After reading this chapter, check to make sure you know:

WHAT ARE THE FOUNDATIONS OF DEAFNESS AND HARD OF HEARING?

• The terms "Deaf," "deaf," "hard of hearing," "hearing impairments," and "hearing" all have specific implications related to perceptions concerning differences versus disabilities and membership in the Deaf culture. (p. 254)
• "Deaf" with a capital D indicates a person who identifies with the Deaf community and Deaf culture. (p. 254)
• "deaf" with a small d indicates someone's hearing status and can also refer to individuals who do not identify with the Deaf community and culture. (p. 254)
• "Hard of hearing" refers to someone's hearing status and indicates the individual has a hearing loss but is not deaf. Hard of hearing individuals may or may not identify with Deaf culture. (p. 254)
• "Hearing impairments" is the term used in IDEA 04 for this disability category that includes students who are deaf or hard of hearing. (p. 254)

History

• The education of students who were deaf or hard of hearing was formalized in the United States in the nineteenth century. (p. 255)
• The Oralist Movement, which began in the nineteenth century, started the debate of what language individuals who are deaf or hard of hearing should use. (p. 255)
• PL 94-142 and the Individuals with Disabilities Act of the late twentieth century ushered in an era of universal educational programming. (p. 255)

Definitions

• Clinical definitions focus on describing hearing loss in terms of type and degree. (p. 256)
• Types of hearing losses include conductive, sensorineural, and mixed. (p. 256-57)
• Degrees of hearing losses include mild to profound. (p. 257)
• Hearing losses can occur congenitally, before birth, or adventitiously, after birth; and prelingually, before the development of speech and language skills, or postlingually, after the development of speech and language skills. (p. 258)
• Educational definitions of deafness and hard of hearing focus on how the hearing loss impacts educational performance and the types of services needed. The hearing loss must adversely affect educational performance. (p. 258)
• Per the educational definition, deafness means that a student will not use the auditory channel as a primary mode of learning. (p. 258)
• Per the educational definition, hard of hearing means that a student will be able to use the auditory channel as a primary mode of learning. (p. 258)

Prevalence

• Less than 1% of school-aged children are served under the hearing impairments IDEA category. (p. 258)
• Hearing impairments is a low incidence category of disability. (p. 258)
• More students are hard of hearing than are deaf. (p. 258)

WHAT ARE THE CAUSES AND CHARACTERISTICS OF DEAFNESS AND HARD OF HEARING?

• Hearing losses can be identified by where the loss originates, or whether they are genetic or environmental. (p. 259-60)
• Causes of conductive losses tend to be in the outer and middle ears and include blockage of the ear canal, otitis media, and perforated tympanic membrane. (p. 259-60)
• Causes of sensorineural losses tend to be in the inner ear or the auditory nerve. (p. 260-61)
• Genetic causes of sensorineural losses are numerous, but rare in occurrence, actually accounting for only a relatively small percentage of cases of deafness. Usher syndrome is an example of a genetic condition that can lead to deafness. (p. 260)
• Environmental causes of sensorineural losses are varied and include infections such as rubella, toxic agents, and trauma. (p. 260)

Characteristics

• Deaf community and culture can have a major impact on an individual's perceptions about his/her own characteristics. (p. 261-63)
• Intellectual capabilities are difficult to assess because IQ tests tend to include many verbal performance items, but nonverbal tests indicate no significant differences between students who are deaf or hard of hearing and hearing students. (p. 263)
• Reading skills and comprehension tend to be lower in students with losses of hearing, especially among students who are prelingually deaf. (p. 263-64)
• As a group, students who are deaf tend to have lower achievement than hearing peers, although many are on or above grade level. (p. 263-64)
• English speech and language skills tend to be lower in students who are deaf or hard of hearing; this lower level is affected by age of onset, type and degree of hearing loss, and language experiences at home and school. (p. 264-65)
• Some students who are deaf tend to have less well developed social-emotional skills, but these can be developed to an age-appropriate level. (p. 265)

HOW ARE STUDENTS WHO ARE DEAF OR HARD OF HEARING IDENTIFIED?

