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Deaf
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- This article is about hearing impairment. See also Deaf culture, which discusses persons who are culturally Deaf.
To be deaf is to be unable to hear, or have a severe hearing impairment.
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Causes of deafness
There are four major causes of hearing loss.
Genetic
- Deafness can be inherited. Both dominant and recessive genes exist which can cause deafness. If a family has a dominant gene for deafness it will persist across generations because it will be expressed in the offspring even if it is inherited from only one parent. If a family had genetic deafness caused by a recessive gene it will not always manifest as it will have to be passed onto offspring from both parents.
- Dominant and recessive deafness can be syndromic or nonsyndromic. Recent gene mapping has identified dozens of nonsyndromic dominant (DFNA#) and recessive (DFNB#) forms of deafness.
- The most common type of congenital deafness in developed countries is DFNB1 , also known as Connexin 26 deafness or GJB2-related deafness .
- The most common dominant syndromic forms of deafness include Stickler syndrome and Waardenburg syndrome.
- The most common recessive syndromic forms of deafness are Pendred syndrome , Large vestibular aqueduct syndrome and Usher syndrome.
Disease or illness
- High fevers can damage the inner ear
- Measles often results in auditory nerve damage
- Autoimmune Disease is a relative new diagonosis for deafness. Unlike most of the diseases in this category such as Lupus, Diabetes, Multiple Sclerosis and Rheumatoid Arthritis, some which can be life-threatning if untreated, autoimmune-related deafness is believed to be organ specific to the ear, thus not life-threatning. In the age of Acquired Immunodeficiency Syndrom (AIDS) many people have mistakenly associated a diagnosis of Autoimmune-related deafness with AIDS by virtue of both terms having the word "immune" encompassed within the definition. These two diseases are wholly, and completely unrelated. AIDS is a viral infection while Autoimmune-related deafness, as yet, has no known pathogen associated with it. Additionally, no instances of deafness or hearing impairment of any kind has been found to be associated with AIDS or HIV infection. Ear specialists and people who work with the deaf often refer to a diagnosis of autoimmune-related deafness as the "catch-all diagnosis". It serves this purpose since many cases of deafness have no known cause.
Medications
- Autoimmune or allergic reactions to some pain and antibiotic medications can cause deafness in varying doses, depending on individuals.
Physical trauma
- There can be damage either to the ear itself or to the brain centers that process the aural information conveyed by the ears.
- Victims of head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent.
- Exposure to very loud noise (90 dB or more, such as jet engines at close range) can cause progressive hearing loss. Exposure to a single event of extremely loud noise (such as explosions) can also cause temporary or permanent hearing loss.
Medical treatments
In addition to hearing aids there exist cochlear implants of increasing complexity and effectiveness. These are useful in treating the postlingually or late deafened individuals, as well as in very young prelingually deafened children. Recent studies http://www.cid.wustl.edu/research/PPR/Geers/Geersppr.htm show that if implanted at a very young age, deaf children can generally acquire effective hearing and speech. The Implantation of very young children is still somewhat controversial, especially among members of the Deaf community.
Views of treatments
There is controversy in the Deaf community as to whether cochlear implants are a Good Thing at all, given the negative impact which the community would suffer from its depletion. Yet the depletion of the numbers of deaf people are inconsequential matters for people with a history of being experimented on. The "technologies of normalization," which including hearing aids, implanted devices and medical intervention designed to "fix" deafness rather than deal with social and intellectual needs of deaf people remain as grave concerns of deaf people generally. The history of deaf education has a parallel history of what deaf people know as "fail-first" philosophy. It is the view that deaf people should be shaped in the image of hearing people at any cost. At paramount risk is the acquisition of language and literacy skills that will enable a deaf person to live a life of complete independence. Among so-called handicapped peoples, the deaf stand out as perhaps the most "able" of any. A literate deaf person can hold a job, own a home, marry and raise a family, pay taxes and work for the betterment of the his community, both hearing and deaf. Yet devices such as hearing aids and implants are not a guarantee of success or even social acceptance within the larger community. One of the most common but, unfortunately, worst experiences a deaf person can have is to be educated exclusively by oral education, experience the world through one of the technologies of normalization, then go to work in their first job and within a short time be taken aside by a supervisor and told their voice is annoying to other employees and they most people can't understand them when they speak. This after enduring on average of fourteen years of speech therapy assisted by a technology of normalization. With no knowledge or skill with sign language the only recourse for the deaf person is to use hand-written communication. He soon learns this, too, is considered too tedious for his co-workers. Like most deaf people, whether they are fitted with normalizing technology or not, this young man most likely graduated from high school with a third-grade reading level. His ability to write the language of the majority culture is severely limited and he does not have access to or interest in the community of deaf people because he was educated and raised in a way that shunned this group as a resource for socializing and problem-solving. In short, he had to fail-first to learn that his best natural resource is the community of signing deaf who, as a group, have multiple strategies to deal with the realities of life as a deaf person in a hearing world.
