How does a child who is born with a hearing impairment acquire a spoken language during the critical stage of language acquisition?
There is considerable evidence that auditory input and spoken language stimulation for deaf children who are to learn spoken language are important to initiate as early as possible (hence, we often talk about “critical periods” for language development). However, such programs Tust be individualized to the particular child, taking into account their audiological, developmental and family needs. Dr. Patricia Spencer suggests looking into either the John Tracy Clinic (http://www.jtc.org/services/distance-education/index.html) or Boystown National Research Hospital (http://Cathy.carotta@boystown.org) for distance programs for parents of deaf children. Dr. Ann Geers also suggests that the AG Bell association (see our Partners page) is an excellent resource for finding helpful professionals in their area, and they have a variety of materials specifically geared to parents. If you are interested in research supporting early spoken language intervention, she suggests looking at chapters in Spencer, P. E. & Marschark, M., Editors (2006). Advances in the spoken language development of deaf and hard-of-hearing children. New York: Oxford University Press.
Dr. Geers also pointed out that “there is ample evidence that the brain is most ‘plastic’ or accepting of new information when the child is young (3 or under) and children who receive auditory stimulation (through a CI or HA) during this time period usually demonstrate normal central auditory maturation within about 6 months of stimulation. Spoken language progress will be affected by additional diagnoses or disorders that can affect learning or communication development independent of hearing loss. Such children can be expected to progress at a slower rate even if stimulation occurs early. Certain nonverbal communication skills (e.g. eye contact, turn taking) are also predictive of spoken language development. Oral motor skills are also considered in the prognosis. Difficulty with oral motor skills like moving the lips, teeth or tongue appropriately will influence a child’s speech production. Taking all of this into account, research has shown that children who are in environments where speech is used and that focus on listening have better speech perception and spoken language outcomes overall.
Dr. Jean-Pierre Gagné emphasized that language does not develop normally nor naturally in most children with hearing loss, so direct/specific intervention programs must be sought. He suggested that (re)habilitation will focus on four or five aspects:
I have 3 deaf children. The reason I am writing is my son who is 10 can barely read at a 1st grade level, yet is on the high honor roll. Which I am very proud of. It seems as though they are just passing him along without no great concern for his reading. I have expressed my concerns everytime his IEP comes along and they say that it is a success for a deaf child to graduate at a 4th grade reading level which is absurd. My son wrote me a note one day and it said “mom I want to learn to read”. That just broke my heart. If there is anything you could recommend for me to try to teach him as much as I can at home it would be appreciated. Most of the recommendations I get from his school are way too expensive. I do as much as I can to help teach him, but I am a high school dropout who didn’t really pay much attention when I did show up. Which I truly regret. Didn’t realize as a kid my actions in school would affect the way I am able to teach my children. It seems to me when they passed the No Child Left Behind Law they left behind deaf and hard of hearing children and others with disabilities. I contacted my state senators and they told me to write a letter to all our state reps and senators. I just want my children to grow up and go to college and be functioning adults. I have done lots of research which is how I found your website, but I am not that well educated and need help. Which is why I am contacting you in hopes you might be able to help me help the thousands of disabled children in Illinois. I also would like to try to address the fact that 90% of deaf and hard of hearing children have two hearing parents and out of that only about 88% of them know sign. That is a shame when you cannot communicate with your child. Which I am sure it has a lot do to with finances and education. I have a hard time, but have been learning for years and I am decent but not great. So please if you could help it would be forever appreciated.
Dawn,
We are working on this at several levels. Most generally, Jenny Singleton (University of Illinois, Urbana-Champaign) offered several things to think about, although different issues may arise depending on whether your children are at the Illinois School for the Deaf or mainstreamed:
“What specific reading objectives are listed in the IEP and what specific focused instructional support is proposed for each of the reading objectives (and what evidence is there that the school followed through with the plan?). If it appears that the school is continuing to push son forward with low expectations, that is of course concerning. Has anyone assessed his sign language fluency? Is he “on target” age-wise for his sign language development?
“Do you have an advocate who attends the IEP with you? One resource that might be helpful is the Midwest Center on Law and the Deaf to think about whether you want to take further steps in determining whether the school personnel are developing and following through with appropriate IEP objectives.”
I also contacted Barbara Raimondo, Esquire, Policy Consultant, who provided helpful information with regard to remedying your situation through the IEP process. You can find that here: IEP Process.
Meanwhile Karen Roudybush (Reading Specialist at the Western Pennsylvania School for the Deaf) offered the following…after emphasizing that “grade level reading remains the goal and that a fourth grade reading level remains unacceptable.”
