Case Studies

Clare

Clare is a 3rd grader at Richmond Elementary School, age 8. She has a bilateral, moderate/server sensori-neural hearing loss. She received a cochlear implant on October 3, 2006, and her implant was activated on November 1, 2006. She has unilateral hearing with her left ear utilizing the cochlear implant, and hears within normal limits across frequencies except 3K and 4K. She has 2 ASL interpreters with her at all times throughout the school day.

Clare has made great gains since she was implanted and activated 2 years ago. She is now able to understand using audition alone (no signs or lip reading) simple, familiar words, phrase and sentences when presented in a quiet setting and within 20 feet. She has greater difficulty when there is background noise, when the length of utterance has been increased, or when the information is unfamiliar to her. She still depends on her interpreters and visual cues within the classroom. She is able to understand better when in small groups or one-on-one. Clare is more independent of her interpreter within smaller groups. She is most intelligible when she uses the total communication process (voice and sign), although she frequently must be reminded to slow down her speech. Clare currently receives 90 minutes of speech therapy weekly to work on articulation and correct pronunciation of speech sounds (especially /r, s, f, ch/). Socially, she is very popular with her peers, and has many friends. She participates in the school plays and talent show (performing a monologue), which has given her increased confidence.

Her classroom teacher, Mrs. Hembrick, says she is an eager learner and participates in class, small group, and partner activities. She is a fluent reader, but does not always understand what she is reading. She shows great weakness in math, but is strong in science and social studies. Clare will always let the teacher know when she can’t hear, or doesn’t understand something. She sometimes asks questions that have just been asked by another student. She often misses information because she is too quick and only hears half of the information the teacher presents.

In the music room, Clare participates fully in all aspects of class. She loves to play instruments, although glockenspiels and metallophones hurt her ears. She is often given a xylophone and preferentially positioned away from the metal instruments. Clare sings songs and chants poems with the class, occasionally relying on her interpreter for unfamiliar lyrics. Her pitch has improved significantly, although she still struggles to reach higher pitches. She sometimes uses her speaking voice when the class is singing. If she does not look up while playing instruments, she often loses the beat, and the interpreter will have to visually or kinesthetically help her maintain a steady beat. The use of Kodaly hand signals has been challenging, as they resemble ASL. Music terminology in foreign languages has also been a challenge for the interpreter and Clare to understand. She sometimes needs to sit close to the stereo speakers to hear certain pieces of music, while others she can hear from across the room.