Download Learners Who Are Deaf or Hard of Hearing

Learners Who Are Deaf or
Hard of Hearing
EDSP 6644
by Linda Jodock
Facts about Learners with Hearing
Impairments
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Most people who are deaf have some residual hearing.
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Deafness poses more adjustment difficulties than does blindness due to inability to
understand and speak oral language.
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The phenomenon of a Deaf culture is natural; too much mainstreaming may diminish
its influence.
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Lipreading refers only to visuals arising from the lips’ movements. Speechreading is a
more accurate term to describe the attention some hearing impaired give to facial
cues and movements of the tongue and jaw.
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Speechreading is extremely difficult to learn. Very few become proficient.
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ASL is a true language with its own set of grammatical rules.
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Some within the Deaf community have argued for the need for a critical mass of deaf
students in order to have effective educational programs. Separate placements are a
way of fostering Deaf culture.
Deaf children born to deaf parents fare better in academic and social areas due to
their parents ability to communicate with them in ASL.
Definition and Classification
 Division
between deaf and hard of
hearing
 Two extreme points of
 view between
professionals:
A physiological
orientation versus an
educational orientation
Beethoven
The Physiological Viewpoint
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Dependent on the measurable degree of impairment: those
who can’t hear sounds above a certain intensity are “deaf”;
others with hearing impairment are considered
“hard of hearing”.
Hearing sensitivity is measured in “decibels”. Zero decibels
is designated as the point at which the average person with
normal hearing can detect the faintest sound. Each
increasing number of decibels that a person cannot detect
indicates a degree of hearing impairment.
The physiological point of view maintains that impairments
of 90 dB or greater be classified as deaf. (This is about the
loudness of a lawn mower.)
Those with lesser impairments are hard of hearing.
The Educational Viewpoint
The concern is for how much the hearing
impairment is likely to affect the child’s
ability to speak and develop language.
 The close causal link between hearing
impairment and delay in language
development causes these professionals to
categorize on the basis of spoken
language abilities.
 “Hearing impairment” covers a range from
mild to profound and includes those who
are deaf or hard of hearing.
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Educationally Oriented Definitions
A deaf person is one whose hearing ability
precludes successful processing of
linguistic information through audition,
with or without a hearing aid.
 A person who is hard of hearing generally,
with the use of a hearing aid, has residual
hearing sufficient to enable successful
processing of linguistic information
through audition
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(Brill, MacNeil, &
Pullen).
Newman, 1986, p.67, as cited in Hallahan, Kauffman, &
Onset of Deafness
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For educators, the close relationship between hearing impairment and
language delay is crucial. An earlier onset means more difficulty for the
child in developing the language of a hearing society.
A congenitally deaf child is born deaf.
An adventitiously deaf child acquires deafness sometime after birth.
Two other frequently used terms specifically refer to language acquisition:
prelingual deafness – acquired at birth or prior to speech or language
development;
postlingual deafness – occurs after the development of speech and
language.
There is a growing sentiment among the deaf community that deafness
should not be considered a disability, but rather a cultural difference.
These tend to refer to themselves as “Deaf”.
Those who refer to themselves as “deaf” with the lowercase usually try to
maintain their contact with mainstream society and usually acquired their
deafness later in life.
Prevalence
About 0.13 percent of the population from six to seventeen
years old as identified by the US Department of Education
is deaf.
 It’s likely that students who are hard of hearing are far
more prevalent.
 Authorities suspect that many hard of hearing who could
benefit from special education are not being served.
 Twenty-five percent of deaf students in the US come from
Hispanic homes.
 Relatively large numbers come from other non-Englishspeaking immigrants.
 Deafness makes native language
acquisition difficult, let alone second
language acquisition.
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Helen Keller
Anatomy and Physiology of the Ear
Anatomy and Physiology
Three sections:
 Outer ear – the auricle and the external auditory canal. The
auricle protrudes from the side of the head.
 Middle ear – the tympanic membrane (eardrum) is the boundary
between the outer and middle ears. The middle ear is made up of
three tiny bones (ossicles): malleus (hammer), incus (anvil), and
stapes (stirrup). All are contained in an air filled-space. They
conduct the vibrations of the eardrum to the oval window, the link
between the inner and middle ear.
 Inner ear – the size of a pea and a maze of passageways, it’s
often called a “labyrinth”. Its two sections are the vestibular
mechanism and the cochlea.
a. The vestibular mechanism is responsible for the sense of
balance.
b. The cochlea, when stimulated by the movement of the oval
window, begins to flow with fluid. The cochlear nerve is then
stimulated, and an electrical impulse is sent to the brain, and
sound is heard.
