Teaching Programme

Module 1. Understanding Hearing Loss

Module 2. The Hearing System and Noise

Module 3. How Loud is Too Loud

Module 4. Protecting our Hearing

Download PDF of Modules 1-4

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Module 1. Understanding Hearing Loss

Why....

Students' motivation to engage in healthy hearing behaviours is significantly influenced by their beliefs about the real life impact of hearing loss on day-to-day life. See Shaping healthy behaviours. Students are more likely to be interested in protecting their hearing if they understand the extent of difficulties faced by people with a hearing loss.

What...

Module Aim:

To raise students' awareness of the real life impacts of hearing loss.

Students will be able to:

  • Appreciate what it is like to have a high frequency hearing loss. (This is the type of loss that occurs through noise injury).
  • Better understand the need to maintain good hearing health
  • Lesson Components:

  • Students discuss their knowledge of, and beliefs about, hearing and hearing loss
  • Students experience simulations of different types of hearing loss through interactive and online activities.
  • Preparation

  • Large piece of paper/smart board to record children's thoughts.
  • Access to hearing loss simulations – For all activities this can be done live (via online resources). However some activities also allow for files to be accessed prior to the class and saved for offline use if preferred.

How...

1. Intro/Discussion

Procedure

a. Begin with the question on the board/paper "What do you know about hearing?"

If desired, prompt a discussion with some of the following questions:

  • How do we hear?
  • Do you know anyone who has trouble hearing?
  • Why is hearing important?
  • What might you find hard if you had difficulty hearing?

  • b. Discuss students' comments and introduce the idea that hearing is important for environmental sounds and particularly for communication. This is reinforced through the following activities.

    2. Hearing Loss Simulations

    The activities below allow students to explore how the world may sound to someone with a hearing loss. The simulations of different types of sounds can be useful for prompting discussions about the range of impacts hearing loss can have.


    The aim of all activities is for students to appreciate the importance of good hearing health, and have a realistic understanding of how their life may be impacted by a hearing loss.


    Both of the activities (A & B) may be used to emphasis different impacts of hearing loss on everyday life and the ability to communicate. Or, if time is limited just one may be chosen to explore in more detail.

    A. Dangerous Decibels' "What's that Sound?"

    Description:

    An interactive "matching" game from Dangerous Decibels that can be done individually or in groups. Students experience how everyday sounds might hear with a hearing loss. The game plays a series familiar sounds (modified to simulate a hearing loss), and students are required to identify and match these to their actual source.

    Procedure

    Introduce the matching game as a way of explaining how even familiar everyday sounds may be difficult to interpret with a hearing loss.

    Using smart boards or computers children play the game by trying to guess the item or activity that matches the sound they hear. Each sound can be done by the whole class, or individual students asked to take it in turns to guess the sound. (To make it harder, ask students to guess some sounds without the visual cluess, this is very difficult). When the correct sound is identified, ask students to listen the same sound without the hearing loss simulation and discuss how they may sound different (i.e. quality and volume of sound).

    B. Hearing Loss and Understanding Speech

    Description:

    Four audio speech files simulating different types and levels of hearing loss. Students are given the opportunity to explore the real life impact hearing loss may have on understanding speech, and thus its ability to impair communication with others

    Procedure

    Introduce the activity by discussing the most important use of hearing for most people – communication with others. Discuss how different types of hearing loss can have different effects on your ability to understand speech.

    Introduce and play each of the audio simulations, giving students an opportunity to discuss what information can or can't be easily extracted from the speech files. Demonstrate to students that simply "turning up" the volume of the files does not necessarily improve comprehension .

    A "fill in the blanks" or similar comprehension activity (based on the written transcript – link provided on the site) may also be developed to give students an understanding of the personal frustration resulting from difficulties comprehending speech.

    Summary

    The aim of this module is for students to better appreciate the value of maintaining good hearing health, particularly for communication. In doing so, students should develop an understanding of the type of difficulties and frustrations experienced by people with a hearing loss.

