A

American Sign Language (ASL)

A visual language. ASL has its own unique vocabulary and grammar. The five factors of sign include handshape, palm direction, movement, location, and expression. The American Deaf community values American Sign Language as the core of a culturally Deaf identity.

Amplification

Devices that make sounds louder. For example, hearing aids.

Annual Evaluation

A meeting every year to assess service plans. The Individualized Family Service Plan (ISFP) is for children under three years of age. The Individualized Educational Plan (IEP) is for children over three. For example, measurable annual goals and short-term objectives that describe the student’s expected learning outcomes can be discussed in this meeting.

Assistive Listening Devices

Devices used to make sounds more accessible to people with varying hearing levels. For example, a hearing loop, FM system, infrared system, personal amplified system, and Bluetooth systems.

Audiological Assessment/Evaluation

Hearing evaluations performed by an otolaryngologist (ear, nose, and throat doctor / ENT) or an audiologist to describe a person's auditory access. For example, evaluation includes pure tone air and bone conduction testing to find the hearing thresholds. Bone conduction testing can show the origin location of the hearing differences. Speech testing involves word recognition and listening to speech in noisy environments. A treatment plan is made based on the results of testing.

Audiologist

Healthcare professionals who provide patient-centered care in the prevention, identification, diagnosis, and evidence-based treatment. Specializing in hearing, balance, and other auditory disorders for people of all ages. 

Auditory Attention

Our ability to extract meaningful speech despite a background of competing noise. For instance, focusing on a conversation while a loud television show plays in the same room.

Auditory Brainstem Response (ABR)

A hearing screening and diagnostic tool using equipment to play clicks into the ear canal. An electroencephalographic (EEG) response is measured from electrodes placed on the scalp. The brain activity in response to the sound is recorded. ABR used for screening hearing will result in a referral if further steps are needed. A diagnostic ABR will determine the hearing status and candidacy for assistive technology.

Auditory Brainstem Implant (ABI)

A device that allows audio stimuli to avoid the inner ear to directly stimulate the auditory pathways of the brain. The implant has two parts: processor and internal implant. The processor can be worn on the top of the ear or the side of the head. The processor contains the microphone that takes in sound to turn it into an electrical signal. A surgeon inserts an internal implant including the receiver stimulator and an electrical paddle. The receiver stimulator is inserted under the skin on the side of the head ending in an electrode paddle. The electrode paddle is placed on the cochlear nucleus complex, the hearing portion of the brainstem surface. An ABI is not the same as a cochlear implant.

Auditory Nerve

The eighth cranial nerve carries electrical signals from the cochlea in the inner ear to the brainstem. Also known as the hearing nerve. For example, changes to the auditory nerve result in symptoms including sensorineural hearing thresholds and vertigo.

Auditory Neuropathy Spectrum Dyssynchrony

An individual with this diagnosis has a typical outer hair cell function in the cochlea. Yet the signals carried by the auditory nerve to the brain are not in sync. The information is not relayed in a consistent manner from the cochlea to the brain. 

Auditory-Oral

A program that uses oral and auditory stimuli for individuals who are D/deaf or hard of hearing. Requires the use of amplification to allow learning through listening, speechreading, and natural gestures. An activity example includes the therapist making a common classroom sound such as ringing a bell. The child will close their eyes and raise their hand when they identify the sound source. Once identified then the child can open their eyes to see the bell making the sound.

Auditory Processing Speed

How the brain receives, understands, and responds to incoming information. For instance, the speed that the brain takes in information contributes to our ability to quickly recognize speech.

Auditory Training/Listening

A program focusing on differentiating sounds. Training the brain in key areas of auditory working memory, auditory processing speed, and auditory attention. For example, listening to pairs of words such as “goat-coat”, “coat-goat”, “goat-goat”, or “’coat-coat.” Then judging whether the two words in each pair are the same or different. 

Auditory Working Memory

Our ability to store words in short term memory to process meaning and linguistic context. For example, auditory working memory is used while engaging in conversations. The brain holds on to what others say so an appropriate response can be made. 

Auditory-Verbal

A program that individuals who are D/deaf or hard of hearing use. This program focuses on auditory input, listening, and speech with an emphasis on no visual cues. For instance, auditory verbal therapy sessions utilize activities such as playing, talking, singing, and playing games. 

B

Bilateral Hearing

Hearing using both ears.

