Deafness

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Deafness has varying definitions in cultural and medical contexts. In medical contexts, the meaning of deafness is hearing loss that precludes a person from understanding spoken language, an audiological condition. [1] In this context it is written with a lower case d. It later came to be used in a cultural context to refer to those who primarily communicate through sign language regardless of hearing ability, often capitalized as Deaf and referred to as "big D Deaf" in speech and sign. [2] [3] The two definitions overlap but are not identical, as hearing loss includes cases that are not severe enough to impact spoken language comprehension, while cultural Deafness includes hearing people who use sign language, such as children of deaf adults.

Contents

Medical context

The International Symbol for Deafness is used to identify facilities with hearing augmentation services, especially assistive listening devices. International Symbol for Deafness.svg
The International Symbol for Deafness is used to identify facilities with hearing augmentation services, especially assistive listening devices.

In a medical context, deafness is defined as a degree of hearing difference such that a person is unable to understand speech, even in the presence of amplification. [1] In profound deafness, even the highest intensity sounds produced by an audiometer (an instrument used to measure hearing by producing pure tone sounds through a range of frequencies) may not be detected. In total deafness, no sounds at all, regardless of amplification or method of production, can be heard.

Neurologically, language is processed in the same areas of the brain whether one is deaf or hearing. The left hemisphere of the brain processes linguistic patterns whether by signed languages or by spoken languages. [5]

Deafness can be broken down into four different types of hearing loss: conductive hearing loss, sensorineural hearing loss, mixed hearing loss, and auditory neuropathy spectrum disorder. All of these forms of hearing loss cause an impairment in a person's hearing where they are not able to hear sounds correctly. These different types of hearing loss occur in different parts of the ear, which make it difficult for the information being heard to get sent to the brain properly. To break it down even further, there are three different levels of hearing loss. According to the CDC, the first level is mild hearing loss. This is when someone is still able to hear noises, but it is more difficult to hear the softer sounds. The second level is moderate hearing loss and this is when someone can hear almost nothing when someone is talking to them at a normal volume. The next level is severe hearing loss. Severe hearing loss is when someone can not hear any sounds when they are being produced at a normal level and they can only hear minimum sounds that are being produced at a loud level. The final level is profound hearing loss, which is when someone is not able to hear any sounds except for very loud ones. [6]

There are millions of people in the world who are living with deafness or hearing impairments. Survey of Income and Program Participation (SIPP) indicate that fewer than 1 in 20 Americans are currently deaf or hard of hearing. [7] There are a lot of solutions available for people with hearing impairments. Some examples of solutions would be blinking lights on different things like their phones, alarms, and things that are important to alert them. Cochlear implants are an option too. [8] Cochlear implants are surgically placed devices that stimulate the cochlear nerve in order to help the person hear. A cochlear implant is used instead of hearing aids in order to help when someone has difficulties understanding speech. [9] A study by Anna Agostinelli et al., was done on four subjects with Single-Sided Deafness that use Cochlear Implants. This study showed their age, what made them lose their hearing, which ear was affected, and how long it has been since they had their Cochlear Implant activated. It was shown that the children had much improvement in their auditory use, [10] Another study done by Shannon R. Culbertson et al., showed that children who had their activation at a younger age, had better auditory skill and perception. Children who had their activation earlier had a higher FLI (Functional Listening Index) score than those who had theirs activated later on. Functional Listening Index was developed by The Shepherd Centre. It is a 60- item scale that tracks the development of auditory skills from birth through 5 years of age for six categories: sound awareness, associating sound with meaning, comprehending simple spoken language, comprehending language in different listening conditions, listening through discourse and narratives, and advanced open listening set (Davis et al., 2015). [11] Merv Hyde, Renee Punch, and Linda Komesaroff completed a study that says that parents have difficulties with making the decision to use Cochlear Implants for their child. A survey was done asking parents how they felt when making this decision. Many only made this decision due to feeling urgency with implanting their child. This can be a serious procedure, which comes with the risk of negative results. In the end, most of the parents felt that this was beneficial for their child. [12]

Cultural context

The flag of the deaf community made by Arnaud Balard Sign Union flag.svg
The flag of the deaf community made by Arnaud Balard