Identification of Hearing Impairment
Screening tests – An initiative by the
American Academy of Pediatricians has
resulted in 93% of newborns being
screened for hearing (AAP, 2007). Some
tests involve computers to measure
otoacoustic emissions of the cochlea to
test its functioning.
 Many elementary schools have routine
screening programs.
 Individually measured tests rather than
group tests and those performed in an
audiologist’s office are the most accurate.
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Pure-Tone Audiometry
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This test is designed to establish the individual’s threshold for
hearing at a variety of frequencies, measured in hertz (Hz) units.
The pitch is higher with more vibrations per unit of time of a
sound wave and lower with fewer vibrations.
Audiologists are concerned with measuring sensitivity to sounds
ranging from 0 to about 110 dB.
The zero decibel level is frequently called the zero hearingthreshold level or audiometric zero.
Each increment in the decibel scale is based on ratios. Therefore,
20 dB is ten times more intense than 10 dB, and 30 dB is one
hundred times more intense than 10 dB. (Normal conversation is
at about 60 dB and a power lawn mower is at about 90 dB.)
The audiologist tests each ear separately in the range of 0 to 110
dB and 125-8,000 Hz until it’s established at what level of
intensity (dB) can detect the tone at a number of frequencies. For
each frequency, there is a level of hearing impairment. For
example, a 50-dB hearing impairment at 500 Hz means that
individual requires 50 dB to detect the 500 Hz sound whereas an
average person would have heard it at 0 dB.
Speech Audiometry
Audiologists use speech audiometry to
test individual’s detection and
understanding of speech.
 The speech reception threshold (SRT) is
the decibel level at which one is able to
understand speech.
 Testing each ear separately with a list of
two-syllable words, the dB level at which
half of those words is understood is an
often-used estimate of SRT.
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Tests for the Young and Hard to
Test
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Play audiometry – examiner teaches the child to
do various play activities when the signal is
heard.
Tympanometry – a rubber-tipped probe is
inserted into the ear canal, sealing it off. The
effects of pressure and sound are measured to
assess the inner ear’s function.
Evoked-response audiometry –
measures changes in brain wave
activity by using an
electroencephalograph.
Causes
These are classified with respect to the
type of impairment and its location.
 Three major classifications:
1. conductive – transfer between middle
and outer ear
2. sensoneurial – problems in the inner
ear
3. mixed hearing impairment – a
combination of the two.
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Outer ear impairment
 Atresia
– a condition where the
external auditory canal does not
form.
 External otitis – “swimmer’s ear” –
an infection of the skin of the
external auditory canal.
 Tumors
Middle Ear Impairments
Usually, the mechanical action of the
ossicles is interfered with in some way.
These problems can be corrected with
surgery or medical treatment.
 Otitis media – infection of the middle ear
caused by bacteria or virus. It’s linked to
abnormal functioning of the eustachian
tubes. It causes temporary conductive
hearing impairment. Untreated, it can lead
to rupture of the tympanic membrane.
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Inner Ear Impairments
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A person with this type of impairment may also have sound
distortion, balance problems, and roaring or ringing in the
ears.
Can be hereditary or acquired – genetic factors are the
leading cause of deafness in children.
Over 400 different varieties of hereditary deafness have
been identified.
Mutation in the connexin-26 gene is the most common
(20%).
Acquired impairments: meningitis (2nd most frequent
cause), prematurity, viral infections, anoxia at birth,
prenatal infections of the mother (rubella, congenital
syphilis, cytomegalovirus), Rh incompatibility, blows to the
head, antibiotics’ side-effects, excessive noise levels.
The most frequent cause in newborns is cytomegalovirus
(herpes).
Psychological and Behavioral
Characteristics
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Functionality in a language-oriented world is difficult.
The hearing impaired population is usually deficient in the language
shared by most of the hearing society. However, they can become
proficient in sign language.
Sign language – under the pioneering work of the linguist, William Stokoe,
at Gallaudet University, ASL became recognized as a true language. Each
sign consists of three parts: handshape, location, and movement. (1960,
1976)
Nonuniversality of sign language – French sign language (promoted by
clergyman Michel de l’Eppe) is as foreign to an American deaf person as
spoken French would be to a hearing American.
Sign languages evolve with usage – Nicaraguan Sign Language is an
example.
