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 son has AIED [Autoimmune Inner Ear Disease, a syndrome involving progressive hearing loss]. He began losing his hearing a little over two years ago at the age of 10. He currently has a profound to moderate sensorineural, bilateral loss. The loss is progressive. He obviously has acquired speech and language as a hearing child. What impact am I looking for as we go forward? Prior to the loss he tested at or above for reading levels, now his reading scores are below grade level. He still makes A’s and B’s in all subjects except math. He does struggle. He attends a small public school with no deaf education resources.

Question from L.W., Missouri. Posted March 3, 2015.
Response from Elizabeth Marcinkus - Gallaudet University

With any child with hearing loss, it is important to monitor different areas of development. The first is language. Based on your description, I am assuming he is using auditory/oral skills. You have indicated that his expressive (spoken) language is on target, but it is also important to monitor his receptive language skills. With the progressive nature of his hearing loss, does he still have good access to spoken language? This may impact his overall functioning, especially in school.

I am not sure what kind (if any) of hearing technologies (hearing aids, cochlear implant, FM system, etc.) he is using, but unless he is using a signed-based language, making sure that he has good audibility is key. If audibility is a concern, providing information in a visual form may be beneficial. His educational needs should also be monitored. It sounds like he continues to do well in school and that is great! If you notice that he is starting to struggle, it is important to question why. Is he understanding what goes on in class? Could support services be provided to help him stay on target? It is important to work with his school to make sure his needs are met. I would work with them to see if he is eligible for an IEP or 504 plan (if he doesn’t already have one). Talk with his teachers, administrators, speech-language pathologists, deaf educators, etc. See if they can work to support his need for deaf education resources.

Finally, it sounds like your son may have had an stressful few years. Often overlooked, it is important to monitor the psychosocial impact of his hearing loss. Does he have a good understanding and acceptance of his hearing loss? Does he have a support system of friends, especially any with hearing loss? Feelings of isolation or questions/concerns about his hearing loss may impact his life. Working with a school psychologist may be beneficial. I hope these suggestions are helpful as you work to provide the best for your son!

We are constantly searching for appropriate assessment tools that address all the developmental areas of young children without penalizing the child because of the language acquisition differences. What do you suggest? We serve children ages 6 weeks through kindergarten with deaf, other communication disorders and hearing siblings all in the same classrooms.

Question from J.P., Oklahoma. Posted February 24, 2015.

This is a tough one, because communication delays and disorders potentially can affect all areas of development and/or give the appearance of doing so. I expected that most states would offer guidance in this respect…but have been disappointed. The New York State Department of Health does offer information ranging from dealing with the communication challenges per se to cultural issues and parent involvement in assessment. Both West Virginia’s and Minnesota’s Departments of Education offer listings of assessment tools for deaf and hard-of-hearing children that appear likely to be useful for a broad range of children.

A couple of book suggestions: In 2008, the Journal of Pediatric Psychology published a special issue on evidence-based assessment of children with various disorders. You could write to individual contributors to that issue who might seem pertinent. In the general area is Cohen and Spenciner’s Assessment of Children and Youth with Special Needs, 4th Edition. Specifically with regard to deaf and hard-of-hearing children is Edwards and Crocker’s Psychological Processes in Deaf Children with Complex Needs – An Evidence-Based Practical Guide.

With the number of children getting cochlear implants and their parents not using sign language with them, what are their outcomes in mainstream schools…are they still affected like deaf signing children (missing out on full access)? What percentage of the deaf student population in mainstream today, use sign language verses oral?

Question from T.H., Florida. Posted February 23, 2015.

Several studies have found deaf children with cochlear implants to be reading at or near grade level during the elementary school years, a great improvement over what typically has been seen among deaf children without implants. By high school and college, however, implants are no longer associated with better reading achievement (although use of spoken language is). Interestingly, the same is true of deaf children who are native users of sign language by virtue of having deaf parents. That is, studies have found those children also to be reading at or near grade level during elementary school, but neither parental hearing status nor sign language ability is longer associated with better reading achievement by high school. These findings might suggest that full access is an issue for both groups, but they also may be related to the greater difficulty and complexity of to-be-learned material in the higher grades.

