Raising and Educating a Deaf Child

International experts answer your questions about the choices, controversies, and decisions faced by the parents and educators of deaf and hard-of-hearing children.

Latest Questions and Answers

My daughter is thirteen and deaf and recently got a cochlear implant. How does she qualify for a free iPad? She attends a school for the deaf and needs the iPad to communicate at school through FaceTime. Please help. I can also provide doctor documentation if you need it upon request

Question from D.K., Delaware. Posted November 24, 2014.
Response from Elizabeth Jackson Machmer - NTID

Well, we haven’t heard of free gifts coming with cochlear implants, but a quick google search returns this: http://www.wonderbaby.org/articles/ipad-funding-special-needshttp://www.wonderbaby.org/articles/ipad-funding-special-needs

If the iPad is desired for personal communication with friends and family, I do not think this is something that either insurance or the school system would pay for. You probably qualify for a free videophone based on your daughter’s deafness and use of ASL. Applications can be found here.

There many alternatives to Facetime that can be used on computers (Mac or PC), other tablets, or smartphones, including Skype and Google Hangouts. If your daughter has access to a computer or smartphone with a video camera, then there is no need for the iPad specifically as alternative video chat software can be used.

If there is a specific therapeutic reason for having the iPad, such as a communication training app or other educationally based app, it may be possible to request that the school system purchase it for her. First, the IEP would have to be changed to indicate the specific need for it. The iPad would be school property in this case but it may sometimes to be possible for the student to use it outside of the classroom, situationally-dependent.

Lastly, some low-communication individuals do use alternative and augmentative communication devices like a DynaVox, but these are costly devices. There are some alternative apps that may be useful for these individuals, and in these cases it may be possible that health insurance might approve the iPad as medically-necessary. It doesn’t sound to me like that’s the circumstance here.

I have a seven month old daughter just diagnosed with profound hearing loss. What are the main things I should be doing with her immediately (apart from starting sign language, which we did before she was officially diagnosed) to promote her language and literacy acquisition down the track?

Question from M.W., Switzerland. Posted November 16, 2014.

You are already doing the most important thing: asking questions. Next, but not unrelated, you should look into family-centered early intervention programs. Descriptions of these, the issues you need to be aware of, and the questions you should be asking can be found in two articles recently published and available from the Journal of Deaf Studies and Deaf Education. Click on “Read Highlighted Articles for FREE.”

Meanwhile, enjoy your daughter and engage in as much communication as possible by talking to her, signing to her, and through touch. Just remember to get her (visual) attention before communicating. You will do great!

My son is five years old. He is hearing impaired and has worn hearing aids since he was two. He is well-educated with ASL and so are we. He has the worst behavior problems at home if things don’t go his way; he starts throwing things, screaming, crying, and hitting anyone in his way. We don’t know what to do anymore. Please help.

Question from R.C., Florida. Posted November 11, 2014.

One of the first questions I would ask is regarding language. Often kids who have difficulty understanding or expressing themselves (verbally or in sign language) resort to behaviours to get their points across. Does your son have age-appropriate language acquisition? If his language is age-typical, then my next consideration is that these behaviours may be indicators of a mental health issue, and he should be assessed professionally by someone knowledgeable about deafness and mental health. Finally, it is not uncommon for children to act differently in different settings. Home is usually very unstructured compared to school and he may also be repeating the same behaviours there if he found them to be successful at home in the past (that is, getting his way). You might check with the school and see if he behaves differently there. If so, his teacher might be able to give you some advice. There may even be a school psychologist who can advise you.

I am needing help with explaining how an 11th grade student who is deaf with ASL as his first language and English as his second language and uses an ASL interpreter in class is struggling with learning Latin IV. He uses a CI and hearing aid.

Question from A.D., Ohio. Posted October 30, 2014.

Research on deaf signers who have ASL as their first/preferred language has clearly shown that their skills in using spoken/written English vary enormously. Those who acquire ASL earliest tend to be better at English overall than those who learn ASL later, but many do struggle with English as it is for them a second language (just as learning say French would be for a native English speaker). Learning then additional spoken/written languages beyond English is even more challenging for the deaf student, particularly when they are being taught alongside hearing students via interpreters. This would be like a native English speaker who can read and write French as a foreign language trying to learn Latin as an additional language in a class full of monolingual French speakers where the class was taught exclusively in spoken French and interpreted (just for that one student) into spoken English. There has been very little research on acquisition of additional/foreign languages by deaf signers in these kinds of situations, but it is clear that such a student must be given proper support in order to achieve the same level of success as his hearing peers.

