Music Therapy


New research suggests that music therapy can help deaf or hearing-impaired toddlers who have undergone a cochlear implantation procedure to acquire speech.

Cochlear implants, which are sometimes called bionic ears, are increasingly common today. The surgically implanted electronic device provides a sense of sound to a person who is profoundly deaf or severely hard of hearing

While toddlers treated with the procedure are likely to gain about 90 percent normal hearing ability, the problem is that a child who has never heard before often undergoes a long rehabilitation process before learning to speak like his or her peers. While speech therapy and audiological training can take months, it typically takes years for a child to learn how to speak age-appropriately.

“Music can constitute the bridge between the quiet world that the child knew and the new world of sounds that has been unfolded following the operation.” 

Relieving the pressure
“Music comprises various elements that are also components of language and therefore as a non-verbal form of communication is suitable for communication with these children, when they are still unable to use language.”

Communicative interactions, especially those initiated by the toddlers, are critical in the development of normal communication, as they are prerequisites for developing and acquiring language.”

Following the implant procedure, toddlers are under a great deal of pressure from parents to begin talking, and they sometimes react to this pressure by becoming introverted. Music therapy can strengthen their nonverbal communication and reduce the pressure to initiate and respond to verbal activity.

“It is important that the parents and staff learn about the best way to expose these children to music, the use of music for communication and the importance of the therapist’s undirected approach.”

 Music therapy is gradually penetrating the field of rehabilitation, but there is still a lot of work to be done in improving awareness of this important area.



Language Development

Language education and rhythm for Hearing Loss Children

During the past 50 years much interst has been shown in the linguistic element of rhythm. Rhythm is both visual and auditive; the auditive aspect is of greater importance. Rhytm is also a constituive element of time and plays a major role in man's movemnts on both macro and micro level. speaking is to be situated within micro motor system.

It is a fact that learning is influnced bty the perception of sensori-motor structres. Rhythm is also significant with regard to affectivity and emotions. the tonality, duration, pitch and accent change according to changes in emotion. without going too deep into each of the above-mentioned elements, it is advisable to consider that a child's conscious body schema is partly realised through the control of movements in time.

Structured movement in time is called rhythm. And man's speech is closely linked to it. More that with hearing people, learning and controlling the speech rhythm (breathing) is of much importance for the deaf. Oral methods attach much great importance to it.



Pronunciation and breathing are trained together by means of breathing exercises. at the Dutch St. Michiels-Gestel speech education is intimately linked to breathing control. learners use an individual small wind organ before producing rhythmical sounds. The child will have trained the rhythmic production of sound on the win organ before trying to pronounce the speech sounds.

In speech therapy one has to train the fundamental rhythmical elements of speech. They differ from language to language. One should study children's rhymes to find the rhythmical elements. 


Hearing Loss

Ear:
There are three sections of the ear, according to the anatomy textbooks. They are the outer ear (the part we see along the sides of our head behind the temples), the middle ear, and the inner ear. But in terms of function, the ear has four parts: those three and the brain. Hearing thus involves all parts of the ear as well as the auditory cortex of the brain. The external ear helps concentrate the vibrations of air on the ear drum and make it vibrate. These vibrations are transmitted by a chain of little bones in the middle ear to the inner ear. There they stimulate the fibers of the auditory nerve to transmit impulses to the brain.

The outer ear looks complicated but it is the simplest part of the ear. It consists of the pinna or auricle (the visible projecting portion of the ear), the external acoustic meatus (the outside opening to the ear canal), and the external ear canal that leads to the ear drum. In sum, there is the pinna, the meatus and the canal. That's all. And the external ear has only to concentrate air vibrations on the ear drum and make the drum vibrate.


The middle ear consists of the ear drum (the tympanum or tympanic membrane) and, beyond it, a cavity. This cavity is connected via a canal (the Eustachian tube) to the pharynx (the nasopharynx). The Eustachian tube permits the gas pressure in the middle ear cavity to adjust to external air pressure (so, as you're descending in a plane, it's the Eustachian tube that opens when your ears "open").) The middle ear cavity also contains a chain of 3 little bones (ossicles) that connect the ear drum to the internal ear. The ossicles are named (not the Nina, the Pinta and the Santa Maria but) the malleus, incus, and stapes. In sum, the middle ear communicates with the pharynx, equilibrates with external pressure and transmits the ear drum vibrations to the inner ear.