    A short discussion may be useful at the conclusion of the chosen activity/s, including prompt questions such as:

    • What sounds were most difficult to hear – did you sometimes confuse them with other sounds?
    • Did turning up the volume help?
    • What things might make it even harder to hear (e.g. background noise, not facing people)

    Module 1. Optional Extensions

    Communication Activities

    Description:

    Inclusion of activities that reinforce the importance of good communication for team and relationship building. Highlight how easily communication breakdowns can lead to difficulties.

    Task :

    There are a wide range of activities already in use in most schools that demonstrated the importance of communication. Nearly any of these can be included here to reinforce that message, while also highlighting the role of good hearing for effective communication.

    Procedure:

    Discuss with students how significantly hearing loss can adversely impact our ability to communicate effectively. Difficulty communicating can lead to frustration. Furthermore it can lead to difficulties developing and building personal relationships.

    Run 1 or more communication activities and discuss how communication breakdowns due to hearing loss may affect the outcome.

    Preserving your hearing

    Description:

    A short (downloadable) flash player file from Sensimetrics including information about hearing loss and providing audio examples of mild, and moderate hearing loss as well as the experience of tinnitus. It also includes a simulation of severe hearing loss, as it might be heard with or without a hearing aid.

    Procedure:

    This clip is less interactive than the other simulator options as it is presented in a straightforward "video" format without the ability to pause easily.

    As such it is best presented with a brief description of what will be viewed and with a note for students to listen carefully to each of the simulations, concentrating on how hearing loss changes the sound of speech and music.

    The clip includes information about hearing loss and hearing loss prevention which may also be discussed briefly at the end of the session.

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    Module 2. The Hearing System and Noise

    Why....

    In order to be able to effectively protect their hearing, students need to have a general understanding of how their hearing works. By understanding how the different parts of the ear function, students are better able to appreciate how noise may threaten to damage their hearing. Ultimately, this knowledge can also help students understand how different hearing protection methods can succeed in removing or decreasing the threat.

    What...

    Module Aim:

    To educate students about how their hearing works, and in doing so teach them about how noise can cause damage

    Students will understand:

    • How the ear and hearing system function
    • How hearing may be damaged by noise
    • Lesson Components:

    • How do we hear? Introduction to the ear and hearing system, and its functioning
    • How does noise damage hearing? A demonstration of how noise can result in damage.
    • Preparation

    • Ear diagram – either in picture of video format (as per below activity)
    • Pipe cleaners/raw spaghetti

    How...

    1. How Do We Hear?

    Description:
    Using a poster or video of the ear, the teacher explains how the ear works.

    Resource:
    Diagram of ear

    Link to online video of the ear with audio commentary

    Procedure:
    Using the diagram or video, familiarise students with the different parts of the ear (e.g. outer, middle and inner ear) and describe how sound travels through the air and ear.

      a) Sounds result from vibrations (or sound waves) in the air
      b) Sound waves travel through the air and enter the ear canal via the external part of the ear (the pinna).
      c) The sound waves travel down the ear canal to the ear drum (tympanic membrane) causing it to vibrate.
      d) The vibrations of the ear drum cause the three small bones in the middle ear (malleus - hammer, Incus - anvil, Stapes - stirrup) to vibrate. NB These are the smallest bones in the human body.
      e) The Stapes is connected to a fluid filled organ called the cochlea in the inner ear. (The cochlea has thousands of tiny sensors called "hair cells".)
      f) The vibration continues to cause these hair cells vibrate and send signals to the brain which is interpreted as different sounds.

    NB: The video also provides an introduction to how high noise levels can damage the ear.


    2. What effect does noise have on our ears?

    Description:
    Use household items to provide a hands-on representation of the permanent damage caused by excessive noise.

    Resources:
    Pipe cleaners or uncooked spaghetti.

