10. EDUCATING DEAF AND HARD-OF-HEARING CHILDREN Educational techniques for teaching deaf children are significantly different from those utilized with hard-to-hearing children. Kirk (1972) wrote that because hard-of-hearing children have the ability to acquire speech and language through hearing, the problem in teaching them is mainly one of making it possible for them to learn through the methods and techniques used with hearing children. With hearing aids, some individual help in speech, speech reading, auditory training, and a few special individuals arrangements, most of these children can acquire an education in classes with hearing children (p. 257). The deaf child faces different problems. Because he never hears speech, he does not normally acquire language or the subtleties of meaning which are more easily mastered through the sense of hearing. Kirk (1972) proposed that the most important factor to remember in educating deaf children is that their major deficiency is not so much lack of hearing as inability to develop speech and language through the sense of hearing. Their education is probably the most technical area in the whole field of special education. It requires more specialized training on the part of the teacher than any other form of special education (p. 258). The first problem the school faces is diagnosing the children needing help. Screening procedures in schools involve either individual or group testing of children in kindergarten to third grade, and periodic examinations in the higher grades. Generally, a sweep-check audiometric test devised for rapid screening of hearing impairments is used. Many people who indicate a hearing loss on the screening test are found not to have a loss when given the more thorough pure-tone test (threshold testing). Kirk (1972) summarized the following steps in identification diagnosis and services: 1. Preliminary screening of children. 2. Threshold testing, and if hearing handicap is found, referral for otological examination. 3. Otological examinations and medical treatment if indicated. 4. Audiological examination to include special tests and hearing-aid evaluation. 5. Psychoeducational evaluation and special educational services (Kirk, 1972, p. 259). Once a child is determined to be hard-of-hearing, choices of programming become the primary focus. What the educator must accept is that hard-of-hearing children are not very different from their classmates. They are not seriously retarded academically except possibly in speech, language and reading. The most widely recommended strategy is enrollment in the regular grades and provision of itinerant or special support services to help the children individually or in small groups. The instruction should consist of (1) training in the using of hearing aids, (2) auditory training, (3) speech reading, (4) speech correction, and (5) assisting the classroom teacher. Training a child to listen to sound clues which are available to him and to discriminate between different sounds is called auditory training. The major aim is to help the child at as early an age as possible to learn to discriminate between sounds. This kind of instruction is generally administered to the child by an itinerant hearing specialist in school. Speech reading (lip reading) is used with hard-of-hearing children to sharpen their understanding of what is said of them. By directing their attention to certain cues in lip and facial movements, they can learn to fill in from visual clues the sounds they do not hear and the words which are indistinct. It is fortunate that the vowels, which are harder to tell apart visually, are easier to discriminate auditorily since they belong to the lower frequency ranges. Some of the consonants, like s's, are harder to hear, because they belong to the high-frequency ranges in speech where a deficit in sensory-neural or perceptive deafness is more common (O'Neill and Oyer, 1961, p. 261). Three methods of teaching speech reading have been used. The phonetic approach emphasizes the analysis of details in a word. In once such system, the Jena Method, the child memorizes vowel series and then combines vowels with consonants and later uses words and sentences (Bunger, 1972). A second method emphasizes thought units as a whole (Stowell, 1928). The child is told stories even though he understands only parts of them. Nitchie (1950) first advocated a phonic method but later developed a whole method of speechreading instruction. Her methods of teaching involved the synthesis of what was read. A third method, described by Bruhn (1947), is based on the German Mueller-Walle Method. In her lessons with children, she presented the most visible sounds at a later time. The lessons begin with syllables and move on to the formation of whole sentences. The three basic approaches currently in use in working with deaf adults are (1) the oral approach, (2) the combined approach, and (3) the simultaneous approach. 1. The Oral Approach refers to the method of instruction which uses speech, speechreading, use of residual hearing, reading, and writing. 