When Their Child Is Born Deaf, Parents Need Accurate Information

I just returned from the EDHI (Early Detection of Hearing Impairment) Conference in Jacksonville, Florida. It was the first EDHI meeting I attended so I was unsure what to expect. The meeting is attended  by representatives of state early intervention programs and by professionals who work with early intervention. The professionals include speech-language pathologists, auditory-verbal practitioners, audiologists, teachers of deaf and hard-of-hearing children, psychologists, social workers, administrators, and parents. This sounds like a plan for a great meeting.

When I entered the hotel lobby I was a little surprised to see a lot of deaf adults signing with voice off. It’s been a long time since I have seen that at a meeting. I expect a lot of signers at meetings like the National Association of the Deaf or similar organizations, but this meeting was primarily for issues relating to infants and pre-schoolers. I was surprised.

 

Childhood Hearing Loss: It’s Not the Same Old Deafness

I have been a pediatric audiologist for almost 50 years. Things have changed dramatically since I started. When I began, technology was not terrific. We had hearing aids, but they were not very powerful. We fit little kids with body aids because the BTE models were so big we couldn’t get them to stay on the child’s head. The hearing aids we had worked well for kids with mild to moderate hearing loss, but not so well for kids with severe and profound hearing loss because they were just not very strong. In addition, there was a lot of distortion.

Things have improved a lot since then. We have powerful hearing aids that provide sufficient gain to work for kids with severe HL, and are a good start for kids with profound HL until they get cochlear implants. We have FM systems, which we did not have when I got started, and, of course, we have cochlear implants!!! Now we can say that almost every child with hearing loss should be able to hear with appropriate technology. (The exception is children without a cochlea.)

Second, newborn hearing screening is identifying babies with hearing loss at birth. In the olden days when I started in this field we considered babies identified at 18 months to be early identified. Now the standard is that babies who fail newborn screening should receive a diagnostic evaluation by 3 months of age and begin intervention by 6 months. (In my mind, this is still too late since babies can be identified at birth, but that’s another story.) Since babies are identified early now, they do not get “delayed.” We begin working with them immediately.

Finally, we now know that auditory brain development requires auditory access and we know that only appropriately fit technology will permit appropriate brain development. Children who use a visual mode first will not be able to fully develop their auditory skills at a later date.

 

How Has All This Changed Parental Decisions?

Let’s remember that 95% of deaf kids are born to parents with normal hearing. They communicate using spoken language. When we ask parents what their goal is for their child, 85% of parents report that they would like their child to listen and talk.  This is a big change from the situation before newborn hearing screening. Then about 40% of families chose sign language and the rest chose auditory-verbal, auditory-oral, or cued speech. It is clear that the world is changing. Many schools for deaf children are closing or becoming smaller as more children get mainstreamed. More and more parental support exists so families can have the energy and know-how to do what’s needed to help their children succeed.

 

What is the Role for Sign Language?

There is and always will be a place for sign language. It does make communication easier in noisy situations and when you are not wearing technology, but is it what we want as the primary communication mode for infants and children currently being identified with hearing loss?

In my mind, parents who choose listening and spoken language are making the right decision. With the technology available today, deaf children can hear. Therapy is available to teach families how to help their children learn, and schools are helping children be successfully mainstreamed.

If deaf children can communicate using listening and spoken language the way their peers do they have limitless opportunities. If they cannot, their choices are limited. Children who only sign have fewer employment choices and fewer social opportunities. Some children who communicate using listening and spoken language will learn to sign as teenagers or young adults, but the data is clear that children who learn sign first will not be as successful using listening and spoken language later because the auditory portion of the cortex will not develop as fully.

 

What Upset Me at the EDHI Conference?

At the EDHI meeting I saw a parent who was considering cochlear implants surrounded by signing adults who were telling the parents that they were going to damage their child by giving her an implant. (She was crying.) I heard one presenter report that it takes at least 2 years to learn to hear with a cochlear implant and that during this time the child will have no language. (This is definitely not true. Children will start hearing when the CI is turned on, but just as with typical hearing children, it will take a lot of listening to learn to use the information.)

I heard a presenter report that the only way a child can learn to read is through sign language. In fact, the average reading level for children who graduate from schools for the deaf is third grade.

 

Parents Need Correct Information

Parents must make very difficult decisions when their child is identified with a hearing loss. They need to make an educated decision about the choices for their family. Some choose listening and spoken language and others will choose signing. But parents need to have honest information to make those decisions.

I understand that there are people who believe strongly that signing is the appropriate method to educate deaf children. That is fine. They should explain to parents why they believe that signing is the right choice. But that information should be based on current evidence – not on what might have been true 20-30 years ago.

 

About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 5 books, and written numerous books chapters and journal articles, and is a well known international lecturer.

57 Comments

  1. For language development, an early exposure to children’s books and storytelling is even more crucial for toddlers with hearing loss.

  2. You state parents need accurate information and I agree. However, you give reasons based on your opinion as a hearing person and often state sign language has a role, “but” when you use the word “but” you are negating your previous statement implying what comes after the word “but” is what is important. Language development is the key and focusing on the strengths of that child is deaf. If language is the key what is the most direct way for a child to develop language needs to be addressed. Assistive technology is wonderful, but it is ASSISTIVE and a told to get information in an auditory way…a child needs to develop interpersonal skills and strong social development interacting with like peers and feel comfortable with their self image. As an audiologist your focus is rightly maximizing their potential to hear things, but (see how I did that) your not addressing the many social learning needs that a child with hearing loss has.

    1. Thank you for your comments. I understand your concerns. BUT, it is important to recognize that 95% of deaf children are born to normal hearing parents. Their natural language is not ASL. so , even if they work hard to learn to sign they will not be fluent and will not be able to provide a rich language environment to their child, thus limiting their child’s language. In addition, ASL is a different language than written English. This results in poor reading levels – children graduating in schools for the deaf read at 3rd grade level. I absolutely agree that social issues are a concern. Research shows that social issues are directly related to language levels. If children do not have language at age level they cannot socialize well. And if they communicate using ASL, they will be limited to communicating with others who sign. That will result in a very small social circle.