With regard to language use in the mainstream, you would think this would be a straightforward question with a straightforward answer. Unfortunately, it’s not. According to data drawn from the Gallaudet University Annual Survey of Deaf and Hard of Hearing Children and Youth, 19.5% of DHH students under age 13 are taught through spoken language only and 22% through sign language only. For students aged 13 and older, 6.7% are taught through spoken language only and 37.2% through sign language only. Data from the Annual Survey, however, are known to be weighted toward special schools and programs for DHH students, and it does not appear that the data are broken down by school type. According to data from the National Longitudinal Transition Study 2 (NLTSES 2), a study of a nationally representative sample of DHH high school students, 51.6% of students in regular schools use sign language (compared to 98.1% in special schools) and 94.5% of them use spoken language (compared to 59% in special schools). What all of this tells you is that most DHH students use both forms of communication, although knowing their fluencies in each and the contexts in which they use them (including school) would require further investigation.

Further Reading:
Allen, T. E., & Anderson, M. L. (2010). Deaf students and their classroom communication: An evaluation of higher order categorical interactions among school and background characteristics. Journal of Deaf Studies and Deaf Education, 15, 334–347.

Marschark, M., Shaver, D.M., Nagel, K., & Newman, L. (in press). Predicting the academic achievement of deaf and hard-of-hearing students from individual, household, communication, and educational factors. Exceptional Children.

Marschark, M., Tang, G. & Knoors, H., Editors (2014). Bilingualism and bilingual deaf education. New York: Oxford University Press.

I am an educational interpreter for a deaf student in high school. She has been taught by a teacher if the deaf all her schooling life in a pull-out English/reading class. This year she was mainstreamed into an English/literature class. She reads at just below grade level. During class, when the (hearing) teacher has the whole class independently read from a book, should I use my finger to guide the student’s reading, or should I sign the whole thing? If the teacher has other children read out loud or uses a audio recording to help read out loud for the hearing students, should I encourage the student to look at the text and guide with my finger, or should I sign the whole thing? The goal I presume is to help enhance reading skills, and my gut tells me to have the deaf student read the visual. But my teacher of the deaf tells me to sign everything. I find that counter intuitive. If the student was learning to read, I would sign and attach the visual word to it at an elementary or preschool level. But this student knows how to read; this is now a high school level reading class. We are talking novels, short stories, etc.

Question from W.D., Maine. Posted February 19, 2015.

While we have little information about the effectiveness of interpreted education for school age students (e.g., Schick, Williams, & Kupermintz, 2006), researchers have found that college-age deaf or hard-of-hearing (DHH) students may gain equally as much or more knowledge from reading as they do from seeing someone sign a lecture (Borgna et al.,2011; Marschark et al., 2009). This information might be something to consider when you begin having important conversations with the English teacher, the teacher of the deaf, and the student.

First, you should talk with the classroom teacher and teacher of the deaf to gather what their goals are for this activity. If the classroom teacher is listening to the hearing students read to gauge their decoding skills, then helping the DHH student follow along by tracing your finger above the words would be appropriate. This way the DHH student would be ready to read when her turn came. Asking the teachers about their goals will clear up any assumptions on your part and you can work with them to be ensure these goals are met.

Second, you should talk with the student and find out her preferences during English class. The student might prefer to read while you aid in tracking or the student may feel uncomfortable having someone that physically close during class. These preferences should be taken into consideration when deciding how to interpret in the classroom but may not be paramount to the teacher’s goal during the lesson. Your combined knowledge and ability to communicate as an educational team will resolve this issue as well as many in the future.

Further Reading
Borgna, G., Convertino, C., Marschark, M., Morrison, C., & Rizzolo, K. (2011). Enhancing deaf students’ learning from sign language and text: metacognition, modality, and the effectiveness of content scaffolding. Journal of Deaf Studies and Deaf Education, 16(1), 79–100.

