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.

Language and Communication

We are a small state with a generic inclusion policy for all students with a disability, which means that deaf students must attend their local school and are supported by itinerant ToD and/or interpreters. Our numbers are small and decentralised so most deaf children attend schools where they are the only deaf child. I would like to influence the Education Department policy to allow deaf children the choice of enrolling ‘out of area’ to be educated in a setting with other deaf and hard-of-hearing students, but I need some research evidence to present to the Department before they will consider this. Can anyone please help with some research supporting the need for deaf children to have access to deaf peers and role models for their linguistic, social and emotional development?

Question from M.R., Australia. Posted August 3, 2017.
Response from Marc Marschark - NTID

As much so we talk about the importance of “supporting the need for deaf children to have access to deaf peers and role models for their linguistic, social and emotional development,” the evidence is remarkably thin. What current evidence (as opposed to testimonials) there is comes primarily from co-enrollment programs, programs that include a critical mass of deaf students in inclusive classrooms that include both a general education teacher and a teacher of the deaf. You can find a description of co-enrollment and access couple of relevant articles through the Raising and Educating Deaf Children website. Two book chapters listed below specifically emphasize the benefits of being with a critical mass of deaf peers for linguistic and social-emotional development, respectively. At this point, however, we do not yet have much evidence to indicate strong effects of co-enrollment on academic achievement. More research is definitely needed.

Further reading:

Tang, G., Lam, S. & Yiu, K.-M. (2014). Language development of severe to profoundly deaf children studying in a sign bilingual and co-enrollment environment. In M. Marschark, G. Tang, & H. Knoors (Eds.), Bilingualism and bilingual deaf education (pp. 313–341). New York, NY: Oxford University Press.

Yiu, K.-M. & Tang, G. (2014). Social integration of deaf and hard-of-hearing children in a sign bilingual and co-enrollment environment. In M. Marschark, G. Tang, & H. Knoors (Eds.), Bilingualism and bilingual deaf education (pp. 342–367). New York, NY: Oxford University Press.

I want my daughter to go to a school with a full program for students with hearing loss. My child’s school is recommending a closer program to home that only offers ASL. My daughter had to repeat 9th grade because I believe she didn’t have the necessary accommodations. Is a school that offers ASL adequate? The other school has a team of audiologists, speech pathologists, career coaches for students with hearing loss.

Question from I.L., California. Posted July 25, 2017.

There are two aspects to your question. First, with regard to language, you do not say whether your daughter has spoken language skills or relies exclusively on sign language. If she has spoken language skills, you want a program that supports those skills (with audiologists, speech pathologists, technology, etc.) as well as any sign language skills she might have. In that case, a school that offers only ASL is not adequate. Second, any deaf or hard-of-hearing student, regardless of their preferred/stronger language modality, will benefit from career coaches and other support/advising services. Both these services and the language-related services you want for your daughter can be built into her Individualized Education Program (IEP). Recent research shows that ending interventions and support services available in elementary school can create real challenges for deaf or hard-of-hearing students if they are ended too early. Many if not most such students will need and benefit from continued support into the high school years. More services are always better then fewer services!

How effective will it be for a child using Melanesian Sign Language in mainstream schools?

Question from W.D., Papua New Guinea. Posted March 3, 2017.

As long as the school provides qualified sign language services or the teachers sign (fluently) for themselves, sign language is just as appropriate as spoken language for educational purposes. There still will be the important issue of effective communication with classmates, but hopefully an interpreter can facilitate that. But, even if sign language and spoken language are both appropriate in the classroom, they are not equivalent. Children who use sign language or spoken language have somewhat different strengths and needs, so it is important for parents and teachers to make sure that each child is getting services that match. Teachers may not have been trained in those differences, and some are subtle, so reading current textbooks or other materials will be helpful. Also, even if children are using sign language, hearing aids can be very helpful for those who have some amount of residual hearing. Finally, I should emphasize the words “qualified” and “fluently” in the first sentence. This may not be possible in all places, but for children who do not use spoken language effectively, fluent language models are essential if they are to have the same opportunities and academic outcomes as hearing children.

I currently live in a state that does not have a listening and spoken language program for deaf children with cochlear implants. A bordering state has such a program. My county’s district will not allow my child to go there. Is there a law that they are in violation of? Do I have the right to have my child attend this LSL school?

Question from C.L., Indiana. Posted February 2, 2017.

It is difficult to give a definitive answer without having more information. However, the guiding principle for placement decisions is the IEP. So, if your child has an IEP that calls for the delivery of services that only an LSL School can provide, and the district does not have appropriate services that meet the needs as stated in the IEP, then the district would be required to find a placement that could provide those services.

As far as “rights” go, there is the right to compliance with the regulations on the part of the district. For example, if an evaluation is requested, the district is required to provide one in a timely fashion in order to be available for review at an IEP team meeting. If you feel that the evaluation and/or IEP recommendations are inappropriate, you have the right to reject the IEP. That is, the IEP process should determine the placement based on assessment data. You and your child have the right to that, but not to an alternative placement unless it can be demonstrated that what was being offered by the district does not meet the goals of the IEP. Parental wishes are considered but not binding.

p.s. The same standard would apply through any appeals process.

