178 Chapter 9
The next day, Ilene is admitted to the hospital’s intensive care unit with the diagnosis of prob-
able meningitis— inf lammation of the membranes surrounding the brain and spinal cord. There
are two types of this serious illness: bacterial and viral. The doctor believes that Ilene has the bac-
terial form, which is more common in young children. Ilene presented with acute onset of fever,
headache, vomiting, earache, and a stiff neck. In the emergency room, she lost consciousness and
suffered a seizure. Prompt, aggressive medical treatment prob ably saved Ilene’s life, but not her
hearing. The doctor prepared Ilene’s mother for the worst: about 20% of patients with bacterial
meningitis can have partial or complete sensorineural hearing loss.
Several days later, an audiologist tests Ilene’s hearing. The results confirm that she has suffered
severe sensorineural damage to both ears. The audiologist’s diagnosis is profound hearing loss
because her pure- tone hearing threshold averages are below 90 dB. And because Ilene is 5 years
old, she is between two clinical definitions of deafness.
In the first definition, Ilene could be considered adventitiously or prelingually deaf. These
individuals have not had functional hearing long enough to learn and use speech and language
normally. However, because the acquisition of speech and language is a gradual pro cess, the effects
vary with the age at which the child becomes deaf. If deafness occurs after the acquisition of speech
and language, the child has had functional hearing long enough to learn speech sounds and to
develop the fabric of language. Sometimes the term postlingual deafness is used to refer to such
persons. Because of Ilene’s age and because she learned speech and language early, she is placed in
the postlingual deafness category. Sadly, the meningitis has damaged more than Ilene’s hearing;
her intelligence is also affected.
The audiologist gives Ilene a body- style hearing aid, which provides high levels of amplifica-
tion and avoids the high- pitched feedback of many standard hearing aids producing maximum
amplification. An added advantage is that the controls of the body hearing aid are large enough
for her to adjust the volume easily in dif fer ent learning environments. Ilene also learns to read lips
and to express herself through a combination of speech and sign language.
Case Study 9-3: Hearing Loss in an 89- Year- Old Man
Ivan has lived through a world war, the Korean and Vietnam conf licts, and the tragedy of
September 11, 2001. He has seen the infancy of f light, witnessed landings on the moon, and viewed
two space shut tle disasters. In his youth, he rode in horse- drawn buggies and black Model T and
Model A jalopies. Now, in the sunset of his life, he rides in a car with satellite global positioning,
SiriusXM radio, a DVD screen, and On Star telephone capabilities. In school, he learned to use the
slide rule; now he occasionally surfs the Internet. During his working life as a farmer and rancher,
he fed millions of Americans.
Noise has been a big part of Ivan’s life. Farming and ranching have periods of quiet solitude,
but too often they are noisy occupations. Tractors, a mainstay for the farmer and rancher, are
loud machines. Early in Ivan’s life, the tractor was a relatively quiet steel- wheeled three- wheeler,
coughing and choking through wheat, hay, and potato fields. Today it is a megamachine with huge
wheels, an air- conditioned cab, power steering, and an engine capable of pulling a 10- point plow.