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.

Education

I read in the New York Times that “all deaf children have some cognitive challenges.” Really?!

Question from S.W., New York. Posted April 15, 2014.
Response from Marc Marschark - NTID

I was surprised to read the New York Times article A Son’s Deafness Prompts a Scientific Journey and learn that its author, Ms. Bouton, with whom I have never spoken, had written that I stated that “All deaf children have some cognitive challenges.” Not only have I never said that, there is no evidence to support such a claim.

When I do presentations about raising and educating deaf children for parents, teachers, and other audiences around the world, one of my clearly stated conclusions, based on the research evidence, is “differences do NOT equal deficiencies.”

Sadly, throughout history, many in our society have believed that individuals who are deaf are less intelligent than those who hear. The evidence simply does not support that perspective. To suggest that “all deaf children have some cognitive challenges” is not only incorrect, it is insensitive. And for Ms. Bouton and the Times to be unwilling to correct the record is simply wrong.

Can you please suggest some good articles, research or data to support having a TOD in a classroom with a 5 year old with significant delays “across the board” (the student has bilateral CIs, no sign language, extreme speech delays [apraxia?])?

Question from J.B., Vermont. Posted April 2, 2014.

Given the huge individual differences among deaf children with multiple challenges, this is an impossible question to answer. You really are (or should be) looking for information relevant to a very specific child, and we don’t have much to go on.  How significant are the delays?  Is the child using the CIs successfully?  What is the cause of the extreme speech delays? Has there been an assessment that suggests apraxia or is that a guess, and if the latter, based on what? Does the child not use sign language because s/he has not responded to it or because s/he has not been exposed to it?

You can find articles and chapters about the educational needs of deaf children with additional disabilities (see below), but you really want to know why that 5year-old should have a teacher of the deaf.  You will not get that from an article.  You are going to need a comprehensive evaluation done by people who know what they are doing and can communicate effectively with the child.  There is no one right answer; it depends on the needs of each child.

Further reading:

Mauk, G. W. & Mauk, P. P. (1998). Considerations, conceptualizations, and challenges in the study of concomitant learning disabilities among children and adolescents who are deaf or hard of hearing. Journal of Deaf Studies and Deaf Education, 3, 15-34.

Vreeland, J. (2014). Educating deaf children with multiple challenges.
www.raisingandeducatingdeafchildren.org

Is it appropriate to place sign dependent deaf students, who have “low” language and “low” IQ scores, but no other diagnosis, in special ed classes with non signing special ed teachers?

Question from L.L., Texas. Posted March 6, 2014.

It is never appropriate to place deaf students (or anyone else) in a classroom in which they cannot communicate with the teacher (or vice versa). Determination of an appropriate school placement for a deaf or hard-of-hearing child should be made on the basis of a thorough assessment by a school psychologist or other individual(s) who are qualified and able to communicate with the child. Specifics of the placement and the student’s needs to be made explicit in an IEP.

However, the fact that you are asking such a question suggests that there is more to this than it might appear.  If any particular student is “low language,” how do you know s/he is “sign dependent”? Is the student being described as low language because s/he does not use spoken language? Has the child been exposed to sign language from an early age but still is not acquiring it in an age-appropriate manner? Is the child from a family that uses some other language at home? Has a formal assessment of the sort suggested above actually been conducted? Ultimately, school placement should be a parental decision  (various states and countries vary in this respect), but it must be an informed one. Parents  in the United States have rights with regard to their children’s educational services (see Recommended Readings). Other “interested individuals” typically do not.

Recommended readings:

“Importance and Need for the Continuum of Educational Placements,” by Barbara Raimondo, Esq., coming April 1 to www.raisingandeducatingdeafchildren.org.

Raimondo, B. (2010). Legal advocacy for deaf and hard of hearing children in education.  In M. Marschark & P. Spencer (Eds.), The Oxford handbook of deaf studies, language, and education, volume 2 (pp. 31-40).  New York, NY: Oxford University Press.

Is there research to support why an additional year of preschool is considered appropriate for a child who is deaf and uses cochlear implants to develop language skills rather than moving on to kindergarten placement?

Question from A.H., Virginia. Posted March 4, 2014.

There does not appear to be any literature on this nor any general conclusions about what is or is not appropriate. It would definitely depend on the individual child and a full assessment of that child’s abilities.

The high school I work at as an educational sign language interpreter will soon be enrolling a young girl from a refugee camp. The student has a hearing loss, but it is not known to what degree. She has had no formal learning experiences except for a few years in the refugee camp she lived in. I would like some resources in order to help the student be as successful as possible. At this point, she will be mainstreamed because there is not a teacher of the deaf full time at this high school. Can you suggest some good resources to tap into in order to help this student with language acquisition?

Question from S.C., Colorado. Posted February 11, 2014.

This profile of a student arriving from a refugee camp, sadly, is not uncommon.