      1. Children graduating from Maryland Scool for the Deaf are scoring higher than the national average on standardized tests. this “third geade reading level” is a myth and a child’s potential for learning is not dependent on whether they can hear or not – it is dependent on having full access to language. My concern with having the auditory-oral route pushed on me and my daughter is that the assistive devices are not always accessible. when a hearing aid needs repaired we are without that aid for up to 2 weeks and without sign language this results in difficulty communicating. as a hearing parent of a deaf child I believe that ASL paired with spoken language gives my daughter the best of everything. she has full access to a language she can use all of the time for fluent communication. she also has access to spoken English and although she does not have constant or complete access to that, she can get by in social situations where others may not know ASL. The position that deaf children should not learn sign language is what is outdated. we do not need to deny our children access to fluent communication in sign language in order for them to be able to communicate aurally/orally. I have met many deaf adults who are able to commu icate using speech and hearing when necessary but who are more comfortable jsing ASL because even with their assistive devices they are missing information. This is not a black and white situation.children deserve access to communication all of the time, not just when their devices are on and working properly and there is not too much background noise or too many people talking at once.

        1. That is misleading. One group of students at Maryland school for the Deaf, ONE YEAR, scored higher on a third grade test. That is not all groups, or even many.

  3. Excellent article. It is so unfortunate that we still have to deal with this kind of misinformation today.

  4. I had to deal with misinformation like this when making the decision regarding Cochlear Implants for my daughter 18+ years ago. What they are saying wasn’t even accurate then. I was told by a teacher before implanting our daughter at the age of 2, that she would hate us for it in the future. Just a few months ago, my daughter marked the 18 yr anniversary of receiving her Cochlear Implant by thanking her parents and saying how much she loves “hearing” with her implant (on Facebook). It really brought everything into prospective. We came full circle :)

  5. David Litman stated ” a child needs to develop interpersonal skills and strong social development interacting with like peers, and feel comfortable with their self image…..”

    I agree with your statement 100%. That is precisely why my husband and I decided to teach our daughter spoken language. We initially considered signing with her and went to a few social gatherings for Deaf people. After very careful consideration, we decided against teaching her ASL as her first language because we are surrounded with hearing people who do not sign.

    There were no signing, Deaf children her age in the city where we resided. Who was she going to sign and communicate with unless we drove to another city? What if those children did not like her or what if she did not like them? If we have chosen ASL, the pool of children she could choose and communicate with would be very limited. For her social well being, we decided to teach her spoken English and have never regretted our decision, because she can choose and socialize with friends from a wide pool of children instead of from a close group of children we limited her to if my husband and I decided to teach her ASL as her first language.

    We did, however, introduced her to other children her age who were deaf, wore hearing aids or cochlear implants and communicate with spoken language. She was friends with these children throughout her life and never felt like she was the only one with hearing loss.

    My daughter is very independent, but most of all, she is very happy. She (as well as her deaf friends who communicate through spoken English) has a strong interpersonal skills and strong sense of self and high self-esteem.

  6. It is possible to teach English without the use of sound and with ASL. It’s real sad that people like you think English and ASL cannot co-exist and that English can only be learned through speaking and hearing. So what if 95% of Deaf children are born to hearing people? It doesn’t mean the Deaf children must fit the social ideals, but the parents should step out of their comfort zones. Deaf children will always be Deaf, there’s no shame in being Deaf.

    That stat on the third grade reading level? It’s based off of SAT scores and does not take various factors into consideration (i.e. level of parental involvement, amount of literature exposure, amount of langauge exposure through written English and ASL, and so on). I have personally seen people who had CIs as children still fall behind because of these factors. Hearing is not an absolute guarantee, and using a CI or a HA does not automatically mean the child will start understanding.

    You said that it takes a lot of listening to learn to understand. What can the parents do in the meantime until the child understands speech? Use ASL, of course!

    However, you are merely an audiologist, not someone I would expect to understand. You are not an expert on child development or language development, either. Leave it to the Teachers of the Deaf to provide options and resources to the families. Plus, Deaf people are the best role models for Deaf children. Don’t look down on Deaf people because they use ASL for communication. It is possible to grow up with ASl and have age appropriate language development and English skills. All it takes is opening your eyes to the bigger picture.

  7. There are Deaf professionals, psychologists and educators, who will disagree with the majority of the remarks in this article. Much of it is outdated. Current research has disproven the misinformation in it. Deaf people have proven that they can develop speech, English competency and social skills independently of hearing devices. For them, hearing aids and cochlear implants are an additional way, not the sole avenue to education. Today we can look to the hundreds of Deaf Ph.Ds, school administrators, professors and researchers, just to mention a few groups, for correct information.

    It is irresponsible to be spreading this type of statements because it can lead parents to overexpectation and false hope that implanting their child will solve the problems of deafness. Some may even demand implantation when it is not medically indicated. It can lead parents to close doors that need not be closed: American sign language has proven to be a tool for education, social interaction and employment for Deaf people just as speech has. An educational program that fully covers all possible bases is the best way for the Deaf child.

    1. Dianrez… show us the research then.

      The key research in this area is Geers which indicates to achieve better spoken language outcomes it is better to only learn spoken language (pretty obvious really).
      There are some other studies going on currently but until they come out, people suggesting SL and spoken language can co-exist happily are simply making stuff up (otherwise known as interviewing their typewriter).

    2. Im a profoundly deaf educator, professional and psychologist. And I agree with the majority of the remarks in this article.

      Bsc (Psychology & Physiology)
      Tutor at university
      Study/work in a health care clinical profession

      If there is peer reviewed legitimate research that disproves these ideas, please, pleaseshow everyone – write a media release and educate the world of audiologists and speech therapists

      So far, no-one has disproved or provided evidence that Geers et al. are barking up the wrong tree.

  8. You need more accurate information, Jane. You are simply one track minded person which explains your job. Check out Gallaudet’s VL2 researches. Do some more researching before just typing an absurd and misleading article.

    1. Ann Gallaudet s research is VERY VERy misleading. If you go back and read the original research articles you will see

  9. It is not a fact the Deaf student graduates from School for the Deaf has a average of third grade level. Your information is incorrect. What you have said is also incorrect about “once a child uses CI, they can pick up language” typical talk has no valid proof. I believe you picked off the Internet that claims were made on 3rd grade level thing. I have graduated from a Deaf School and enrolled at Gallaudet as a freshman, not a prep. I have not taken any non credit English classes at Gallaudet. I was qualified for the credit English class. A 3rd grade level Deaf student would not be able to do that like what I did. Please remove false information, unless you have factual proof with bibliography to show where you got the information from. You have not provided that.

