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Case Study – Biosciences and Auditory Difficulties

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Case study A: a premedical student majoring in Biology has a severe-to-profound bilateral hearing loss. Case Study B: a Chemistry student is hard of hearing and discusses how this impacts on group work and discussion. Case Study C: a marine biology student has dyslexa and hearing difficulties. She describes how this impacts on her studies including laboratory and fieldwork. Case Study D: a research student describes her experience as field note-taker for a student with a hearing impairment.

Case Study A: This case study is taken from the University of Washington DO-IT website (information extracted and accessed November 2007)  

Case Study B: This case study is taken from the University of Washington DO-IT website (information extracted and accessed November 2007)

Case Study C: This case study is taken from: The Geography Disciplines Network (GDN) Inclusive Curriculum Project (ICP) Case Studies, HEFCE Project, University of Gloucestershire, (information extracted and accessed September 2006).

Case Study D: This case study is taken from: The Geography Disciplines Network (GDN) Inclusive Curriculum Project (ICP) Case Studies, HEFCE Project, University of Gloucestershire, (information extracted and accessed September 2006).

Case Study A 


My name is Roberto and I am a premedical student majoring in biology. I have a severe-to-profound bilateral hearing loss and use hearing aids and speech reading (watching the movement of a person’s lips) to maximize my communication skills. I have some knowledge of American Sign Language but not enough to effectively use a sign language interpreter as an accommodation.

Access Issues

My biology courses, as well as many other courses in science and mathematics, involve intensive lectures; some have interactive discussion sessions, and all of them make extensive use of advanced technical terms. Many of these terms are difficult to hear with hearing aids or to lip-read. I tried to use an FM amplification system (which through a microphone and transmitter worn by the instructor sends his or her words directly to my hearing aid) in these classes, but it was not helpful because of the nature of my hearing loss. If I miss information because of my hearing impairment, then I can’t follow the lecture or adequately participate in discussion and ask questions. Note taking provides limited assistance since the notes are not verbatim, I can only review them after the class session, and sometimes the notes are available only one or two days after the class session. Note-taking assistance and front-row seating are adequate for me in nonscience and nonmathematics courses. Because the pace of instruction in science and mathematics is fast and the volume of material covered in each session is large, it is important that I have an adequate means to access the course lecture and discussion as it happens.


I contacted the office of disability services and requested the provision of real-time captioning in my science and mathematics classes. I told the counselor that I had tried various accommodations like note taking and the FM system but that I was still having difficulty with the lectures. The deaf services counselor reviewed my request and then approved it.

Real-time captioning as an accommodation involves having someone with adequate stenography training (often a court reporter) come to the class with me. The stenographer has a steno machine and laptop that is loaded with stenography software, and he or she sits next to me so I can see the monitor. When the instructor talks or others participate in class discussion, the stenographer enters all spoken words. The words spoken then appear very quickly on the monitor, and I can follow the discussion, ask questions, and, after class, get a hard copy of the notes. Alternatively, the office of disability services arranges for a stenographer at a remote site to provide the same service; in this situation, the instructor wears a wireless microphone that transmits the voice back over the same phone line that is used to instantly send back the real-time captions to the student with a laptop in the classroom. This alternative procedure is used when there is a shortage of qualified stenographers, there are scheduling difficulties, or it is the most cost-effective method to provide the accommodation.


This case study demonstrates the following:

  • Students who are deaf or hard of hearing may have differing accommodation needs, and the accommodations may not be the same in all courses for the same student.
  • Accommodation procedures and alternatives must be in place, or there must be a capacity to quickly make arrangements to implement the accommodation.
  • There are advanced technical accommodations, such as real-time captioning, that may be available anywhere in the country when students and support staff are aware of the resources.
  • Students who are deaf or hard of hearing and those with other sensory disabilities can compete in scientific and technical fields and careers.  

Case Study B

My name is Allison and I’m a chemistry major. I am hard of hearing and wear hearing aids in both ears.

Access Issue

I’m taking my first lab for an organic chemistry course. The lab involves a great deal of instruction and direction by the teaching assistant, as well as discussion and questions by students in the lab. The teaching assistant routinely walks around the room to observe student work, makes comments, and responds to questions from anywhere in the room. I am unable to hear most of the discussion, and I’m confused about some steps and procedures in lab sessions. There is also more background noise in the lab than in most lecture halls, and this reduces the effectiveness of my hearing aids. I am getting behind in each lab, and my lab reports are incomplete. In lecture classes so far, I am able to hear most of what the instructor says by adjusting my hearing aids and always sitting in the front row, but adjusting my hearing aids does not help in the lab.


I met with the deaf and hard of hearing specialist in the disabled student services office to explain my problem. She arranged to loan me an FM amplification system to use during labs. With this system, the speaker is provided with a microphone, and the sound is transmitted through a receiver directly to my hearing aid. This eliminates a lot of the background noise. I went to the next lab and explained how the system works to the teaching assistant. She wore the transmitter unit, and when a student in the lab asked a question, the TA would repeat the question so I could hear it. When the TA walked around, I could hear the comments. This system worked very well in the lab, and I plan to use the FM system in other labs or classes where there is discussion.