2. The Combined Approach, often referred to as the Rochester Method since its establishment in a Rochester, New York, school in 1878, is an approach which combines the oral approach with simultaneous use of fingerspelling. The teacher using this approach spells every word near her face as she says it. 3. The Simultaneous Approach refers to the simultaneous use of oral communication, fingerspelling, and the language of signs (some words are fingerspelled, others are given signs). Kirk (1972) noted that the oral, fingerspelling, and manual sign approaches were not completely exclusive. For many years controversy has raged between the so-called oralists and manualists without much concrete research to settle the disputes. Markovin (1960) summarized the research on neo-oralism conducted in Russia and reported that they initiated simultaneous fingerspelling and speech at an early age and claimed that by age 6 the children acquired a vocabulary of several thousand words. By the age of 8, the Russians claimed that the children had developed sufficient language to abandon fingerspelling. Quigley (1969) reviewed the Russian literature and failed to find definite substantiation of the claims of superiority over other methods. He conducted a five year study on the Rochester Method and concluded that: (a) fingerspelling plus good oral techniques improves achievement in meaningful language, (b) learning fingerspelling is not detrimental to the acquisition of oral skills, (c) fingerspelling produces greater benefits with younger rather than with older children, and (d) fingerspelling is a useful tool for instructing deaf children, but it is not a panacea. In a review of Tervoort and Verbeck's study (1967), Moores (1970) stated: For generations, the majority of educators of the deaf have operated under the assumption that the use of manual communication would inhibit the development of speech and language. Tervoort's position appears to be that systematic controlled use of manual communication would facilitate language development and have no adverse effects on speech (p. 15). Stuckless and Birch (1966) compared the language development of a group of deaf children exposed to manual communication with a group of children not exposed to early manual communication. They found that the group with early manual communication was superior to the control group in reading, written language, and speechreading. They were equal in speech intelligibility and in psychosocial development. Meadow (1968) conducted a similar experiment in a state school for the deaf, by comparing children raised by deaf parents (manual communication) with a group of deaf children from homes with hearing parents. He found the group of deaf children who had been exposed to early manual communication to be superior in self-concept, academic achievement, and written language. Speechreading and speech ability were similar in both groups. Vernon (1972) compared the later educational achievement, communication skills, and psychological adjustment of 32 children who had received early manual training with that of 32 children who had early oral training. The children who had early manual instruction scored significantly higher on the Standford Achievement Test than did the early oral-trained group. There was no difference between the groups in communication skills or psychological adjustment. As with all children, Kirk (1972) reported that many environmental influences and factors produce individual differences in development among deaf children. He found the more tangible and important factors are (1) intelligence, and related functions, (2) degrees of deafness (severe or extreme), (3) age at onset of deafness, and (4) other handicaps. The progress of a deaf child in school is partially dependent upon his intelligence, his rate of learning, and his ability to generalize, draw conclusions, and make use of subtle cues. Pintner et al (1941) surveyed the results of various language and performance intelligence tests given to deaf children mostly in residential schools. They stated, "Our best estimate at present, therefore, is that the average IQ of the deaf does not quite reach 90." In general, children attending oral schools and public day schools tend to be close to and IQ of 100 while the larger group attending residential schools averages around an IQ of 90. Brill (1962) studied the relationship between intelligence test scores and later academic achievement. He found the distribution for 499 deaf children to be similar to a random sample of hearing children with a mean IQ of 102 and a standard deviation of 17. For those given an academic diploma from the school, the average IQ was 112, and for those given a vocational diploma the IQ was 101.7. The certificate group had a mean IQ of 90.1. The academic achievement level of each group showed similar differences. The college group had a mean grade of 9.4; the academic group a mean grade of 7.2; the vocational group a mean grade of 4.9; and the certificate group had a mean grade of 3.1. Birch et al (1963) studied the relationship between the Leiter International Performance Scale and school achievement eleven years after the deaf completed school. They found a significant relationship between the early intelligence rating and educational achievement. Vernon (1968) reviewed the research on the intelligence of the deaf and hard of hearing for nearly fifty years. He stated that when psychological testing of the deaf was conducted by individuals experienced with deaf children, the results showed the deaf and hard of hearing nearly equal in intelligence. He concluded that there was no substantial difference between the hard of hearing, the deaf, the congenitally deaf and the adventitiously deaf. No relationship existed between degree of hearing loss and IQ or age of onset and IQ. Myklebust (1960) pointed out in his study of deafness and mental development that although the deaf seem to be inferior to hearing children on some intelligence tasks, they are equal or superior on other tasks. He found that the deaf are superior to