Hearing Loss Determining Eligibility for Social Security Benefits (2005) / Chapter Skim
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6 Impact of Hearing Loss on Daily Life and the Workplace
6 Impact of Hearing Loss on Daily Life and the Workplace
Pages 163-179
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From page 163... ...
The ability of an individual to carry out auditory tasks in the real world is influenced not only by his or her hearing abilities, but also by a multitude of situational factors, such as background noise, competing signals, room acoustics, and familiarity with the situation. Such factors are important regardless of whether one has a hearing loss, but the effects are magnified when hearing is impaired.
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From page 164... ...
When hearing loss occurs after the development of spoken language, and particularly when it occurs slowly, as it does in aging or as the result of prolonged noise exposure, there is a loss of functional hearing ability, but other cognitive skills and competencies are not greatly affected. The terms "hard-of-hearing" and "late deafened" are often used to describe these individuals.
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From page 165... ...
, computer-assisted note-taking systems, and other accommodations. However, for various reasons, including background noise in the classroom, communication is often less than clear, thereby affecting access to the English language and educational achievement.
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From page 166... ...
While some value their previous speech and auditory therapy to maximize spoken English abilities, others may experience such exposure as stressful and potentially inadequate in providing them with functional expressive and receptive spoken English skills (Bain, Scott, and Steinberg, 2004)
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From page 167... ...
Psychosocial Adjustment and Hearing Loss The majority of those with hearing loss acquire it later in life at a time following the acquisition of spoken language. The prevalence is particularly high among those who are over 65 years of age and among those who have been exposed to noise.
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From page 168... ...
In a study of psychological change over 54 months of cochlear implant use by 37 postlingually deafened adults, the researchers used standard psychological measures of affect, social function, and personality prior to implantation, and then at regularly scheduled intervals after implantation, to assess the impact of audiological benefit. There was evidence of significant improvement on measures of loneliness, social anxiety, paranoia, social introversion, and distress.
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From page 169... ...
For example, according to a survey of 80,000 households in the National Family Opinion (NFO) panel conducted in November 2000, 275 per 1,000 households reported having a person with a hearing difficulty, in one or both ears, without the use of hearing aid (Kochkin, 2001)
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From page 170... ...
When hearing loss occurs during adulthood, after the completion of formal education and after establishment of a work history or career, it poses challenges for job performance and future job mobility. Because these adults have already acquired the knowledge and skills needed to perform their jobs, the difficulties they face are related to communication barriers, such as working conditions and employer attitudes, as discussed in the following sections.
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From page 171... ...
However, most studies of the potential effectiveness of these devices are based on laboratory or clinical research, not on assessment of actual functioning in the workplace. For persons with severe or profound hearing loss, the literature on cochlear implants provides data showing significant restoration of function for many implant recipients.
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From page 172... ...
xii) states that "the greatest challenge we face regarding communication access is neither technological nor legislative, but societal attitudes toward hearing loss-attitudes that seem to be shared fully by many people with hearing losses." These findings point to the need for education and intervention both with the individual with hearing loss and with his or her coworkers and supervisors.
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From page 173... ...
This highlights the dilemma posed by trying to predict the consequences of hearing loss that occur in daily life: the farther one moves from testing the ear per se, the more meaningful the measure may be, but the less it is a function of hearing ability alone. This implies that impairment in a specific auditory ability may not be strongly correlated with disability, and indeed this has been shown to be true for the relation between degree of hearing loss measured audiometrically and self-reported communication function in daily life.
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From page 174... ...
In the final stage, minimal acceptable performance criteria were established and screening scores were determined. This comprehensive and systematic approach, integrating theoretical and statistical models, psychometric instrument evaluation, and empirical determination of workplace characteristics, clearly illustrates the challenges involved in direct assessment of functional hearing abilities.
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From page 175... ...
Doubly indirect assessment compounds the difficulties in arriving at valid conclusions because of the many additional assumptions that must be made about the relation between the target variable and the one actually assessed. In the sections that follow, examples of all three types of indirect assessment can be found.
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From page 176... ...
. Distinctions between objective and subjective outcomes, and conceptual distinctions among hearing aid benefit, satisfaction, and use, along with statistical analysis of their interrelationships, have led to the conclusion that hearing aid outcomes are truly multidimensional (Humes, 1999)
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From page 177... ...
Bess (2000) reviewed studies that used the Sickness Impact Profile, the SELF, the SF-36, and the Dartmouth COOP Functional Health Assessment to evaluate the outcomes of hearing-aid fitting, often in conjunction with more communication-specific assessments.
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From page 178... ...
In clinical settings, there is little motivation for exaggeration of problems, but in the context of disability determination, conflict of interest poses a serious threat to the validity of self-reports. The committee examined the potential usefulness of quality of life as
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From page 179... ...
Tests that purport to measure or predict functional hearing ability in daily life must be validated against real-world criteria measured in natural settings. Validation in a simulated test environment is appropriate if a strong relation between the simulated and naturalistic settings can be demonstrated or assumed.
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