We have a 5 year old, bilaterally implanted son who has been mainstreamed into a general education kindergarten. He is awesome at reading people’s body language and just assuming answers to questions. He is an awesome parrot. [But these do not mean he is understanding fully.] The school continues to say that he is a typical 5-year-old boy and that he has adjusted well to being mainstreamed.

He is a very visual child, and we use sign language and spoken language to communicate at home, but the school says they cannot accommodate that, even though we know that there is an interpreter around the corner who has a contract with the school. Is there any way to get sign language into the classroom? We were originally told that if they got an interpreter for him they would need to get one for every foreign language student in the school. Which we know is against the law.

He went to the deaf school for half a day last year in Pre-K, and were told that that was all they could offer him, as he is so advanced due to us working so hard with him. But his working so hard has come back to bite us. He now comes home tired and burned out, not wanting to listen to us anymore. All we want is for him to get the same education as his hearing peers, please help!

Question from L.W., New York. Posted October 9, 2014.

You and your child are going through a difficult time that needs to be resolved as soon as possible. Your mentioning that he is in a mainstream setting suggests that he has had an evaluation through special education and has an Individualized Education Program (IEP). If he has, I would suggest requesting a meeting to review his current placement. If an evaluation was not done, you can request a referral for an evaluation through special education.

Your child is entitled to have access to the curriculum and to instruction in the classroom based upon the evaluation and the IEP (it is important that the assessment regarding modalities of instruction be done by someone knowledgeable with regard to hearing loss). If that access requires an interpreter, then it is the school department’s responsibility to provide that service, assuming that it is part of the IEP. There should be no negative consequences for your child because he has had opportunities (with your support) to develop his skills. The goal of special education is to insure that all children achieve to the greatest extent possible given their capabilities. Your son’s strong abilities are no less worthy of support than if he was weak in the same domains.

With regard to the school’s response to your request, not speaking English is not a disability. A child who is a native speaker of a language other than English does not qualify for special education services. That argument is a “red herring” and has nothing to do with your son’s situation.

Our five year old son has mild to moderate bilateral sensorineural hearing loss. He has had hearing aids since he was 2 1/2 years old. He is speaking very well due to all the support he has received from speech therapists and deaf educators over the past two years. When he was three we put him in two different half day programs for children with hearing loss. He seemed to flourish in those settings. However, he recently began Kindergarten at a school that specializes in D/HH children, but is mainly hearing students. He is one of two in his class who has hearing loss. We have begun to see behavioral issues that he did not have (or at least did not rise to this level) at his preschools. At one point he pushed a little boy and pulled his hair and spit on him. These behaviors are odd for him outside of the home. (He has a three year old brother who he sometimes hits). He has also began to act very odd when he leave certain places. For instance, last night we went to his open house at school and he was doing fine, but when we were getting ready to leave he began to lay on the ground and laugh and would not cooperate. He recently did this at a park as well. We also continue to have problems with him in the bus line, where he is hitting/pushing kids.

Since this is all new for us we are unsure what measures to take. He has a deaf educator who is in his classroom in the mornings and she has been very helpful. I should also mention that this summer we had a baby and moved to a bigger house, so he has had a lot of change. I appreciate any information that you might be able to offer.

Question from S.K., USA. Posted October 3, 2014.

I must start by saying that without spending time with your son and looking closely at everything in his life, it is impossible to explain what is happening with any level of confidence. What I can do is offer some thoughts on possible explanations given what you have described.

My first thought is that you’ve described a number of quite significant changes in his life. He is now in a different sort of school program, he has a new sibling in the family, and is living in a different house. Even with all the best preparation, that can be very hard to accept and adjust to. It also can leave a youngster feeling like life is not in his control. Some of the behaviors you’ve described seem to be connected to exerting control – pushing other kids out of his way, not transitioning out of an activity, and those sorts of things. This is one possible underlying theme.

