ERIC Identifier: ED414666
Publication Date: 1997-08-00
Author: Pollack, B. J.
Source: ERIC Clearinghouse on
Disabilities and Gifted Education Reston VA.
Educating Children Who Are Deaf or Hard of Hearing: Additional
Learning Problems. ERIC Digest #E548.
What is meant by "additional learning problems" in the deaf or hard of
Hearing loss has far-reaching, critical effects on childhood development of
cognitive (thinking) and linguistic (language) skills. The occurrence of other
disabilities in combination with diminished hearing creates "additional learning
problems" which significantly add to the complexity of educating the student who
is deaf or hard of hearing. The prevalence of other disabilities in addition to
hearing loss is approximately three times as large (30.2%) in the deaf or hard
of hearing population as in the general school population. Some of this may be
explained by the varying causes of hearing loss. Some of the current documented
etiologies of childhood deafness include maternal rubella (2%), prematurity
(5%), cytomegalovirus (1%), and meningitis (9%) (Moores, 1987). It is logical to
assume that the population demonstrating a hearing loss is at a high risk for
additional disabilities since the previously mentioned etiologies are also known
to be associated with neurological involvements.
The prevalence of several specific disabilities occurring with diminished
hearing has been documented over time (Craig & Craig, 1993, 1983, 1973). The
three additional disabilities most often reported in children who are deaf or
hard of hearing are learning disabilities, intellectual disabilities, and
emotional/behavioral disabilities. The 1993 reference issue of the American
Annals of the Deaf reports learning disabilities as the largest co-occurring
disability at a prevalence of 9%. The prevalence of intellectual disabilities
occurring with a hearing loss followed closely at 8%. The co-occurrence of
emotional/behavioral disabilities was the least at a 4% occurrence rate.
Although there are difficulties in definitively characterizing these
frequently co-occurring disabilities, the following definitions may apply.
Students with co-occurring emotional/behavioral disabilities are described as
displaying inappropriate, disruptive, aggressive behaviors that interfere with
learning. Students with hearing loss and intellectual disabilities are
characterized by a generalized delay in development across all areas of learning
with limited problem-solving abilities and lowered adaptive or functional
skills. Students diagnosed with learning disabilities and hearing loss are
generally found to be in the average or above average range of intelligence
displaying skills and abilities in many different ways while displaying specific
learning deficits that restrict accomplishments. They are described as
exhibiting unusual learning characteristics considered atypical of students who
are deaf and hard of hearing in general; these greatly affect their progress.
These students are not progressing academically in comparison to the documented
parameters of delayed language and concept learning found in the general
population of students who are deaf or hard of hearing (Bunch & Melnyk,
1989). In an effort to recognize this subgroup's uniqueness, the field appears
to be moving away from using the label "learning-disabled hearing-impaired" and,
instead, is beginning to label these students "deaf or hard of hearing with
additional mild disabilities," "atypical learners with hearing loss," and "deaf
or hard of hearing learners with additional learning problems."
How are additional learning problems identified in children who are deaf or
hard of hearing?
Identification of additional learning problems among children with diminished
hearing is a difficult and complex task. Part of the difficulty arises from the
fact that a hearing loss by itself creates pervasive learning problems that
usually result in very delayed language acquisition and consequently delayed
academic skills. Therefore, the identification of any other interfering or
additional influencing factors affecting the students' learning can pose
difficult issues. What difficulties come with the hearing loss and what
difficulties are caused by another source or element? Furthermore, recognizing
the additive effect of co-occurring disabilities, what unique learning profile
is created by the combination of a hearing loss and the additional disability
that are above and beyond any profile characterizing each individual disability
Sound assessment practices using interdisciplinary teams are important when
identifying additional disabilities in students who are deaf or hard of hearing
(Paplinger & Sikora, 1990). This is particularly true when one considers
that the characteristics displayed by students with co-occurring disabilities
are often the same. A consistent lack of language learning, attention problems,
retention difficulties, and delayed academic skills are phrases that are heard
when professionals in the field describe students who have hearing losses and
learning disabilities, intellectual disabilities, or emotional/behavioral
problems. Therefore, differential diagnosis is critical to determining an
accurate learning profile for the individual student, which includes a clear
determination of the disabilities influencing that profile. The assessment
should consist of teacher observations and appropriate standardized assessment
measures as well as informal assessment procedures. Professionals involved
should include school psychologists, classroom teachers, occupational and
physical therapists, speech/language pathologists, audiologists, and any
necessary medical personnel such as nurses, psychiatrists, etc. The team should
provide careful interpretation of the assessment results with recommendations
and suggestions for educational programming.
What are some questions to ask in deciding whether or not to refer my
child/student for an evaluation?
Is the student who is deaf or hard of hearing progressing as would be
expected when compared to his/her hearing impaired peers? This should be the
first question when considering evaluation for a student with a hearing loss.