The internal ear is highly complex. The essential component of the inner ear for hearing is the membranous labyrinth where the fibers of the auditory nerve (the nerve connecting the ear to the brain) end. The membranous labyrinth is a system of communicating sacs and ducts (tubes) filled with fluid (the endolymph). The membranous labyrinth is lodged within a cavity called the bony labyrinth. At some points the membranous labyrinth is attached to the bony labyrinth and at other points the membranous labyrinth is suspended in a fluid (the perilymph) within the bony labyrinth. The bony labyrinth has three parts: a central cavity (the vestibule), semicircular canals (which open into the vestibule) and the cochlea (a snail-shaped spiral tube). The membranous labyrinth also has a vestibule which consists of two sacs (called the utriculus and sacculus) connected by a narrow tube. The utriculus, the larger of the two sacs, is the principal organ of the vestibular system (which informs us about the position and movement of the head). The smaller of the two sacs, the sacculus (literally, the little sac) is connected with a membranous tube in the cochlea containing the organ of Corti. It is in the organ of Corti that are situated the hair cells, the special sensory receptors for hearing.














Causes of Hearing Loss

A. Causes of conductive hearing loss

All kinds of infections of the outer and middle ear, e.g. otitis, glue ears, a perforated drum. When too much fluid is produced so that a stick slime settles on the respective parts of the middle ear: the ear drum swells and bursts; the hammer and stirrup stiffen. thus there is no conduction of the sound wanes to the neural portion of the inner ear.

















B. Causes of perceptive deafness (sensori-neural hearing loss)
  1.  Can be congenital (from birth).
  2. Negative influences during pregnancy, e.g. a viral infection of the mother: scarlet fever, influenza, some medicine like streptomicin.
  3. An accident whereby the inner ear (e.g. the perceptive canals) is severely injured. 


Causes and Consequences

Causes and Consequences of Hearing Loss

1. Conductive hearing loss
Hearing loss of between 30 and 50 dB will lead to retarded language development. Three percentage of all children prove to be hard of hearing. Three out of thousand children have grater hearing loss so that their language development is severely hampered.

2. Sensory-neural hearing loss
Prenatal hearing loss becomes congenital deafness. Language acquirement in an oral manner is severely hampered. Without audio-visual methods these prenatal deaf children, prelingual children, can not learn verbal communication. the audio-visual aids consist in making use of hearing apparatus and visual support. To visual means belong lip reading and signs. Total communication, i,.e.body language, should also e involved.
We talk of postnatal deafness. it is an acquired deafness, after birth. if it occurs after some verbal language development was achieved, everything should be to maintain this ability.


Hearing Loss Overview

To understand hearing loss it is important to understand how normal hearing takes place. There are 2 different pathways by which sound waves produce the sensation of hearing: air conduction and bone conduction.

  • In air conduction, sound waves move through the air in the external auditory canal (the "ear canal" between the outside air and your eardrum). The sound waves hit the tympanic membrane (eardrum) and cause the tympanic membrane to move.
  • The bones in the middle ear are connected to the tympanic membrane. When the tympanic membrane moves, this movement is transmitted to the bones. These 3 bones are called the malleus, the incus, and the stapes. Movement of the stapes causes pressure waves in the fluid-filled inner ear.
  • The cochlea is an inner ear structure surrounded by fluid. It contains multiple small hairs. Pressure waves in the fluid cause the hairs to move. This movement stimulates the auditory nerve. Different frequencies of noises stimulate different hairs on the cochlea, which translate to the sensation of sounds of different pitch. 

  • Hearing by bone conduction occurs when a sound wave or other source of vibration causes the bones of the skull to vibrate. These vibrations are transmitted to the fluid surrounding the cochlea and hearing results.




       

    Teacehing and Educating

    Aspects of Educating and Teaching Deaf People

    Before explaining the concept of deafness we will consider the consequences of deafness. In a world where sounds have been made into system, which we call language, through which people mostly communicate with one another, we have to take into account that not being able to pick up auditive stimuli is the greatest limitation for dear people to acquire oral communication.
    Communication is predominantly oral in the hearing world. Therefore deafness is taken as an essential disorder of language development by the “talking” world. Additive stimuli are insufficiently or not al all registered by hearing-impaired people.