    I even function independently. I even am about to accomplish as a book author. Please do not insult my intelligence. I am proud to graduate from a Deaf School. I would send my Deaf children there, if I have Deaf children.

    I am disappointed with you, since you did not provide any bibliography to prove the “facts” you claimed.

  10. Are you saying deaf signers with hearing parents are no intelligent and can’t work that a bunch of crap my husband is proufobdly deaf and was moved from oral program one right after another until he was immersed in langauag e and culture at the school for the deaf we are happily married live breathe and think IASL WORK IN IT LIVE AT HOME IN IT we have a rule at our house if you come in to visit u will sign period no matter what kindnof ASL skill u possess if this is a lack of I tell whence because of auralcentric view if the world forget it these statement are inflamtory and audist please refrain from ur thought less view of deaf culture a slangy age it highly offensive

    1. Deb… have a careful read of what you have written here and tell us that the spelling, grammatical structure and punctuation doesn’t illustrate the point.

      1. Sym, Just between us, I suspect Deb is hearing. There’s a tendency among hearing folks to spell the way they talk.

  11. Thank you so much for your thoughts and comments regarding the conference. As a parent of a profoundly hearing impaired son, now 27 years of age, I was stunned to read the that statistic regarding the average reading level for graduating hearing impaired seniors is third grade. That is the exact same grade level it was when my son was an infant, and I am absolutely shocked regarding the lack of improvement, considering the significant technological advances over the last 20 years.

    I only recently joined a FB group for parents of hearing impaired/deaf children, and from reading the comments everyday, nothing much seems to have changed in that arena, either. I see things like ‘the hearing aids are not working for my child’ and ‘when will my daughter begin speaking?’. Many parents still assume the school system and speech therapists are going to be the ones that give their child ‘language’, and/or relying on a cochlear implant to solve most of the issues.

    Parents must read every possible item regarding educating these kids prior to making their decisions. Then they need to keep reading, and know that no matter what path is decided upon, parents are the ones ultimately responsible for ‘how well’ their child’s does with regard to their language skills, particularly during those early years.

  12. I’m a teacher… I’ve taught middle school, high school, and ece/family education at a deaf school. I’ve assessed many deaf children. And, the results shows that most children who are delayed academically and socially are often, if not all, from a non signing homes. The deaf children who had signing homes (hearing or deaf parents) performed far better than those of non signing homes. And, you mentioned that 95% of the deaf children are born with normal hearing parents. Hence, the average reading grade level, although your statement isn’t accurate.
    There are nothing wrong with hearing devices…as long as ASL is included.
    By the way, I’m deaf also.

    1. Are you interacting with and testing deaf children in the mainstream or only those at a Deaf school? Of course Deaf children who use ASL and have families who do not sign will be much further behind than those who have family who do.

  13. Jane.. thank you for sharing your information Jane.. I always love reading your articles.. My daughter has a cookie bite hearing loss at the age of 7 and we found great comfort in your work.thank you..

  14. I am Deaf Adult with Master’s degree in Deaf Education. It saddened me to see the Parents of Deaf children who are against sign language and limited to spoken language. It is WRONG WRONG WRONG!!! DO NOT LIMIT your child with any kind of tools to use for language development. I would strongly suggest you to support your child every way she or he wanted to learn. There’s nothing wrong to learn ASL (American Sign Language) in order to understand the concept of words instead of how to pronounce the words or It would be a waste of time focusing on sound only that will delay their social skills, basic interpersonal skill and cognitive language academic proficiency. It is very important to develop basic interpersonal communication skill by using sign language, field trips, interact with other peers, visual aids, music with pictures, words and sign would be a wonderful tool before stepping into something is difficult like speech. It is like putting your child to learn how to sing! Please be considerate to your child than yourself. Thank you!

  15. We are best able to impart sophisticated language to our children in the language in which we are fluent. Cochlear implants provide a tool for access to listening and spoken language, and with today’s technology, they are an incredible tool, but it is then up to the parents during those very early language learning years to impart language. Through the Auditory-Verbal Approach, I was able to do this for my daughters, now ages 27 and 19, who have excelled academically in mainstream schools throughout their lives and also lead happy social lives. I could never have provided them with language of the same level of sophistication in a language that I was trying to learn myself and wasn’t using with other fluent adults on a daily basis. This is the problem with sign language for hearing parents who comprise 95% of the parents of children who are born deaf. In addition, I know unequivocally that my daughters would not have done as well as they have had we used a total communication approach. First, introducing a visual language would have rewired the auditory pathways in their brain. This has been proven by scientific research. Second, any time I spent learning sign and teaching my girls sign would have meant time away from working on their English language skills. Finally, as Jane says, with today’s technology, why would hearing parents not want to teach their children to listen and talk and enable them to be fully integrated into the hearing world? They can always learn a visual language when they are older, but they cannot learn to hear and speak well once that critical window of brain flexibility for learning to comprehend spoken language through their hearing closes.

  16. You are completely wrong. “Teaching my girls sign would have meant time away from working on their English language skills” you quoted. That insults me. I learn my English language skills from signing with my hearing parents. They took time and went to Gallaudet and it was my first language learn from my parents. To learn the English language skills, I have to learn sign and acknowledge what they are saying to me in order to learn! Do not be lazy. Picking up sign language helps learn the English language skills faster.

    It is a fact that Audiologists passed on wrong information saying signing can destroy the language structure. Did you realize 95% of hearing parents hear from doctors and doctors get paid bonuses on every cochlear implant by provide wrong information so doctors could get bonuses? Do your homework. Doctors do not care about each child. They care about getting the bonuses. It is the same for the Audiologists.

    Failing the hearing test and apologize in front of the parents also scare them by stating the Deaf child would not be able to function independently is WRONG. We do function independently. I picked up English language skills earlier than any Deaf child with hearing parents who are lazy to learn sign language. They expect the Schools to do all the work and be quiet at home! I am proud my parents learned sign language as well as my brothers. We all communicated equivalently at dinner tables, swim meets, etc. I had 12th grade reading level at an early age. Please do not insult our intelligence.

