My husband and I adopted our fourth child at age 3.5 from Eastern Europe. He had virtually NO language other than pointing, and indicating if he was happy or sad. The orphanage that we adopted him from reported that they did not realize he was profoundly deaf until he was 3 years old. He had never had any speech therapy, preschool, or early Intervention. Once he was part of our family, through much testing, we confirmed that he was profoundly deaf in both ears. He was fitted with hearing hearing aids, and at age 6, due to concerns for safety, he received a cochlear implant, and continues to wear one hearing aid. Our son is an absolute joy, and makes our family complete. He is now 7 years old, and has learned SO much. We use Total Communication both at home and at school. He is in a first grade class, with most academics taught in a self-contained HOH classroom, and spends part of the day in the “regular education class.” Socially, he is mostly like other 7 year old boys: fun-loving, action-packed, into sports and playing outside. Academically, he is still at a pre-school/kindergarten-ish level, and his receptive and expressive language is severely delayed. He talks and signs, but the majority of his words are not understandable. He mostly uses ASL/Signed English to communicate. Our major concern for our little guy, is, that his school is VERY focused on how behind he is language-wise, and academically (which he is). However, it is very difficult for them to see how far he HAS come in the four years we have had him. We don’t know any other families that have Deaf Children, that had NO Early Intervention, that were adopted internationally, and have the extreme language delay that our son has. We feel like we don’t know how to advocate for him at school, have high/yet acheivable expectations for him. All the literature that we find talks about how very important early Intervention is….but our child was not given that, and it was not in our control until he came to us. How do we provide him the most support possible, and help to increase his global language. His language delay is obviously impacting how much he is able to take in/learn at school. But we don’t know how to “hurry language along” for him. He gets “speech/language” 5 days a week at school…and we constantly talk and sign at home. It just doesn’t seem to be enough. Does he need some type of intensive therapy?
From what you have written, it really looks as if your son is thriving being in a loving home and has developed a way to communicate in a social way. You are correct about him getting a “late start” with regard to his exposure to consistent language, listening, and speech. When we, as professionals, begin working with children who are “budding roses,” I like to think that we all look at “potential” for blooming, and it is fairly common and appropriate to look at how much progress he makes over time, now that he is in a consistent educational environment. We hope to see one year of progress from where he is, for each year of experience.
He is currently in the mainstream classroom, and in a HOH classroom. What I cannot get a real feel for is how consistent his language input is within each modality. If he is getting a “total communication” philosophy, I worry that he may not be getting immersed in language consistently. It looks as if that is a concern from his educators. I typically am an enthusiastic advocate for total communication, but given his late start with language exposure, combined with the question of how much he was able to hear even after he had hearing aids, I feel more compelled to be sure he gets immersed in a consistent, accessible language system. Given this, I wonder whether you have considered a school for the deaf? Is there one close to you? Is there an intensive summer program that uses American Sign Language? I am asking this because I would be really curious to see how fast he picks up on a completely accessible language system when he is immersed in it.
While I am not abandoning speech and listening, I do think that we need to temper expectations a bit with regard to his potential to be an auditory learner given we can only verify that from age 6 on he is getting consistent access to sound via his CI.
As a first step, try contacting Hands & Voices (www.handsandvoices.org) or the American Society for Deaf Children (www.deafchildren.org) to find other families with deaf children in your area. Talking with other parents who have had similar experiences will be immensely helpful.
I am wondering if you have any information about testing Deaf and hard-of-hearing students who come from non-English backgrounds to determine English proficiency? State laws require all students who have any other language spoken at home be tested when the enter preschool, before they leave preschool, and every year in school thereafter. The tests used by the district in preschool (Pre-IPT and WIDA-MODEL) do not allow sign language to be used, though they are spoken language and listening tests. Besides the obvious concern that students may score low because of a language delay due to their hearing loss and not just the second language at home, there is also the concern of testing students without sign when Total Communication is their mode of communication documented on their IEP. The problem is two laws colliding. The result from a low test score is a letter to parents saying their child qualifies for a bilingual or ESL classroom, though the team is recommending the DHH classroom. Do you have any information or ideas of other ways DHH students are tested to comply with state mandated ELL testing?
Let me share my experience in Colorado: As stated in this request for information, the primary area that language proficiency becomes an issue is with regards to eligibility for special education as there is a question on the eligibility form that asks if the learning problems are a result of lack of proficiency in English. In Colorado, the legal interpretation at the Department of Education is that the hearing loss trumps primary language, so that children would be eligible for special education even if they come from a family that es ASL or a language other than English in the home.