Milestones in language development in sign language mirror the
milestones in spoken language development – babbling, first words, and
two-word phrases.
Neurologically, left cerebral hemisphere of the brain is the
primary site responsible for both spoken language and for
sign language.
Louis Frisino:
“Black Labrador Puppy”
Intellectual Ability
Performance tests offer a fairer
assessment of intelligence, particularly if
they are offered in sign.
 There is no
measurable
difference in
IQ between
hearing and
deaf persons.
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Marlee Matlis
Academic Achievement
Reading ability, reliant on English
language skills, is most affected.
 Average hearing impaired student leaves
school with a deficit of 5 years in reading
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(Kyle and Harris, 2006, as cited in Hallahan, Kauffman, & Pullen).
Those students with deaf parents have
higher reading achievement and better
language skills than those with hearing
parents.
 A supportive home environment is key to
higher achievement.
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Social Adjustment
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Social development and personality development depend on communication just as in the hearing
community.
Two important factors:
inclusion
hearing status of the parents
In inclusionary settings, research has shown that very little interaction occurs between the hearing
peers and the deaf students. Some interventions using cooperative learning have been successful
in increasing interactions.
Students who are deaf feel more emotionally secure if there are others who are deaf that they can
communicate with.
A need for social interaction leads many to associate primarily with others who are deaf.
The Deaf Culture – a unifying influence of sign language is the first of six factors marking this
community as a true culture:
1. Linguistic differentiation – many are bilingual in English and sign language.
2. Attitudinal deafness – self-perception as deaf although hearing impaired
3. Behavioral norms – more physical contact; frank discussions
4. Endogamous marriage – 90% ingroup marriage
5. Historical awareness of significant
people and events pertaining to deafness.
6. Voluntary organizational networks –
Goya’s
Deaf Olympics, National Theatre of the Deaf
“Old Men Eating Soup”
Erosion of Deaf Culture
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There is a concern among those within the Deaf community that
the increase in inclusion is eroding the cultural values of the Deaf
culture.
Authorities recommend that schools involve members of the Deaf
community in developing classes in Deaf history and culture.
Deaf Activism – the Gallaudet experience:
1. Deaf President Now Movement – From 1864 to the 1980’s,
Gallaudet had never had a hearing president. When a second
hearing president was announced in March of 1988, there followed
8 days of protest, resulting in the naming of a deaf president and
a majority of deaf members on the board.
2. Unity for Gallaudet Movement – In 2006, Fernandes’
appointment as president was protested. Although she is deaf,
she was considered too progressive, favoring inclusion of those
with cochlear implants as well as those who had not grown up
with sign language. She was replaced by Robert Davilla.
Deaf Activism
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The cochlear implant – the procedure involves surgically implanting
electronic elements behind the ear and in the inner ear. A small
microphone picks up sound and sends it to a small computerized speech
processor which sends coded signals to an external coil worn behind the
ear. This coil sends the signals to electrodes implanted in the inner ear,
and they are sent to the auditory nerve.
It’s recommended for those with profound sensorineural loss in both ears.
In children, most implants occur between the ages of two and six.
The debate – the Deaf community views these implants as invasive both
physically and culturally.
In order for the implants to be most effective, intensive oral instruction is
recommended. Since many in the Deaf community favor manual (ASL)
instruction over oral teaching methods, this is problematic. They are
concerned that not enough exposure to sign language will occur for them
to preserve their heritage.
Another scientific discovery which could help sustain Deaf culture involves
the connexin-26 mutation. In vitro fertilization could ensure that only
fertilized eggs containing this mutation would be implanted.
Some deaf couples have actually used artificial insemination by a donor
who has a high probability of carrying genes causing deafness.
Oral Approaches
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Auditory-Verbal Approach –
focus is exclusively on using audition to improve
speech and language development.
assumes some residual hearing and relies heavily
on amplification technology like hearing aids and
cochlear implants.
heavy emphasis on speech training – many
children with hearing impairments must be
explicitly instructed in how to produce speech
sounds.
Granville Redmond:
“California Poppy Field” c. 1926
Auditory-Oral Approach
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Similar to the auditory-verbal approach, but also
stresses the use of visual cues like speechreading
and cued speech.
Speechreading’s goal is to teach children to
attend to a variety of stimuli in addition to the
movement of the lips, contextual stimuli like
facial expressions and tongue and jaw
movement. (Sometimes referred to as lipreading)
Cued speech is a way of augmenting
speechreading by using hand shapes to represent
certain specific sounds while speaking. There are
8 hand shapes for consonants and 4 for vowels.