In a cultural context, Deaf culture refers to a tight-knit cultural group of people whose primary language is signed, and who practice social and cultural norms which are distinct from those of the surrounding hearing community. This community does not automatically include all those who are clinically or legally deaf, nor does it exclude every hearing person. According to Baker and Padden, it includes any person who "identifies him/herself as a member of the Deaf community, and other members accept that person as a part of the community", [13] an example being children of deaf adults with normal hearing ability. It includes the set of social beliefs, behaviors, art, literary traditions, history, values, and shared institutions of communities that are influenced by deafness and which use sign languages as the main means of communication. [2] [3] While deafness is often included within the umbrella of disability, members of the Deaf community tend to view deafness as a difference in human experience or itself as a language minority. [14] [15]

Many non-disabled people continue to assume that deaf people have no autonomy and fail to provide people with support beyond hearing aids, which is something that must be addressed. Different non-governmental organizations around the world have created programs towards closing the gap between deaf and non-disabled people in developing countries. As children, deaf people learn literacy differently than hearing children. They learn to speak and write, whereas hearing children naturally learn to speak and eventually learn to write later on. [16] The Quota International organization with headquarters in the United States provided immense educational support in the Philippines, where it started providing free education to deaf children in the Leganes Resource Center for the Deaf. The Sounds Seekers British organization also provided support by offering audiology maintenance technology, to better assist those who are deaf in hard-to-reach places. The Nippon Foundation also supports deaf students at Gallaudet University and the National Technical Institute for the Deaf, through sponsoring international scholarships programs to encourage students to become future leaders in the deaf community. The more aid these organizations give to the deaf people, the more opportunities and resources disabled people must speak up about their struggles and goals that they aim to achieve. When more people understand how to leverage their privilege for the marginalized groups in the community, then we can build a more inclusive and tolerant environment for the generations that are yet to come. [2] [3]

History

The first known record of sign language in history comes from Plato's Cratylus, written in the fifth century BCE. In a dialogue on the "correctness of names", Socrates says, "Suppose that we had no voice or tongue, and wanted to communicate with one another, should we not, like the deaf and dumb, make signs with the hands and head and the rest of the body?" [17] His belief that deaf people possessed an innate intelligence for language put him at odds with his student Aristotle, who said, "Those who are born deaf all become senseless and incapable of reason," and that "it is impossible to reason without the ability to hear".

This pronouncement would reverberate through the ages and it was not until the 17th century when manual alphabets began to emerge, as did various treatises on deaf education, such as Reducción de las letras y arte para enseñar a hablar a los mudos ('Reduction of letters and art for teaching mute people to speak'), written by Juan Pablo Bonet in Madrid in 1620, and Didascalocophus, or, The deaf and dumb mans tutor, written by George Dalgarno in 1680.

In 1760, French philanthropic educator Charles-Michel de l'Épée opened the world's first free school for the deaf. The school won approval for government funding in 1791 and became known as the "Institution Nationale des Sourds-Muets à Paris." [18] The school inspired the opening of what is today known as the American School for the Deaf, the oldest permanent school for the deaf in the United States, and indirectly, Gallaudet University, the world's first school for the advanced education of the deaf and hard of hearing, and to date, the only higher education institution in which all programs and services are specifically designed to accommodate deaf and hard of hearing students.

Schooling

Nicole M. Stephens and Jill Duncan say that parents often encounter difficulties when it comes time for them to choose an educational setting for their child. There are many things they consider when choosing that setting for them. Three things to consider would be the needs and abilities of the child, how the school can make accommodations for the child, and the environment itself. There are four themes that connect to eight sub-themes that the author refers to. Child-Centered connects to Inclusion and Additional Needs and Well-Being. Familial connects to Complex Processes, Information Input and Flow, and Caregiver perceptions of Education. School connects to School Systems and Personnel, and School Character. And finally On Reflection connects to No Regrets. [19] It can be profitable for both the child and the parent to do trial and error with different schools. This can lead to the child being in the proper environment for them and their needs.

See also

Related Research Articles

<span class="mw-page-title-main">Hearing loss</span> Partial or total inability to hear

Hearing loss is a partial or total inability to hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to acquire spoken language, and in adults it can create difficulties with social interaction and at work. Hearing loss can be temporary or permanent. Hearing loss related to age usually affects both ears and is due to cochlear hair cell loss. In some people, particularly older people, hearing loss can result in loneliness.