hearing children on memory for designs, tactual memory, and memory for movement. But they were inferior to hearing children on digit and picture span, and memory for dots. Olsson and Furth (1960) administered visual memory span tests to a group of adolescents who were deaf and a group who had normal hearing. They found that with nonsense forms there was no difference between the deaf and the hearing group, but the digits the deaf were inferior to hearing subjects. Kirk (1972) concluded from the research cited above that the deaf child needs special attention, but is not necessarily condemned to a life without some normalcy if he receives adequate professional intervention as soon as a hearing disability is discovered, the degree of severity is diagnosed, and appropriate strategies to correct the problem are designed. A specialized curriculum of a class for the deaf emphasizes the development of communication through vision and residual hearing and includes: (1) speech development, (2) speechreading and auditory training, (3) language development, (4) reading, and (5) other school subjects. Regarding speech training through vibration and the sense of touch, the tactile sense was used intensively by Kate and Sophia Alcorn (1938, 1942) in teaching deaf-blind children and also in teaching deaf-seeing children. With his eyes closed the child feels speech vibrations by placing his hand on the teacher's cheek, near the mouth, and so begins to discriminate between sounds, words, and sentences. The child develops comprehension through touch before he is required to speak, just as a normal child understands through hearing before he speaks. Understanding of ideas precedes expression of ideas, the researchers concluded. Through the use of visual aids, Espeseth (1969) found that intensive treatment could significantly improve the visual sequential memory span abilities of the deaf. He concluded that there exists a relationship between visual memory span and reading achievement. Improvement in this ability, he concluded should have a positive effect on accelerating the communication skills of the deaf. Using auditory stimulation, many deaf children have some residual hearing even though not enough to understand or learn speech. Through powerful hearing aids their residual hearing can help them to learn rhythm patterns and discriminate differences, and it is used in teaching speech (Kirk, 1972, p. 276). Using an electronic instrument called an oscilloscope, it is possible to display on a screen instantaneous wave-like patterns of light corresponding to varying sound vibrations. This has been labeled "visible speech." Potter, Kopp, and Green (1947) described the possibility of using this visible speech to develop more adequate speech in deaf children. Kopp and Kopp (1963) described how the Bell Telephone Visible Speech Translator was used to enhance the hearing of the deaf. An example of one such device was reported by Pronovost (1970) entitled "The Instantaneous Pitch Period Indicator (IPPI). The IPPI displays the rhythm and intonation patterns of spoken phrases on a five- inch storage oscilloscope screen. The teacher displays his voice on the channel so that the student can match the visual display. Matching occurs immediately. The deaf child is able to monitor his own response, and through this feedback learns to control his rhythm, intensity, and intonation. Pronovost reported rapid learning with this type of visual analyzer. Kirk (1972) described how the highly technical tasks of teaching speech to deaf children is only part of the curriculum. Teaching speech is related to teaching language, speech reading, reading, and the content subjects. Deaf children must rely heavily on their ability to interpret the lip and face movements of other people in order to understand their speech. For this reason, speech reading is emphasized from a very young age. A combination of various methods is usually used by most teachers of the deaf. When the child is young, the teacher or the parent talks to him in whole sentences. At a later stage these vague whole impressions are converted into lessons which emphasize details. For many years, research workers wondered why some deaf children become proficient in speechreading while others do not. Studies on the variables that might account for success or failure of speech reading training, intelligence, rate of speech, and concept formation. Sharp (1970) administered a series of visual closure tests to 18 good and 19 poor speech readers in two schools for the deaf. She found that good speech readers were superior to poor speech readers in visual and movement closure, and short-term memory. These results were consistent with other studies with hard-of-hearing adults, which showed that good speech readers had superior visual synthetic ability over poor readers. In a study using speech reading films to teach speechreading, Evans (1965) found that visual recognition was the best predictor of speech reading potential. One of the major by-products of deafness, Kirk (1972) wrote, is the deficit which results from the inability to hear language spoken by others. Language is one of the most complex human skills. It involves many facets, including concept formation. It may be easy to teach a child the concept of a ball through lip reading, and whether the ball is large or small, or gray or white. Reading and language are combined, because the deaf child learns language through reading, and reading primarily through language. One approach which has been dominant in the past is based on the hypothesis that all children