This is a decidedly different view of the deaf experience when juxtaposed with efforts to "medicalize" a human being. To wear a cochlear implant or hearing aid does not make one "un-deaf". It places a deaf person into a permanent duet of dependency with human-services providers whose sense of urgency over the "depletion" of their clients, far and beyond, exceeds the concerns of the deaf. Human-service professionals react by finding yet more "needs" of the deaf person that must be fulfilled and they will not hesitate to appeal for funding with tears rolling down their faces and dollar signs in their eyes. One must ask, "Is the depletion of deaf numbers more important to the individual deaf person or to the $3 Billion dollar a year human-services industry that surrounds it?"
Deaf cutlure
Main article: Deaf culture
The word deaf is used and understood in two ways. First, there is the medical, pathological and audiological sense of the word, in which deafness describes a disease or impairment. Deaf, often capitalized, may also describe a culture and community whose members may or may not be able to hear but for whom the medical condition of deafness is somehow relevant or present to their lives. This split in perspectives causes what can seem to be odd constructions using the word. For example, a person could be said to be deaf but not Deaf. Conversely, one could be Deaf and yet not be deaf. Therefore, it can be important to discern which sense the word is being used by a speaker or writer.
The capitalized word "Deaf" is a natural outcome of the evolution of the signing deaf communities centered around schools for the deaf. When deaf education entered the realm of public education in Paris in the latter half of the 18th century, for the first time deaf people had access to social opportunities that were made possble by their acquisition of sign language. As public education for the deaf branched out into the whole of Europe and the Americas, along with it came the development of deaf communities around each school. In present-day America, some cities have streets in which vitually every home has a deaf family who socializes with deaf neighbors. Since signed language is the central value of this community, people who use it as their first language and who embrace the values of the deaf community are referred to as "Deaf". These "Deaf" people can either be physically deaf or they can be the hearing friends, children or relatives of deaf people who use and value sign language in the way the community of signing deaf value it. This is hardly a "cult" as uninformed people sometimes refer to the Deaf. Rather it is a cultural view of life almost identical to that of the cultures of language minorities who live and function within the confines of a majority language and culture.
In contrast, a person may be born deaf but not use any form of sign language at all. These deaf persons are almost always those who were educated exclusively by the oral education method and who speak the majority language and do not identify with the community of signing deaf people or their language. These people are deaf but not "of" the Deaf community and the dividing line is language and values. Most Deaf people find the term "hearing impaired" to be diminishing; something on the order of referring to a woman as a "non-man". So the signing Deaf prefer designations of "deaf" and "Deaf" rather than the politically correct and pathologically associated "hearing impaired" to differentiate the views of deaf people. Thus the capitalized "Deaf" evolved from the signing deaf community as a means of identifying the worldview, either cultural or pathological, held by both deaf and hearing individuals.