    Bottom line, I call hearing parents lazy to learn sign language and are co-dependent on Schools to teach oral. So I guess it is really the hearing parents do not know how to function independently for their Deaf child.

    1. Wow! You are a little angry. I’m sorry you’ve clearly had bad experiences in your life. Have you ever known and Auditory-Verbal family? We are anything buy lazy. The main premise of the AV approach is that the parents are the child’s primary language role models during the formative early language learning years. Thus, we don’t send them off to schools or to therapists to do the work while we idle away the hours. Instead, we go to therapy with them for one to at most two hours a week, which are as much to teach us as to teach them. Then we work with our children both formally and informally. I gave up my career for several years to focus on my girls. Don’t go hurling insults when you don’t know the facts.

  17. Kudo’s to Melissa’s statements. I can basically trump everyone here, including Jane. I am 63 years old. I was diagnosed as deaf at age 2. Fitted with Hearing Aids on my fourth birthday. Hearing parents and no known hearing disabilities within all the generations that we can document into the 2 digits realm. I did not learn SL. My vocabulary is top 10%. I have mingled with all the groups from SL to AVT. Having observed all of them and having participated in hundred of meetings, presentations, conferences and in every media venue possible for nearly 60 years – I can and do speak from experience as a deaf child into the senior years. The worst and most bias information comes from the DC (deaf community). I can also speak to piss poor audiologists and SLP’s too. So if 1 out of a 1000 is born severe to profoundly deafened… why would I accept the monastery of silence, self segregation and victimhood as the experts on what it takes to be a self sustaining and contributing member of society. I have read the critics online here and it is the same schtick and spiel that I have heard for 59 years. My doctoral research focuses on organizational intelligence, decision making, technology and so forth. Jane is speaking from a level of summation and the experiences behind it. 50 years gives credibility. Melissa, here, has 2 phenomenal daughters. And to bad mouth her accomplishments and the technology behind it? That is really borderline “hate” stuff. And our anonymous contributor here cannot write intelligible English. I do not consider Gallaudet that credible and I have my deaf peers who went their that will testify to that too. Going to take a “ghost” writers to help her publish. There are two things that have to be accomplished educationally – literacy and competency. Competency cannot be achieved without literacy. An engineer of any persuasion has to master the language of his discipline. To function in the world of the 99% you have to master that language. Mastering the language of the 1/10 of 1 percent will not accomplish that. Yes, you can sign, but even if you put a string of signs/pictures together, you still have to navigate the words that explain those pictures. Remember – A picture is worth a thousand words”. The picture is useless if you cannot produce the words and that includes the huge combination of possible words. Most Deaf Interpreters have to also work as social psychologists too to communicate for their clients. Online the largest SL dictionary I can find is about 7,000 signs. The English dictionary is around 1 Million. Yes, you can learn to read and speak English without hearing, but what are the statistical probabilities of that? Very very low and extremely difficult. Now, I will finish my remarks by saying this, I am smarter because I was and I am still deaf. I now have 2 CI’s. This provides insight that I would hope that Jane would then contact me regarding this. Some extra ordinary deaf intellectuals have phenomenal correlation skills. Their minds function as incredible database and correlation mechanisms. But, you cannot fully correlate without mastery of the alpha-numeric world. Yes, there are bi-lingual folks out there who do both SL and Spoken Language. They are not plentiful and the only way that is achieved is in settings where both are present. And I would hazard the guess that 90% of them work somewhere with mostly deaf/Deaf clientele. So unless you navigate in an environment that has both, you will drop one language for the other. So just like the lingo of the gang bangers, you learn from those you hang out with and you will speak like them too.

    1. Just an FYI. If you read Melissa Jensens blog she was a part of the deaf community for years I believe about 10. She learned ASL and so did her daughter. She omits that part in her comments. Her daughters success had an ASL foundation first.

      1. I was not the person talking here. This is Melissa Chaikof. Not me. Good try though.

  18. I’m appalled at some of the discussion happening here in response to Jane’s original post. In response to Don– this is not a “one-upping” contest– this discussion is about creating the best possible opportunity (or opportunities) for deaf and hard-of-hearing children to succeed in life. Aside from communication methods as a marker of success, I can safely surmise we all agree on a few basic definitions of this success in life. Integration in society, effective interaction with peers and family, economic self-sufficiency, a healthy sense of self, and living happily. I’m rather disgusted at the tone in your message. For the others in this discussion, I’d like to introduce myself and dispute some of the “facts” or ideas being put into play here.