learn the grammatical forms of language through imitation. Another approach to the development of language has been proposed by psycholinguists. They point out that grammar is not all developed through imitation. The hearing child is able to generalize rules for words not encountered in his experience. In a study by Cooper (1965) it was found that deaf children apply generalized rules to words, but not to the same extent as hearing children. Lennenberg (1965) stated that children, deaf or hearing, inherit the predisposition for language in very nearly the same way they inherit a predisposition to stand and walk. He stated: Language development...is relatively independent of the infant's babbling, or of his ability to hear. The congenitally deaf who will usually fail to develop an intelligible vocal communication system, who either do not babble or to whom babbling is of no avail, will nevertheless learn the intricacies of language and learn to communicate efficiently through writing. Apparently, even under these reduced circumstances of stimulation the miracle of the development of a feeling for grammar takes place (p. 589). Brown and Bellugi (1964) proposed three processes by which children develop language: (1) by imitation, even though the imitation is an approximation, (2) by expansion in which the parent repeats what the child says ("want milk") in an expanded phrase ("I want some milk"), and (3) by induction in which the child constructs language he has not heard (I sitted, two mans, etc.). The best known language development system is the Fitzgerald Key (1954). It is used after children have learned some language forms in a natural way, without crutches or mechanical devices. The speech teacher introduces this series of symbols and structured sentences with questions: "Who?" "What?" "How many?" and "Where?" in relation to the grammatical structure of their sentences. These four questions are the key words of the method. By a structured procedure the children gradually develop an understanding of grammar. When this becomes automatic in speech and writing, they have acquired intelligible language. It is a slow and laborious process, and cannot be accomplished through speech reading or other activities alone. The greatest aid to the development of language in its higher forms is through the skills of reading and writing. The common technique is the "natural method" of teaching language. Groht (1958) advocated this method which uses language in natural situations through speechreading and writing, then later presents language principles formally. The method is inductive and is more in harmony with the principles of learning language used by hearing children. Surveys of reading achievement show that deaf children are markedly retarded in relation to their chronological and mental ages. Pugh (1946) studied the reading ability of deaf children in a large number of schools for the deaf by administering the Iowa Silent Reading Test and the Durell-Sullivan Reading Achievement Test. She found that as a group the deaf are notably retarded at the older ages, less so at the younger ages. Pugh found a small population of deaf children, however, reading at a level, exceeding the norms for hearing children of their age. Moores (1967) compared deaf children with hearing children on a "cloze" procedure, and postulated that standardized reading tests "give spuriously inflated estimates of the psycholinquistic abilities of the deaf." Kirk (1972) concluded that much more research would need to be conducted before educators would know what specific techniques of reading would be most effective with deaf children regardless of age. Deaf adults adjust to practically any kind of job which does not have as a prerequisite the ability to hear. A very extensive survey was done during the depression of the 1930's by Elise Martens of the United States Office of Education (1936). Of 3,786 employed men who were profoundly deaf, about one-third (1,173) were operatives in mills or factories, 533 were unskilled laborers, 330 were typesetters, and all types of other occupations were represented. The professions accounted for only four mens' current positions. Out of 1,151 profoundly deaf women, 574 were employed as operatives in mills or factories, 120 as hotel or domestic servants, 75 as teachers, and 65 as dressmakers. One was a real-estate agent, one was a trained nurse, and several were managers, librarians, bookkeepers, or cashiers. The others had positions as cooks, typists, waitresses, housekeepers, clerks, and welfare workers. In a later study, Lunde and Bigman (1959) in cooperation with the National Association of the Deaf, distributed a questionnaire to deaf individuals throughout the United States. They received 10,101 completed schedules. Of these, 97 percent were from white respondents, 86 percent of whom ranged in age from 20 to 59. Of the total group responding, 7,920 or four- fifths, were employed. The rest were housewives, retired persons, or others. From their study, they found that the distribution of occupations as compared to the general population, there were fewer deaf in the professional fields, managerial positions, and clerical and sales positions because of the necessity of communication in these jobs. There were greater numbers of deaf serving as skilled and semiskilled workers and machine operators, and in similar jobs. The industrial stronghold of deaf male respondents was in the printing and publishing industries. The national surveys indicated that 85 percent of the deaf workers are successful in their occupations.