Hearing Loss and Deafness

Controversy still exists as to the relative effectiveness of oral and manual educational systems. Some intensive oral programs do report good English proficiency. Some total communication programs likewise report positive outcomes in English proficiency for their graduates. Studies suggest that the academic and social benefits of total communication are increased and sustained when total communication is used both in the school and in the home.

There is some agreement that the nature of the child's hearing loss and the degree of the child's cognitive ability may have a greater effect on successful educational outcome than other intervention program variables that are measured. At present, "un-equivocal statements about the value of particular approaches or the consequences of not following one approach or another are unwarranted" (Musselman, Lindsay, and Wilson 1988, p. 88).

Specialists agree that early interventions with deaf infants and young children must emphasize communication exchanges during activities. When adults exchange signs in play contexts (such as "peekaboo" and pretend driving a toy car on a track) and during daily routines, such as getting ready for bed or going shopping for a toy, then young deaf children begin to organize knowledge of events into mental representations and cognitive categories. The more generous the provision of such intimate and motivating interactions, the more a child has an opportunity to attempt to express cognitive structures in ASL or in oral language. Thus, organized, interpretable, and rich experiences within naturally occurring social routines are necessary for language development. Early interveners, often parents, need to provide abundant opportunities for signing. They need to maintain eye contact and show vigorous interest in the deaf baby's attempts to communicate gesturally. When the infant is playing with a toy, adults need to compose their hands in front of the baby and provide the sign for that toy. In contrast, toddlers will be delayed in learning signs if the parent takes a toy away first and waits for the child to look up and see the parent making the sign while holding the toy. Parents can receive much help from written materials.

Teachers need to seat a deaf child so there is good visibility. They must learn the optimal distance (under one foot) to stand when trying to communicate with a child using a hearing aid; and they must learn to change a hearing aid battery and/or cord. When a child with profound hearing loss wears two hearing aids connected to a cassette-player-like box suspended by straps at the waist, this apparatus is sometimes called a "phonic ear." Teachers may wear a microphone that amplifies their voice for a hearing-impaired child with poor lipreading and sign language skills.

Teachers need to use a child's name and articulate clearly and slowly when directing speech to a hearing-impaired child. They should kneel at a desk and focus on cuing. Cued speech, developed by Dr. Cornett at Gallaudet University in Washington, D.C., is a system of teacher hand cues that enhances lip-reading by children. The hand cues, used near the lips, match what is being said to clarify ambiguities. Cued speech used by a trained adult helps the hearing-impaired school-age child increase reading skills.

Multimedia technology has been used to develop materials and activities for Mexican-American deaf children, the fastest-growing minority group in the U.S. school-age population of deaf children. Video dictionaries of sign language can be built directly into stories onscreen. CD-ROM reading software is now becoming available for hearing-impaired children.

Teachers and parents working together create opportunities for deaf children so that they can use total language communication to achieve interpersonal goals. Enthusiasm and acceptance help hearing-impaired children experiment with their language systems so that they can learn well and have a positive social effect on others, as well as engage in peer friendships.