ERIC Identifier: ED414667
Publication Date: 1997-08-00
Author: Easterbrooks, Susan
Source: ERIC Clearinghouse on
Disabilities and Gifted Education Reston VA.
Educating Children Who Are Deaf or Hard of Hearing: Overview.
ERIC Digest #E549.
When a child has a hearing loss during the developmental years, all areas of
development can be affected significantly. A hearing loss limits ease of
acquisition of a communication system, which further influences development of
interactions with others, the ability to make sense out of the world, and ease
of acquiring academic skills. Early identification of a hearing loss is critical
to a child's academic and emotional adjustment. What is a hearing loss, and how
is it caused?
There are three major types of hearing losses. The first is called a
conductive loss. This occurs when something goes wrong with the outer or middle
ear, impeding sound waves from being conducted or carried to the inner ear. The
second type of loss is called a sensorineural loss and occurs when damage to the
inner ear or the auditory nerve impedes the sound message from being sent to the
brain. The third type is referred to as a central auditory processing disorder
because, although there is no specific damage to the ear itself, the neural
system involved in understanding what is heard is impaired. Children with
central auditory processing disorder may have normal hearing as measured by an
audiometer (device used to test hearing levels), but they often have difficulty
understanding what they hear. A child may also have a combination of these forms
of hearing loss (Easterbrooks & Baker-Hawkins, 1994).
Many terms are used to refer to the population of individuals who have
difficulty hearing. The word "deaf" by federal definition means a hearing loss
which adversely affects educational performance and which is so severe that the
child is impaired in processing linguistic (communication) information through
hearing, with or without amplification (hearing aids). The term "hard of
hearing" means a hearing loss, whether permanent or fluctuating, that adversely
affects a child's educational performance but which allows the child access to
some degree of communication with or without amplification (Individuals with
Disabilities Education Act, 1990). The term "Deaf" used with a capital D refers
to those individuals with hearing losses who identify themselves with the Deaf
Culture. These individuals view themselves as a population united by a common
heritage, a shared experience, a multi-generational history, and a language,
American Sign Language (ASL) (Padden & Humphries, 1988).
The term "hearing-impaired" is used inconsistently around the country today.
Some use it to mean all degrees of hearing loss while others use it to refer to
the hard-of-hearing population. The terms "deaf mute" and "deaf and dumb" are
antiquated. Not only are they seen as outdated, they are also viewed as
How many people have hearing losses?
The National Center for Health Statistics (Adams & Benson, 1992)
estimated that more than 22.5 million Americans have some degree of hearing
loss. Of these individuals, 1,053,000 were under 18 years of age. This means
that one of every six children has diminished hearing to some degree at any
given point in time (Berg, 1986). Schildroth and Hotto (1994) reported results
of demographic information on 48,300 children identified as having hearing
losses. The students in their research represented 60-65% of the number reported
by the federal Office of Special Education Programs (OSEP), U.S. Department of
Education. The vast number of individuals with hearing losses are hard of
hearing or are older adults who have lost their hearing.
What are the signs of a hearing loss, and how is it diagnosed?
In very young children the signs of a hearing loss are lack of attention or
inconsistent attention, lack of vocal interactions or reduced vocal
interactions, and lack of or reduction in language development, especially
related to the quiet word endings such as -ed, -ing, and -s. In school-aged
children, the signs of a hearing loss are a high degree of frustration with
school and with others, low grades or a noticeable drop in grades, or a change
in patterns of paying attention (Davis, 1989). In adults, the signs of a hearing
loss are complaints that others are mumbling or playing equipment such as the TV
or radio too loudly.
How do people with hearing losses communicate?
The debate over the best way to teach a child with a hearing loss to
communicate has raged since the 1500s (Winefield, 1987). Although this debate
continues today, there is a growing number of individuals who recognize that no
one system of communication is right for all children. The choice of a
communication system must be made on an individual basis, taking into
consideration the characteristics of the child, the resources available, and the
commitment of an individual family to a communication method. Additional ERIC
digests explore each of these options in depth. As an orientation, the following
definitions are useful:
The Auditory-Verbal philosophy is a set of guiding principles for early
intervention that are used to support the development of residual (remaining)
hearing and speech and that focus on a strong development of listening skills
(see ERIC Digest E552 (ED414670)). The Auditory-Oral philosophy is a set of
principles that are used to develop spoken language and listening skills at all
ages and that may incorporate visual methods of teaching these (see ERIC Digest
E551). Cued Speech is a sound-based system of hand cues that supplement
speechreading. English-Based Sign Systems are those systems that use signs from
ASL plus invented signs along with prefixes and suffixes to represent the
English language in signed form. The Bilingual-Bicultural philosophy stresses
the importance of early development of ASL, which has a grammar different from
spoken or signed English, as the deaf child's natural language, using ASL as a
bridge into English as a second language. Total Communication (see ERIC Digest
E559 (Ed414677)) refers to a philosophy of using the system most needed by the
child at any given time. Total Communication usually involves simultaneous use
of speech and sign and is the most commonly used form of instruction (Schildroth
& Hotto, 1993).
