Deafness And Other Communication Disorders Education Essay

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According to the National Institute on Deafness and Other Communication Disorders (2005), approximately 17 in 1,000 children under the age of 18 are diagnosed with a hearing loss. Hearing loss remains a common birth defect and a huge concern for many countries, particularly with the increasing number of children being detected with a hearing loss (The National Child Traumatic Stress Network, 2006). This essay will illustrate a case study example of a 3-month-old girl, recently diagnosed with a moderately severe sensorineural hearing loss. The case study states that both parents are fluent AUSLAN users and use AUSLAN to communicate at home, and are uncertain about the language and educational options for their child. This essay will therefore aim to act as a guide in providing additional information for the child's family so they are better able to understand each language and educational option (Auditory-Verbal, Auditory-Oral, Total Communication and Bilingual-Bicultural) for their child, along with a discussion of the disadvantages and advantages of each option respectively. Prior to discussing the importance of early intervention as well as language and educational options for the deaf child, it is essential for every parent to understand that there are two conflicting and very different perspectives that influence how society views hearing loss. The most common view - the medical perspective - is where many parents are more likely to associate deafness with a disability and believe that it is necessary to "fix" this deafness with hearing aids and cochlear implants so that one can operate in mainstream society (Tucker, 1998). This is particularly so, especially since 90% of deaf children are born to hearing parents (Sparrow, 2005). However, there is also the cultural perspective that many parents are unaware of. Deafness can also be associated with culture. For instance, certain aspects of the Deaf culture such as sign language can be particularly useful when hearing aids or cochlear implants fail to function or are unable to provide the hearing impaired individual the benefit required (Sparrow, 2005). Understanding two different perspectives would seem more viable in widening parents' choices particularly when making the tough and informed decisions in determining which cultural identity would be suitable for their deaf child to grow up in. Which parent would not want to maximise their child's opportunities and develop their child's full potential for education and career purposes?

TWO DIFFERENT VIEWS OF SOCIETY ON HEARING LOSS

The first perspective, the medical or pathological view, believes "deafness" to be a tragedy, a disability or a disease that should be "fixed" and that the deaf individual should be sympathised (Tucker, 1998). Those who are in strong support of this model would commonly seek the help of a medical professional, and may be more inclined to go forth with the intervention of hearing aids, cochlear implants, and/or speech therapy, where recommended. Some deaf individuals believe that in order to become assimilated with members of the hearing world, they must first welcome the technology that can assist the deaf (The National Child Traumatic Stress Network, 2006). For a few years now, the medical professionals in the hearing world have supported the idea of cochlear implantation and believe that they are the way forward for a better future for the deaf, in providing all deaf people with the opportunities they lack in life, so that they will be better able to achieve their full potential as would any normal hearing person in terms of education and career paths (Tucker, 1998). However, this view has not been accepted by the Deaf community - cochlear implants have clearly brought a hardened and ongoing debate between the hearing and the Deaf communities respectively.