Adaptations to deafness
Many deaf individuals use certain assistive devices in their daily lives. Deaf individuals can communicate by telephone using Telecommunications devices for the deaf (TDD) Signing deaf people call the device by its original name of teletypewriter (TTY) in the same sense that Americans refer to a refrigerator as an "ice box"; "T-T-Y" is both a signed concept that generalizes about the devices' physical appearence and function, or an idiom, in this instance, in American Sign Language. Deaf culture also includes the understand that the device isn't just for the deaf; that hearing people use it also and that the connotation that such a device is exlusively for the deaf is like saying that pencils and chalk are technologies used by the hearing to overcome their communication barriers. In short, all people employ assistive devices for uniques purposes, yet we don't call the tools used by mathematicians "MDM" or "mathematical devices for the mathematican" simple because very few people use the tools and would be inconvenienced or limited without it. The deaf cite certain inconsistancies associated with the designation of a particular thing or behavior as "for" a particular group. "Math for girls," would be frowned even though educational data shows boys surpassing girls in mathematical achievement. "Masculinity for effeminate men," would likewise create an uproar even though most people recognize behavior in males that is traditionally and culturally associated with women. This device looks like a typewriter or word processor and transmits typed text over the telephone. Other names in common use are textphone and minicom. In 2004, mobile textphone devices came onto the market for the first time allowing simultaneous two way text communication. In the U.S., the UK, the Netherlands and many other western countries there are telephone relay services so that a deaf person can communicate with a hearing person via a human translator. Wireless and internet text messaging are beginning to take over the role of the TDD. Other assistive devices include those that use flashing lights to signal events such as a ringing telephone, a doorbell, or a fire alarm. Video conferencing is also a new technology that permits deaf-to-deaf signed converations as well as permitting an ASL-English interpreter to voice and sign conversations between a deaf and hearing person, negating the need to use a TTY or computer keyboard.
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This article may need to be reworded to conform to a neutral point of view; however, the neutrality of this article is not necessarily disputed.
Historical attitudes toward deafness
For much of time, deaf people were thought to be mentally retarded. Isolated deaf people rarely, if ever, learned language, which is fundamental to much of human culture. Aristotle believed that the deaf were incapable of learning or thinking. The kind of prejudice based on speech and hearing that Aristotle expressed has influenced attitudes toward deaf people and the teaching methods for and expectations of deaf students for ages.
Education of the deaf
For most of history deaf people were not thought capable of learning and so were not educated at all. The first known teacher of the deaf was Pedro Ponce de Leon, a priest of the Catholic Church in Spain. He taught children of the royal and aristocratic classes principally because these were the only childen whose families could afford this type of education and, significantly, because European laws of the 17th century held that a person who could not speak was not considered a person under the law and, therefore, not entitled to inherit titles or property. It is not known how successful Ponce de Leon was in teaching speech, but it is certain his efforts resulted in the children receiving their rightful inheritance. The first public school for the deaf in history was set formed by Charles Michel de l'Epee, the Abbe de l'Epee, in Paris, France in 1760s. Epee used the signs he learned from two deaf twin girls in his parish as a basis for instruction. Epee's was an intellectual leap by orders of magnitude since no other teacher of the deaf had understood the effacacy of using the deaf person's very own language as a bridge to the majority language - a principle of learning a second language that was well understood by hearing people then, as now. Yet, since it was generally not yet understood that sign language was, itself, a language with the same power as a spoken language, hearing people, with the exception of Epee, dismissed the notion of using sign language as an educational bridge. The most prominent complaint of this era was that sign language was only able to convey concrete concepts and it lacked the ability to express abstrations. Though Epee's students put such concerns to the test in public demonstrations by writing origiinal sentences devised by sign language opponents, interpreted by Epee in sign language and written by the students in French, Spanish and Latin before the very eyes of the person objecting, the complaints persisted and Epee was often accused of trickery. Oralists simply refused to believe their own eyes. Like Ponce de Leon before them, teachers of speech at least recognized the usefulness of the Spanish manual alphabet in teaching. This alphabet was always the first tool employed in initially reaching the deaf student's mind, but from that point speech teachers focused entirely on teaching lip-reading and speech articulation. In other places, the emphasis was on lipreading and speaking English. The debate between which of these two approaches is the most efficacious to deaf students has gone on for hundreds of years and continues today.
Oralism versus manualism
There are two opposing perspectives on how to teach language to deaf people:
- Manualism holds that deaf students should be taught primarily in sign language.
- Oralism holds that deaf students should be taught primarily (or exclusively) to speak and lip-read.