I’m also struck by the change from being in a school program for kids with hearing loss to one where most of his peers are hearing, even though the program specializes in kids with a hearing loss. It’s wonderful that he has made such good progress with his aids and speech therapy, but it is critical to keep in mind that a youngster with a hearing loss living in a hearing environment expends a great deal of energy over the course of a day. Even the most skilled oral communicators will admit to being completely tired out at the end of the day. Constantly working to fill in the blanks in the sound stream of language can be exhausting. When children are stressed or simply very tired, their ability to cope with everyday stresses of playing with peers, learning, moving in and out of activities is diminished. While you described some problems at home, such as difficulties leaving the park, many of the issues appear to involve school in some way. This would suggest examining the challenges of the new school.

Some ways to address this include giving him as much reasonable decision making power as is possible, and giving lots of warning about transitions. If he feels many things have changed without his “input,” one way to help with that is to emphasize the things he can make decisions about, such as clothes to wear, games to play, and any of the normal choices 5-year-olds make in a day. For managing school stresses, perhaps some quiet times during the day when he need not worry about what his classmates are saying, or some structured time where the communication is adult mediated and made clear to all could be integrated.

If these issues do not resolve with reasonable understanding and support, it would be wise to involve the school counselor or school psychologist for help with further evaluation to understand more deeply what might be happening.

I’m a pediatric occupational therapist who only occasionally works with deaf children. I don’t have time (or a library) to read papers and books about deaf children. Is there something like Cliff’s Notes on deaf kids?

Question from R.P., Virginia. Posted July 16, 2014.

Yes, Virginia, there is a Santa Claus. (sorry!)

Raising and Educating Deaf Children is a new site offering objective, evidence-based information for policy-making and practice associated with raising and educating deaf children – with an eye to improving them. New eBulletins are posted quarterly; each includes sections on The Issue, What We Know, What We Don’t Know, and Implications about various topics, all written so as to be accessible to parents as well as professionals.  eBulletins include Further Readings with content offered free of charge by Oxford University Press.

What language/sign system/ communication mode is best in regards to educating deaf children? In particular, does using SEE correlate to higher reading and writing levels when compared to ASL, total communication, or Sim Comm? Many times people argue that SEE is best because a certain school or program’s students have higher reading levels. To me that is not evidence based data. There are many factors that can contribute to higher reading levels at a certain school when compared to another school or program. Looking at one aspect is not enough unless the schools are identical in all other areas. Is there any evidence based research to support SEE? Also, is it possible to use elements of SEE, but still continue signing ASL or conceptually?

Question from L.L., Texas. Posted June 30, 2014.

I just love loaded questions! Here’s an answer many people will dislike:

There is no language/sign system/communication mode that is “best in regard to educating deaf children.” Certainly, you can find proponents (and data) to support any of the ones you listed. What that tells you is that different things work for different children in different settings. Generally, forms of manually-coded English were created to help deaf children acquire English literacy skills. Generally, they have not proven more successful over the long term than American Sign Language (ASL) or anything else, but the comparison is not a simple one. Proponents of ASL as a link to literacy typically cite data showing that early ASL (e.g., from deaf parents) supports early literacy. So does early spoken language (e.g., from a cochlear implant). The key is early access to fluent language and being surrounded by it in formal and informal settings.   There are programs that use SEE, ASL, SimCom, and other systems that report successful reading achievement in their students. The data from these programs vary in how strong they are, but, again, what this shows is that when deaf children are surrounded by consistent language they will excel. SimCom, for example, has been criticized for not being “a true language,” but has been found to work as well as anything else in the classroom, at least in high school and college. And children in a real total communication school (i.e., SimCom, ASL, assistive listening devices, etc.) have been found to read as well or better than peers in a well-known bilingual program (in which over one third of the children had deaf parents) (see Knoors & Marschark, 2012, below). SEE is an English-based sign system; ASL has a completely different grammar. Many deaf and hearing people use signing with English word order and characteristics of ASL, but trying to mix in SEE signs rather than using ASL signs seems an unnecessary complication. The goal is to give young deaf children a foundation for language (signed and/or written/spoken). Unfortunately, there is no simple solution.

Further reading

Knoors, H. & Marschark, M. (2012). Language planning for the 21st century: Revisiting bilingual language policy for deaf children. Journal of Deaf Studies and Deaf Education, 17, 291-305.

Schick, B. (2011). The development of American Sign Language and manually coded English systems. In M. Marschark & P. Spencer (Eds.), The Oxford handbook of deaf studies, language, and education, Volume 1, second edition (pp. 229–240). New York: Oxford University Press.