There are a few things that you can do to support your son’s reading.
First and most importantly, READ, READ, READ. Initially, you need to find a topic/story of interest for him. Start out with easier materials, moving to more complex. How well does he recognize words? What does he do when he comes to a word he doesn’t know? Does he keep or reading, reread, look for know chunks (meaningful or common spelling units) in the word?
Help him to increase his vocabulary. Then find those new words and concepts in print everywhere. Move from over using simple words (e.g., ‘big’) to more robust and less common words (‘enormous,’ ‘huge,’ ‘gigantic’) and talk about the differences in these words.
Help him classify texts:
| Fiction (story) | NonFiction (fact) |
| want to enjoy it | learn from it |
| look for characters, | what is topic, what do you know, want to learn? |
| beginning, middle, & end? (see story map) | what did you learn? |
| Graphic Organizers – narrative story | Graphic Organizers – see KWL |
Encourage him to begin to ask questions while he reads. Look at the questioning strategy.doc for some questions he can use repeatedly depending on the type of text.
Summarize as he reads. Have him retell as he’s reading and help him with his misunderstandings.
Some great web sites are www.fcrr.org You can find support for all the big ideas in reading including vocabulary and comprehension and word attack. Look under the student center activities search tool. You can pick an area of need and get support materials to address the need. www.readingquest.org has comprehension strategies that help support non fiction text understanding.
I like reading a to z http://www.readinga-z.com/ Although it’s a pay-for-use site, it offers leveled books from pre-primer through fifth grade in fiction and nonfiction with support worksheets and evaluation tools. It also offers advice for teaching various skills.
Evaluate his reading strengths and needs and capitalize on his strengths and work on his needs. I hope this helps.
Can you tell me what the story is on sign-supported English?
I know, I know, everyone says that sign-supported English (SSE) and simultaneous communication (SimCom) – both involving speech and sign at the same time – are bad. On the theoretical/political side, people point out that neither is truly a language unto itself, and argue that they therefore are “inappropriate.” Empirically, people point to two studies, both done over 20 years ago, which found that several teachers and parents of young deaf children said more than appeared on their hands (by anywhere from 20 to 50%). The sign abilities of those parents and teachers were never examined, however, and some people are extremely good at SSE (or whatever language) and SimCom. Research over the past 30 years has shown that when teachers are highly skilled at SSE or SimCom, students learn just as much or more than with ASL from a teacher, interpreting, or spoken language alone. In our own work, we’ve recently have found the same thing, as deaf college students learned exactly the same amount when they had teachers using SimCom, voice-off ASL, or utilizing interpreters. Importantly, these were skilled teachers of the deaf, who had been using SimCom for many years with classes that included oral students, ASL students, and everything in between. Although it frequently is not discussed (at least in public) many deaf students request teachers to use SimCom and ask interpreters to include “English on the lips.” It seems likely that SimCom would be particularly beneficial for children with cochlear implants, who generally do not receive auditory input as clear as that received by hearing children.
Unfortunately, the unearned stigma associated with SSE/SimCom seems to have prevented anyone from doing the appropriate study. Meanwhile, both are used effectively in many classrooms, even if students use a natural sign language or spoken language in other settings. What is essential is that deaf and hard-of-hearing children have early access to fluent language. That usually is difficult with spoken language alone and most parents are not fluent in sign. So, SimCom/SSE might be helpful in ensuring communication for new-signing parents, but this DOES NOT mean that SimCOM/SSE can replace full access to a natural language (actually, there isn’t research one way or another). The issue clearly is more complex than we can deal with here. For full discussion of what we know and what we don’t know, see Spencer, P.E. & Marschark, M. (in press). Evidence-based practice in educating deaf and hard-of-hearing students. New York: Oxford University Press.
I am a Kiwi mum of an amazing little girl now aged 8, who was born with a severe-profound sensorineural hearing loss. I taught D. to speak, as well as supplementing our lives with Sign Language, and anything else we could possibly use to help her communicate. After hearing about the John Tracy Clinic when she was 3, I fund-raised and managed to get our family over to the Summer International Session when D. was 4. She is now just starting her fourth year at school, and is a very intelligent little girl with a reading age of 13 years and comprehension of 12 years. She is a dear wee person with a genuinely nice nature, and a compassion and maturity beyond her years.
