatuses, either because they have a too major deafness to make use of it effectively, or by personal choice: it is known especially that, for the deaf persons and unquestionable deaf (born deaf persons of birth), equipment is not a miracle although all the sound reference marks are very different with those from hearing.

The Implant cochléaire is an electronic device made up of an internal implant (a metal plate placed behind the ear and of the electrodes inserted in the Cochlée at the time of an surgical operation) and of an external implant (a magnet which is stuck behind the ear and an external case or a contour of ear which collect the sound and transmits it to the internal implant). It is used for the deep deaf children and the adult become-deaf persons under certain conditions (seniority of deafness, state of the cochlea, classical devices noneffective, etc). The implant cochléaire thus makes it possible to the deep deaf persons to find an auditive perception, but it does not replace hearing and requires an important auditive rehabilitation.

Education/Teaching

As a whole, one distinguishes two great methods in education of the deaf persons:

The Bilingualism which consists of the training of a Langue of the signs (for example LSF, LSQ or ASL) and of an oral language in its written form (for example written French or written English), in order to allow the deaf child to reach the national language and the majority culture of its country while making language of the signs its native tongue and while allowing him to develop a clean identity, related on the deaf community and the deaf culture.

The oral Rehabilitation which consists in giving to the deaf child the language and the majority culture of the company, generally divided by his/her hearing parents, and thus to allow him to express itself with the oral examination, with or without the assistance of auxiliary communication mode like the supplemented spoken language. It allows the deaf child who can evolve/move in a medium intending to be integrated in the company, according to the standards of the majority culture. This approach has more relevance for the deaf people who have a autiditif remainder, the deaf people, or the people become deaf who already acquired the oral language like native tongue. For the people who live with a major deafness, the language of the signs remains priority to evolve/move and be integrated in the company.

However, it is important to specify that these two methods of education are not inevitably contradictory, even if they are the object of conflicts and interminable discussions between the partisans of each method to know which is the best.

Normally, the parents confronted with this choice can choose to choose one or the other of the educations exempted to the deaf children although the means are not also distributed on the whole of the territory: one sees families moving or many long enough transport for the deaf children. The choice is thus done between the language teaching of the signs and the oral examination with equipment, or the supplemented Spoken French language and the oral examination with equipment, it is possible to use the three, and to then retain the formula which succeeds best with the deaf child.

Relations Deaf person-hearing

The relations Deaf person-hearing are often tended. Basically, it is the vision of deafness as a handicap which runs up against more the Deaf persons. There is confrontation between the vision of deafness like pathology and deafness like identity and base of the common experiment in a community. Gathered between them, the Deaf persons feel any lack, no deficiency. They share values, ways of being and of including/understanding the world. In hearing medium, the situation is different, because standards " are imposed; entendantes". One generally tries to repair hearing. This ideology is found in all the spheres of the life: family, school, etc the Deaf persons are offended that decisions with regard to them are made without their opinion. It is almost invariably the case in the school system. The relations between Deaf persons and hearing are mainly marked by two elements: difficulties of communication and the acceptance of deafness. Sometimes they feel " psychologically; inférieurs".

Family

For the great majority, the Deaf persons are minority even in their own family. Here hardly 20 years, one still disadvised to the families learning the language from the signs. Here, in fact the difficulties of communication characterize the experiment of Deaf person in his family. In the majority of the cases, the family members is unaware of the language of the signs. There is often a feeling of insulation and sometimes of rejection to the center even of the family. The exchanges with the mother are generally easier. But it happens that brothers or sisters must interpret between the Deaf persons and his/her parents. The contacts with the widened family are generally remote and surface.

Travail

the social relations resemble much lived family. The problem of communication is omnipresent. With work, the Deaf persons are often isolated. One of the colleagues hearing will perhaps learn some signs and it will have to help the deaf person to include/understand the others. It is rare that solid friendships are woven in the work context.

Amitié

Of the difficulties of communications is also present in the friendships between Sourds and hearing. In general, the Deaf persons will say that their friendly relations with hearing are different from with other Deaf persons. As for the family circle or work, it is the degree of acceptance of deafness and the comprehension of the deaf identity which influence the relation. To know the LSQ is not sufficient, it is necessary to be able to know the Deaf persons, their values and their behaviors. They are bored and are tired often quickly in the medium of hearing.

Social relations

the difficulties of communications involve sometimes a feeling of insulation and rejection. That appears as one of the factors which encourage the Deaf persons has to become gestural and to integrate the deaf community. The contacts between Deaf persons and hearing are marked by the difficulties of communication but as much by the degree of acceptance of the deafness on behalf of the hearing person. Indeed, to accept deafness, it is to open with another means of communication but also another mode of interaction.

There are prejudices with respect to the Deaf persons but also on behalf of the Deaf persons with regard to hearing. In the company, one knows very little the reality of the Deaf persons. Rare are the people who know that the language of the signs is a specific language (nonuniversal) and comparable with French, for example. The Deaf persons are seen like handicapped people and one often doubts their intellectual abilities.