My 4 year old son has been diagnosed with severe sensorineural hearing loss in both ears. He was not born this way; we believe he lost his hearing sometime between 2.5 and now. He was just diagnosed in June and he will be getting his first pair of hearing aids at the end of July. I’ve been told by his ENT and Audiologist that we need to make a decision about cochlear implants (CIs) very soon. My son had lots of vocabulary and speech sounds; he now is a little difficult to understand but communicates with family and friends. My question is where can I find good information about CIs and also why must I rush to make a decision?

Question from M.H., New Jersey. Posted June 27, 2014.

It sounds as if your child’s loss predominantly occurred after he acquired verbal speech and auditory language, so his deafness is categorized as “post-lingual.”  This means your son’s brain has a memory of what speech sounds like, even if that memory and how to reproduce it are fading a bit. That is one reason why implantation is recommended sooner rather than later – research has demonstrated that the shorter the lag between onset of the hearing loss and input from a cochlear implant, the better the child does.  We believe that is because the auditory memory (part of that auditory path design) has had less time to “forget” the sounds of speech.  There are lots of research articles that talk about keeping that time-frame short between onset of hearing loss and use of the CI, although outcomes are more variable than they might appear.

The signal from the hearing aid is amplified speech and other sounds, so your son will hear things at a louder level with his aids.  The sounds will be distorted and some sounds may not be transmitted very well (sounds like /sssss/ and /shhhhhh/).  His brain and his ears are connected by a path of nerves (the auditory path), and the signals that the ears receive must be interpreted by the brain.  There is big difference between the signal provided by a hearing aid (loud speech) and the signal transmitted by the cochlear implant (kind of like Stephen Hawking’s electronic speech).

Without knowing more details as to the cause of the hearing loss, it is unclear whether there are specific reasons for recommending earlier implantation – some audiologists and ENTs simply believe that CIs are for almost every deaf children and the sooner the better. However, I can tell you that there are some conditions that can cause a bony growth to happen in the cochlea (which is the organ if hearing) and, if so, this growth begins after the hearing loss in a gradual and slow manner.  If this occurs, the longer one waits, the more difficult it can be to insert the electrode of the cochlear implant.

There may be other reasons your healthcare providers are wanting you to make a decision, but you need to do your homework first. One of the predictors of children’s success with CIs, literally, is how much time their parents spend getting information on the subject. Here are two links that let you compare what the signals of a hearing aid sound like and the signals of a Cochlear Implant sound like

https://www.youtube.com/watch?v=1l37lzLIgQU

http://www.etc.cmu.edu/projects/tatrc/?page_id=371

Here are some article review links:

http://www.scielo.br/scielo.php?script=sci_pdf&pid=S1808-86942012000200019&lng=en&nrm=iso&tlng=en

https://ore.exeter.ac.uk/repository/handle/10871/11533

[Ed. – For more, very objective information visit the UK’s Ear Foundation]

Over the years I have had many hard of hearing students deny their hearing losses and refuse to wear any amplification. I usually tell students that amplification needs should be discussed with their parents. I generally support whatever the parent wants to do.

One of my students’ parent wants to develop a contract for hearing aid and FM use next school year for her seventh grader. The prospective seventh grader will not acknowledge the hearing loss or any of its impact. At this point, I am truly concerned for the student’s well-being. My inclination is to teach clarification and compensatory skills while working to help the student come to some acceptance of the hearing loss.

What does research say about acceptance of hearing loss or amplification use in adolescence?

Question from S.K., Ohio. Posted June 17, 2014.

Your question about available research is difficult to answer – after all these years, we still only have anecdotes to inform us, and not even enough of these to work with.  But we can take an educated guess at what this young person is thinking: “I have a problem but I want it to go away; all I want is be like everyone else so I will pretend I am.”

We do know quite a bit about acceptance in general, though: a mindset that first requires the hard work (and pain) of looking at a situation honestly.  This young person may need to work with a counselor to “get there.”  Additionally, while working on the strategies mentioned, perhaps you might ask her to chat about the concept of resilience.  It’s often more comfortable to talk less about the issue at hand (amplification decisions) and instead discuss a bigger but semi-related topic, as in: “People are talking a lot about resilience these days, have you noticed? When adversity occurs, how do people rebound? What strengths do people draw upon to recover and move forward? Any examples come to mind?” Just generally about “people,” but most of us insert ourselves into the answers.  All children need practice talking about their emotions. She is fortunate to have you in her life.