The second perspective, the cultural view, represents people sharing a common culture, social affiliation, and heritage (Tucker, 1998). These people associate themselves within a cultural community known as the Deaf community, and define deafness as "a cultural identity rather than a disability" (Tucker, 1998). They believe that a deaf child will be able to develop great self-esteem and learn a rich set of values, language and culture by interacting with Deaf people, and as a result, will develop a sound identity and become part of his or her own community (Tucker, 1998). Those who support and identify with the Deaf community tend to conform to Deaf cultural norms, socialize mainly with Deaf individuals, and use sign language such as ASL or AUSLAN (depending on the country they are being brought up in - every country has their own national sign language) (The National Child Traumatic Stress Network, 2006). The Deaf community, in particular, see sign language as superior to English, and undermine the medical view that technology can "fix" their deafness (The National Child Traumatic Stress Network, 2006). Many Deaf individuals question the use of the auditory devices, particularly the cochlear implant. They fear that the cochlear implant could lead to "a cultural genocide" of their culture; thus strongly believing that it is essential to protect and preserve their culture for as long as they can (Tucker, 1998). The strong stance argued by the Deaf advocates who were once associated with the Deaf community and have now assimilated into the hearing world, have managed to be so convincing because of their early mode of oral training (Tucker, 1998). Yet despite the oral training they had, they do not believe oral training to be a good communication learning mode for deaf children, and that deaf children should focused on sign language instead (Tucker, 1998). The prime language of the Deaf community is ASL, or American Sign Language. Each country has its own sign language - for instance, the sign language of the Deaf community in Australia is AUSLAN, Australian Sign Language. The National Child Traumatic Stress Network (2006) describes sign language as "a gestural, visual, and a spatial method that uses movement, and placement, of hand, face, and body expressions to communicate". Breivik (2005) states that the language itself helps to create bonds found within the Deaf community, and that it is within this community that deaf children and deaf adults feel the most comfortable. Breivik (2005) further mentions that the Deaf community are proud of their heritage and culture, and more importantly, proud of their deafness.

IDENTITIES

It is difficult and complex for a person in the hearing world to understand why a Deaf person would choose to be Deaf, and why a Deaf parent would want their child to grow up Deaf and further deny them the right to develop their full potential in educational and career settings similar to that of a hearing person (Lane, 2005). Likewise, it would also be difficult for a Deaf person to understand why a hearing parent who has a deaf child would want to deny the child of his/her deaf identity by "fixing" them with cochlear implants (Lane, 2005).

The identity of the deaf person is influenced by the beliefs of a community. There are three kinds of cultural identities - the hearing, the deaf, and the bicultural identities respectively. Often, a child who is born deaf, or individuals who have lost their hearing early in their lives, associate themselves with the Deaf culture, and occasionally have difficulty relating to the hearing world (The National Child Traumatic Stress Network, 2006). Those who have lost their hearing later in life, tend to still associate themselves with the hearing world, as they were previously associated with that community (The National Child Traumatic Stress Network, 2006). The third type of cultural identity - biculturalism - represents people who are aware of both the deaf and hearing cultures (The National Child Traumatic Stress Network, 2006). These people respect both sign language and English, and can comfortably place themselves within either culture (The National Child Traumatic Stress Network, 2006).

THE EFFECTS OF COMMUNICATION AND EARLY INTERVENTION

Communication is an important aspect for developing a child's language and speech development. Lynas (1994) states that human communication is vital for speech and language development, and that language itself is where a person can become "a fully socialised, integrated human being". For most hearing people, the prime language system of human communication is speech or the auditory-oral system of language (Lynas, 1994). When speaking, people with normal hearing communicate language order words according to the intricacies of syntax, rhythm, stress and intonation (Lynas, 1994). However, if a child is born deaf, language and communication development would certainly be hindered or limited (Lynas, 1994).

Age certainly plays a major factor in developing the necessary speech and language skills required for effective communication. According to Woll (1998), every infant born has the potential to learn any human language, but which language or languages they acquire will actually depend on the languages they have access to. Woll (1998) states that the first six months in an infant's life represents an especially sensitive period in early language development as the child progresses from being able to babble to forming syllabic combinations. In later months, the child would often develop utterances for parents and caregivers to respond to, thus setting the foundations for interaction and further language development.

Clinicians who work with deaf children agree that early identification is the key to language learning and the development of intelligible speech. In 1993, the National Institute of Health called on hospitals to begin universal screening for hearing loss for newborn babies (Halpin, Smith, Widen, & Chertoff, 2010). The report recommended identification by at least three years of age, followed by subsequent follow-ups, and intervention services to assist the child and family (Halpin, et. al., 2010).