This case illustrates the following:

  • Existing technology for deaf and hard of hearing individuals can be quickly acquired to provide an accommodation.
  • Technology can be used by the student in a variety of settings, and the student can keep it with her so it can be quickly put to use.

Case Study C

Rosie studies Marine Biology. She has dyslexia, Mearles Irlen and a hearing impairment.

‘I’m partially deaf in my left ear so in very loud environments with about 50 people I pick up say about 50% of what you say, I lip-read about 25% and then I make the rest up!

Staff are very helpful. With regard to my dyslexia, I take longer to write things down, notes for example – if I ask, either a slide will be left up for longer or they are quite happy to give me the powerpoint presentation, and I can take my own notes from that. With regard to the hearing impairment, none of the staff have a problem with either wearing or walking near a recording device.

It’s much harder in a lab environment because I can only hear 50% of what is being said – it’s harder to fill in the gaps because they are not your common words – they’re complex chemical words. If there’s hydrochloric acid and you mistake it for hydrocarbon there’s a bit of a difference if you put the wrong one in the jar! It can slow me down a bit, but luckily most of my friends know that I’m a bit slow on the uptake so they help. What would help would be a very precise written instruction sheet. A lot of staff do do instruction sheets but they’re not always very precise. Being able to record the lab session would also help but then having the time to go back and listen to it while I’m doing it isn’t really feasible. I don’t bother taking the recording equipment into the labs – I rely on my friends in those circumstances.

With lectures and tutorials I don’t have a problem as such, it’s just that some people talk too fast or have a really strong accent – getting past the language barriers is sometimes a problem but that’s probably the same for everyone.

I’ve got Meare’s Irlen Syndrome as well and a lot of tutors provide handouts on coloured paper now, which makes it much easier for the flow of reading. A few still use white paper which means it takes a bit longer, – it’s harder because you tend to have to re-read passages. Going back to the lab situation, if staff prepare a handout, you spend a lot of time working on the chemicals and studying the handout, so it is helpful to have it on coloured paper. I’ve got coloured lenses as well which do help to a degree – if I didn’t have them I’d start getting a headache after about 25-30 minutes but with them I can prolong it to 1 ½ – 2 hours, but I still have to have a good break after that. It would be really good if the Student Union Shop stocked notepads which had coloured paper. With Powerpoint presentations, coloured backgrounds are easier on the eye.

I have to manage my fieldwork trips as they’re a lot different to a two hour practical. There’s no rush to do anything, most of the time with Marine Biology you’re sat waiting for the tide to come in or out! So there’s more than enough time to go back to the tutors and ask them specific questions about anything I may have missed. I also rely on my peers, but a lot of it is observation – sitting and waiting and watching. The tutors were very good; any material that we had to memorise was out from day one.The tutors were very good; any material that we had to memorise was out from day one. Unfortunately all handouts were done on white paper, there was no coloured paper on the field course.

I had a problem being near the sea as waves tend to make a lot of noise, so with my hearing impairment, it made it harder to hear what someone was saying. But the tutors were more than happy to repeat anything.

With written exams, for the most part it’s not a problem – the information is in there somewhere, it’s just a matter of finding it. But there are a few questions where you have to sit down for maybe a quarter of an hour just to understand the question because the wording doesn’t quite flow properly so you have to re-read and re-read. I get 10 minutes extra per hour which is quite good but you start getting panicky if on the first question you’ve wasted ten minutes just reading it. Everyone else has read it and done it straight away and I’m still trying to make sense of it – that can be very panicky because you know you’ve got eight more questions and you’re going to waste what could be ten minutes on each one. It can get unnerving.

With regards to alternative assessments – I honestly don’t have any idea of what could be better. If you told me I could do a project with my mates on my course instead of an exam, that to me would be a lot easier. For example, I’ve got this really good friend who’s one of these people who is really good at everything. Say you wrote down a paragraph which I found hard to understand, he would read it and translate it into words that I could understand without being too taxing and then I could go ahead and do it. But is it right that I should be assessed on someone else’s ability to understand a problem?

In class, tests tend to be multiple choice. Just being able to identify the words – like I said earlier – [is problematic.] If the word hydrochloric is written down, I may read it as hydrocarbon as the first few letters are very similar. Many a time I’ve looked at something, I’ve studied it and thought ‘right – that’s absolutely the right answer’ and then I’ve looked back up to see what numbered answer it is and I’ve marked the letter I thought I was looking for but it was the wrong numbered answer. Not being able instantly to identify similar aspects of sentences, words etc. is a problem because it’s a key thing in the multiple choice test. I’d definitely go for a written examination instead of a multiple choice because I can put it in my own words. On a written examination it’s harder to get the good marks but the marks you do get are more representative of the student. For someone who can just glance at a word and pick up the wrong meaning, multiple choice can be quite scary.

I don’t find written work a major problem but obviously there are barriers there. You’ve got essays and reports which don’t need to be done in an hour so I have time to plan them and ask someone to look over my work which is easier. There are barriers there but they are easier to overcome.