Marschark, M., Sapere, P., Convertino, C. M., Mayer, C., Wauters, L., & Sarchet, T. (2009). Are deaf students’ reading challenges really about reading? American Annals of the Deaf, 154(4), 357–70.

Schick, B., Williams, K., & Kupermintz, H. (2006). Look who’s being left behind: Educational interpreters and access to education for deaf and hard-of-hearing students. Journal of Deaf Studies and Deaf Education, 11(1), 3–20.

I am a Teacher of the Deaf in a mainstream setting. I have a teenage student with a cochlear implant. She struggles with feelings of isolation and had a very bad experience at a school for the Deaf a few years ago. She desperately wants to have a friend that actually knows what she is going through but is unwilling to attend any Deaf teen events in the community due to the experience she had at the school for the Deaf. I believed she was bullied pretty severely for having a CI. I would love to help her find a friend that might be going through the same situation so she could videochat or even email. I am having difficulty finding other mainstreamed teens out in the world to with CIs to connect her with and wondered if you had any suggestions.

Question from E.B., New York. Posted February 16, 2015.

Some people at NTID have tried to get funding for a “video buddies” project that would allow students like yours to connect. Students who use different communication modalities, are different ages, have different interests could find friends around the country for video or text chats. Unfortunately, they have not yet found a foundation or organization willing to support the project. In the meantime, here are some possibilities:

Online forums
Hear US Teens https://www.facebook.com/hearusteenspage

There are several active cochlear implant groups on Facebook both brand-specific and general). A few are listed here:
Advanced Bionics www.hearingjourney.com
Connect to Mentor site http://apps.advancedbionics.com/CTM/US
Medel’s Patient Support Group implants@medelus.com
Cochlear Americas: http://www.cochlearcommunity.com/

Videos
A new series of captioned interviews with cochlear implant users has been posted on YouTube by an RIT student. The student hopes to educate others about cochlear implant technology and the experience of the users. he first two videos are intended to be educational and humorous.
CI Interview: Braden https://www.youtube.com/watch?v=7CFBOay2tyY
Cochlear Implant: Funny struggles https://www.youtube.com/watch?v=DujSeNPHB48

Conferences/Events
Leadership Opportunities For Teens http://www.listeningandspokenlanguage.org/LOFT/
Listening and Spoken Language Symposium http://listeningandspokenlanguage.org/
Biennial Northeast Cochlear Implant Conference http://listeningandspokenlanguage.org/

Empowering teens is also addressed with self-advocacy strategies. The document, Self-advocacy for Deaf and Hard of Hearing Students is posted at http://www.handsandvoices.org/needs/advocacy.htm.

I am doing research on the benefits of early language acquisition and teaching d/Deaf babies ASL. I am having trouble locating those who oppose it outwardly in either a scholarly journal or university publication. Do you have any suggestions as to where I may find this information?

Question from A.D., Michigan. Posted February 5, 2015.

I am not aware of credible arguments against teaching sign language to deaf babies, in principle. There are some arguments that sign language can interfere with the development of spoken language, but there is considerable evidence that refutes that position (see below).

At the same time, there also is evidence that children with cochlear implants who are in “oral” programs show better spoken language development than those in sign language or Total communication programs (see below). However, it is unclear whether that is because children with greater spoken language skills (or potential) are more likely to be “oral” programs or dividing children’s – and parents’, early interventionists’ and educators’ – time and resources between two languages is not as efficient as focusing on only one. Without something resembling a randomly controlled trial, this is not a question that is going to be answered easily (see below). Further, the “politics” of the issue are such that even what appears to be support for one position or the other is not going to be accepted by many.

Further reading:
Davidson, K., Lillo-Martin, D., & Chen Pichler, D. (2014). Spoken English language development among native signing children with cochlear implants. Journal of Deaf Studies and Deaf Education, 19, 238–250.