    I am a deaf adult. I have been granted a Doctor of Philosophy degree from a top-ranked program in my discipline (History) with an international reputation. I have been appointed as a tenure-track faculty member of a Catholic “Ivy League” college, an institution with a national reputation for academic rigor. At the age of 12 I scored 11.8 on expressive and 12.0 on reading on standardized tests. Translated, that means I wrote at the late 11th grade level and read at the 12th grade level at the age of 12. I also scored off the charts in mathematics and vocabulary comprehension. I consider myself fully bilingual in both ASL and English. My parents and the remainder of my family members are hearing. I do not speak or use any assistive devices such as hearing aids or cochlear implants. I attribute my academic success, economic independence, and happiness to my family. They learned sign language when they discovered I was deaf at the age of 18 months. They never became fluent in ASL but they became fluent enough in sign language to communicate with me effectively, to provide me with access to communication and language as early as possible, and to carry on conversations on complex topics when I reached adulthood. This, combined with stellar teachers and the bilingual educational approach, I achieved literacy and the ability to communicate. Not only did I achieve those two objectives, I also learned to think critically, which I think is more important. This is in response to Melissa. “What ifs” makes for poor arguments. She claims that she knows unequivocally that her children would not have done as well if she had adopted the total communication approach. The truth is, you just don’t know. My family did and I’m the end result of their effort– hearing, not fluent, using that time to learn sign language rather than teach me how to talk… well, I’ll tell you something. This approach worked out perfectly. I can tell you the same of dozens of other deaf peers with graduate degrees and successful employment who had hearing parents that learned sign language and tried the total communication approach. The REAL factor in success for deaf children is parental involvement. Period. That leads me to my critique of Jane’s post. You can operate on a deaf kid, you can give the child all the tools in the world, you can throw all the money in the world at the problem, but the deaf child will not learn language- spoken or signed- without intensive parental involvement and investment. This is an universal truth. I don’t think we emphasize this enough. Parents must be fully invested and involved from the beginning. This ASSUMES a few things though. Melissa mentioned she took a few years off from work to invest in her daughters. Hurrah for her. The reality is that most parents do not have this luxury. We’re talking class privilege here. Much of the discussion here neglects the factors of race, class, and socioeconomic status of deaf children and their families. The truth is that class is rearing its ugly head in this debate. Children from impoverished backgrounds do not have the type of access to Auditory-Verbal Therapy that children from more privileged backgrounds do. This skews results. Most of the children in deaf schools, other than deaf children of deaf adults, are from ethnic/racial backgrounds with lower socioeconomic backgrounds as opposed to the wealthier white children taking on the AVT approach in private schools or in mainstreaming programs. This skews results coming out of deaf schools. This also addresses Jane’s “fact” that children graduating from deaf schools read on average at the third grade level. Here’s a fact for your readers. 1) This test actually aggregated ALL deaf children’s reading scores- those mainstreamed, in deaf schools, in total communication programs, etcetera. So, it would be more accurate to claim that the reading average of all deaf children, upon graduation is the third grade level, regardless of educational background, pedagogical approach, and language use at home. 2) This data collection design is clearly flawed. The people collecting and interpreting this data should have separated the subjects by pedagogical approach, educational backgrounds, language use at home, language use at school, and factored in socio-economic, race, and ethnic factors as well. 3) The national average for a hearing adult, in terms of reading ability, is at the fourth grade level. A differential of only ONE grade level. We have a problem, as a nation, when it comes to education- be it deaf or hearing.
    We also neglect to consider the impact of the AVT approach and Cochlear Implants in the event that those approaches fail. What Bi-Bi proponents are arguing, and which I agree with, is that sign language guarantees access to language and visual information. Taking the AVT approach is akin to a gamble. You can hope, believe, think it will work– but you don’t know for sure. By the time you know for sure, at the age of 5 or 6 or 7, it’s too late and that critical window for language acquisition has passed. There are scientific studies out of Harvard University that argues that if cochlear implants are measured solely upon the effectiveness of language acquisition and not hearing ability, cochlear implants fail more often than they succeed in this particular objective.

    1. “There are scientific studies out of Harvard University that argues that if cochlear implants are measured solely upon the effectiveness of language acquisition and not hearing ability, cochlear implants fail more often than they succeed in this particular objective.”

      Really? References please.

  19. Don- who said I graduated from Gallaudet? I did not. I graduated from University of Phoenix. Surprised? Yup. UOP requires very good English skills to do term paper on a weekly basis. For my other peers who graduated from Gallaudet, do not insult them. Some of them went on and got doctorate degrees and work at National Institute of Health, again, are you surprised? I bet. NIH is one of toughest employers to get in to work with the research study teams. In fact, I am having my book released soon so it is not even written by a ghostwriter, Don! Also, 90% is even not accurate unless you can prove the facts that 90% of Deaf without CI have Deaf clients? I bet not. There are Deaf business owners I know of who works independently and have hearing clients. CI or not, ASL is the best communication at the baby years to pick up the language skills. Why teach sign language to the hearing babies, while it is not OK to teach to the Deaf children?

    I am sorry to say, Jane’s writing is not accurate at all. In fact, yes, in fact I repeat, a group of oral toddlers in Kansas could not speak or read anything well. They were very slow. A Deaf role model determined to use her sign language with the toddlers, they were delighted to see it and learn quickly. The children are in progress of recognizing things with sign language communication. Unfortunately, their parents refuse to learn sign language at home. One of the parents said, “My audiologist told me not to.” That is really sad.

  20. I came across this blog from someone’s Facebook post and I have to say that this post is rife with misinformation and it is heart-wrenching. I am profoundly deaf in both ears and my hearing parents learned ASL when they discovered that I was deaf at 8 months old. Today, I am extremely thankful that this was the route they decided to go. I am currently a medical student at a top-tier medical school and there is no way I would have gotten here if they had taken the oral route. Having ASL as my L1 allowed me to completely master a complex language that was 100% accessible to me. This was an important step towards mastering the English language with limited access to sound. Even with today’s technological advances, no deaf child will have the same type of access to the English language that a hearing child has. A cochlear implant only has 23 electrodes compared to 23,000 hair cells in a functi

    1. Speaking of mis-information…
      Cochlear brand implants have 22 active electrodes (plus two earths)
      AB brand have 16
      MED-EL have 12 channels with 24 contact points.

      Great that your journey worked for you. Many of us parents of little ones are choosing a different path. For children with simultaneous bilateral CIs at early ages, language access is simply the same as for kids with normal hearing.

      1. My apologies, I meant to say 22 electrodes. I used Cochlear as an example because I actually have one in my right ear when my hearing aid no longer worked on that ear. I stopped wearing it because sound was not natural and the side effects outweighed the benefits. The exact number is irrelevant as all the technology we have today are relatively similar in quality. They are all not even close to the quality of natural hearing. Before you say that it requires a lot of training to hear and comprehend sound, you must understand that there is a limitation to the technology that exists today. We know that you can only capture a certain frequency range. For example, I cannot hear my doorbell with the implant on while I can with my hearing aid. Also, there are some heart sounds that I cannot hear through the implant with my stethoscope.
        This is where ASL comes in. You can complement your child’s neural development with ASL and ensure that all the gaps are filled. It also provides your child with confidence and social skills. My observations have led me to believe that those who can sign ASL fluently are often more socially well-off than those who do not. Neuro is a passion of mine and is probably the field I will choose to specialize in so I am familiar with the current literature on neurological development and language. There are plenty of studies that have shown that a bilingual approach is the most optimal and has been shown to even increase the child’s IQ. Since an ASL signer is a bimodal bilingual because ASL is communicated visuospatially, the signer also had increased perception and spatial skills. Why would you prevent your child from benefitting from this?

        1. A couple of comments…
          Firstly it is very misleading to compare pre-lingually implanted infants with adult implantees. For a child who grows up with CI hearing as their hearing, the journey is a whole different kettle of fish.
          Secondly… attributing the benefits of learning two or more oral languages with learning an oral language and a VISUAL language is not valid and certainly not shown by research.