    Procedure

    • Revise the importance of the small "hair cells" within the cochlear for transmitting sound information to the brain.
    • Explain to students that they are going to walk through events of a day where they expose their ears (and their hair cells) to different levels of sound.
    • Teacher demonstrates the activity: Have students hold the base of 4 or 5 pipe cleaners in one hand so that the pipe cleaners point upwards as a representation of some hair cells. The free hand is used to brush against the hair cells (pipe cleaners) gently if the sound is soft and more vigorously as the sound increases.

    This can be conducted as a class activity with the teacher providing a "scripted day" with all students following. Or the teacher may prefer to demonstrate with an example of their day, and ask other students to give their own examples – either in pairs, groups or to the whole class.

    For example

    • The day starts with quiet breakfast at home. (lightly brush hand over tops of pipe cleaners)
    • Students arrive at school and gather in the playground chatting and playing. ( slightly stronger movement, taking care not to bend pipe cleaners)
    • The bell rings ( Stronger movement –pipe cleaners may start to bend)
    • It is the school swimming carnival. Sitting in the stand, while cheering for your house or team, and everyone is yelling or shouting support. (Strongest movement with some of the pipe cleaners bent over at the end)

      • Recap on the events chosen and the effect of the sounds on the hair cells. Demonstrate how, once bent, the hair cells do not easily recover from the damage caused by noise. Alternative: If Pipe cleaners are not available, raw spaghetti can be used as a substitute. In this case the spaghetti will break as stronger "noise" is used. NB The activity may be best conducted outside

        Summary:

        Explain that although the hair cells are meant to move when sound hits them (this is how we hear!), too much noise causes them to bend too far or to break. Sound (or music) is not a bad thing – but we need to make sure that we don't have so much that it hurts us.

        Module 2. Optional Extensions

        The emphasis of "How do we hear" is on providing students with the necessary background about the hearing system to enable them to appreciate the threat posed by noise. However, if desired this component can be expanded to create a greater focus on the ear and hearing process. Suggestions include:

        • A drama/dance of parts of the ear. Get students to act out the different parts of the ear as a soundwave passes through the system.
        • Build models of the ear using everyday items. E.g. a funnel may be used as the pinna and ear canal. A tambourine as the ear drum etc. The focus should be on remembering the part each section plays in processing sound rather than a realistic/visual representation of each part.

        The idea of sound waves can also be explored through many activities, to suggest a few:

        • Feeling the vibration of music, by holding a balloon near a speaker
        • Paper cup & string "telephone"
        • Experimenting with tuning forks
        • Make your own "tuning fork". Tie a fork in the centre of a approx 70cm of dental floss/cotton. Wrap each end of the cotton around your forefingers so that the fork still swings freely between them. Press forefingers with string to the small bump where the ear meets the cheek. Swing the fork on the string so it gently hits the table or another object. The vibrations of the fork will travel up the cotton and be felt/heard as a ringing noise.
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        Module 3. How Loud is Too Loud?

        Why....

        Students need to be able to recognise risky environments in order to protect themselves from hearing damage. This module assists students' ability to judge their exposure and identify when it is high enough to potentially threaten hearing health.

        What...

        Module Aim:

        To inform students how to recognise risky noise-exposure environments.

        Students will be able to:

        • Understand the relationship between volume, time and risk
        • Identify noise environments which might pose a risk to their hearing
        • Lesson Components:

        • Defining noise exposure
        • Measuring noise exposure
        • Preparation

          Arrange a variety of objects to be made available for volume measurements. In the days leading up to the module, if possible, encourage students to bring in objects they may wish to measure the volume of (e.g. musical instruments, toys).

        How...

        1. Defining Noise Exposure

        Description:
        This is designed as a basic introduction to noise and how it is measured. This component should be kept short, highlighting the information most relevant to the students involved. It is likely unnecessary to provide too much detail about how decibels are defined or the more complex calculations that accompany some noise exposure measurements.