The three models of deafness are rooted in either social or biological sciences. These are the cultural model, the social model, and themedicalmodel. The model through which the deaf person is viewed can impact how they are treated as well as their own self perception. In the cultural model, the Deaf belong to a culture in which they are neither infirm nor disabled, but rather have their own fully grammatical and natural language. In the medical model, deafness is viewed undesirable, and it is to the advantage of the individual as well as society as a whole to "cure" this condition. The social model seeks to explain difficulties experienced by deaf individuals that are due to their environment.

<span class="mw-page-title-main">Cochlear implant</span> Prosthesis

A cochlear implant (CI) is a surgically implanted neuroprosthesis that provides a person who has moderate-to-profound sensorineural hearing loss with sound perception. With the help of therapy, cochlear implants may allow for improved speech understanding in both quiet and noisy environments. A CI bypasses acoustic hearing by direct electrical stimulation of the auditory nerve. Through everyday listening and auditory training, cochlear implants allow both children and adults to learn to interpret those signals as speech and sound.

Lip reading, also known as speechreading, is a technique of understanding a limited range of speech by visually interpreting the movements of the lips, face and tongue without sound. Estimates of the range of lip reading vary, with some figures as low as 30% because lip reading relies on context, language knowledge, and any residual hearing. Although lip reading is used most extensively by deaf and hard-of-hearing people, most people with normal hearing process some speech information from sight of the moving mouth.

<span class="mw-page-title-main">Deaf culture</span> Culture of deaf persons

Deaf culture is the set of social beliefs, behaviors, art, literary traditions, history, values, and shared institutions of communities that are influenced by deafness and which use sign languages as the main means of communication. When used as a cultural label, especially within the culture, the word deaf is often written with a capital D and referred to as "big D Deaf" in speech and sign. When used as a label for the audiological condition, it is written with a lower case d. Carl G. Croneberg was among the first to discuss analogies between Deaf and hearing cultures in his appendices C and D of the 1965 Dictionary of American Sign Language.

<span class="mw-page-title-main">Audiology</span> Branch of science that studies hearing, balance, and related disorders

Audiology is a branch of science that studies hearing, balance, and related disorders. Audiologists treat those with hearing loss and proactively prevent related damage. By employing various testing strategies, audiologists aim to determine whether someone has normal sensitivity to sounds. If hearing loss is identified, audiologists determine which portions of hearing are affected, to what degree, and where the lesion causing the hearing loss is found. If an audiologist determines that a hearing loss or vestibular abnormality is present, they will provide recommendations for interventions or rehabilitation.

Oralism is the education of deaf students through oral language by using lip reading, speech, and mimicking the mouth shapes and breathing patterns of speech. Oralism came into popular use in the United States around the late 1860s. In 1867, the Clarke School for the Deaf in Northampton, Massachusetts, was the first school to start teaching in this manner. Oralism and its contrast, manualism, manifest differently in deaf education and are a source of controversy for involved communities. Listening and Spoken Language, a technique for teaching deaf children that emphasizes the child's perception of auditory signals from hearing aids or cochlear implants, is how oralism continues on in the current day.

Unilateral hearing loss (UHL) is a type of hearing impairment where there is normal hearing in one ear and impaired hearing in the other ear.

Audism as described by deaf activists is a form of discrimination directed against deaf people, which may include those diagnosed as deaf from birth, or otherwise. Tom L. Humphries coined the term in an unpublished manuscript in 1975, which he later reiterated in his doctoral project in 1977, but it did not start to catch on until Harlan Lane used it in his writing. Humphries originally applied audism to individual attitudes and practices; whereas Lane broadened the term to include oppression of deaf people.

<span class="mw-page-title-main">Atlanta Speech School</span> School in Atlanta, Fulton County, Georgia, United States

The Atlanta Speech School is a language and literacy school located in Atlanta, Georgia, established in 1938. The school provides educational and clinical programs. The Atlanta Speech School's Rollins Center provides professional development for teachers and educators in partner schools and preschools. The Rollins Center focuses on the eradication of illiteracy. The Rollins Center has an online presence called Cox Campus, which is an online learning environment with coursework targeted for the education of children age 0–8.

Auditory processing disorder (APD), rarely known as King-Kopetzky syndrome or auditory disability with normal hearing (ADN), is a neurodevelopmental disorder affecting the way the brain processes sounds. Individuals with APD usually have normal structure and function of the ear, but cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech. It is thought that these difficulties arise from dysfunction in the central nervous system.