So, we’ve done a good job so far in some areas, BUT we are broken hearted parents because she has no friends. I have been trying for a long time to figure out why, and simply after eliminating everything I can think of, I can only assume it’s because she is Deaf. I desperately want to help her and I would do anything to achieve that. Can you please give me some advice? [Readers: This is an interesting and all-too common challenge faced by hearing parents of deaf children. For that reason, we are going to post the full series of exchanges related to this query.]
First it would be important for the mom to talk to D. about the situation. Is she concerned herself about not having friends? What social relationships does she have. Is she able to Video Conference? Does she have technology access? Has mom observed her daughter at school interacting with her classmates? Is there anyone person D. can identify that she might want to be friends with? Can mom see about hooking her up with a one on one friend outside school activity? Does her daughter have any interests outside of school that would lend them to peer interactions, art club, photo club, soccer, tennis… Has mom talked to the teacher about the situation? Are their dyad projects in the classroom? Can the teacher identity suitable friends? Is D. bullied or left alone? Can she teach other students sign language, or about deafness? Does she have good nonverbal social language? Can she read other people’s nonverbal cues? Maybe her maturity level is higher than her classmates? Maybe her interests are different? Maybe mom can help D. find individuals with similar interests. Maybe having her paired with a peer coach that can who her in social situations. Also have her share her strengths by helping out with students who may not read at her level. Another suggestion is to consider deaf summer camp for her to meet other students like her. Another thing is for mom to nurture D.’s comfort with solitude. There is some preliminary qualitative research that suggests solitude may be a unique deaf ‘resilience factor,” meaning that that your daughter may be perfectly content with her solitude and finds it “safe.”
Thank you for your response! D. has become extremely adept at reading “body language” as we call it, in fact she’s an expert. She is a very socially atuned person and we have worked on these non verbal cues for years in many ways. Her own body language is open, welcoming and expressive, and she has an alert, smiling face and responds to nearly everyone with delight. I’ve been lucky enough to observe her at school over the last few years on a regular basis, as I have worked as a special needs teacher aide at school in a variety of classrooms, including hers on occasion. I have been privileged enough to be able to observe her without her knowledge and I genuinely feel that she is not transmitting any signals that are in any way off putting to peers. I’ve checked that out with teachers and they feel the same way.
My suspicions are this – D. has a lovely, friendly nature and adores playing with others. It seems to me that as the years are progressing, the level of cattiness with girls is increasing, and that there seems to be a dislike of anyone that doesn’t fit the “norm” image. D. also misses out on whispers, muttered jokes and asides, and if a comment is flung out in The playground for example “let’s go to the slides,” and the children run off – they look back and see she hasn’t followed, they think she doesn’t want to – she looks and sees them all take off without her and thinks they don’t want her. I’ve observed this and while the teachers and I make all efforts to explain to the children that D. doesn’t hear them, it makes little difference to children in the end. Basically it seems that when she approaches groups of different children and asks to join in their play, they say NO. I’ve observed what happens when other hearing children do the same thing, and the answer seems to be predominantly YES.
I have definitely worked hard at encouraging all out of school socialisation and she is a good netball player and a valued member of the team. She does gymnastics with another group, and I have had many playdates and so on, but children/parents seem not to return them. D. And I have both done little educational sessions on sign language, hearing aids, that sort of thing in the classroom as well, to see if we can encourage more acceptance and interest.
At present, D. is going to sessions with the school psychologist, and I in fact have gone to my own psychologist to discuss my distress, as I don’t want to project it on to D. Both of them have asked me to work on the “being happy alone” theme which I’m doing without making it terribly obvious. I often talk about how wonderful it is for me to have a book wherever I am, so that if I’m bored, lonely or just simply want to be alone, I can disappear into my lovely book and those feelings dissipate.
We have deaf friends that we have playdates with – deaf children with profoundly deaf parents who only sign, and oral deaf friends and we intersperse these into our lives so that she has access to all of her worlds, because after reading many books on deafness, it seems that often parents try and force their children to go only down one track – either sign, or oral, and not let them have everything. I have a strong belief that if D. is familiar and comfortable with the Deaf world, as much as the hearing world, then there will be periods in her life where she will naturally gravitate to one or the other for reasons at the time.
I feel as if I am facing a horrible fact now, that it IS hard for Deaf children to function well in mainstream friendship groups, and that they are, despite having excellent speech, vocabulary etc., excluded. I simply can’t think of what else to do, but I hate seeing the change in her bubbly, happy personality, and watching the incredibly expressive sadness in her body language when she talks about spending playtime and lunchtimes alone, day after day.