Other factors complicate the picture of which system should be used to teach
children who are deaf and hard of hearing to communicate. Cochlear implants are
computerized devices implanted into the cochlea of individuals who are deaf,
which influence the ability to develop speech and listening skills (see Digest
E554 (ED414672)). They are supported by the various oral philosophies.
Attendance at a residential school (see ERIC Digest E558) is considered a key
component in the success of a child whose family has chosen the
Bilingual-Bicultural approach to education. The presence of additional learning
disorders (see ERIC Digest E553 (ED414668)) may also affect a child's progress
in any method or philosophy; therefore, this challenging-to-test population must
be assessed adequately (see ERIC Digest E550 (ED414675)).
Where are children who are deaf or hard of hearing educated?
According to the annual report of the Center for Assessment and Demographic
Studies (CADS) at Gallaudet University (Schildroth & Hotto, 1996), 21% of
the students in the study attended residential schools, 8% attended day schools,
and 70% attended their local schools. These figures represent about 60-65% of
the children reported on the federal child count, and the assumption is often
made that the additional students not in the CADS study are being educated in
local education agencies that are unaware that they may participate in the CADS
process. Whatever the reason, over the past two decades, more and more children
who are deaf or hard of hearing are receiving instruction in general education
environments (see ERIC Digest E557).
What kind of technology is available for people who are deaf or hard of
Today the options for support from technology are exciting. A wide variety of
hearing aids can be tailored to individual patterns of loss. Students in
classrooms may use a variety of assistive listening devices that help them hear
the teacher while filtering out ambient noise. Telecommunication Devices for the
Deaf (TDDs) are available to provide people who are deaf with access to
telephones (Compton, 1991). Many states have relay services that work in
conjunction with TDDs. Television sets are now produced with built-in closed
captioning capabilities, or for older TVs, viewers may purchase captioners. A
variety of alerting devices are available which use visual means to alert
individuals to doorbells, telephones, a knock at the door, a baby's crying, oven
timers, and smoke detectors, among other sounds of daily life. Vibrating devices
may be used in place of an alarm clock. In addition, computer technology such as
fax machines, programs for teaching speech, real-time graphic display devices
for recording lectures, and a myriad of machines and programs are affecting
education and daily life to an ever-increasing degree.
Adams, P.F. & Benson, V. (1992). Current
estimates from the National Health Interview Survey, 1991. Vital and Health
Statistics, Series 10. National Center for Health Statistics.
Berg, F. (1986). Characteristics of the target population. In F.Berg, J.C.
Blair, J.H. Viehweg & A. Wilson-Vlotman (Eds.), Educational audiology for
the hard of hearing child. (pp. 157-180). New York: Grune and Stratton.
Compton, C. (1991). Assistive devices: Doorways to independence. Washington,
DC: Gallaudet University.
Davis, D. (1989). Otitis media: Coping with the effects in the classroom.
Stanhope, NJ: Hear You Are, Inc.
Easterbrooks, S. & Baker-Hawkins, S. (1994). Deaf and hard of hearing
students educational services guidelines. Alexandria, VA: National Association
of State Directors of Special Education.
Individuals with Disabilities Education Act, PL 101-476. (1990).
Schildroth, A. & Hotto, S. (1994). Annual survey of hearing impaired
children and youth: 1991-92 school year. American Annals of the Deaf, 138(2),
Schildroth, A. & Hotto, S. (1996). Changes in student program and
characteristics, 1984-85 and 1994-95. American Annals of the Deaf, 141(2),
Padden, C. & Humphries, T. (1988). Deaf in America: Voices from a
culture. Cambridge, MA: Harvard University.
Winefield, R. (1987). Never the twain shall meet. Washington, DC: Gallaudet