Bone Anchored Hearing Aid (BAHA)

A surgically implantable device that uses vibrations through the skull to send sounds directly to the cochlea. A BAHA consists of three parts: a titanium implant, external connector, and sound processor. The titanium implant is surgically placed directly behind the ear in the mastoid bone. The implant is about half the size of a pea. Next the connector is placed. Skin will heal around the connector and a small portion will stick out slightly which allows the sound processor to attach to the head. The processor can be removed while sleeping and showering. A nonsurgical bone conduction hearing aid can be worn by children under the age of five. The device is attached directly to the skin with adhesive or part of a headband. 

C

Coaching

A conversational activity that aims to support families to learn and develop a variety of auditory skills. For example, listening skills include detection, discrimination, identification, and comprehension.

Cochlea

A winding, snail-shaped organ that forms a portion of the inner ear. The cochlea is lined with hair-like cells that turn vibrations into signals sent to the auditory nerve.

Cochlear Implants

A hearing device that avoids the inner ear and directly stimulates the auditory nerve, also called the cochlear nerve. A sound processor fits behind the ear and receives sound. The sound signals are sent to the receiver that is surgically placed under the skin behind the ear. The receiver sends the sound signals down an attached wire that holds tiny sound electrodes. The electrode filled wire is fed through the cochlea. The electrode array mimics the role hair-like cells play in the cochlea creating electrical stimulation. The electrical signals trigger the cochlear nerve which sends the signals to the brain. A cochlear implant is not the same as an auditory brainstem implant. A cochlear implant stimulates the auditory nerve while the ABI bypasses the auditory nerve to stimulate the brainstem.

Conductive Hearing Loss/Levels

Type of hearing loss/thresholds due to sound waves not reaching the inner ear through the outer and middle ear. Possible causes include ear infections, blockages, or structural abnormalities. 

Confidentiality

The right that personal information about children and family is not released without parent consent. This right could only be changed if permitted or required by law. For example, personal information includes phone numbers, addresses, medical records, and social security. 

Consent

The approval a parent or guardian gives to a program most commonly in writing. Consent is always optional and can be taken back at any time. For example, sections of a consent form can include the purpose of the study, possible risks, possible benefits, confidentiality of records, protection and rights.

Cued Speech

A mode of communicating that uses handshapes and hand location near the mouth to help the person looking tell the difference between speech sounds. Many speech sounds look the same on the face even though the sounds are different. For instance, the words “mat”, “bat”, and “pat” look the same on the lips and mouth. 

D

Deaf Mentor

D/deaf and hard of hearing role models who are uniquely qualified to provide information based on life experiences. Children, parents, and professionals benefit from the information. For example, they can give specific examples of daily activities as a member of the D/deaf and hard of hearing community.

Decibel

A unit used to measure the loudness of a sound. Commonly abbreviated as dB. Hearing thresholds are in dB HL which stands for decibels hearing level. For example, 60dB – normal conversation, 70dB -vacuum cleaner, 80 dB -power tools.

Due Process

Procedures designed to protect a person’s rights. This includes requirements for confidentiality and consent. As well as the process to resolve disagreements and file complaints in the IEP process.  For example, filing a complaint form can spark a meeting to ensure due process. 

E

Early Intervention

A collection of services provided by public and private agencies. Designed by law to support children and their families in improving a child’s potential growth and development from birth to age three.  

Early Intervention Services

Services provided by qualified personnel that meet the needs of the child and family as described in the Individualized Family Service Plan (IFSP). May include speech therapy, audiology, physical therapy, deaf educators, language teachers, and other types of services based on the needs of the child and family.  

Earmold

A plastic or silicone piece that is made to fit a child’s ear. The earmold has a short tube that is attached to the part of the hearing aid that sits behind the child’s ear. They seal the user’s ear canal, thus channeling sound into the ear.

Electroencephalogram (EEG)

A non-invasive test that measures electrical activity in the brain using small, metal discs (electrodes) attached to the scalp. Brain cells communicate through electrical impulses and are active all the time. This activity is shown as lines on an EEG recording.

F

Fingerspelling

A communication method that uses hands and fingers to spell out words. Hand shapes stand for the letters in the alphabet. Fingerspelling is a part of ASL.

FM/DM Systems

FM stands for frequency modulation. FM signals send sound from a microphone used by the person speaking to an individual wearing the device. This system is sometimes used with the FM system. This extra piece is called an “audio input boot.” DM stands for digital modulation systems which use digital signals to transmit sound from a microphone, worn by the speaker, to a receiver worn by the individual with hearing differences. For example, the transmitter (microphone) can be worn by a teacher and the receiver is built into the individuals hearing assistive technology. The individual will hear the teacher's voice when in a noisy classroom environment.