Tracey, it sounds as if you are doing all the right things. But, here is one more suggestion: Perhaps once a week or so, for lunch and/or during play time, D. could have an “arranged” group to meet with peers that she selects. Maybe the school psychologist can help with that. More to come. Stay tuned…
I am interesed in adopting a 10 year old girl that is deaf. I have had some experience with sign language. I would like to communicate with parents that have children like her so that I can be more informed and other issues that I might experience. Is there a book of signing that anyone might recommend for me?
I have contacted several parent groups, and both Hands & Voices and the American Society for Deaf Children (see Partners page) have urged you to get in touch with them. They have a number of parents who were in your situation, and they would be happy to share. [Separately, I will send you e-mail addresses of individuals who have adopted deaf children themselves.] With regard to learning to sign, these organizations, sign language experts, and I all urge you not to depend on books or related material. Learning to sign is just like learning any other language, and it is neither as quick nor easy as many people expect. There are some good DVDs out there, and the (expensive) “Bravo! ASL” series was highly recommended, but face-to-face sign language lessons are essential. And not all sign language programs are created equal. Your best bet is likely a local university or community college. If you let us know where you live, we may be able to make specific recommendations.
I would like to know if i can get a list of schools for the deaf in the Netherlands. I have a 14 year old deaf daughter who is finishing primary school this year.
All schools for children with hearing and/or language problems in the Netherlands are listed on the following website:
http://www.simea.nl/vhz/kaart-online.html?categorie=onderwijs. All these schools accept hard-of-hearing children, 50% of the schools also accept deaf children.
A friend recently met a woman who had a deaf child with a cochlear implant. She was not happy with the outcome of the implant on her child and admitted that she should have contacted a deaf person first before making a final decision to get the implant for her child. Now she is taking an ASL course. It is widely known that about 30% of deaf children with cochlear implants have success. That child I mentioned above falls into the 70% group. I am aware that there are some more deaf persons who no longer use cochlear implants. Also, I have met more people and parents who are disgruntled with cochlear implants. Enough to require a legislative action? But we do need statistics. Where can we get the statistics? Should we ask legislators to create a bill to research and collect progress data and outcome on the children with cochlear implants?
First, let me clear up a misunderstanding: Different people mean different things by “success” with cochlear implants, but by far, the vast majority are at least “satisfied” and most are happier than that. Cochlear implants benefit most deaf children with regard to hearing, speech, language, and academic achievement, although none of these necessarily reach the same levels as hearing children. Not all children are successful with spoken language, but even when they are not, access to environmental sounds can be beneficial for incidental learning and cognitive development.
Certainly, parents should seek a variety of perspectives before choosing a cochlear implant for their child. In fact, the amount of time parents spend with such investigations is a good predictor of children’s “success.” In part that is because some parents discover that their child is not a good candidate for an implant (thus reducing the chances of a poor outcome), and other parents learn just how much long-term support is necessary, so that their children are more likely to receive the therapy and other services that will allow them to optimally benefit from their implant. In this context, parents also learn that cochlear implants do not turn their deaf children into hearing children. The typical child with a cochlear implant functions as though they have a mild to moderate hearing loss – some better, some worse.
While most deaf children benefit from the cochlear implants, it is not clear how many “disgruntled” former implant users are out there. Those individuals may be more visible, but they likely are a relatively small minority. And, I freely admit that prior to 2000-2001, I was not a supporter of pediatric implants, because I did not think there was enough evidence to support their value given the relatively risky surgery. Since that time, the surgical risks have been minimized, and there is now abundant evidence of the great value of implants for most kids. Enough to convince me.
It would be helpful to all concerned if parents received full, objective information about pediatric cochlear implantation. Pollard (1996) discussed this issue in the context of “Informed consent at a phenomenological… conceived as freedom from undue bias based on ignorance or unfounded beliefs about life with deafness or, more specifically, life with or without a cochlear implant.” That information would include the fact that sign language is not necessarily a bad thing for children with cochlear implants and may be helpful in supporting spoken language development as well as social-emotional development and academic achievement.
For more information, see Pollard, R.Q (1996). Conceptualizing and conducting preoperative psychological assessments of cochlear implant candidates. Journal of Deaf Studies and Deaf Education, 1, 16-28.
Spencer, P. E., Marschark, M., & Spencer, L.J. (in press). Cochlear implants: Advances, issues and implications. In M. Marschark & P. E. Spencer, Editors (in press). Oxford Handbook of Deaf Studies, Language, and Education, Volume 1, second edition. New York: Oxford University Press.