          1. Sym, I am not trying to say that the experiences of pre-lingually implanted children are the same as those of adult implantees. I am only demonstrating that, from my own experience, access to sound is very different via CIs when compared to hearing aids. Hearing aids simply amplify natural sound so use of hearing aids is the closest one can get to normal hearing depending on the degree of damage to the cilia of the cochlea. CIs, on the other hand, require the brain to understand sound quite differently. Pre-lingually implanted children hear and comprehend sound very differently than a hearing child or a deaf child wearing hearing aids. Suppose a “cure” is discovered in which hair cells can be regenerated in the cochlea, pre-lingually implanted children would struggle to relearn sound while those wearing hearing aids will likely not struggle as much since their brains are already accustomed to receiving sound this way, albeit in a limited sense. The main point I am trying to present is that CIs do have some limitations and are not a cure for deafness. It is this mistaken perception that leads parents to believe their child does not need further accommodations. This is where ASL comes in.

            There is absolutely a plethora of studies out there that show that learning a spoken language and a visual language is beneficial for the child. This is called bimodal bilingualism. A good summary of this issue was published in Psychology Today a few years ago that can be accessed here: http://www.psychologytoday.com/blog/life-bilingual/201103/sign-language-and-bilingualism

            At the end of the article there are several other articles cited that can be of use to you as well. You can also look up the works of Karen Emmorey who did studies on the effects of bimodal bilingualism on the brain. Doing a simple search for “bimodal bilingualism” in PubMed or even Google would give you plenty of reading material.

            I sincerely hope you take the time to consider this and think about how you can maximize your child’s success in the world using both ASL and English. There are plenty of deaf physicians, scientists, professors, and lawyers who are bimodal bilinguals like myself who can attest to the fact that it is the way to go.

  21. I came across this blog from someone’s Facebook post and I have to say that this post is rife with misinformation and it is heart-wrenching. I am profoundly deaf in both ears and my hearing parents learned ASL when they discovered that I was deaf at 8 months old. My parents didn’t directly teach me ASL — they learned ASL with me. Today, I am extremely thankful that this was the route they decided to go. I am currently a medical student at a top-tier medical school and there is no way I would have gotten here if they had taken the oral route. Having ASL as my L1 allowed me to completely master a complex language that was 100% accessible to me. This was an important step towards mastering the English language with limited access to sound. Even with today’s technological advances, no deaf child will have the same type of access to the English language that a hearing child has. A cochlear implant only has 23 electrodes compared to ~23,000 hair cells in a functioning cochlea. In other words, even with the use of the best assistive technology out there, a deaf child will not have 100% access to the English language using the AV approach. ASL is easily accessible to the deaf child and the child can have 100% access to English by teaching it using ASL in addition to speech therapy. This is so essential when you consider the brief period in which language learning is critical. It is so important for the child to be able to master a language before the critical period ends. There is plenty of research out there that has shown this to be the most effective method of language learning that I need not list them all here (for a head start, try looking up the works of Ted Supalla and Catherine Best). As Octavian mentioned earlier in the comments section, the reading level statistic is unreliable and outdated. I grew up attending a deaf program and mainstream school and I’ve interacted with students who have gone the AV route as well as the ASL route. One thing I’ve heard very often from those who took the AV route was that ended up learning ASL later in life and wished they (along with their parents) learned ASL much earlier. From my observations, I believe it boils down to parental involvement in the child’s language acquisition. Parents who take the time to learn ASL ensure that their child has 100% access to a language that can then be used to teach the child English. I’m not saying that parents who decide to go the AV route are less involved, but that they can only do so much utilizing the AV route. A deaf child wearing cochlear implants is not likely to have complete access to spoken language and the gaps in language acquisition may end up harming the child’s development after the critical window of language acquisition closes. This approach may work for some but I feel that this is a gamble and to say that this is a better route than the ASL route is just wrong. Believe it or not, there are many individuals like me out there who are just as successful because their parents took the time to learn ASL with their child. I am not making this point to promote ASL but to see more deaf children grow up to become successful people.

    P.S. Sorry about the truncated post above, it accidentally got posted when I wasn’t done.

  22. wow she needs to retire ASAP.
    there is a thing called Audism and this hearing woman clearly is swimming in it.
    fact is that I have friends at WSD, a Deaf school, who are waaaaayyy beyond 3rd grade English, LOLOLOL.
    it is often ORAL kids who are given slack in mainstream schools. they are the ones who graduate with a 5th grade English comprehension, and all the scientific journals I have read said that the average was 5th…where is that THIRD grade coming from??

    at Gallaudet…a SIGNING school…my teachers are often born Deaf, some are even from Africa, and there are multiple student from other nations and around the Americas who are fluent in several spoken/written and signed languages. there is no proof whatsoever learning a signed language first will prevent ability to learn a spoken language later, and recent studies of the “auditory” part of the brain (soon to need to be renamed language center) can utilize either spoken or signed, hearing and Deaf alike.
    It is interesting that she felt it was right for social workers to attend, but nobody who is Deaf should attend who signs…I am hard of hearing and going Deaf and am a social work major here, and there are so many fully Deaf as well. should we stay home?? Really?
    I think the name for you my lady is BITCH. How should I say it, in ASL or spoken English?

  23. Reading this article and then reading these comments breaks my heart on many levels. It amazes me, that still, to this day, we are still fighting with each other as a field. Now granted, there is (in my professional opinion) a lot of mis information presented from both sides, and I understand that this is a highly impassioned argument. We should, however, all be working together towards the greater good and success of children who are deaf and hard of hearing, no matter what their communication choices and preferences.

    Why does a parent have to chose one or the other? Why do they not have the option to choose to use ASL with their child, and still implant them? Why do we shun a parent who choses to only use ASL? Why do we shun a parent who choses to only use listening and spoken language? The only way anyone can make an informed decision on the topic is to look at all the options, without bias towards other’s personal philosophies, and make the right choice for their child and their family. Isn’t the end goal success for these children? Who cares how that success is obtained…. as long as it is obtained. #iamtheradicalmiddle

  24. “In fact, the average reading level for children who graduate from schools for the deaf is third grade.”