Free Appropriate Public Education (FAPE)

The Individuals with Disabilities Education Act enforces that all schools are upholding the right that children with disabilities get a free appropriate public education. Free special education services refer to a range of aid given without extra cost to the guardians. Appropriate refers to goals that are specific, measurable, relevant, and time-based are set in an Individualized Education Program (IEP). Public refers to the right that students with disabilities must attend the same school as their peers in the least restrictive environment. Education refers to the quality of the teaching as it is appropriately challenging to meet the IEP goals. 

H

Hearing Aids

A small electronic device that is placed in or behind the ear. Hearing aids contain components that work together to amplify sound. The three basic parts include a microphone, amplifier and a speaker known as the receiver. Sounds go in through the microphone. Then, the microphone converts sound waves to electrical signals before sending them to the amplifier. Finally, the amplifier sends the sounds to the ear through a speaker.  There are many types of hearing aids. Hearing aids are worn by people of any age including infants. 

Hearing Threshold

The lowest level that a sound can be perceived by an individual more than half of the time. Hearing thresholds can be found through pure tone audiometry testing performed by an audiologist. For example, the minimal threshold for typical hearing is 25 dB in adults and 15 dB in children.

I

Identity First Language

The individual includes their differences as a core part of their identity. For example, an individual with autism would introduce themselves as an “autistic person” as they identify as a member of the autism community.  

Individuals with Disabilities Education Act (IDEA)

A law guaranteeing a free appropriate public education to eligible children with disabilities. This applies to children throughout the nation. The law ensures special education and related services as well. 

Individuals with Disabilities Education Act Part B

Provides free and appropriate public education. As well as education related services for all school-aged children with disabilities. Ages range from three to twenty-one. 

Individuals with Disabilities Education Act Part C

Creates the early intervention program for eligible infants and toddlers ranging from birth through age two and their families. Services include, broadly, speech language pathology, audiology, transportation, vision, special instruction, physical therapy, occupational therapy, and nutrition services. For example, family services provided, if appropriate, include family counseling, training and home visits. Family services are provided by qualified professionals, including social workers and psychologists, to assist in understanding the needs of the child. 

Individualized Education Plan (IEP)

A plan or program developed to ensure that a child with an identified need receives expert instructions in there elementary, or secondary education institution. This is included in Part B of IDEA. State guidelines specify the special education and related services necessary to meet the child’s needs. The IEP is developed by a team of individuals from various educational disciplines, the child, family members, and/or designated advocates.

Individual Family Service Plan (IFSP)

A service and catered program that is provided if a child is eligible for early intervention services included in Part C of IDEA. For example, a service coordinator can help schedule services including speech and language therapy, physical or occupational therapy, and home visits

Inner ear

The inner ear is made up of the snail-shaped organ for hearing (called the cochlea) and the nerves that go to the brain. 

J

Joint Attention

When one person purposefully coordinates their focus of attention with that of another person and they are mutually aware that they are doing so. For example, a child shows a parent a toy train and they both watch it move on the track in a circle.  

L

Lip Reading

The individual watches the movement of a speaker’s mouth and face to understand what the speaker is saying. This practice is also referred to as speechreading. For example, about forty percent of the sounds in the English language can be seen on the lips of a speaker in good conditions such as a well-lit room where the child can see the speaker’s face.

Listening Fatigue

The mental, physical, and emotional exhaustion from overworking your brain while trying to hear. For instance, an individual experiencing listening fatigue may also have low energy, difficulty concentrating, elevated stress or shifts in mood.  

M

Middle Ear

The middle ear is made up of the eardrum (tympanic membrane) and three small bones (ossicles). 

Mild Hearing Loss/Levels

Describes a hearing range between 26 to 40 dB HL. For example, this individual does not hear people whispering, refrigerators humming, and water flowing down a stream.

Mixed Hearing Loss/Levels

A hearing diagnosis that is a combination of conductive and sensorineural components.

Moderate Hearing Loss/Levels

Describes a hearing range between 41 to 55 dB HL. For example, this individual does not hear people working in a quiet office, rain falling, or coffee brewing. 

N

Natural Learning Environment Practices

Using activities that children participate in every day to assist learning. Providing learning chances which lead to increased participation and skill development for children. 

Non-invasive

Any medical test or treatment that does not cut the skin or enter any of the body spaces.