My 8 year old DHH, speech and gifted son is in a high achieving gifted classroom. He is the only DHH student in his school. He began the 3rd grade reading on a 2.4 reading level. He was reassessed and has made no gains since the middle of 2nd grade. Do you have any suggestions on what can be done? We are new to the DHH life as a family. My son was diagnosed with progressive hearing loss at age 6. His hearing has significantly gotten worse.
Without assessment information [and several experts recommended that you immediately arrange for an assessment through school psychologist or reading specialist], my comments would be generally good practice but may not target this child’s real needs. Without knowing what approach(es) are being used in reading instruction, it is difficult to know what’s not working. My guess is that as the reading materials have become more conceptually complex, vocabulary load has increased dramatically, and sentence structures more complex, this student’s word recognition skills – which were sufficient to make good progress at earlier levels – now are not sufficient. Added to this is the possibility that as his hearing has declined, he may be less able to apply phonic skills to identifying new words, which had been his strong skill area … I would suggest the following emphases: building background knowledge and introducing new vocabulary before reading the material, teaching and reinforcing cognitive strategies for comprehension during and after reading through approaches such as asking questions that require analysis, synthesis, and evaluation; teaching how to generate self-questions and use mental imagery; retelling; responding in writing (e.g., journals). I also see writing instruction- such as writing workshop – as important for this student. I don’t see any particular reading program better than any others in meeting this child’s needs – Guided Reading Approach, DRTA, Reciprocal Teaching – could all be successfully used. At home, parents should continue to read to him, and if he has a younger sibling, he could read his stories to his brother or sister.
And here are more pieces of the puzzle from John Luckner, University of Northern Colorado:
The fact that your son did not make any progress in reading over the course of one year is very concerning. Your query raises many questions.
It is my hope that the responses to these questions will help you and the professionals you work with develop a more aggressive plan for dealing with your son’s lack of progress in the area of reading.
I am talking with a parent who has a deaf, signing fifteen year old who is way behind in reading and writing. (Not an isolated case, I know.) She is working with the school to find the best way to catch him up. It is a mainstream school without the capacity to be successful with deaf students. She may be filing a complaint and needs to know what literacy approach the school should use. I am always at a loss about what to recommend the best way to teach deaf students literacy. I have my own opinions, but it seems there is very little scientific validation of the approaches used. In your opinion, what is the approach that is best supported by the evidence? If there is not one, what would you recommend as the best way to go about determining the best approach for this student?
There is no one particular way to approach this situation. It depends on the individual, and if he’s that far behind at age 15, it seems most likely that what he needs is one-on-one work. Beyond that, here is the collected wisdom from three experts in the field: Barbara Schirmer, University of Detroit; Beverly Trezek, DePaul University; and Cheri Williams, University of Cincinnati.
Without information about what approaches have been used with this student up until now, and diagnostic information about his strengths and weaknesses in reading, it’s not possible to identify a particular approach likely to be successful with him. Therefore, it would be important to begin with an assessment to identify the student’s strengths, weakness and needs in the area of reading. The Southwest Educational Development Laboratory (http://www.sedl.org/) has an extensive database of assessments which includes both general reading batteries as well as those targeting specific areas (e.g., phonemic awareness, phonics, vocabulary, etc.).
Regardless, one-on-one is undoubtedly needed, and likely to involve as much word recognition skills as possible within the context of either (1) language experience type stories generated by the student with the tutor and/or (2) a structured reading program in which words are introduced gradually and with repetition. These series, such as those using Direct Instruction, are phonics-based, and would need to be paired with visual phonics. If this student could be tutored by a Reading Recovery trained teacher who has experience working with deaf students, I believe he might make progress. One of the program’s strengths is matching explicit instruction to the student’s specific literacy needs. One possibility is to approach this as a severe reading disability (as we would with hearing students. Programs like Wilson are designed for adolescent and older students who have such disabilities. Although none of us have first-hand knowledge about the research on these programs, second-hand reports indicate that they are very effective.
In addition to the curricula already mentioned (i.e., Wilson, Reading Recovery, Direct Instruction), the Florida Center for Reading Research (http://www.fcrr.org/) has reviewed literally hundreds of core and supplemental reading programs and organized their review around the NRP’s recommended five areas of instruction. Once an assessment can pinpoint specific areas of instructional need, a curriculum can be chosen. Naturally, the instruction will need to be supplemented to meet the unique needs of the deaf learner (e.g., Visual Phonics, sign language, visual supports, etc.) but the curriculum will provide a foundation for explicit and systematic instruction.