A principle that Dr. Gilbert Delgado established in his groundbreaking book The Hispanic Deaf, published in 1984, is that above all, each student has to be dealt with on a case-by-case basis. This seems like common sense, but unfortunately, we often hope that there are solutions that we can pull off the shelf or recommend for whole categories of students.

With that principle I mind, I can recommend the following:

Where is she coming from? Are there other refugees from the same refugee camp and country in the school district? What resources exist in the community for this group of refugees. People who are providing community support for the refugees should have more information that can be relevant. It is important to network.

How does the student communicate with her family and people in her environment?

If she is hard of hearing, does she speak? What language? What language does the family speak?

Does she use gestures and home signs?

The student’s hearing loss should be determined as soon as feasible.

If the student is hard of hearing, and high school age, hearing aids are not likely to be effective without one-to-one therapy.  This may be a goal a little further down the road.

Placing a student with a hearing loss in mainstreamed classes with an interpreter is not an appropriate placement. Unless she and the interpreter share a sign language, she has no access.

If she doesn’t know English, under Federal law, including Title IV of the Civil Rights Act, her language needs must be addressed. “ELL students must be provided with alternative services until they are proficient enough in English to participate meaningfully in the regular program.” https://www2.ed.gov/about/offices/list/ocr/qa-ell.html

Regarding resources for language acquisition, all students entering special education are required to have a full educational evaluation. These professionals should, after evaluating the student, provide goals for language and literacy development. Materials used should be at a basic level, and because she is an adolescent, not designed for very young children. If there are other hearing students in the district who also lack formal schooling, what has been done for them?  Does the district have ESOL specialists? What materials does the district have for teaching English to students new to the language?

These are very broad and general suggestions for a complex issue. Without more specific details, such as how the student communicates, family language, specifics about the school district, it is difficult to be specific. Finally, a sign language interpreter should not be responsible for language development of this student. I do not believe this satisfies Federal Law requirements for alternative services to assure acquisition of English.

I have a 5 year old son with mild to moderate, sensorineural bilateral hearing loss. He is currently in private school and his teacher identified him as needing an FM system. Who is responsible for providing/paying for the system – the public school, private school or parents? He does not have an IEP, only a 504 plan with the private school. Thanks for any guidance or information.

Question from M.R., New York. Posted January 16, 2014.

Given the fact that your five year old son does not have an IEP, the public school does not have any responsibility to provide equipment. A 504 plan includes  accommodations to the academic program. You may consider referring your son to the home district for an evaluation. If it is determined that his hearing loss is effecting his progress through the academic program, he would receive an IEP, and the school would be responsible for providing such equipment.

A word of caution, however: If the loss is minor and he is doing well in school it is unlikely he will be found to be eligible. As his teacher was the one who recommended an FM system, I would suggest you meet with the private school and investigate how they can provide it. I would also suggest if that fails if the home district could be approached about offering a loaner.

What is the average ACT score for students with a unilateral hearing loss? Is it lower than the national average for hearing students? My daughter has microtia/atresia of her left ear and is a great student but has taken the exam multiple times with a highest score of a 26. Wondering if her hearing loss is some of the issue.

Question from K.W., Michigan. Posted January 3, 2014.

As far as we can tell, ACT (American College Test) scores are not available for sub-populations like students with unilateral hearing losses. Generally, however, even mild and unilateral hearing losses will affect spoken language comprehension, especially in noisy environments (like classrooms). It may be that your daughter has other skills that allow her to compensate in school, but standardized entrance tests tap a variety of  knowledge and abilities, not all of which necessarily are reflected in her school grades. (I am assuming that your daughter has not had difficulty understanding spoken instructions during the ACT test administration.)

It is wonderful that you (and presumably her daughter) aspire to higher ACT test scores, but you might want to recognize that students with almost any degree of hearing loss generally struggle academically as well as with standardized tests;  a composite score of 26 is quite good in that context. The Gallaudet University website, for example,  indicates that as of 2007-2008, deaf and hard-of-hearing students only have been required to have a composite score of only 14 to gain entrance.  Compared to deaf and hard-of-hearing students currently enrolled in baccalaureate programs at Rochester Institute of Technology , your daughter’s score put her in the top 50%.

I’ve seen and heard Marc Marschark say repeatedly that there is no evidence showing Cued Speech supports reading skills. He also writes “.In its more than 60 years of existence, it has never been found to facilitate the acquisition of reading skills by deaf children who are learning English.”

My question is has anyone ever bothered to do a proper unbiased research study on using cued speech with D/HH students to learn literacy?

Question from C.T., Washington. Posted December 27, 2013.

You’re almost correct. What he says is that there is no evidence to support cued speech facilitating the acquisition of literacy skills in deaf or hard-of-hearing children learning English. He readily acknowledges that there is a wealth of supportive evidence from children learning French. The difference appears to be that French (and Spanish and Italian) have very regular sound-to-spelling correspondence whereas English does not (see Alegria & Lechat, 2005).

