Hearing Loss and Deafness

Language deficits are the most serious consequence of hearing impairment. The effects of deafness on language development are complex. Hearing loss may vary across the range of frequencies. Children with severe or profound hearing loss generally have greater difficulty learning language. Children "who are born deaf, or who become deaf in the first year of life, have considerably more difficulty in developing language than do children whose deafness is acquired later in life" (Harris 1992, p. 96). Their opportunities as infants for turn-taking talk with significant caregivers are limited. Hearing parents use far fewer signs with them than the number of words used by hearing parents of hearing infants. Deaf toddlers of hearing parents cannot carry on extended conversations nor can they ask for clarifications, repetitions, or confirmations to repair frustrating communication breakdowns.

Whether a child has hearing or deaf parents is an important influence on the effect of hearing loss. Children born to deaf parents may be familiar with sign language from birth. Often on developmental tests they outperform their deaf peers born to hearing parents (about 95% of deaf children), who may experience sign language only when they go to school. Some studies show that deaf preschoolers lag about two years behind on language development tests, but they have similar categorization skills and similar scores on tests of nonverbal cognitive ability as their hearing peers.

The timing of diagnosis and intervention differs quite widely for infants born deaf, and this timing affects social and language development. Only about 10 percent of deaf infants are diagnosed in the first year, and accurate diagnosis may not occur until three years of age for up to 44 percent of deaf babies. Many children do not have a chance at early intervention because identifying hearing loss is not a regular part of an early detection system in infancy. Yet, current technology makes it possible in the earliest months of life to confirm that infants with normal hearing respond clearly to changes in phonemes, even when these phonemes are confounded later in their culture's language system (such as "l" and "r" in Japanese); for example, by about ten months of age, hearing Japanese infants no longer respond differently to the "l" and "r." Thus, early diagnosis of hearing can be accomplished and needs to become a mandatory procedure included in pediatric care for young infants. Legislation is beginning to mandate screening for hearing in newborns.

Social skills and intimate interactions of deaf children suffer when diagnosis is delayed. Adults may not be sensitive to orienting the infant to watch for facial expressions or to alert the child to visually relevant and interesting events. Peers in nursery school may shout at the deaf child who seems to be able to move about the playroom with ease to get a preferred toy, but who does not respond to invitations to play or to cues for assuming a role in a pretend play scenario. Sensitive teachers in inclusive preschool classrooms help deaf children so they, too, can participate in the world of imaginative play so typical of and so important for preschoolers. The deaf child without a friend in such a situation may shadow an adult teacher or act lonely and withdrawn. Teachers can actively encourage play group entry skills and teach all the children how to sustain sessions of play activity.

Training of early childhood educators should include ideas for activities and interactions that will increase chances for deaf children to be included in social play. In some inclusive classrooms, all the children learn some signs in order to communicate with children with hearing deficits. Finger plays and singing games that involve a lot of hand and body motions are one way to promote inclusion in play.