The rationale behind the latter method is that deaf people will have to interact with hearing people most of the time, so they must learn to communicate as hearing people do. The rationale behind the former method is that sign language is a natural form of communication while lip-reading and speaking are extremely difficult for those who cannot hear and particularly for those who are pre-lingually deaf with little or no experience with hearing the spoken languages. Those who prefer the sign-language method take the approach that spoken language should be used only as an auxiliary language. Some of the most obvious rationale includes the problem of labor and time involved in learing to speak (a lifetime in most cases) precluding the learing of the fundamental set of subjects, such as reading, history, mathematics, and to the exclusion of the deaf child's social development. Sign language skill be can be learned simultaneously with this fundamental set of subjects while speech learing necessarily requires large blocks of time that reduce the opportunity to attend to disciplines that serve as tools for future employment. Historically speaking, orally educated deaf children of our modern times continue to complete their basic education of twelve or more years reading somewhere between the age group of nine and ten year old hearing children (third and fourth grade in the education system of the United States). While children educated with sign language, a language, unlike English, that is not taught by hearing educators but learned from other deaf children, fare no better then their orally educated deaf peers, deaf children who have deaf parents are a glaring exception to this problem. They perform as well as their hearing age mates throughout their education and the difference in their success points to their fluency in sign language in the earliest moments of their lives; a language they learned from birth. In practice, deaf people have been observed to learn and communicate much faster and more fluently when taught in sign language than when taught orally.
In the U.S., the sign-language method was primarily used until 1880, when the second International Congress on the Education and Welfare of the Deaf (composed of 163 hearing individuals and 1 deaf individual) voted to use the oral approach to teach deaf students. It is not widely known that participation in the Congress required no professional affiliation. In truth, organizers of the Congress invited common citizens of Milan to participate and these citizen, even though not affiliated in any way with Italian deaf education, were given full voting power. It is important to mention here that there were five votes cast against the proposal to make oral education the exclusive method of teaching the deaf. Those five votes were cast by the contingent from the United States, the only country respresented by a deaf person at the Congress and the country with a larger population of deaf people than all the other participating countries combined. To this day, deaf people refer to that Congress, held in Milan, Italy, as the Milan Massacre. By the end of the 19th century the number of deaf teachers of the deaf went from about 60 per cent to almost none world-wide when Oralist were able to enact legislation that required teachers of the deaf to be able to speak, thus legalizing discrimination against the very group of people whom the participants of the Milan Congress had vowed to raise to the level of civilization and justice. Part of the reason for the emphasis on oralism was the melting pot ideology, that everyone should share the same culture and speak the same language. Also, because sign language was not recognized as a true language, it seemed deficient as a method of communication.
One of the major factors in changing public opinion was William Stokoe's findings, published in 1960, that American Sign Language was a true language. This idea was not accepted immediately, but it played a major role in shifting the emphasis of teaching back toward manualism.
A growing movement in deaf education today is called bi-bi, which stands for bilingualism/biculturalism. This method aims to respect and foster Deaf cultural identity, stress and strengthen sign language competence, while simultaneously teaching and encouraging skills that facillitate functioning in the dominant hearing culture, such as English mastery.
Resources
There are many different assistive technologies such as hearing aids available to people who are deaf, hearing impaired or hard of hearing. There are also Hearing dogs which are a category of Assistance dogs. The advent of the internet's World-Wide-Web and closed captioning has given the deaf unprecedented access to information. Electronic mail and online chat have virtually eliminated the need for deaf people to use a third-party Telecommunications Relay Service in order to communicate with the hearing and other deaf people. Prior to closed captioning, deaf people's only independent access (for example: not needing a family member to intrepret a film or television program) to film and live television broacasting was through subtitled foreign films and silent film titles.
See also
- Deaf culture
- hard-of-hearing
- List of deaf people
- Association of Late-Deafened Adults
- Dorothy Miles Cultural Centre - organisation set up to bridge the gap between deaf and hearing people
- Gallaudet University - school for advanced education of the deaf and hard-of-hearing
- International Deaf Children's Society
External links
- ESL Literacy for a Linguistic Minority: The Deaf Experience. ERIC Digest. http://www.ericdigests.org/1993/deaf.htm
- Educating Children Who Are Deaf or Hard of Hearing: Inclusion. ERIC Digest http://www.ericdigests.org/1998-2/inclusion.htm