<span class="mw-page-title-main">Cortical deafness</span> Medical condition

Cortical deafness is a rare form of sensorineural hearing loss caused by damage to the primary auditory cortex. Cortical deafness is an auditory disorder where the patient is unable to hear sounds but has no apparent damage to the structures of the ear. It has been argued to be as the combination of auditory verbal agnosia and auditory agnosia. Patients with cortical deafness cannot hear any sounds, that is, they are not aware of sounds including non-speech, voices, and speech sounds. Although patients appear and feel completely deaf, they can still exhibit some reflex responses such as turning their head towards a loud sound.

An auditory brainstem implant (ABI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf, due to retrocochlear hearing impairment. In Europe, ABIs have been used in children and adults, and in patients with neurofibromatosis type II.

<span class="mw-page-title-main">Deaf education</span> Education of the deaf and hard of hearing

Deaf education is the education of students with any degree of hearing loss or deafness. This may involve, but does not always, individually-planned, systematically-monitored teaching methods, adaptive materials, accessible settings, and other interventions designed to help students achieve a higher level of self-sufficiency and success in the school and community than they would achieve with a typical classroom education. There are different language modalities used in educational setting where students get varied communication methods. A number of countries focus on training teachers to teach deaf students with a variety of approaches and have organizations to aid deaf students.

Prelingual deafness refers to deafness that occurs before learning speech or language. Speech and language typically begin to develop very early with infants saying their first words by age one. Therefore, prelingual deafness is considered to occur before the age of one, where a baby is either born deaf or loses hearing before the age of one. This hearing loss may occur for a variety of reasons and impacts cognitive, social, and language development.

Language acquisition is a natural process in which infants and children develop proficiency in the first language or languages that they are exposed to. The process of language acquisition is varied among deaf children. Deaf children born to deaf parents are typically exposed to a sign language at birth and their language acquisition follows a typical developmental timeline. However, at least 90% of deaf children are born to hearing parents who use a spoken language at home. Hearing loss prevents many deaf children from hearing spoken language to the degree necessary for language acquisition. For many deaf children, language acquisition is delayed until the time that they are exposed to a sign language or until they begin using amplification devices such as hearing aids or cochlear implants. Deaf children who experience delayed language acquisition, sometimes called language deprivation, are at risk for lower language and cognitive outcomes. However, profoundly deaf children who receive cochlear implants and auditory habilitation early in life often achieve expressive and receptive language skills within the norms of their hearing peers; age at implantation is strongly and positively correlated with speech recognition ability. Early access to language through signed language or technology have both been shown to prepare children who are deaf to achieve fluency in literacy skills.

Language deprivation in deaf and hard-of-hearing children is a delay in language development that occurs when sufficient exposure to language, spoken or signed, is not provided in the first few years of a deaf or hard of hearing child's life, often called the critical or sensitive period. Early intervention, parental involvement, and other resources all work to prevent language deprivation. Children who experience limited access to language—spoken or signed—may not develop the necessary skills to successfully assimilate into the academic learning environment. There are various educational approaches for teaching deaf and hard of hearing individuals. Decisions about language instruction is dependent upon a number of factors including extent of hearing loss, availability of programs, and family dynamics.

Language exposure for children is the act of making language readily available and accessible during the critical period for language acquisition. Deaf and hard of hearing children, when compared to their hearing peers, tend to face more hardships when it comes to ensuring that they will receive accessible language during their formative years. Therefore, deaf and hard of hearing children are more likely to have language deprivation which causes cognitive delays. Early exposure to language enables the brain to fully develop cognitive and linguistic skills as well as language fluency and comprehension later in life. Hearing parents of deaf and hard of hearing children face unique barriers when it comes to providing language exposure for their children. Yet, there is a lot of research, advice, and services available to those parents of deaf and hard of hearing children who may not know how to start in providing language.

Treatment depends on the specific cause if known as well as the extent, type, and configuration of the hearing loss. Most hearing loss results from age and noise, is progressive, and irreversible. There are currently no approved or recommended treatments to restore hearing; it is commonly managed through using hearing aids. A few specific types of hearing loss are amenable to surgical treatment. In other cases, treatment involves addressing underlying pathologies, but any hearing loss incurred may be permanent.

<span class="mw-page-title-main">Richard Dowell</span> Australian audiologist and researcher

Richard Charles Dowell is an Australian audiologist, academic and researcher. He holds the Graeme Clark Chair in Audiology and Speech Science at University of Melbourne. He is a former director of Audiological Services at Royal Victorian Eye and Ear Hospital.

