It’s Not the Same Old Deafness

At the recent Early Hearing Detection and Intervention (EDHI) meeting there was, as always, a lot of hallway discussion about auditory-verbal therapy vs sign language. Some of the deaf participants said that, in their view, asking deaf kids to use listening was an indication that the parents (and professionals) did not accept the children as deaf. Their view, if I understand it correctly, is that signing is the “natural language” of deaf children and that they have a right to learn it.

The human brain is programed to learn language whether a child is born hearing or not. Children learn the language they are exposed to: Chinese children learn Chinese, French children learn French, etc. But to learn language, a child has to be exposed to it on a full-time basis. That means that parents need to be able to expose their children to language every waking minute. All the research on language exposure indicates that the more language to which a child is exposed the better his language will be. Not a surprise. We would not suggest that parents who speak Italian teach their children English. It would result in children having limited language exposure.

While parents of deaf children can (and many do) learn sign language, very few become fluent. While they can communicate basics they often cannot communicate complex information nor discuss complicated thoughts. Their children may well be exposed to people with complex sign language skills at school. But children are in school for a limited number of hours/day; and in pre-school, it is for a very few hours. For children to learn a language well they need exposure all day long.

 

What is different today for deaf kids?

Even as recently as 15 years ago, kids with severe and profound hearing loss really had a difficult time learning to listen. Hearing aids were not of good quality and cochlear implants were just being developed. As a result, these kids had to rely on speechreading to follow conversation, and speechreading is, at best, inexact.

Today’s technology is different. We can fit hearing aids on infants at birth, and if they do not hear well with hearing aids, we can fit them with cochlear implants. With cochlear implants we expect kids to hear very well. Will they hear as well as their typically hearing peers? No, they will not. But they will hear well enough to use hearing to learn language and to communicate easily with those around them.

I recently spoke with a couple in their 80’s who were diagnosed with hearing loss as young children. They attended Central Institute for the Deaf from age 3 years, at a time when there were no personal wearable hearing aids. They did auditory training with a large amplifier on the desk and wore earphones to hear sound. At the time these desktop amplifiers used vacuum tubes and the quality was not great. Still they learned to talk.

As they got older they also learned to sign and found it made communication easier when talking to each other and to their deaf friends. But they worked in the hearing world and talked to their colleagues. They also talk when they are with hearing people when not at work. They have a deaf grandson who uses cochlear implants. I asked them what the difference was between them and their grandson, and they said, “He hears, we don’t.” That really said it all. It’s not the same old deafness. Because of the technology available today, kids have things much easier than those who did not have access to high-quality technology.

Helping deaf kids hear better does not mean we are rejecting deafness or rejecting our children. It just means that we are taking advantage of what is available today. We take advantage of all kinds of medical and educational advances. Why would we not do this with deafness?

 

We are not saying there’s no place for sign language

Of course, there is a place for sign language. Many deaf people will learn sign language at some point in their lives. If they have friends who are deaf it may facilitate communication. Some will learn sign as infants, and others will learn it as tweens or teens, or as adults. It is a second language and will be helpful for many.

I would no more say a child should not learn to sign than I would say that a child should not learn Spanish or French. Others will find themselves living in a hearing world and will choose to use listening and spoken language as their primary means of communication. The better their listening and spoken language skills, the easier it will be for them to live, at least part of the time, in the hearing community.

A lot of people who still argue that all deaf kids should learn to sign are not recognizing that “it is not the same old deafness.” Today’s kids have more choices. And the better their spoken language skills the more choices they have.

I talk with oral deaf adults in their 20’s and 30’s who had hearing aids, but did not have access to cochlear implants until they were in their teens. When I ask them what advice they would give to parents of young deaf children, they say they would suggest implanting their kids in the first few months of life. In their view, having hearing early, as is possible today, would mean that they would grow up hearing and not need all the therapy that these young people needed.

Are hearing aids and cochlear implants available today perfect? No. But they are terrific and in the future will be even more terrific. Suggesting that deaf kids today should choose sign language over spoken language is not taking into account what we have available today.

Ideally, it would be great if kids could easily learn both at the same time, but the research does not indicate that that works well. Once kids have a basis in listening and spoken language, they can learn sign language and then code switch. But it appears that they need to learn to listen and speak first. We know that the better they listen the clearer their spoken language will be. That alone will make their lives easier.

 

So let’s take advantage of what is available today

Let’s give kids access to the best technology available. Let’s give them auditory-based therapy to teach them to listen and talk. If they want to learn sign language when they have developed a listening and spoken language base, great. They then have the choice to be whoever they want to be. That is the goal.

 

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.

5 Comments

  1. Beautiful piece. It is logical and balanced and it should be mandatory reading for beginning students in audiology.

  2. This was a very interesting article.Yes, I did attend Central Institution for the Deaf as a young child. Back in those days, they had those huge body worn hearing aids, and we had auditory therapy by sitting at u-shaped tables with headphone attached and the teacher would sit in the middle to talk to us. Granted she used a lot of hand written words on cards to encourage us to learn the language. It worked. All those years of wearing the hearing aids has prepared me for the cochlear implant at age 50. Why didn’t I get it sooner? Because I thought I was doing well, until I had a major hearing loss of 30 db in one day. Today I am so grateful to have this technology, and strongly encourage all deaf children to be implanted as soon as possible.

  3. I appreciate you saying that ASL is a language that can be acquired the same as other languages. I support the idea of young deaf children being exposed to language as early as possible. Whether that be spoken language or sign language. The one thing I would want to emphasize with you is that there does not have to be a choice of this language or that language for young deaf children. Expose them to both languages and permit them to become bilingual do not force parents or deaf children into having to choose one method. Not every child that is implanted will be successful, but if parents are told they have to choose one language they are going to continue to use spoken language with their child even if it is not the most effective way to communicate with them. Likewise some deaf children will be in environments where just using sign language is not the best access to communication. Let’s have parents utilize both languages in their home. Their natural spoken language but also introduce sign language. Further, based on what you wrote I assume you would agree that deaf children of deaf (signing) parents should be raised with sign language only since that is the natural language of the parents, right?

    1. I’m not the author, but I believe her answer would be yes, if that is the language that can be modeled fluently.

  4. To reinforce this, look at the body of work by Prof. Anu Sharma on cortical reorganization due to cross-modal neuroplasticity

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