Regarding assessment, I think it would be discriminatory to provide the language assessment without the accommodation of sign when a child uses sign. The child’s primary language should also be assessed and when sign is used by the child, the assessment should be conducted by an individual fluent in the sign language of the child (ASL, Spanish, Chinese, etc.) to compare competency in the child’s primary language and in English.
I am looking for listening comprehension programs for elementary HH/CI students. Again, I find checklists but few programs for what we used to call ‘auditory training’. All are either for young, early implanted (Dave Sindrey for example) or teenagers (music and phone use). I have used the SPICE program… but is that all?
I am delighted to see that you are investigating different listening comprehension programs. There are several out there and more that are being developed all the time. It is a bit interesting that many of the materials are now being hosted by the Implant Corporations, but in a way it makes sense. They employ the people who do the work and creative aspects. I know that the cost of developing materials is very high and the market is relatively sparse compared to other products, so this may be why Implant Corps can absorb the cost. (example– you mentioned Sindry, and his work is now available through these websites). Here is a resource list of my favorites for elementary age:
Hearing Rehabilitation Foundation materials—many are developed by Geoff Plant and are very good http://www.hearf.org/Materials.html
Hear at Home
Rhythm, Rhyme & Song
Step by Step
Goldberg Stout, G., & Windle J. Developmental Approach to Successful Listening II (DASL)
Tye-Murray, N. (2002). Conversation Made Easy. Three 6-set CD-ROM Training Programs. Central Institute for the Deaf, St. Louis, MO.
Have you tried the CI company’s websites? Each company offers a multitude of materials ranging from reproducible materials, listening logs, listening activities etc, which are not just telephone use or music, and many are free to donload. Activities are appropriate for CI users or Hearing Aid users. See, for example the Listening Room by Advanced bionics http://www.hearingjourney.com/Listening_Room/preview.cfm?langid=1
Cochlear Corporation offers their HOPE website which has so many resources, some to purchase, some are training seminars, some are apps for IPad (it is WONDERFUL) http://hope.cochlearamericas.com/
MedEL offers the BRIDGE http://www.medel.com/us/rehabilitation/ and this site again has items to purchase items to download for free.
*For many of these sites, you do need to register and login in, but that is a small price to pay for the wealth of information you receive. Do register and you will see so many listening tasks and activities.
I have a son who is 3 1/2 years old. We found out this year that he is profoundly deaf in his right ear and has a moderate to severe loss in his left. He has a hearing aid in his left ear. He has hardly got any speech, his balance is very poor, and I’ve been told he’s a year behind for his age. Since he has got older, he has started to get very angry – kicking, biting, hitting, and throwing things at me; sometimes he hits his head on the floor. I’m getting worried. Do you think he could be autistic as well as being deaf? It really is starting to worry me. My paediatrician has said that it’s all frustration. I don’t go out with him because of the looks I get off of other people and because he has no sense of danger.
When children don’t have language yet they express their needs or wants through their behaviour. In terms of your son, the paediatrician might be right that he is frustrated. But knowing that won’t just stop the behaviour. Your son should be assessed to determine if his hearing aids are giving him the best amplification and. even more importantly, your son needs to have language in the most accessible modality. If an oral approach is not working, do not waste time! Begin using a more accessible language like sign language. In addition, your son should see a clinical psychologist familiar with deafness to assess if there are other issues that need to be addressed.
What should I as a parent of an 11 year old deaf child adopted from Liberia this past July 2012 ask to have written into his IEP. He also has mild Cerebral palsy.
An Individualized Education Program (IEP) is intended to provide deaf children with the educational services they need in order to achieve their full potential in school. As such, they can include everything from communication support, medical assistance, and tutoring to test accommodations and technology in the classroom. The whole point of an IEP is that it is individualized, and that means that it is necessary to be very familiar with your child in order to know what needs to go into the program. A school psychologist familiar with deaf children should be included in planning the IEP, as should someone who can fully evaluate your child’s language strengths and needs, someone who can provide specific information with regard to audiological support, and a teacher (or someone from a local school for the deaf) familiar with deaf children in the situation. as you will see if you search the site for the term “IEP,” you need to be the strongest advocate for your child in the process.
I have noticed with a lot of my students who seem to have additional learning problems, they switch hands frequently during signing. Whether the switching early in life caused the learning problem, or vice versa, or if they are completely unrelated, I’m not sure. I believe there was some research in the 1980s or 1990s about how changing hands doesn’t allow the correct hemisphere in the brain to retain the information. Can you help?