Researchers (Kretschmer & Kretschmer, 1989; McAnally et al., 1994; and
Yoshinaga-Itano, 1986) have documented parameters of delayed language
acquisition and academic progress commonly seen in learners who are deaf or hard
of hearing. Given the opportunities to learn language and academic skills
through appropriate and efficient modes of communication, a learner with a
hearing loss should progress in expected patterns of growth and achievement. If
this is not happening, questions should be raised as to the reasons why.
Is the student with a hearing loss displaying any characteristics that are
not usually seen with a hearing loss?
Having a hearing loss brings with it many characteristics that affect the
learning of the student. However, the hearing loss alone is not necessarily
accompanied by such characteristics as visual-perceptual problems, attention
deficits, perceptual-motor difficulties, severe inability to learn vocabulary
and English structures, consistent retention and memory problems or consistent
distractive behaviors or emotional factors. If any of these kinds of behaviors
characterize the student who is deaf or hard of hearing, then an investigation
into the possible influencing factors should be requested.
What are common strategies used to help these students?
It is very difficult to determine common strategies for students with
additional learning problems primarily because each individual learning profile
will be different depending on the number and nature of the various influencing
factors. After some time spent looking for "fix-it" strategies, the
professionals in this field appear to be moving toward the belief that all
students with hearing losses should have individualized approaches to
instruction, including those with additional learning problems (Powers, 1993).
It is indeed a challenge to the professionals in the field to match the
assessment learning profile with appropriate educational strategies to address
the delineated problems. Generally speaking the following strategies may be
useful. For those students with additional learning problems that include severe
lack of vocabulary and simple syntax knowledge, work using pictures and picture
symbols to support speech and/or signs has proven beneficial (Chalk, 1996). For
those hard of hearing students who display characteristics more commonly
associated with processing or understanding of sound, learning disabled students
have benefited from many of the aural/oral remediation techniques used to
improve listening skills (Roth, 1991). Behavior techniques that include clearly
defined choices and expectations with natural consequences have proven
effective. Addressing emotional factors through the educational program and
individual or group counseling when appropriate have also proven beneficial
(Gage, et al, 1994; Rasing & Duker, 1993).
Bunch, G. & Melnyk, T. (1989). A review of
the evidence for a learning-disabled, hearing impaired sub-group. American
Annals of the Deaf, 134, 297-300.
Chalk, P. (1996, Oct). New says of using communication symbols. Paper
presented at the Fall LEA Workshop, Cave Spring, GA.
Craig, W.N. & Craig, H.B. (Eds.).(1993). Tabular summary of schools and
classes in the U.S. American Annals of the Deaf, 138(2), 169-170.
Craig, W. N. & Craig, H.B. (Eds.). (1983). Tabular summary of schools and
classes in the U.S. American Annals of the Deaf, 127(2), 188-189.
Craig, W.N. & Craig, H.B. (Eds.). (1973). Tabular summary of schools and
classes in the U.S. American Annals of the Deaf, 118(2), 134-135.
Gage, S., Lou, M.W. & Charlson, E.S. (1994). A social learning program
for deaf adolescents. Perspectives for Teachers of the Deaf, 13(2).
Kretschmer, R. & Kretschmer, L. (1989). Communication competence: Impact
of the pragmatics revolution on education of hearing impaired children. Topics
in Language Disorders, 9(4), 1-16.
McAnally, P.L., Rose, S. & Quigley, S.P. (1994). Language learning
practices with the deaf. Boston: Little, Brown and Company.
Moores, D.F. (1987). Educating the deaf: Psychology, principles, practices.
(3rd ed.). Boston: Houghton Mifflin.
Paplinger, D. & Sikora, D. (1990). Diagnosing a learning disability in a
hearing impaired child. American Annals of the Deaf, 118, 480-487.
Powers, A.R. & Elliott, R.N. (Eds.). (1993). Deaf and hard of hearing
students with mild additional disabilities. Monograph. Tuscaloosa, AL: The
University of Alabama.
Rasing, E.J. & Duker, P.C. (1993). Acquisition and generalization of
social behaviors in language-disabled deaf children. American Annals of the
Deaf, 138(4), 362-369.
Roth, V. (1991). Students with learning disabilities and hearing impairment:
Issues for the secondary and post-secondary teacher. Journal of Learning
Disabilities, 24(7), 391-397.
Yoshinaga-Itano, C. & Downey, D. (1986). A hearing-impaired child's
acquisition of schemata: Something is missing. Topics in Language Disorders,
For more information about the assessment process, see ERIC Digest E550
(Ed414668), on assessment of students who are deaf and hard of hearing. For more
information about services available in your state, contact your state's school
for the deaf. A listing of these may be found annually in the April edition of
the American Annals of the Deaf periodical.