    I would like to know your source for this statistic, Jane. What year was that study last performed? Is it even applicable to the most recent generations? How does that reading statistic break down among categories – oral, bilingual ASL, SEE/PSE/TC? It is fairly well known that any older iterations of that study were completely contaminated by the pool of deaf young adults/adults who grew up oral, in an era when oral education without cochlear implant technology was the norm. To throw out that blanket statistic now, and to apply it to current generations without any clarification (i.e., that this held mostly true of children whose parents were not involved enough), is unprofessional and unethical.

    An audiologist just like you trotted out this tired old tripe to my parents when I was first diagnosed at 13 months old. Thankfully, they chose to give me full visual access to language through Total Communication (it worked in my family’s particular circumstances). At that time, implants were not an option – they were still very experimental.

    Had my parents chosen to raise me through the oral method, I would have turned out just like my cousin, 16 years older than me, whose parents listened to their audiologist and initially chose oralism. Once they realized their error, it was too late. No amount of backtracking or trying various methods could repair the damage. Today, she is completely illiterate and socially dysfunctional.

    On the other hand, because of my parents’ choice, 30 years later, I have a successful professional career and hold a B.A. in English, B.S. in Journalism and M.A. in Literature. I scored a perfect 800 on the SAT English section and picked up numerous honors throughout my education. And that entire education as well as my whole career has been in “the hearing world.”

    I don’t like to brag about my accomplishments, but seeing articles and statements like these from audiologists and “professionals” like you make it imperative for me to step up and say, no, you are completely WRONG.

    Please feel free to prove otherwise by providing recent, decent studies that validate that “third-grade reading level” claim as applicable to my and later generations. I sure know plenty of deaf people my generation and younger who grew up with sign language and who are reading and writing far better than most of their hearing peers.

    1. In addition to my question about categories, how about some data/statistics on deaf children who graduate from the mainstream? What is the average reading level of a mainstreamed child who transfers into a deaf school (and at what grade does the transfer occur)? What about a student who is mainstreamed K-12?

      I’m tired of generalized statistics being bounced around and repeated ad nauseam. Scientists and scholars know well enough that in order to truly understand anything, you must break down the data into subcategories and compare them. But thus far, too many professionals in the fields of deaf education and audiology have been resistant to doing this, preferring to paint with broad brushes and oversimplify rather than analyze and discover the nuances. Why?

      Why are some students graduating from deaf schools with outstanding English skills, and others graduating from public schools nearly functionally illiterate? And vice versa. There has to be more to the story than simply deaf school vs. public school/mainstreaming. Get rid of the rug and start examining the dust motes that were under there. Implement thorough tracking of every single deaf child in this country, from birth through college, and ask the right questions. Maybe then all of us can get some real answers.

  25. I recently attended a panel discussion put on by our state chapter of Hands and Voices. It was comprised of teenagers- some with hearing aids, some with CI, and some Deaf (one did not use any hearing technology, one had a CI but identified as Deaf). There were structured questions and opportunities for the attendees to ask questions. What was striking to me was how the “unaided” Deaf girl seemed so isolated. Many of her answers were “I can’t/don’t because I can’t hear”– doesn’t play in the band at school, can’t attend a social event or even school without an interpreter, doesn’t enjoy social events put on by her school. She is mainstreamed full time with an interpreter. Her parents do not sign much and there is not a large Deaf community in her rural area. While those things are absolutely not her fault, she seemed so isolated and almost sad compared to the other kids. Many of her comments suggested that she lacks confidence and a strong self image. I know another family (not at the panel) that has two children, both deaf, with bilateral CI and Usher syndrome. The oldest has already started to show signs of vision loss at 6. The parents and both kids are fluent in ASL. But the parents (who did not know that the kids had Usher until a year ago) are so grateful that their girls hear and speak given their diagnosis, since they will likely be blind before adulthood.

    I must disclose that I am a pediatric audiologist. Parents need choices, yes. But they must understand all the implications of choices they make. There is an incredibly small window for auditory brain development and we have to tell parents that in full disclosure. While oral language and sign are absolutely not mutually exclusive, it takes a special family to manage doing both and doing it well. We also have to consider that these kids, who are mostly born to hearing parents, will most likely grow up in a hearing world. Parents who do not want to use sign are not lazy, or “audist”. Rather, they may just be considering that they have other children whose needs must also be met, full time jobs, and may not live in an area where there is easy access to Deaf culture and even quality sign language instruction. There should be no judgement here. On the rare occasion when I’ve seen a Deaf family and have confirmed deafness in their baby, options are offered and no judgement is passed when they simply take their baby home. That baby will grow up in a rich culture and have language access from day one. But please extend the same courtesy to hearing parents who choose listening and spoken language for their child. It is natural to want our children to be “like us”. That works both ways.

  26. Jane, you said: “I expect a lot of signers at meetings like the National Association of the Deaf or similar organizations, but this meeting was primarily for issues relating to infants and pre-schoolers. I was surprised.”

    Why are you surprised, Jane? Deaf people were once infants and pre-schoolers. They, more than anyone, *know* what it is like to be Deaf and they *know* the consequences of parental decisions relating to communication choices.

    Who better to speak at infant/pre-schooler-related meetings?

    Lastly, you said: “…it is important to recognize that 95% of deaf children are born to normal hearing parents.”

    That sentence is rife with audism. In your sentence, you set the standard: Hearing is Normal; Deaf is….Not Normal, Abnormal, Undesirable, and so on.

    Poor hearing parents, saddled with icky Deaf children. Certainly *have to* do all they can to get rid of any reminder that they did not give birth to hearing children. Great way for the unfortunate Deaf baby to begin her/his life.

    So tough on hearing people, having to share this planet with icky Deaf people who stubbornly persist in speaking signed languages and maintaining their culture.

  27. Jane Madell, you emphasizes on the importance of providing the accurate information on the educational options to the parents of Deaf children. Do you ever disclose the rate of failures in the oral education option? Do you ever disclose the rate of Deaf children who failed the oral method end up going to the Deaf program in mainstream schools? Do you ever disclose the rate of Deaf children with cochlear implants end up going to an ASL school for the Deaf? Do you know the percentage of students with cochlear implants are currently in an ASL school for the Deaf? I believe you know! Your failures are the reason you strive to close the ASL schools for the Deaf because they have evidence of your failures. You are NOT being honest. Even you do not provide the accurate information to the parents of Deaf parents.