        Procedure:
        The dangers of noise exposure can be taught in a similar way to other traditional health messages in schools that related to cumulative exposure– e.g. sun exposure, or healthy eating. Using such examples not only assists students understanding of noise, but also reinforces their knowledge about identifying risk across these other health concerns.

        Module 3 Table

          Key ideas to include are:

          • Sound by itself is not a bad thing – but needs to be enjoyed in moderation and in a safe way.
          • As the noise level goes up, the "safe time" decrease.
          • Noise can start to be dangerous once it hits 85dB*.
            • A good approximation of 85dB is any noise that forces you to shout to be heard by someone 1m away (this idea is expanded upon in the next component)
            • Noise at 85dB generally is regarded as "safe" for an exposure time of 8 hours (an approx work day).
          • The key element to focus on is that even a small increase can have a big effect on the risk posed by the noise source.
            • A table of exposure levels and times can be shown to students as a guide showing how increases of 3dB, halves the acceptable exposure time.
          NB A fuller description of noise, its measurement, and associated units is outlined in the teaching notes for this module.

          2. Measuring Noise Exposure

          The following activities all aim to provide students with a better understanding of different noise levels and their relative risk to hearing. Ideally, students are given the opportunity to measure day-to-day noise for themselves (Activity A) and contrast the relative risk of different levels through the online interactive game (Activity B). This can be supplemented or replaced by the more low-tech options (Activity C) as appropriate.

          Activity A: Measuring noise using a sound level meter.

          Description:
          This activity aims to give students some hands-on experience measuring the sounds in their day-to-day environment using a Sound Level Meter (SLM). Ideally, measurements can be done by students in small groups (either by running other parallel activities at the same time, or accessing multiple SLMs for the session) to allow all students hands-on experience. Alternatively, the activity can be done as a class exercise with a smaller number of single/pairs of students taking turns to measure items in front of the class group.

          Procedure:

          Start the activity by showing students the SLM, explaining what it is used for, and how to care for it (e.g. Taking care not to damage microphone).

          Discuss what sounds may be useful to measure – e.g. objects teacher or students have brought to class, a school bell, stereo. Some schools may also be able to measure external sounds from within the school premises (e.g., traffic noise if next to a busy road or highway)

          Get students to measure different noises*, and record their findings.

          When measurements are completed, compile a table of results listing items measured in order of volume. Discuss and classify which activities were "quiet" (under 85dB), which were loud (above 85dB) and any that were very dangerous (100dB+)

          Depending on the measurements taken, it may be interesting for students to compare their findings to published sound levels online for similar activities.

          Extension:

          For louder noises, get students to measure the noise up close, and at different distances (e.g. 1m away, 3 m away) and record their results

          Activity B: Dangerous Decibel Interactive How Loud is Too Loud?

          Description:

          This is an online, interactive activity, whereby students can "test" their knowledge of which sounds pose a risk to their hearing. The test begins with 18 "cards" that can be selected and flipped to display a noise source (e.g. blender, washing machine). The student must then decide whether the noise source shown is potentially dangerous or safe. Once a choice is made, further information about the source is revealed including dB level and "safe" exposure time.

          Procedure

          This activity can be done individually or in groups with students at desktop computers, However it lends itself particularly well to use of a smart board or similar as a full class activity.

          Suggested procedure:

          Explain/remind students that any sound over 85 decibels will potentially damage their hearing if they listen to it for more than 8 hours. You may also wish to include the information that this safe time halves for every 3 decibel increase. (e.g. Write example/table on the board: 88dB = 4 hour, 91dB = 2 hours etc.)