What is the best way to teach a child who is deaf to attend to sign?

Question from J.B., Florida. Posted October 11, 2016.

There are a number of strategies that deaf parents and teachers use to ensure that deaf children attend to (signed) communication and maintain that attention. You can find a description of some of these strategies in a recent posting on the Raising and Educating Deaf Children website.

I have a son who is deaf…or so we thought. We had an ABR done recently, and he has no permanent hearing loss. Great news! I still feel that he has hearing issues. Small ear canals, frequent ear infections, but no permanent hearing losses. He also has oromotor issues that are congenital. He can’t drink, can’t eat more than purees, drools, right sided weakness, low tone, etc. He’s had 4 oral surgeries. It makes sense that he can’t talk. He did say his first word this summer, “Go!” So, I want him to learn ASL. He started at 30 signs 6 months ago, and now he has a vocabulary in excess of 250 signs.

We had an IEP meeting last week. brought 3 doctor reports and a speech therapist report that all indicate that he needs to be taught sign language in his classroom. The school “accepts” but will not teach ASL. They want him to use an iPad with pictures. I feel that all of his gains in speech are linked to his sign language acquisition.

I did reach out to the school for the deaf. We are signed up to do some of their outreach programs. He’s not deaf, so they won’t/can’t help us. I want my son in a Total Communication class. There is one about 20 minutes from our house.

How can we get what (we feel) our son needs?

Question from M.G., New York. Posted September 7, 2016.

If a finding of special needs is found (which clearly is the case) then the child is eligible for special education. At that point, it does not matter how the school “feels” about the recommendations, the school has to provide services based upon the assessments to provide access to the curriculum. Rejecting sign language because he is hearing is not an appropriate determination if the assessments indicate that as an adoption that will facilitate access to instruction and social interaction. This is a child with multiple needs and the recommendations that were cited do not come close to the extensive level of support the child will need to be able to be successful. Pull out services will not suffice at least not during his early childhood years and the need to intervene comprehensively to promote development is necessary.

So, first, the school should assess the child’s language level, both receptively and expressively. This is the starting point. Then goals should be developed based on the needs identified during the assessment. The overall goal should be achievement of age-level language skills. Age level skills will enable him to access the general education curriculum. The Individuals with Disabilities Education Act emphasizes age appropriate skills and access to the same educational material that other children receive, that is the general education curriculum. In other words, the school should be attempting to get the child’s skills to the same level of his peers so that he can participate in the classroom similar to his peers, to the extent possible. Will using an iPad with pictures do that? It’s hard to see how. The fact that you can show that he is succeeding using sign language is helpful.

Once goals are developed, then the services should be determined, such as teaching sign language by a trained teacher. After the services are agreed upon, then placement is made. The placement must be based on the child’s needs and services. If there is a total communication class that would fit the method used in the class, that would seem to be a more appropriate choice. If there is any capacity for spoken language, a simultaneous communication approach may be better in the long run.

Sounds simple, but I know when you are advocating for your child it is not easy. In the end, litigation may be the only way forward, with the experts lined up prepared to make recommendations based on their findings and to have the school system respond on how they will fulfill the requirements. Hopefully, it will not come to that. Meanwhile, a few tools you can use:

First, if you believe that the school has not done an appropriate assessment of his language skills you should request they do (or re-do) that right away. Also, are his goals consistent with getting him to the level of his peers (and helping him continue to progress)? They should be.

Second, as for placement, when a school refuses to change the placement of a child (or for other purposes), it must inform the parents of the reasons. This is called “Prior Written Notice.” See the form developed by the U.S. Department of Education at http://idea.ed.gov/download/modelform2_Prior_Written_Notice.pdf. As you can see, the school must explain the reasons why it refuses the placement, based on evaluation procedures, assessments, and records. You can request that the school provide the information required on this form.

Another law that applies in this case is the Americans with Disabilities Act (ADA). Among other things, that law requires schools to ensure that students with speech disabilities can receive information from, and convey information to, others. This communication must be as effective as communication with students without disabilities. The U.S. Department of Education has issued guidance on the ADA and effective communication at https://www.ada.gov/doe_doj_eff_comm/doe_doj_eff_comm_faqs.htm. Under the ADA schools must give “primary consideration” to the request of the student or parent.

My son was implanted at 2 years of age with a CI. He is now 3 years old. He was diagnosed with Auditory Neuropathy Spectrum Disorder and he is severely to profoundly deaf. They describe his disorder like a static radio most of the time it’s static but every once in a while he hears something but not enough to form speech or understand what a sound is. The CI was not a guarantee that it would work, but as my husband and I are both hearing and no one else in the family with hearing loss we figured we should give it a try. We have also been signing with him since he was 15 months old. Our son is now in school, and at his last IEP meeting we were told that they probably don’t have the funds for an interpreter or enough children to start a deaf class. I don’t know how to get my son the education he needs! I just don’t think it’s fair. He is very smart, very visual, and has an amazing memory. What can I do and how can I fight for my son’s education??

Question from C.D., Florida. Posted July 26, 2016.