    Behaviorally disabled

    They can oath receive and assimilate sensory stimuli. But have difficulty in expressing the results.
    Classification and frequency
    •   Physically and neurologically disabled (0.3)
    •   Language and speech disabled (0.7)
    • Affectively disabled (0.9)
    • Chronically disabled
    Main characteristics
    •   Limited motion
    •   Heightened aggressive behavior
    •  Egocentric
    • Normally gifted
    •  Normal intelligence;social inhibited; weak family environ end
    •   Limited conscious less of norms; social deviant behavior;anxiety
    • Weak family environ end
    •  Chronic diseases;tuberculosis;diabetes:such people are often very egocentric
    • They require mostly much attention, kindness; are in need of help but may use this as a defense mechanism



















    Details about pastoral care

    • The word service should not be made difficult
    •  Pastoral care should be a moment of meeting in peace and affirmation
    • The process is very slow
    • Personal bonds are needed 
    •  The aspects of suffering and acceptance ha e to be highlighted
    •  Egocentrism can be moderated through universal bond with the Church

















      Possibilities and limitations with regard to catechesis and liturgy
      • All theses groups are open to liturgy and catechesis 
      • Active anticipation in liturgy
      • Respect for their own rhythm 
      • The problematic of suffering 
      • No infantile treatment of the Faith content 
      • The Church as a group of friends
      • Christ as the One who delivers and grants peace morality problems and sacramentality
      •  Stressing the meaning of suffering “fill u what is lacking in Christ’s suffering” 
      • The resurrection perspective as a process leading to the finial aim of creation.

      Intellectually Disabled

      Definitions:
      1. They receive sensory stimuli but interpret or structure them very little or in a limited way
      2. Sensory stimuli are not assimilated normally understood so that they have approximate way of understanding, living and structuring their environment
      Classification: 
      • Mildly mentally disabled
      • Moderately mentaly disabled
      • severly mentally disabled
      • profoundly mentally disabled
       Main Characteristic
      • their intelligence is limited
      • the meaning of life is limited and more general
      • their verbal development is very limited
      • they interpret reality fragmentary
      • their cognitive development is hampered
      • their memory is less structured
      • their shoe impulsive behavior
      • rigidity symptoms\
      • their self-image is threaten
      • they overestimate physical performances
      • increased vulnerability
      • increased dependency on others
      • affective competence approaches normality
      • egocentric and unstable (cf. Prof. Dr. M Van Walleghem)

















      Deatials for pastoral care
      • pastoral care among them is possible
      • the hcice of conte4nt is limeited
      • the main points about the Faith can be taught
      • specail study of their verbal capacity is to be made: simple structures;much repetition
      • language is to be supported by visual and auditive means
      • historical data of Christology are less important
      • pastoral experices are to repeated in other places;conveyance is hampered
      • make them expericen the beautty of nature:contact, living, enlarign, religious meanign gare necessary
      • visual matter concentrates on othe essence of what is to be taught
      • pastoral workers shoudl be realistic
      • the severre the disability the styrogher the support given by th ebelieving community sohoud be

















      Possibilites and limitations with regard to catechesis and liturgy:
      • special attention for the use of symbols in liturgical pastoral care
      • adaptaton of the liturgical and catechetical langauge is needed
      • making good use of experessive techniques in liturgy and catechesis
      • team work in liturgy an catechesis
      • miracles are "common" to meatally disable: they are not easily amazed
      • sacramental life needs special attention
      • their moral foundation is weak
      • the logival structure of catechesis is of less importance ot them
      • group acitons are all right, but individual teaching is necessary

      The Deaf

      Frequency: 0.35

      Main Characteristics:
      • they have no hearing language
      • their language is less cultural and is limited
      • this leads to a different way of thinking
      • their sigh language is less time-defined
      • this limits their (verbal) expression   and communication
      • they struggle with a "we" relationship













      Details for pastoral care
      Many pastoral problems occur due to lack of verbal experiences:
      • No experience for them of the liberating word, no dynamic sound nor motion experience
      •  Difficulty to integrate in the parish community
      • Need of adapted permanent pastoral care
















      Possibilities and Limitations in respect of catechises and liturgy:
      • use of symbols of a visual nature is highly recommended
      • Special care to be taken of liturgical and catechetical problems
      • The miracles of Jesus are to be put in the right light
      • Their is a danger of ritualism
      •  Magic elements or outlooks draw their spontaneous attention


      The Blind

      According to A. Sanders, the frequency is 0.31.

      Main Characteristics
      As they have no sight, this may give rise to:
      • Isolation
      • Dependency on their environment
      • Limited mobility, spatial limitations and consequently it may lead to:
          • Egocentrism
          • concentration on their own body
          • frustrated feeling of freedom

















         Details for Pastoral Care
        This care is quite possible:
        • We have to see to it that we create a sense of universal brotherhood
        • To form community with several people at large. 















         Possibilities and Limitations in Respect of Catechesis and Liturgy
        • The liturgical word is very important
        • the are aspects of the liturgy are highly useful
        • symbols are less suitable
        • the use of expressive techniques is reduced
        • attention for treating of miracles

        Sensory Disabled

        Sensory disabled is their reception of sensory stimuli is hampered.

        The World of Disabled.

        It is important for us to know the fundamental characteristic of any type of disability so that our pastoral care can dovetail with it.

         

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