References

  1. 1 2 Elzouki AY (2012). Textbook of clinical pediatrics (2 ed.). Berlin: Springer. p. 602. ISBN   9783642022012. Archived from the original on 2015-12-14.
  2. 1 2 3 Padden, Carol A.; Humphries, Tom (Tom L.) (2005). Inside Deaf Culture. Cambridge, MA: Harvard University Press. p. 1. ISBN   978-0-674-01506-7.
  3. 1 2 3 Jamie Berke (9 February 2010). "Deaf Culture - Big D Small D". About.com. Archived from the original on 4 March 2016. Retrieved 22 November 2013.
  4. ↑ "International Deafness Symbol". Deafness Forum Australia. Retrieved 2022-11-18.
  5. ↑ Campbell, Ruth; et al. (29 June 2007). "Sign Language and the Brain: A Review". Journal of Deaf Studies and Deaf Education. pp. 3–20. doi:10.1093/deafed/enm035. PMID   17602162 . Retrieved 14 Dec 2020.
  6. ↑ "Hearing Loss in Children". 21 June 2021.
  7. ↑ Mitchell, R. E. (2005-10-12). "How Many Deaf People Are There in the United States? Estimates From the Survey of Income and Program Participation". Journal of Deaf Studies and Deaf Education. 11 (1): 112–119. doi: 10.1093/deafed/enj004 . ISSN   1081-4159. PMID   16177267.
  8. ↑ "Know-the-ADA".
  9. ↑ "Cochlear Implant Surgery". 18 July 2022.
  10. ↑ Agostinelli, Anna; Pegolo, Margherita; Montino, Silvia; Maritan, Francesca; Gambalonga, Mattia; Trevisi, Patrizia; Brotto, Davide (2023). "Improving Auditory Perception in Pediatric Single-Sided Deafness: Use of Cochlear Implants' Direct Connection for Remote Speech Perception Rehabilitation". American Journal of Audiology. 32 (1): 52–58. doi:10.1044/2022_aja-21-00271. PMID   36538514 . Retrieved 2024-04-02.
  11. ↑ Culbertson, Shannon R.; Dillon, Margaret T.; Richter, Margaret E.; Brown, Kevin D.; Anderson, Melissa R.; Hancock, Sandra L.; Park, Lisa R. (2022). "Younger Age at Cochlear Implant Activation Results in Improved Auditory Skill Development for Children with Congenital Deafness". Journal of Speech, Language, and Hearing Research. 65 (9): 3539–3547. doi:10.1044/2022_jslhr-22-00039. PMC   9913281 . PMID   36001854.
  12. ↑ Hyde, M.; Punch, R.; Komesaroff, L. (2010). "Coming to a Decision About Cochlear Implantation: Parents Making Choices for their Deaf Children". Journal of Deaf Studies and Deaf Education. pp. 162–178. doi:10.1093/deafed/enq004. PMID   20139157 . Retrieved 2024-04-02.
  13. ↑ Baker, Charlotte; Carol Padden (1978). American Sign Language: A Look at Its Story, Structure and Community.
  14. ↑ Ladd, Paddy (2003). Understanding Deaf Culture: In Search of Deafhood. Multilingual Matters. p. 502. ISBN   978-1-85359-545-5.
  15. ↑ Lane, Harlan L.; Richard Pillard; University Press (2011). The People of the Eye: Deaf Ethnicity and Ancestry. Oxford University Press. p. 269. ISBN   978-0-19-975929-3.
  16. ↑ Wong, Fay; Tang, Gladys; Li, Qun; Yiu, Chris Kun-Man (2021). "Literacy Learning of Deaf and Hearing Preschoolers in a Sign Bilingual, Coenrollment Setting in Hong Kong". American Annals of the Deaf. 166 (4): 527–553. doi:10.1353/aad.2021.0034. ISSN   1543-0375. PMID   35185037.
  17. ↑ "Cratylus, by Plato". gutenberg.org. Retrieved 2022-02-05.
  18. ↑ "Institut National de Jeunes Sourds de Paris" (PDF). Archived (PDF) from the original on 2014-10-10.
  19. ↑ Stephens, Nicole M.; Duncan, Jill (2022). "Decision-Making Processes of Caregivers Choosing an Educational Setting for Children Who Are Deaf or Hard of Hearing". American Annals of the Deaf. 167 (4): 414–430. doi:10.1353/aad.2022.0042. PMID   36533476 . Retrieved 2024-03-26.
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