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Excerpts from: Definitions and Descriptions “ by Mark Ross Ph.D.,  in

 “Our Forgotten Children; Hard of Hearing Children in the Schools” J. M. Davis

SHHH Publications, MD U.S.A , 2001

 

It is easy to forget hard of hearing children. There is nothing about them that immediately calls attention to itself or tugs at one's heartstrings. Most hard of hearing children have lit­tle difficulty understanding face‑to‑face conversational speech. Their speech is ordinarily perfectly intelligible, even if often marked by evident articulation deficiencies. Their voice quality and speech rhythmic patterns are usually not too different from those exhibited by normally hearing children. In other words, lit­tle about them marks them as disabled, unless they wear visible hearing aids (which is one important reason why many object to wearing them). Ironically, their superficially normal appearance and abilities may make the situation worse for them. Hard of hearing children do not get the services they need and deserve because their very real problems are masked by an apparently normal facade.

When we get past this facade, however, and focus on the impact of a hearing loss upon their speech, language, academic performance and behavior, it is apparent that the potential conse­quences of the condition are far from trivial. What has often hap­pened in the past, and no doubt still happens, is that if a hearing loss is not understood to be the basic genesis of their problems, then other reasons (i.e., intelligence, emotional adjustment, attention deficit disorder, etc.) may be ascribed as the responsible agent. A hearing loss in a child, of whatever degree, is not a benign condition. It has ramifications that can pervade every aspect of the child's life.

Hard of Hearing – a Definition

A hard of hearing child develops speech and lan­guage skills primarily through the auditory mode and employs (or is capable of employing) a primarily auditory‑verbal system of communication. While many of these children may be depend­ent upon visual cues for interpersonal communication, vision is still a secondary channel compared to audition. “Deaf” refers to any person whose development of communication skills occurred primarily through the visual channel and whose current mode of communication is primarily visually based. (Note that this an audiological definition, not a psychosocial one. Some audiologically hard of hearing people identify themselves as Deaf and part of the Deaf community)

In this respect, hard of hearing children are much more like normally hearing children than they are like deaf children, exactly the opposite of what is commonly presumed. Thus, a child who is hard of hearing is frequently treated as a high‑achieving deaf child rather than as a lower achieving normally hearing child. It makes a difference. In the latter case, parents and teachers would be expected to increase the pressure for higher accomplishments. Expectations are higher if they are based on normally hearing children. In the former instance, the child would be considered to already be doing quite well for a deaf child. Expectations are lower, since the educational achievement of deaf children is often much lower than that of normally hearing children). Many of the educational aberrations to which hard of hearing children are exposed follow from this erroneous, limiting, and basically pessimistic conception.

Hard of hearing children vary widely in the attributes, experiences, and backgrounds that characterize all children, but also in the dimension that defines them as hard of hearing ‑ the degree, and nature of their hearing losses. Some have a hearing loss in only one ear, a “unilateral hearing loss”.

The kinds of difficulty children with unilateral hearing loss experience are quite different from those manifested by children with bilateral hearing losses. The former seem to hear better and usually manifest no speech or language problems but will have more academic deficiencies than their normally hearing peers. They are also likely to have more difficulty localizing sound sources and understanding speech in adverse acoustical circumstances than children with bilateral hearing losses. Because their behavior is harder to predict, they tend to be rated more negatively by parents and teachers than children with bilateral hearing losses (Bess, 1986).

Vocabulary

Perhaps the most glaring deficiency in the language capabilities of hard of hearing children is the status of their vocabulary. All studies of vocabulary usage by these children indicate that they know and use many fewer words in their utterances than do normally hearing children (Davis, Elfenbein, Schum, and Bentler, 1986). Hard of hearing children often learn, or are taught, a single meaning for a word or, conversely, a single word to express some general concept. For example, the word "run" may mean an act of rapid, bipedal locomotion, but not striving for a political office, having difficulty with a nylon stocking, or the nasal consequences of a bad cold.

Hard of hearing children appear to be bound by the literal meaning of words, in much the same way as someone who is learning a second language. Words expressing nuances of meaning may be either lacking or seriously reduced. Because a great deal of normal conversation is made up of idiomatic or metaphoric expressions, slang, and colloquialisms, these children are often lin­guistic strangers in their own homes. Often, they "just don't get it."