Many developed countries look to pass laws requiring the screening of newborns for hearing difficulties. Getting diagnosed and securing the right intervention within the child's first six months of life assists the child in achieving better outcomes in therapy (The National Child Traumatic Stress Network, 2006). Early diagnoses would allow the child to hear sound by way of a hearing aid or auditory training, and would also provide for the option of early cochlear implantation (Tucker, 1998). Identifying deafness early and educational programs that emphasize speech would make a deaf child better able to absorb instruction in verbal language (Lynas, 1994). These verbal therapy programs are helpful to parents if they wish to see their deaf child mainstreamed with hearing children (The National Child Traumatic Stress Network, 2006).

Children who are profoundly deaf are often exposed to sign language early on in life, to communicate and interact with their family members and other deaf individuals, as they embrace the Deaf culture and community (The National Child Traumatic Stress Network, 2006). Fischer (1998) states that children are indeed very adept at language acquisition, while adults who have acquired a first language often become good at learning other languages; however the contrary is not always true. Fischer (1998) subsequently argues that young deaf children have often been forced to learn when they are better able to acquire language. Parents would then have to make the informed choice about which type of communication their child should acquire - signed or spoken.

Wiesel, Yosipor-Kaziar (2005) state that some clinicians believe that a deaf child can benefit from being reared in a signing home, and where he or she can develop social and cognitive skills on a level similar to the hearing child. Research in the 1970s indicated that Deaf children have an advantage in the area of education, socio-emotional adjustment, and language competence when they also have Deaf parents (The National Child Traumatic Stress Network, 2006). Berke (2007) states that Deaf children born to Deaf parents are "linguistically superior", that these children have a command of sign language and English usage that often is greater than the deaf child born to hearing parents. Sign language, in this case, becomes the deaf child's first language, and English becomes their second.

Petitto and Holowka (2002) states that parents should not need to make a choice and their children can and should be exposed to both sign and spoken languages from the time a hearing loss is discovered. Petitto and Holowka (2002) believe that parents should be compelled to provide their young children with the earliest possible bilingual language exposure (whether it be two spoken ones, or a spoken and signed language), particularly since the world we now live in is becoming more multilinguistic and multicultural. One other reason, according to Petitto and Holowka (2002), is that current research also shows that the optimal period for a child to acquire language is traditionally identified as from birth to five years of age.

COMMUNICATION METHODS AND ITS OPTIONS

There are several communication methods that a parent of a newly diagnosed deaf child can consider. First, the Auditory-Oral method emphasizes on oral language building by prompting the deaf child to use whatever hearing he or she has, along with speech-reading to speak effectively (Lynas, 1994). The focus of this model is to provide the deaf child the skills to be mainstreamed into regular classrooms with hearing children (Lynas, 1994). However, most Auditory-Oral programs are full-time therapy, along with Auditory-Oral education. Schools offering Auditory-Oral programs use self-contained classrooms, and instruct using the English language (The National Child Traumatic Stress Network, 2006). The Auditory-Oral method is one of the more traditional approaches to teaching the deaf child (Lynas, 1994). If the Auditory-Oral method is the preferred option, the child must use whatever residual hearing they have (Lynas, 1994). The child must also have hearing aids, or other assistive listening devices to enhance their auditory senses (The National Child Traumatic Stress Network, 2006). An advantage of this therapy is that the child is trained to speech-read. However, to excel in this method, the child must have the ability to grasp language quickly and effectively (National Child Traumatic Stress Network, 2006).

Second, Auditory-Verbal Therapy teaches a child who is deaf to use a hearing aid, or cochlear implant to learn to talk, and understand language (Lynas, 1994). With the use of these devices, a child does not depend on their visual cues (Lynas, 1994). Hearing aids are devices that amplify sound when worn at the ear. The cochlear implant, on the other hand, is a surgically implanted hearing device, designed to enhance the hearing of sound, and also has the potential of improving speech understanding in children with a profound hearing loss (The National Child Traumatic Stress Network, 2006). The Auditory-Verbal method maximizes a child's residual hearing and works closely with the child's parents by educating them how to instruct their children (Lynas, 1994). This method focuses on preparing the hearing impaired child for regular mainstream classrooms. One major disadvantage of the Auditory-Verbal method is that it is not readily available in the community (The National Child Traumatic Stress Network, 2006). Another disadvantage is that this program is only for children diagnosed at a very young age and that the child must have some residual hearing (Deaf Linx, 2007). Supporters of oralism believe that verbal language should be used in education, and that sign language should not be permitted in the learning process (Lynas, Huntington, Tucker, 1997).