• Identification of newborns and infants requires special audiological techniques. (p. 266)
• Identification of older children with hearing losses usually occurs through screening followed by standard audiological assessments. (p. 266)
• Audiological evaluations are used to establish the degree and type of hearing loss. (p. 266)
• Adaptations and special tests for students with severe hearing loss must be done carefully and be reviewed by experts to ensure validity and reliability. (p. 266-67)

WHAT AND HOW DO I TEACH STUDENTS WHO ARE DEAF OR HARD OF HEARING?

Instructional Content

• Curriculum should be based on a number of considerations relevant to the individual such as current achievement levels, communication mode, learning abilities, and dependency on visual information. (p. 267-68)
• Literacy skills are particularly important, but all curriculum areas should be addressed. Students should be able to comprehend, remember, and communicate information from reading. (p. 268-69)
• Constructivist approaches may be preferable to rote memory learning. (p. 268)
• Deaf studies may be important for understanding and learning about Deaf culture for students with hearing losses as well as for hearing peers. Information about technology use, Deaf culture, and ASL could be incorporated into traditional curriculum areas such as science, social studies, and language arts. (p. 269)
• Transition planning should include key factors such as access to the general education curricula, assessment of career interests, internships, and high expectations for success. (p. 270)

Instructional Procedures

• How the student communicates is a major factor in determining how to best teach a student with a hearing loss. (p. 271)
• Different approaches to instruction include oralism, bilingual-bicultural, and total communication. (p. 271)
• Oralism is an approach that focuses on speechreading and other techniques to emphasize the development of English speech and language over ASL. (p. 271)
• The bilingual-bicultural approach emphasizes ASL as the first and natural language with English language being taught as a second language. (p. 271)
• Total communication involves using both oral English speech and language along with ASL during instruction, so that skills in both areas may be developed or used by students. The student's preferred mode of communication is emphasized. (p. 271)
• The approach that works best for any given student should be based on a team decision related to the best method of instruction and cultural considerations. (p. 271)

WHAT ARE OTHER INSTRUCTIONAL CONSIDERATIONS FOR TEACHING STUDENTS WHO ARE DEAF OR HARD OF HEARING?

Instructional Environment

• Determining a student's least restrictive environment should consider communication mode, academic level, and socialization needs. (p. 272-73)
• Deaf culture considerations may influence student and family preferences as to the least restrictive environment. (p.273)
• Some families from Deaf culture may prefer special classes or schools for those with hearing losses over inclusive neighborhood school classes. (p. 273)
• There is a lack of research indicating whether inclusive or special programs are more advantageous to learning. (p. 273)
• Environmental arrangements could include consideration of such factors as visual materials, posting of rules and class jobs, using cards and charts to establish schedules and routines, maintaining organizers with steps for completing tasks, the use of graphic organizers in teaching content, and teaching patterns in learning. (p. 273)
• The use of interpreters and note takers is also a consideration in arranging the environment. Interpreters should be trained and collaborate with the teacher, but not be responsible for ensuring student learning. (p. 273-74)

Instructional Technology

• Hearing aids are commonly used, and it is important to know how they work and are maintained. (p. 275-76)
• Loop systems are helpful for listening in large or noisy environments as they allow the student to hear the teacher from anywhere in the room. (p. 276)
• Cochlear implants can aid listening in students with sensorineural losses, but their implantation is invasive and may not be preferred by Deaf culture members. (p. 276-77)
• Closed captioning produces typed words on a television screen to accompany what is being said. (p. 277)
• Telecommunication relay services allow a person with a hearing loss who has a text telephone to communicate through an operator with hearing persons who have traditional telephones. (p. 277)
• Instant messaging and e-mail can bypass the need for telecommunication relay services, allowing direct communication with others with hearing losses or hearing individuals. (p. 278)
• Word processing, databases, spreadsheets, and computer-based publishing programs can aid students in producing written products. (p. 279)

WHAT ARE SOME CONSIDERATIONS FOR THE GENERAL EDUCATION TEACHER?

• Most students with hearing losses are educated in general education settings at least part of their day. (p. 280)
• Teachers should promote family involvement, especially during early childhood. (p. 280)
• Self-determination skills are important as are activities to promote social skill development. (p. 280)
• Teachers can collaborate with other IEP team members to devise pre- and post-teaching strategies. (p. 280)
• Holding high but realistic expectations for students is important to encourage achievement. (p. 281)