Even if he can’t do the math (cued speech was developed in 1965-1966), Marschark explains that if, after more than 40 years,  there are no published studies supporting cued speech for English, the alternatives are that either (a) the research has not been done or (b) there has not been positive evidence. In fact, there has been a number of studies conducted aimed at supporting cued speech for deaf children in the United States, but apparently none have yielded sufficiently positive results and been “unbiased” enough to have been published in a peer-reviewed journal.

Cued English clearly facilitates speech reception and may support literacy subskills for some deaf or hard-of-hearing children, but English is simply too irregular for it to be of benefit more generally.

Recommended reading:  Alegria, J., & Lechat, J. (2005).  Phonological processing in deaf children: When lipreading and cues are incongruent.  Journal of Deaf Studies and Deaf Education, 10, 122-133.

Is there any research available which supports the decision to send hard-of-hearing children to preschool early? We have families sending their children to school during the spring semester (age 2 turning 3), as opposed to waiting for fall enrollment following the 3rd birthday.

Question from S.R., Iowa. Posted December 27, 2013.

I am not aware of any research that supports (or recommends delaying) the decision to send hard-of-hearing children to preschool when they initially turn 3 as opposed to waiting until the fall enrollment following their 3rd birthday.  Children eligible for special educational programming may transition to preschool when they are three years old.  The value of preschool education (e.g., child-centered programming that is center-based) for children who are hard of hearing varies child to child and depends upon many factors such as: 1) individual characteristics and needs of the child, 2) quality of the child’s home and/or other environments to promote language learning and overall development, and 3) quality of the preschool program. Programming may be full time or part-time and may be fully child-centered or include a family-child component. Family involvement in the transition from early intervention to preschool and the determination of services needed to support their child’s development is essential.

It is well-established that early identification and intervention (e.g., specialized support and collaborative family-centered services well-before one year of age) improve the overall outcomes for children who are deaf or hard of hearing.  The Joint Committee on Infant Hearing Position Statement of 2007 recommends that all children who are deaf or hard of hearing with permanent congenital bilateral or unilateral hearing loss, including those with permanent conductive or neural hearing conditions, receive early intervention programming. The Position Statement emphasizes that children with all types and ranges of hearing differences are at increased risk for delays in multiple areas of development.  Outcomes gained as a result of early intervention may be lost in subsequent years without continued and appropriate services.

Children who are hard of hearing are dependent upon the quality of the auditory environment for language development because they are likely to rely primarily on listening and speaking for communication.  Studies point to the importance of the quantity and quality of the language in the child’s environment as well as the child’s opportunities to engage in conversations as factors that influence language development.  There is evidence that suggests that children who are hard of hearing require even more exposure to language than children who are hearing to attain the same outcomes as their hearing peers. Quantity and quality of language input varies according to the adults with whom the child interacts on a daily basis. While some parents and caregivers provide rich, age-appropriate and meaningful language exposure others do not. Another variable is auditory access.  In order to obtain maximum benefit from the auditory input, the child’s hearing technology must provide good quality access to language, must be monitored to assure that it is functioning as designed, and must be used consistently.  The listening environment must also be conducive to maximize auditory access.

Both deaf and hard-of-hearing children benefit from a preschool program that includes professionals with the knowledge and skills to support specialized early learning opportunities and who attend to the individual needs of the child and the quality of the language environment.  Some children who have just turned three years old and are hard of hearing may do well at home or in another environment with consultative services from specialists who can provide family members and other caregivers with support to ensure that the language-learning environment is appropriate and accessible to the child.  Other children will be better off in a well-designed program with educators and other professionals with specialized skills. The measure of effectiveness of any learning environment, i.e., home, childcare program or preschool program, is child outcomes. Children who are hard of hearing should demonstrate the same outcomes as their normally hearing peers.  Monitoring of the child’s progress using appropriate and comprehensive measures should determine the effectiveness of the child’s learning environment and identify any additional supportive services needed.

Which reading curriculum(la) do you recommend using with deaf/hh students? Do you support using cued speech with English speaking deaf/hh students?

Question from D.D., Arkansas. Posted December 9, 2013.

Thank you for providing the opportunity to remind visitors that this site tries to provide people with evidence-based information about raising and educating deaf children. Only in rare circumstances does the site offer opinions or preferences, and then we ensure that the person writing the response is clear about that.

I do not recommend any particular reading curriculum for deaf and hard-of-hearing students. I know of different schools and programsusing different curricula, and I’m not aware of any evidence that suggests that one is any better than the other. The issue is the extent to which the curriculum is appropriate for the student and matches their strengths and needs (and is delivered in a corresponding manner).

With regard to cued speech, I used to be a stronger proponent than I am now. Cued speech clearly supports the reception of spoken language by deaf and hard-of-hearing individuals. I infer, however, that your question relates to reading. There has never been any evidence that cued speech supports deaf children learning to read English.  The evidence demonstrating cued speech to support reading subskills comes from work involving French or Spanish, which are far more regular in their sound-to-spelling correspondence. Clearly, cued speech has its proponents, and some children succeed well with it. But the evidence for supporting the the reading of English is lacking, and has been for the more than 40 years since cued speech was created.