In general, the Deaf persons will be curious, even being wary, with respect to hearing who are interested in the community: they will want to know the motivations of these people and will seek to check if they include/understand the culture of the Deaf persons well. Even if hearing it expresses itself well in language of the signs, a distance remains between the Deaf person and hearing it.

History of deafness

; the Middle Ages It is one period during which the deaf persons and their signs seem accepted well.

Aude of Saint-Wolf found the trace of one hundred twenty deaf persons of the medieval time. Only four were beggars, all the others work: they are workman, clothier, butcher, plowman, maidservant, gatekeeper and even monk. Into the Middle Ages the deaf persons probably were integrated better into the hearing world than it was not the case at the 20th century. The cultural context was favorable to the gestural expression so much so that sometimes one speaks about the Middle Ages like civilization of gesture , even if it remains dominated by the primacy of the word. Moreover it should be known that the monastery of the Ordre cistercian, founded in 1098, obliges its monks with the rule of silence. They thus communicate between them by signs. Their monastic Langue of the signs in common does not have signs with LSF.

Religious communities accommodate deaf children. The deaf persons are authorized to use their signs for the baptism, to marry and pronounce the monastic vows. After at the 5th century Saint Jerome had recognized that “by the signs and the daily conversation, by the eloquent gestures of all the body, the deaf persons can include/understand the Évangile”, to the 13th century Thomas d' Aquin in the Summa Theologica , invites them to be confessed by signs.

; At the 16th century

In its Treated painting , Léonard de Vinci writes that those there would be well taught which would imitate the movements of the dumb men who speak with hands and eyes and eyebrows and with any person, in their will to express the concept of their heart. Montaigne says that “our dumb men discuss, argue, and content with the history by signs”.

; At the 17th century

Rene Descartes writes in one of its lettres : “I say word or other signs because the dumb men make use of signs in same way as us of the voice”. The gestural language used then by the deaf persons thus seems having same qualities as the vocal languages.

; At the 18th century

Condillac sees in the gestural languages the languages first of humanity. The first chapter of its Grammaire entire is devoted to the language of action , term which will be re-used during all the 19th century to indicate the language of the signs.

In its Lettre on the deaf persons and dumb , Denis Diderot says that to obtain “the true notions of the formation of the language”, it is necessary to go to see “that which nature deprived of faculties to hear and of speaking”.

Jean-Jacques Rousseau makes an analysis of an astonishing modernity of the language of the signs in its Essai on the origin of the languages. It is in this intellectual climate that the company of Abbé of the Sword is registered (1712-1789). A long time isolated and regarded as idiotic by hearing, the Abbé of the Sword - one hearing - supports so that their the access to the Human rights is recognized. That is carried out in 1791; the Constituent one by a law of the July 21st and 29th 1791 will make it possible to the deaf persons to at least become on the legal level, of the full citizens.

See on this subject the part which is devoted to him in the article LSF and especially the article deaf Histoire.

Some famous deaf persons

Joachim of Bellay, French poet (1522-1560)
Joseph Saver, French acoustics expert (1653-1716)
Francisco Goya, Spanish painter (1746-1829)
Ludwig van Beethoven, German type-setter (1770-1827) - Become deaf
Jean Massieu, repeater (1772-1846)
Laurent Clerk, professor (1775-1869)
Ferdinand Berthier, French writer (1803-1886)
Forest Claudius, professor (1810-1891)
Bedřich Smetana, Czech type-setter (1824 - 1884)
Beautiful Graham, American scientist (1847-1922) (It is his wife which is deaf)
Helen Keller, private, deaf teacher and blind man (1880-1968) - Deaf and blind man
Eugene Rubens-Alcais, founder of CSSMP, the FSSF and CISS (1884-1963)
Ernest Hemingway, writer American (1899-1961) - Become deaf
Marlee Matlin, American actress - Deaf person
Raymond Lévesque, Québécois composer-songwriter (1928)
Emmanuelle Laborit, French actress (1971) - Deaf
Deanne Bray, American actress (1971) - Deaf person
Constantin Tsiolkovski, Russian physicist (1857-1935), theorist of modern astronautics - Become deaf during childhood

Culture

Prohibition of the language of the signs? to see the article LSF Rejection of the apparatuses Pride identity to see article deaf culture Bi-Bi: bilangue-biculturel -->

See too

To speak about the handicap

External bonds

Bébian, Roch. - Ambr. - Auguste (1790-1839): '' Éducation of deaf-mute the setting to the range of the primary institutions and all the parents: Leaflet of edition '', Paris: Printing works of Béthune. - 8 p.: boards; 21 cm.
Information centers on Deafness (DRASS)
deafness in Quebec

Subtitling for deaf persons and deaf

Medias-soustitres.com the site militant of the media subtitled for the deaf and deaf people.
Cinécriture Works for the promotion and the development of subtitling to the cinema for the deaf or deaf people.

Random links:

Crush' S Coaster | Canton of Crécy-in-Ponthieu | Courts of revision of the RPC and the Program of the SV | Polyus | Shieling