          Explain the interactive game to the students by demonstrating the first example on the smart board with the whole class. Select a hexagon on screen and when the item is revealed discuss with the class if it would be "Safe" or "risky". NB It may help them to consider if they think they could have a conversation with someone 1metre away while next to the object making noise. Choose "yes" or "no" and check the answer. Presentation ideas:

          • Give students opportunities to select the next hexagon themselves, and/or to answer individual items. E.g. Ask a student to estimate how loud they think the object might be and how long they can listen to it for (refer them to the safe noise table as a reference). The remainder of the group indicate whether they think the student is correct or if the sound is louder/quieter before revealing the answer.
          • You may wish to divide the class into "teams" and keep score of who has the most correct answers – e.g. table groups, house groups etc.
          • As each item is shown, nominate a student to fill out the dB and time information on a card with the name of the object. At the end of the game, ask students to arrange the cards into order of quiet to noisiest.
          • After revealing a noisy item, students can be prompted to think how they might protect their hearing if they were around that noise (thinking about when they might come across the object, and what methods might be available/possible in that environment)

          Activity C: Hearing Loss Prevention Strategies

          Description:

          This is an "offline" version of Activity B which can be used as a replacement for or in addition to. Students explore and compare the sound levels of different items using flash cards:

          Resource: Flash cards & description table (to allow classes to make their own)

          Procedure

          As for Activity B, students choose a flash card and the item is shown to the class. Discuss whether students believe the item is a safe or risky noise source. Check decisions by displaying the dB/time information on the reverse of the card.

          A list of the flashcard information is also provided in the resource sheet to allow teachers/students to make their own flashcards. Classes may also want to include flashcards depicting items they have measured or objects that are of particular relevance to their own lives.

          Module 3. Optional Extensions:

          Activity D1 Personal Stereo Player Volumes

          Description:

          A topic of concern often raised is young people's use of personal stereo players (PSPs - e.g., ipods, mp3 players etc), and their potential to damage young ears (see teaching notes for more information). PSPs have the potential to play music at high volumes, and for extended periods of time. This activity aims to give students important information about the volumes produced by their music players, so they are better able to make decisions to protect their hearing.

          Resource:

          PSP Use Survey (or similar) can be used in class – or as a take home activity.

          Procedure:

          Ask students to complete the PSP use survey at home prior to class. Students may record their own listening habits, but it may be more beneficial to also ask them to survey family members/friends.

          Collate and compare the listening habits of class members, and those surveyed.

          Compare the volumes for quiet and for noisy environments

          As a conservative estimate, 75% volume can be considered potentially "risky". Count the number of people listening at this or higher volumes, and discuss the impact of long-term vs short term listeners.

          Using the 60-80% rule*– count the number of people who are listening at 80% volume regularly or who are listening at 60+ % volume for more than 90 mins a day

          Activity D2 Measuring PSP outputs

          Description:

          Students may create and/or use a Jolene type doll or appropriate equipment to measure their Personal Stereo Players

          Resources:

          This activity requires some technical equipment to build a measurement tool. Information such as that contained in the Dangerous Decibels' "Jolene Cookbook" may assist.

          Suggested Procedure:

          Ask students to do three measurements.

          1. First students play their music as loud as they would normally listen to it, and measure their "normal" volume
          2. Then removing the ear bud from their ears, they measure and record the maximum volume of their player
          3. Finally, while connected to the measurement tool, students adjust the volume to a level below 85dBs which is a potentially safe listening level, and note the player volume setting that achieves this (e.g. "60% full volume).
          Teaching Notes

          *Researchers (Fligor, 2009) suggest that PSP should be limited to volume to 80% of the maximum dial setting if the listening time is 90 min or less per day, and to limit volume to no more than 60% of the maximum setting for longer listening times.

          Fligor, B. J. (2009b). Risk for noise-induced hearing loss from use of portable media players: A summary of evidence through 2008. Perspectives on Audiology, 5, 10–20


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          Module 4. Protecting our Hearing

          Why...

          Students will be more likely to look after their hearing health if they know the different ways to do so. The more comfortable they feel that they are capable of reducing their noise exposure and carrying out related behaviours, the more likely they are to engage in making healthy hearing decisions.