  28. Darn those auto corrections on my iPhone!
    Typos corrections:
    Jane Madell, you emphasize
    parents of Deaf children.
    Thanks!

  29. This should NEVER be about the professionals deciding what’s “right or wrong”. Every approach and every program has huge success stories and equally huge failure stories. There is no absolute right or wrong and any professional speaking like that isn’t all that professional. It’s about giving parents all views and information and letting THEM make a choice that feels right for their own family situation. The scene Jane described where the parent was being told negative things about implants is just unprofessional and quite frankly Bullying. That should NEVER happen anytime, anywhere period! Jane, I’m sad that it’s happening here too and aimed at you of all people who work so hard to advocate for families. I’ve only recently understood that the information within the Deaf community is not consistent with the information outside of it…..hence a lot of misunderstandings!

    1. I agree with you. Having the parent in tears, crying is not educating her, it is bullying. Parents need to be provided the information in an unbaised way to make an educated decision. Unfortunately, that still isn’t happening.

  30. Jane your article was wonderful! I agree with Pam, it’s apparent decision. No one and I mean no one has the right to tell another person how to raise their child. It is about respect…. That respect has to go both ways!

  31. Brenda, when you said “there is nothing wrong to learn ASL in order to understand the concept of words instead of how to pronounce the words or it would be a waste of time focusing on sound only that will delayed their social skills, basic iinterpersonal skills and cognitive language academic proficiency…”

    Now I understand where you are coming from. Teaching deaf children to sound out words and correcting speech is very outdated. Those were therapy sessions from decades ago. Present-day auditory verbal therapist focused on language, not speech. Our children are also very happy socially with a wide circle of friends. My daughter is deaf and she is proud to be deaf. Not knowing sign language as her first language does not mean she is not proud of who she is.

    Have you visited any auditory-verbal clinic? I am suggesting you should so you will see for yourself how present day auditory verbal therapy works
    ( I think you are confusing auditory verbal therapy with the decades old traditional oral therapy). AV therapy is fun and children love those therapy sessions. They learn through play and we learn how to teach our children not only to speak, but to think cognitively. We are definitely not a bunch of lazy parents. AV is a way of life and we took our responsibility as parents seriously.

  32. For those who had genetic testing that was inconclusive, if you are still interested in getting an answer, I would encourage you to try again using Harvard or U Iowa. These are the only two places in the US that have new tests that are much more comprehensive than anything done in the past.

  33. I thought I was coming here to share my perspective on why our family does what we do with our kids with hearing loss. Then I started reading the comments and felt both saddened and appalled- such great potential degraded into a sea of conflict over this way versus that way or who is “right”. How parents chose to raise their children is deeply private and personal, at it’s core unique, and frankly… no one’s business but theirs.

    It is clear that it is totally possible to raise well adjusted, bright, healthy, happy kids with hearing loss who reach academic and social success and have every opportunity for professional success and beyond regardless of how they were taught language, which language/s they use, how they communicate and if they wear technology. But it’s not that simple, there is a lot that goes into raising that child- hearing loss or not; that’s parenting.

    What contributes to one child’s success versus another varies because kids are unique and no two families are alike. Family history, culture, family literacy and education, existing resources, access to greater resources, family acceptance, geographical location, child care, work demands, multiple disabilities, first hand experience, siblings, socioeconomic status, professional support, family support, audiological resources- these are some of the many critical elements that factor into the success of that child and influence parent decisions.

    Parent involvement and vigilance, professional expertise and competency, early access to language, early identification & intervention, language and/or auditory skill habilitation, appropriate educational setting, educational plan with good supports and services, audiological management, role models, peer group with and without hearing loss in school or out of school… No matter how your child learns language and communicates, what devices they do or do not wear- if you don’t have many of these universal things in place I feel their social, emotional and academic success will likely be impacted in varying degrees.

    I think we can all agree a child with hearing loss is at risk. It is our job as parents and professionals to give these at risk kids the building blocks to succeed. Every family’s set of building blocks are going to be different colors and shapes and some may build castles with what they have and others may build cabins.

    What families don’t need is people judging or saying things like we are denying our kids language by not signing or robbing them of sound by not implanting, harming them by choosing assistive devices or isolating them by not choosing assistive devices; the list goes on and on and on. These are heart felt choices families make, ones that are not made lightly and in some cases made with great fear because the world is YELLING AND FIGHTING THAT IF YOU WANT YOUR CHILD TO BE OK DO THIS. Everyone is saying something different and misinformation is pandemic which you may or may not realize while making important decisions. So you do what seems right for your child and your family, and get to the very hard work at hand of raising children and grow blinders for conversations like this thread.

    It is totally possible to be impassioned but respectful. Your passion may be from the heart but misplaced if the delivery is heavy handed or disrespectful. No one is taking anything in when they are being pressured, strong armed or insulted. It’s human nature to broadcast something you know to be very successful either through study or practice- just do this and it works! But the fact is it may not be right for someone else and as hard as it might be to understand personally or professionally finding a way to respect that when talking to people is essential. These are personal, private and often complicated matters laden with emotion including fear and anxiety because no one gave you a crystal ball as a birthing prize.

    Your conduct even in a comment section of an article affects scared parents who are reading quietly on the sidelines trying to wrap their head around what the hell they are going to do. You read enough of this vitriol and you head to the hills instead of reaching out to this potentially great collective resource thinking “I’ll just make my way solo, because these people are kind of crazy and I am too scared of getting crucified for saying the wrong thing or worse I’m going to be seriously judged about how I am raising my child”. This ‘go it alone’ exodus is to the detriment of everyone because we lose another important piece of our community rainbow.

    I love the internet like no other, but it creates a veil of anonymity that prevents some necessary self-censoring when having these conversations. Would you really talk to someone like this if they were standing in front of you? These great opportunities to exchange and learn from each other degenerate into unhelpful and competitive battles of who is right. A great pity and missed opportunity.

    Spend more of your energy learning from each other so when someone does ask for your help or input you might be better able to present information in a compassionate, educated, respectful, gentle, accurate, non fear generating and unbiased way!

    I have waxed philosophically long enough… Practice peace people, if not for you, for the kids!

  34. Yes I agree that parents should have enough knowledge in rearing their deaf child. Very importantly how to take care and educate the child with special needs…

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