Most children pick up vocabulary almost automatically. All par­ents have experienced the "big ears" of their normally hearing children who overhear conversations they were not supposed to. These children can hear and learn new vocabulary from any direction within earshot, whether or not the words are intended to be heard. Hard of hearing children, on the other hand, tend to master only those words directed right to them. But who will take the time to teach a hard of hearing child the additional meanings of such words as "cool," or the multiple meanings of common words such as "ball" and "get (as in get sick, get back, get a grip, get a life, get going, etc.).

Psychosocial Status

Superficially, there is nothing about the appearance of hard of hearing children that sets them apart from their peers. Some of them may exhibit behavioral problems, but so do many normally hearing children. They may be withdrawn or aggressive, socially adjusted or maladjusted, quiet or outspoken. Rarely do hard of hearing children behave in ways that are not also frequently found in some of their normally hearing classmates. Even the fact that they have hearing losses does not mark them uniquely. These chil­dren are not deaf. They can and do respond to speech and other sounds. When they do respond, or respond incorrectly or inappropriately, their reactions are not necessarily attributed to a hearing loss. Instead, they are often accused of not listening, not paying attention, or daydreaming. They are sometimes described as chil­dren who "can hear when they want to" and who are deliberately provoking their parents and teachers by willfully ignoring or mis­understanding them. Professionals and parents cannot understand why these children are able to comprehend in some, but not in other, superficially comparable situations.

The effect of language complexity, dialectical or poorly articu­lated speech, distance from the speech source, and poor room acoustics will often have a disproportionate effect upon the abili­ty of hard of hearing children to understand spoken messages. Levels of reverberation and room noise, that normally hearing children can tolerate easily may make speech comprehension extremely difficult or impossible for hard of hearing children. Although they can hear in almost all situations, they cannot understand in many of them. Because of their unpre­dictable responses, observers often expect communication behav­iors beyond their ability. Adults assume that they will compre­hend a message because they can so evidently hear it. Other chil­dren may consider them less than desirable playmates for reasons that neither group really comprehends. The resulting, reciprocally reinforcing conflicts between societal expectations and the capa­bilities of the children, and between the needs of the children and the elusive and blocked gratification of those needs by an insensitive and ignorant environment, can affect these children all through their school years.

Children who are hard of hearing appear to depend more upon the teachers for mediating classroom activities than do normally hearing children, who rely much more on their peers (Kennedy, Northcott, McCauley and Williams, 1976). This is understand­able when one considers the difficulty many hard of hearing chil­dren have in following classroom discussions (ensuring effective child‑to‑child communication in a classroom may be the major acoustic challenge).

As the children get older and become peer­ dominated (just like other adolescents), their personal and social problems may increase (Reich, Hambleton and Houldin, 1977). During adolescence, they may rebel against wearing visible hearing devices and personal identity problems may occur. As has been emphasized in this chapter, hard of hearing children are not deaf, but neither are they normally hearing. A hard of hearing child wearing, or requiring personal amplification, may be the only such student in the school. They often feel different and isolated.

Their situation, however, need not be so unremittingly gloomy. Social maladjustment and problems with self‑esteem are not inevitable (Elser, 1959; Kennedy, et al, 1976; Reich, et al, 1977; Ross, 1978). Many of the apparent differences between hard of hearing children and their normally hearing peers fall within an accepted range of behaviors. This is not to deny the existence of problems, potential or existing, but to affirm that the problems can be alleviated or reduced with proper psychosocial management (Schwartz, 1989). Before this can be done, however, the psychosocial problems must be recognized for what they are, problems secondary to the hearing loss and not an inherent personality factor. The key is understanding the perceptual implications of all types of hearing loss. Once this is done, behaviors that are apparently inexplicable become clear, as do the potential solutions.

 

 

Some Summary Comments

            It should be understood that not every child who is hard of hearing will display communication or educational problems secondary to the hearing loss. What can be asserted, however, is that based on the research, children with any type and degree of hearing loss are at risk for possible problems due to hearing loss.

            Above all, what must be kept in mind is that an individual’s needs and unique personality transcend any categorization that divides children who are hard of hearing or deaf, or somewhere in between. It may be a cliché, but it is one with a great deal of truth: children are children first, and only secondarily a member of any defining category.


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