I don’t know of any research that links frequent hand switching with learning problems. There was some research in the early 1980s that examined when deaf signing children began to show a preference for linguistic handedness (i.e., for signing) and non-linguistic handedness (e.g., for reaching, handling objects, etc.). Sign handedness develops early and is relatively robust. Right hand dominance is linked to left hemisphere language (the typical pattern for both speakers and signers). Anecdotally, left-handers seem to switch hand dominance when signing more often than right-handers, but this doesn’t have anything to do with the brain retaining information. Note also that switching dominance is rule-governed and does not occur at random for fluent signers.
My son is 5 1/2, hard of hearing, moderately-severe to profound, bilateral aids since he was 4 months old. He is currently in a mainstream school, and also knows ASL, although he doesn’t like to use it. His reading skills are incredible – he has read dozens of “chapter books” since he learned to read last winter/spring. He has really good fine-motor control. But his pencil skills however are truly awful, well behind everyone else in his class, and he is even very unwilling to even try printing/tracing letters. He is on the waiting list to see the school board OT about a possible dysgraphia diagnosis. Is there any connection between his written language problems and his hearing problems? Or between his written language problems, and his unwillingness to use ASL?
It appears that your son’s problem is not a written language problem. Instead, as you have described it here, the problem is with his handwriting. If his reading skills are strong, then his written language skills may also be strong. However, you and his teachers will need to bypass handwriting in order to accurately assess his written language knowledge and skills. That can be done easily with the use of magnetic letters and/or the computer. He can construct his stories using magnetic letters or he can type his stories, instead of trying to print them. I used this approach with a kindergarten student who was hard of hearing and also had cerebral palsy and could not write with a pencil. She was allowed to compose her stories using magnetic letters until she had learned the alphabet and then on the computer. The approach was highly successful.
I cannot say whether your son’s handwriting problem is related to his hearing loss. A consult with the school’s occupational therapist is definitely in order.
With regard to his unwillingness to use ASL, that is most likely an identity issue. Most children, regardless of age, do not want to be different from their peers. Because your son is mainstreamed with children who are hearing and use spoken language to communicate, I am not at all surprised that he doesn’t want to use ASL. My best guess is that he wants to be like his peers and use spoken language to communicate. Using ASL sets him apart from his peer—makes him different—the very thing children try to avoid.
I am from Turkey. My son has autism and was born with a profound sensorineural hearing loss. He was implanted at 5 years of age. He is now 12 years old.. He cannot speak or write. It seems there isn’t anybody else like him in Turkey and I cannot get any assistance in dealing with his multiple challenges. I want to teach him speak. How can I do that? How can I help my son?
I am sorry to hear that you have not been able to access help for your son that you feel has been useful. Certainly deafness and autism each present their own challenges, but together things are much more complex.
Autism alone is associated with language impairments that are often quite significant. Many hearing children who have autism develop only very limited speech, and some only sounds, with no functional speech. The focus for these children should usually be on communication, not speech. This means trying to build communication of any kind, including gestures, manual signs, picture systems, as well as speech — basically anything that allows the child a chance to communicate with the world around him. And an important part is trying to motivate the child to want to or need to communicate.
Your son also has a profound hearing loss. That is also by itself a high risk factor for acquiring speech. A cochlear implant may make speech sounds more available to him. But even if that were the case, he still may be affected by the language disorder I mentioned in connection with autism. So many, many questions remain that will impact on your son’s ability to speak and to write.
So the situation is complex. But does that mean there is no hope? Absolutely not! With appropriate and consistent support, most children make significant gains in many areas. If it has not already been done recently, I would recommend having an assessment done of your son’s intellectual, language and daily living skills, so you can understand where his skill levels are currently. Then try to find someone who can provide a program of systematic behavioral therapy, with a special focus on communication in as many activities as possible.
I don’t know the availability of services in your area, but hopefully a physician might know of available services, or the professionals who did the implant, or perhaps if there is a university in your area. Did anyone provide you with support after the implant? That person may also be able to help connect you with services. Two sources that I am ware of online are: The Tohum Foundation http://www.tpfund.org/TOHUM/default.asp and The Gunsigi Services http://www.gunisigichildtherapy.com/cigdem-ergul.php
Both, I believe, are in Istanbul, but hopefully they can connect you with services where you are located. The Tohum Foundation indicates their “ key purpose is to lead and disseminate early diagnosis, education, and social integration services for children with autism throughout Turkey.”
There is a family support group in North America that you should be able to access through http://groups.yahoo.com/group/DEAF-Autreat I have met some of these families, and they are wonderful people and many have struggled with similar concerns.