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.

Lyness, C.R., Woll, B., Campbell, R. & Cardin, V. (2013). How does visual language affect crossmodal plasticity and cochlear implant success? Neuroscience and Biobehavioral Reviews 37, 2621–2630.

Svirsky, M.A., Robbins, A.M., Kirk, K.I., Pisoni, D.B., Miyamoto,
R.T. (2000). Language development in profoundly deaf
children with cochlear implants. Psychological Science, 11,
153-158.

Do DHH students succeed better in academic and other assessments by using ASL or SEE?

Question from L.T., Florida. Posted January 20, 2015.

I’m afraid (or happy) that it is not quite that simple. There are certainly individuals who will argue that deaf learners will benefit more from ASL (American Sign Language) or SEE (SEE1 – Seeing Essential English or SEE2 – Signing Exact English) than the other, or from other forms of communication. The research, however, indicates that there is no one form of signed or spoken communication that is going to work for all deaf learners.

English-based signing systems (like SEE) were developed on the assumption that they would help deaf children learn to read English, but there is little evidence that they work any better than American Sign Language (ASL), which is a natural language (rather than an artificial sign system) but does not easily map onto English. Regardless of language and modality (signed or spoken), the key to deaf children’s academic success (and other aspects of growth) is early, effective access to language and being surrounded by it consistently. “Effective” is emphasized here because what is effective for one deaf child might not be for another. It is essential that deaf children are evaluated (and regularly re-evaluated) to determine how their language is progressing and whether whatever language(s) they are using is the most appropriate.
Sorry, there are no silver bullets.

For more information on what we know and what we don’t know on this issue, see this eBulletin on the Raising and Educating Deaf Children website.

I currently work as a nanny for a family with small children but previously worked for the school system as a sign language interpreter. I was trying to find some resources on an Early Language Development Curriculum for deaf children and their parents. I would love to be able to offer families a service in which they have their deaf preschool children (0-5 ages) learn cognitive/ fine motor skills/ language development through ASL. I have read some of the previous posts, and found a very interesting link to the NCSD family sign language (FSL) based through the UK. I would however be very much interested in learning if there was a similar program here in the United States.

Question from A.M., North Carolina. Posted January 7, 2015.

There are a number of excellent ASL-related sites available through the website of the American Society for Deaf Children.

I work as a teaching assistant in a primary school and work one to one with a deaf child aged 4. The main educational focus for this child is to develop their understanding and ability to use sign language however I’m not sure which way would be the best way to teach this?

I am able to use a basic level of sign language. The student has picked up some signs on their own like drink, toilet and food; however, this is a very slow process, does anyone have any tips?

Question from L.A., England. Posted December 23, 2014.

Your question which is massively important for the pupil with whom you are working. You clearly recognise that the situation you describe is not working, and you are absolutely right to voice your concern.

For this or any child to acquire a language, accessible, fluent language models are necessary, and consistent use is essential. That means that if sign language is the goal, the child will need to be surrounded by fluent and consistent language at school and at home. This may be a huge challenge for the whole family, but it’s an essential ingredient to long-term success. It would be helpful to have them look into NDCS family sign language curriculum.

It would appear from the description of your situation that both you and this child are being put in an untenable position. It is unreasonable for you to be given the responsibility to teach the child sign language: a highly-skilled sign language user trained to work with young children in an educational setting, ideally a native signer, is needed for the child’s future language, cognitive, and social-emotional development. With only a handful or words/signs at the age of four there should be a clear, focussed and frequently monitored language development programme in place for this pupil. If the child already has had extensive exposure to sign language, it also might be worthwhile requesting a cognitive evaluation just in case there are other factors at play.

The circumstances will of course be more complicated than you are able to express in a few short sentences, and it is important, therefore, that a much more detailed and extensive review of the situation is undertaken. In the first instance, you need to discuss this with the class teacher, SENCo and teacher of the deaf as soon as possible.

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.

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.