          What...

          Module Aim:

          To educate students how to best protect their hearing in different environments

          Students will be able to:

          • Understand the different methods for reducing their noise exposure in risky situations
          • Choose which methods may be most appropriate in different contexts

          Lesson Components:

          • Noise reduction strategies
          • Choosing the right strategy
          • Promoting Healthy Hearing (optional)
          • Using earplugs (optional)

          Preparation

          Where possible have some examples of hearing protection available for students to see and handle. If teaching students how to insert earplugs, have a set for each child (with spares), and ensure all children have clean hands before commencing.

          Some teachers may prefer to invite an audiologist or other hearing specialist into the classroom to teach about use of earplugs, and hearing health issues.

          How...

          1. Noise Reduction Strategies

          Description:

          Students discuss ways they can look after their hearing health, and environments where they may need to take steps to reduce their noise exposure.

          Procedure:

          Discuss/brainstorm the different strategies available to prevent noise injury. Ask children to brainstorm all the strategies they can think of that will help protect their hearing from noise injury. It may be helpful to write students suggestions on the board and discuss with the students any strategies that are ineffective and why – and mark less than ideal strategies (e.g., with a "?" or a "X").

          As students suggest ideas, make sure the key three are included in the final list:

          • Moving away from noise
          • Turning down noise at the source
          • Using barriers/hearing protection

          Recap on the preventive strategies. Ask students why it might be useful to have a range of different strategies.

          2. Choosing a Safe Strategy

          Description:

          There is not one "right" strategy for reducing noise exposure. This activity aims to assist students understand the differences between hearing protection methods, and choosing the most appropriate strategy for the situation.

          Resource: Worksheet - Choosing a safe strategy

          Procedure:

          In small groups, or as a class, get students to recall noisy situations they have been exposed to in the past, or may be exposed to in the near future and list these (5-10 is likely to be plenty).

          Once the list is complete, remind students of the different hearing protection strategies and ask students to discuss each situation/activity and decide which strategy may be best in each. It may be helpful to have students transcribe their list onto the attached template and complete the table.

          For example

          Noisy activity table

          Remind students that sometimes different strategies may be possible. E.g. "wearing hearing protection" will nearly always protect hearing – but it may not be the best option in environments when you are exposed to unexpected noise and don't have hearing protection with you!

          Module 4. Optional Extensions

          Activity A Spread the Word!

          Description:

          Students are more likely to engage in health behaviours they feel a part of. Ask students to be involved in educating others about healthy hearing.

          Suggestions:

          • Ask students to design a poster about how we can protect our hearing.
          • As a class – design a healthy hearing campaign for the school/local area
          • For older students, involve students in teaching younger grades/classes about hearing.

          Activity B Using Earplugs

          Description:

          Students' motivation to wear earplugs will be improved if they feel comfortable and confident about how to access and use them.

          Procedure:

          Inexpensive foam earplugs can be purchased from most Chemists or hardware stores, and usually include instructions for use. If available, you can also show students other available types of earplugs.

          If possible, invite an audiologist, or other hearing health expert to assist in running the lesson. NB: Basic hygiene precautions should be taken prior to the lesson. Ensure children have clean hands and that they only trial the activity with clean earplugs (do not allow them to swap earplugs with each other or between ears). If any students have discharge from their ears or heavy wax buildup they should not be involved in the activity.

          You may wish to demonstrate the correct procedure and send children home with earplugs to try under parental supervision.

          Explain to students that earplugs can be used to protect their hearing, but they need to be worn correctly. Show students how the foam earplugs should be rolled to a thin cylinder, then inserted into the ear canal ( while pulling up and out on the pinna). Earplugs should be held in place for approx 10 seconds while the foam expands to fit the ear canal. Some earplugs will also include indicators to show if they are not inserted correctly.

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