O

Occupational Therapist

A healthcare provider who helps their patients improve their ability to perform daily tasks. They work with patients to identify challenges, develop goals, and come up with ways to help meet the objectives.  

Ossicles

The chain of three tiny bones, the malleus, incus, and stapes in the middle ear. Ossicles send the movement of the eardrum to the inner ear.

Otitis media

A middle ear infection. Children with recurring ear infections may experience changing hearing levels. Symptoms include unusual irritability, difficulty sleeping, pulling on ears, fever, fluid draining from ear, loss of balance, and ear pain.

Otoacoustic emissions (OAE)

A hearing evaluation or screening that uses a microphone placed in the ear canal to measure sound waves made in the cochlea in response to clicks or tone bursts. 

Otolaryngologist

The medical name for an ear nose and throat doctor (ENT). They diagnose and treat conditions affecting the head and neck. They are trained to perform surgical and nonsurgical treatments. Individuals should see an otolaryngologist if they are experiencing a persistent sore throat, persistent runny nose, chronic cough, sinus pressure, difficulty swallowing and dizziness.

Outer Ear

The outer ear is made up of the parts we see: the pinna, the ear canal, and the eardrum (tympanic membrane).

P

Person First Language

A way to highlight the person and view that diagnosis, disease, condition, or disability as only one part of the whole person. Person first language avoids using labels or adjectives to define someone.  For example, “person who is blind.”

Pinna

The part of the ear that we see on each side of our heads. It is a part of the outer ear. The pinna collects sound and sends it down the ear canal to the rest of the ear. 

Post-lingual Hearing Threshold

Hearing differences that are present after a person learns to talk.

Pre-lingual Hearing Threshold

Hearing differences that are present before a person learns to talk. 

Profound Hearing Loss/Level

Describes a hearing range between 90+ dB HL. For example, this individual does not hear shouting, lawnmowers, or motorcycles

Physical Therapist

A healthcare provider who helps their patients improve their physical movements.

R

Referral

The process of sending a patient to another recommended provider for assessment, treatment, or opinions. For example, a speech language pathologist can send a patient to an audiologist.

Residual Hearing

The amount of hearing a person has without the assistance of hearing technology.

S

Sensorineural Hearing Loss/Level

A type of hearing threshold occurs when the inner ear or the actual hearing nerve itself is not functioning properly. The hair-like cells in the cochlea are not sending signals to the auditory nerve.

Service Coordinator

A professional in the Birth to Three program within the Individualized Family Service Plan (IFSP). The coordinators' role is tailored to the family’s specific main concerns and daily activities. For example, the coordinator can ensure that the family sees a specialist. 

Severe Hearing Loss/Level

Describes a hearing range between 71 to 90 dB HL. For example, this individual does not hear doorbells, telephones ringing, traffic noises or a vacuum cleaner. 

Signing Exact English (SEE)

A manual communication method that uses signs to represent English grammar and vocabulary. It allows parts of English to be seen and heard at the same time.

Speech Language Pathologist (SLP)

A professional in communication. SLPs work with people of all ages. They treat many types of communication and swallowing differences. SLPs work with speech sounds, language, social communication, voice, fluency, and feeding. They work in private practices, physicians’ offices, hospitals, schools, colleges/universities, rehabilitation centers, and residential health care facilities.

Speech Detection Threshold (SRT)

The minimum hearing level for speech that an individual can just determine the presence of a speech material fifty percent of the time. The listener does not have to identify the material as speech but must indicate awareness of the presence of sound.  

Speechreading

The ability to understand speech by carefully watching a person’s lip patterns and movement of their tongue and face. For instance, on average an English-speaking person will create about thirteen to fifteen specific speech movements per second in a normal-paced conversation.

T

Teachers of the D/deaf (ToDs)

Qualified teachers who have taken additional training to teach children with hearing differences. They provide support to children who are D/deaf or hard of hearing. As well as their families and professionals involved in the child’s education. 

Tympanic Membrane

Also called the eardrum. A thin, circular layer of tissue that separates the outer ear from the middle ear. The eardrum plays an important role in hearing. Sound waves reach the eardrum causing the membrane to vibrate. The vibrations travel to your ossicles, the three tiny bones inside the middle ear. The hair cells in the cochlea in the inner ear capture the vibrations and convert them into electrical signals. The auditory nerve carries the signals to the brain. The eardrum also protects the middle ear from dirt, bacteria and debris.

U

Unilateral Hearing

Hearing using one ear.