You indicate that your son has auditory neuropathy and received a cochlear implant at age two. Some children with auditory neuropathy will benefit from cochlear implants, but most will need sign language for the very reason you described—auditory neuropathy produces static rather than a clear auditory signal, making it very difficult or impossible to access spoken language auditorily, even with a CI. It sounds like you have been doing everything right for your son by providing sign language since he was 15 months old.

I was sorry to hear that the school’s IEP team decided not to provide sign language for your son. Your son is entitled to a free appropriate public education (FAPE) under the Individuals with Disabilities Education Act (IDEA)—the federal law which governs every public school district in the U.S. For deaf students, the IDEA specifically states that communication needs, including the need for sign language, must be considered by the IEP team when making educational placement and services decisions. Furthermore, an IEP team may not use “lack of funds” as a reason not to provide interpreting or any other special services required for him to obtain FAPE.

The IDEA grants parents of children with documented special needs, including deafness, the right to appeal an IEP team decision. Every IEP team must, by law, provide parents with written procedures for appealing an IEP team decision. You should request the written procedures from your school district immediately and file an appeal according to the procedures described in that document.

In my experience, school districts often do not understand the communication needs of deaf children. However, you can and should advocate for your son through well-established legal procedures. In so doing, you will also be educating the school district – paving the way for future families with deafness—as well as for your son. I encourage you to be confident and persistent, because your son has the right to a free appropriate educational program, which in his case should include sign language.

My 8 yr old daughter has sensorineural profound deafness. She’s using hearing aids and is at par with her hearing friends in mainstream education. She’s a bright child with immense understanding and grasping power. English has been her second language here, her first language was her mother tongue.
We are relocating to USA this year. Her language skills in English are comparatively low, say 30-40% of a hearing child in US. I would like to know the basic expectations of school from her so that I can make her understand the needs and prepare her accordingly. Likewise, what will be the process to take her admission in mainstream education school?

Question from U.D., India. Posted May 18, 2016.

Depending on where you move in the United States, there are two services I would seek. First, the staff at the school will need to meet with you to decide if your daughter is eligible for special education services. During that meeting, the school will review your child’s hearing levels from her audiogram and her school performance up to this point. If they request to do any testing, ask them to complete the testing in her first language and in English. This will give the school team an idea of how to proceed with her education. If you believe that support from a teacher who specializes in working with children who have a hearing loss would benefit your daughter, let the school know that you want a teacher of the deaf and hard of hearing at the meetings. A teacher of the deaf and hard of hearing has been trained to work with children who have different types of hearing loss and who communicate in different ways. This teacher can work with the school and the classroom teacher to make sure that your daughter is getting the education she has a right to under the US law. Second, I would ask the school for access to a teacher who specializes in teaching students who are learning English as another language. This teacher will have been trained specifically to work with students who have first languages other than English. This teacher along with the teacher of the deaf and hard of hearing can work with the mainstream or general education classroom teacher to make sure that your daughter’s education is optimized. In my personal opinion, this team of teachers bringing their knowledge together would be a great start for your child.

I have a 6 year old with CIs, implanted at 11 months; he has perfect speech. We have a IEP meeting soon, and they want to discontinue speech support. He is mainstreamed and has difficulty staying focused in the classroom. Any help at all we can get for his meeting, we would greatly appreciate. Currently we have a ToD an hour a day five days a week, an educational Interpreter, and right now speech 1 day a week for a half hour in a group setting. That is what they are looking to discontinue.

Question from L.W., New York. Posted March 5, 2016.

Speech Language Services are not only limited to working on speech production. Our scope of practice includes vocabulary development, pre-teaching concepts, teaching advanced language structures, phonological awareness skills, comprehension of language as it relates to processing text and creating text, executive functioning including memory, judgement and pragmatics. It is rare to find a deaf child who has skills in all these areas that develop without careful intervention and monitoring. Speech-language clinicians are intrinsic to optimal development of these skills, and this is the tack I would take in this meetings. [Try to find an advocate who can support this in the IEP meeting and make sure it is written into the program.]

I really want to know if the Informed Consent for a Clinical Trial is only read by a deaf person or there is an interpreter during the procedure who is able to help the volunteer to better understand what is written. Is a Video Interpreting (relay) service (VIR) usually employed or a Computer Assisted Realtime Transcription (CART) service? Do you think that a platform with VIR service could help the deaf person’s understanding?

Question from V.Z., Italy. Posted March 1, 2016.

Essentially, the answer to your question is “it depends on the individual.” For most deaf individuals, at least in the United States, reading an appropriately-worded informed consent document is sufficient. It is the responsibility of both the researcher/medical professional and their institutional ethics review panel to ensure that the document is, indeed, “appropriately worded.”

For deaf individuals with lower levels of literacy, of course a sign language interpreter would be helpful (either live or via VIR). The kind of interpreting, in that case, also would need to depend on the individual, because there are deaf adults (as well as children) who do not have fluent sign language skills. Those who are low-language, for example, would need very different kinds of interpreting than those who are skilled in Italian Sign Language. Deaf individuals who are “oral,” also might need support with an informed consent document, either through further explanation or more simplified language.