I have a son who was born deaf but has a cochlear implant. he doesn’t want to pick up on spoken language so im introducing sign language to him. He also has many developmental delays and was wondering what would be the best way to go about teaching how to sign.
This is a tricky question, not one that can be addressed fully on this site. There are so many questions that need to be asked! Crucially, I would want to know things like: How old is the child? How long since he had his implant, and has he been wearing it consistently? Are you sure the technology is working correctly and that your son was mapped correctly? What do we know about these other developmental delays?
Importantly, we need to know what is meant by “doesn’t want to pick up on spoken language.” This is an interesting and unusual way of phrasing this, and I would need to know how you have reached this conclusion? It is only with this sort of information that we can give you any clear advice. Plus, assessments describing the child’s progress or lack of progress from the pre-implant stage to now would be very useful indeed.
The next step would be to think about what you mean by sign language. To professionals this may be very clear, but to parents it can mean many different things. Are you looking to use signs to support spoken language? Or, are you looking at a whole new language? Using simple signs to support spoken English would be a great place to start. Learning a language like American Sign Language would require a big commitment from you and other family members. And, she would need to explore at length whether your child’s developmental delays might act as a barrier to language learning – sign languages are not an easy option!
I think you really need to talk to your local professionals, so the whole family can all think about what you are trying to achieve with your child and refocus on the goals. Importantly, if they tell you either that you must not sign with your son or that he will never achieve spoken language, you should look for another opinion. There is no “black and white” here, you are asking about a complex situation that likely does not have any simple answer.
Can you suggest criteria or guidelines for a speech-language pathologist in deciding amount and type of articulation services for an 11 year old, with a cochlear implant and with a cognitive disability (FS IQ 67)? He can produce all the phonemes in isolation but has many errors, deletions, and substitutions in connected speech. This student’s many needs all require large amounts of time and repetition (sometimes years) in order to develop, though we do see progress. In part the slow progress is because the student is complex (history, etiology, needs). In addition however, the student’s services and placement are not adequate to meet his complex needs; we work with it as best we can. The good news: I hope he will receive an evaluation at the Clarke School this spring. Meanwhile another year is ticking away.
My suggestion to the SLP was to embed articulation work within the pragmatic, social communication we will be focusing on this year. Suggestions or examples of what this more specifically might look like would be welcome since she is not trained in working with deaf and hard-of-hearing children.
In looking at your description of this child, his cognitive skills, age and current articulation skills, my first inclination is to ask whether a phonological analysis has been done on his speech production patterns? I ask this because you say that he can produce all phonemes in isolation, (this is great!!!), yet he has errors in connected speech. A phonological disorder is characterized by difficulty acquiring the rules that underlie the sound system. A child with a hearing loss and cognitive issues would be at risk for this. For example he may be producing phonological processes that are characteristic of a younger child, such as deleting final consonants (“home” is pronounced “ho”) or fronting velar sounds (“Kiss” is pronounced Tiss), or he could be displaying the process of stopping (substituting a stop sound for a fricative or affricate sound, so “Funny” is pronounced “Punny”). There are several tests that can assess whether the child is producing phonological processes – you might want to look into having an assessment done.
• Bankson-Bernthal Test of Phonology
• Clinical Assessment of Articulation and Phonology (CAPP)
• Computerized Articulation and PhonoEval System
• Hodson Assessment of Phono Patterns (Happ-3)
• Kahn-Lewis Phonological Analysis (KLPA-2)
• Phonological Process Analysis
• Smit-Hand Articulation and Phono Eval (1997)!
• Structured Photographic Articulation Test
The other issue I wonder about given your description is whether he has apraxia, a motor programming issue, and a good test that checks for apraxia is called the Kaufman Speech Praxis test. The website provides other tests http://www.apraxia-kids.org/site/apps/nl/content3.asp?c=chKMI0PIIsE&b=788447&ct=464141
I see that he has an evaluation coming up at Clarke and that will be great, but in the meantime, it would be valuable to know whether he has characteristics of either apraxia or a phonological disorder. I say that because these types of disorders do not respond well to traditional therapy methods, and for these he will need direct targeting. It would be important to begin adapting his therapy plan accordingly. The “Cycles” method can be very effective in treating either issue and even for children with hearing loss. A typical session in the “Cycles” method goes like this:
• Review past session
• Auditory bombardment
• Target word cards (adapt with photos, or photos with words printed under them and take vocabulary from his units in school )
• Production Practice with different activities every 5-7 minutes
• Stimulability probes
• Auditory bombardment
• Home Program
Best of luck!