Criticisms of the Oral Approach
Critics object to the deemphasis of sign language in this
approach; they assert that most children with profound or
severe hearing impairment are being denied access to a
language to communicate.
 Good speechreaders are rare due to several factors:
1. speakers produce many sounds with very little movement
of the mouth
2. English has many homophenes – sounds that are visually
identical (p, b, m)
3. variability among speakers
4. poor lighting
5. rapid speaking
6. talking with one’s head turned
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Educational Considerations
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For the educator, communication with the hard of hearing
and those who are deaf is a major obstacle.
Oralism-manualism debate – Oralism involves teaching
speech. Manualism advocates use of manual
communication. It predominated until mid-nineteenth
century, when oralism began to gain favor.
Currently, professionals recommend both – a total
communication approach.
The Deaf community believes this is inadequate and
advocates for a bicultural-bilingual approach;
this promotes ASL as the first language and instruction in
Deaf culture.
Goya:
Self Portrait
Total Communication
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Simultaneous use of speech with one of the
signing English systems, like fingerspellingrepresenting the letters of the English alphabet.
Criticism of this method has focused on the use
of signing English rather than ASL.
The advantage is that signing English uses the
same word order as spoken English, allowing one
to speak and sign simultaneously.
ASL advocates believe this method is too slow
and awkward and that word order is not the
critical element in learning to use and
comprehend English. They add that ASL evolved
over several generations of users while signing
English systems are relatively new.
Bicultural-Bilingual Approach
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Many critics of total communication advocate this approach.
Several variations, but most contain three features:
1. ASL is considered the primary language and English is
secondary.
2. People who are deaf play an important role in curriculum
and program development.
3. The curriculum includes instruction in Deaf culture.
Studies have shown a relationship between ASL usage and
academic performance in English. (Wilbur, 2000, as cited in Hallahan, Kauffman, & Pullen)
“…a range of approaches will probably best serve the needs
of a range of deaf children.” (Schirmer, 2001, p.203, as cited in Hallahan, Kauffman, & Pullen)
Douglas Tilden, sculptor
Technological Advances
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Hearing Aids – FM systems can be connected to a wireless lapel microphone on the
teacher.
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Captioning – television, movie, and video. Federal law requires it.
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Telephones – text phones. Federal government requires each state to provide a relay
service to allow communication through an operator.
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Video relay service – allows a sign language interpreter to serve as an intermediary
between hearing and non-hearing communicators.
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Computer-assisted instruction – visual displays of speech patterns can help the
hearing impaired learn speech. C-print transcribes speech with reduced keystrokes to
a computer in a lecture setting. The deaf student can receive a real time display and
a printout.
Internet – electronic mail, world-wide web, information access, on-line classes. All
are open to both the hearing and non-hearing world.
Goya:
“The Parasol”
Transition to Adulthood
Besides Gallaudet University and the
National Technical Institute for the Deaf,
many other postsecondary institutions
offer programs for those with hearing
impairments.
 A common accommodation – sign
language interpreters
 Expanded transition programming,
postsecondary education, and public
awareness predict successful futures for
the hearing impaired.
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References
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Beethoven, L. Image retrieved November 27, 2009 from buzzle.com
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Ear anatomy image retrieved November 21, 2009 from www.bing.com/images/search?q=anatomy+ear&FORM=IGRE5
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Ferrigno, l. Image retrieved November 28, 2009 from About.com:Deafness
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Frisino, L. “Black Labrador Puppy”. Retrieved November 29, 2009 from
About.com:Deafness
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Goya, F. “Self Portrait”, “Old Men Eating Soup”, and “The Parasol”. Retrieved November 27, 2009 from the Prado
Museum on line.
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Hallahan, D., Kauffman, J., & Pullen P. (2009). Exceptional Learners: An Introduction to Special Education. (11th ed.).
Pp.339-369. Boston, MA: Pearson.
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Keller, H. Image retrieved November 27, 2009 from About.com:Deafness
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Matlin, M. and her translator, Jack Jason, all images retrieved November 27, 2009 from
About.com:Deafness
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Redmond, G. “California Poppy Field” (circa 1926). Retrieved November 29, 2009 from LACMA Collections on line.
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Tilden, D. “The Young Acrobat” and “The California Volunteers’ Monument” retrieved November 27, 2009 from
About.com:Deafnes
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Waterford crystal bell image retrieved November 27, 2009 from www.bing.com/images/bells