The Total Communication method examines how spoken language develops. One of the major advantages of the Total Communication method is that it is adjusted to suit the child (Lynas, 1994). The child is free to choose the method of communication they are most comfortable with. If a child does not speak well, the method calls for help from instructors and sign language. One disadvantage of Total Communication is that clinicians are concerned that learning to sign and talk simultaneously could damage the child's ability to learn both (Lynas, 1994). Supporters of oralism believe that Total Communication reduces the rate of speech used by the instructor, and that English could be simplified in the effort to use sign language (Lynas, 1997). Both positive and negative ideas have been expressed by parents who chose this method as a choice for their deaf children (Berke, 2007). However, in the case of the 3-month-old girl with a moderately severe hearing loss whom both parents are fluent in AUSLAN, this method would be more preferred as compared to other methods.

The Bilingual-Bicultural method combines both sign language, and the spoken word (Lynas, 1994). It allows the child to experience the deaf culture, as well as the culture of the hearing. In the use of bilingual-bicultural education before age seven, sign language is the main language used in the interaction with others (Lynas, 1994). The child experiences an identity within Deaf culture. After mastering sign language, the child begins the process of learning to speak English. This method gives a child the opportunity to function in both societies. The advantage to bilingual-bicultural is that the child enters school with language skills, and can be mainstreamed into the regular classroom (Pittman, Huefner, 2001). Other advantages of the method are that sign language is available to the child. If in a residential school, all of the children sign, there would be no feeling of isolation. Deaf parents can also model the sign language for the child. The problem with this method is it is not often available outside of the local residential setting.

Wiesel, Yosipor-Kaziar (2005) state that some clinicians believe that a deaf child can benefit from being reared in a signing home, and where he or she can develop social and cognitive skills on a level similar to the hearing child. Research in the 1970s indicated that Deaf children have an advantage in the area of education, socio-emotional adjustment, and language competence when they also have Deaf parents (The National Child Traumatic Stress Network, 2006). Berke (2007) states that Deaf children born to Deaf parents are "linguistically superior", that these children have a command of sign language and English usage that often is greater than the deaf child born to hearing parents. Sign language, in this case, becomes the deaf child's first language, and English becomes their second.

CONCLUSION

In conclusion, the academic, and communication skills of a deaf child depend on how committed the child's parents are to preparing the child. The earlier in life that a child is diagnosed with a hearing loss and the earlier a child is implemented with the appropriate tools or methods for communication, the better a child would perform in language, communication and social skills. Today, a deaf child has more opportunities to maximise their potential in terms of having access to greater technology (assistive listening devices for example) and various types of educational services or communication methods to facilitate language development.

Although Bilingual-Bicultural is an excellent method allowing the child in the above case study to participate in both the hearing culture and deaf culture, it is not readily available in the community. Similarly, although the Audio-Verbal method provides a role for the child's parents to learn how to teach the child, it also is not available everywhere. The Total Communication method tries to meet the needs of every child. If the child has trouble speaking, instructors step in to assist, and sign language is brought in to fill the gap. With regards to the above case study, the Total Communication method is perhaps the most practical for the moderately-severe hearing loss child. However, no matter which approach a family decides to use to communicate with their child, there remains controversy. There are positive and negative viewpoints of each of the modes of communication. The family must make an informed decision as to what is best for the child - it is certainly not as easy job for the parents. It would take strong commitment and many long hours of therapy and hard work with the child (Lynas, 1994).

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