From the DSA, I got a PC with Texthelp and Inspiration which I find really helpful – I use it all the time. I like the mind-maps – I’ve just done a report on the field trip and I started off with one word and then came back to it – I don’t have to sit there for hours planning the report. If something pops into my head I’ll go and put an extra leg onto the mind map. I find it very good, it’s an extension of my memory because I’ve got a terrible memory. It was one of the most useful things that came through the DSA. I also got a Dictaphone which works as a very good paperweight at the moment, it’s not that good – it came with a sky-mike – it didn’t come with any instructions so I’ve never been able to work out how to use it. The Dictaphone is good for this environment – quiet 1:1 – but in a lecture, you can’t pick up the lecturer if he moves away from it. With the sky-mike it’s supposed to pick up the lecture wherever the lecturer moves but I haven’t sussed out how to work it.

I also got a talking dictionary which is quite good but I tend to use the software dictionary instead of the Oxford talking dictionary. I really only use the talking dictionary for pronunciation of words. Luckily my subject being Biology most of it’s in Latin – it sounds strange but Latin is actually a very simple language – the construction of words is easy to pick up. The computer also helps because I’m able to sit at home at my leisure and work and I can download any helpful software onto it.

With oral presentations, I find memorising the talk hard because I’ve got a very bad memory. Trying to keep the presentation fluent – keeping it going without stuttering is difficult, so to combat that I generally keep an A4 sheet with bullet points on it but it’s all about multi-tasking which I’m not good at. Having to talk while looking down at my notes and reading the next sentence is hard because I can’t take it in; I have to stop talking to read the next bit which gives a pause – and a prolonged pause in a talk isn’t good. Once I know I’ve done something wrong it’s a snowball effect it all goes downhill from there. The hearing is not so much a problem during the presentation but when it comes to questions at the end it’s a problem when I encounter people who have very high pitched voices.

I tell people beforehand that I have a hearing problem and ask them to talk to my good ear. In a formal lecture I’d make a joke of it and say ‘speak up I’m deaf’! My deafness is actually high-tone deafness – it’s a certain frequency band that I’m deaf at – generally men are not a problem because they have lower voices but some women have very squeaky voices and it’s like sitting listening to a guinea pig, I can’t hear it at all. For me personally it’s very tone dependent – this ear picks up both tones and the other ear only picks up low tones so in lectures I can only pick up maybe the beginning of a sentence where people start off quite low but lose the end of it.

The bane of my life is tutors that go too fast – with both handouts and verbally. It’s difficult enough to listen to what they’re saying while writing – that in itself is really hard, so when they’re talking at a fair rate of knots you come away with a quarter of what you should. There’s one tutor who has a very strong Hindi accent and I can’t hear anything he says because the pitch of his voice is too high. I have tried recording him but he speaks too fast for that as well.’ 

Case Study D

The following case study was written by a research student about her experience as field note-taker for a student with a hearing impairment.

‘My experience of field note-taking relates to two trips as a note taker for an Environmental Science student with a hearing impairment. These two trips involved 10 days looking at glaciation in the Swiss Alps and 3 days looking at glacial geomorphology in North West Wales.

I found these experiences tremendously enjoyable and far removed from the usual lecture theatre note-taking situation. For fieldwork, I needed to be prepared to take long and sometimes physically challenging hikes in rough terrain, whilst ensuring I had a waterproof pen and notepad at the ready for any talks by the field course leader. In addition I needed to make efforts to be sure I could hear the lecturer in often noisy environments (due to background wind, rain and rivers for example). This sort of fieldwork requires some fitness on behalf of the note taker as well as enthusiasm for a demanding day’s hike. I also found I drew quite heavily on my own environmental knowledge in order to follow the field lectures and therefore identify key points from often complex geomorphological explanations of landscape features.

I felt that maintaining a dialogue with the lecturers helped me be better prepared for field sessions (including seeking references for reading up on the subject in order to follow the discourse). For environmental fieldwork at level 2 and above, it is probably preferable that the note-taker has some environmental background in order to ‘keep up’ with the content of lectures.

Overall, a note-taker needs to be a good communicator. They need to be confident enough to address issues with a diverse range of students on potentially personal and sensitive topics relating to the student’s impairment, as regards the actual format of the note taking itself and the role of the note-taker. Each note-taking relationship requires some care and discussion between the note-taker and student to agree on practice and this evolves with time. At the very least, a note-taker’s work will be enhanced by an awareness of the individual student’s support needs. Students can be shy, or wish to maintain their privacy and uncomfortable with drawing attention to themselves in the group, thus a significant amount of tact and discretion is required by the note-taker. I found the role inevitably extends beyond simply taking notes regardless of the student’s individual circumstances.

Definitely my note-taking seemed to make a difference to the student. He was able to concentrate on listening to the lecturer and understanding the environment we stood in without the worry of looking down to write notes and thus missing what the lecturer said next – as would have happened otherwise in the case of this student, who relied significantly on lip-reading. The student could thus be confident that he had a complete record of the day’s learning which he could review in his own time and therefore be sure he had equal access to the same information as non-disabled classmates when it came to writing assessments.’

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