This is a blog dedicated to learning more about Early Interventions (young children age birth to 3 years old) in Autism and Sensory Impairments (Visual Impairments and Deaf/Hard of Hearing). As professor of Family Centered Practices in the Early Interventions program, I am hosting a conversation among experts, researchers, professors, universtiy students and parents in the field of autism and sensory impairments. It is my hope that early intervention specialists will also join this on-going conversation and offer insight and advice from professional experiences to graduate students who may be new to the field of Early Interventions.
Here are the topics that we will be discussing for the next two weeks include but are not limited to:
- Early diagnosis of deaf/hearing impairment,
- Advantages of teaching ASL to toddlers with deaf/hearing impairment,
- Indoctrinating hearing parents to the Deaf Culture,
- Resources for hearing parents who want to teach their toddler with deaf/hearing impairment sign language,
- Dilemmas for using the transdisciplinary teaming approach: if the primary service provider does not know ASL on the early intervention team
Looking forward to following the conversation!
rpan52
Early Interventions 
I often think what my life would be like now if my hearing impairment had been pre-lingual. As a three year old with a typical vocabulary, my hearing parents discovered quite suddenly that I lost my hearing. Back in 1955, the worlds between the hearing and the Deaf Community were divided.
Today, there are many options for parents of infants and toddlers who have hearing impairments or are severely or profoundly deaf. I’ve always been curious about how hearing parents make the decision for their child whether or not to teach them sign language. I’ m requesting my students to examine the research and professional literature for answers to this dilemma. For those of you who are following along who have professional or personal experience, please feel free to share your insight with us.
Dr. Panagos, I have a personal question for you. Please do not feel obligated to answer but after reading your post it popped in my head. After telling us some of the costs of different theorpies you went through and the hearing aids you have; were your parents ever eligiable or offered scholarships or grants to help pay for it all?
I don’t mind answering at all, Stephanie. Voc rehab actually paid for my hearing aids when I was young, but now I don’t qualify for financial assistance. Voc rehab did pay for all my tuition and room and board for both my BA degree and my MA degree though. My Ph.D. was also paid for as I was a graduate research assistant. I was truly fortunate to have completed all my education without loans.
Dr. Panagos, in some of the websites I viewed, it seemed people were completely for sign language or against, and the same with hearing devices. My question is, if you want to answer, is were you or your family completely for hearing devices-or did you experience and learn both sign language and hearing devices?
You need to remember that in 1955 when my parents learned I was deaf, speech therapy was not in the public schools, nor was special education. Knowing that context, and the fact that my parents didn’t know ASL (American Sign Language), the only way that I would learn sign was for my parents to send me to a school for the deaf where ASL was the only language used. I must have had a pretty good innate ability to read lips at a very young age, although I absolutely do not remember hearing sounds, but rather “feeling” them. My parents couldn’t bear the thought of sending me away to a residential school for the Deaf and went against the advice of the audiologists and medical doctors and enrolled me in my neighborhood school. Thankfully, my grandmother was my “Oral Interpreter”. She did not sign, but prompted me and made sure that I understood what the teacher taught.
Back in the ’50s, almost all of those who were deaf went to the state school for the deaf and grew up learning sign language. Jen, as you mentioned, today there are far more options for parents to consider. I do believe that today our society is much more open and receptive to learning sign language and do not view those who are Deaf as “Deaf and Dumb” as some unknowledgable people may have in the ’50s. While there is still controversy surrounding cochlear implants, you need to realize that cochlear implants are not always successful and accepted by the deaf child. Hearing aids, however, offer for most who are hard of hearing, more natural speech sounds and are easier to become adjusted to than cochlear implants. After recieving a cochlear implant, there are months of therapy before one learns how to fully use the implant. Yes, some of those in the Deaf Culture do resent the use of cochlear implants for deaf children.
In the end, we, as early intervention specialists, need to be prepared to give parents information about all the options. Just recently I was at a home visit where the early intervention specialist was conducting the “exit” visit. The child was turning three after having successfully met her IFSP goals for speech and language. The option was offered to the family to keep the IFSP open for the school district to screen the child for further services. Apparently, the father had negative experiences growing up after being diagnosed with a disability and the parents didn’t want their daughter to be “labeled”. The mother noticed that I wore hearing aids and asked about my personal experiences. I shared that I had speech therapy from the third grade through college. Crying, the mother noted that I did not appear to have been negatively affected and had even gone on to be successful. I noted that her daughter (who truly was an absolute, charming doll) was doing well because she had made the decision for her daughter to receive early interventions. I also noted that whatever she decided, she could always contact the school district any time in the future and request screening for services. I could see what an emotional decision it was for the mother. We have to remember that our parents are the expert of their child and our job is to empower them with all the information so that they can make a qualified decision.
Thank you Dr. Panagos, what I have read just seemed to be so black and white on the subject. Sometimes when I read information I forget to put the emotion aspect to what is being learned. I really have had little interaction with children or even adults with hearing impairments, so this is a new world to me and I am learning how many different emotions go into making a decision for a child.
I have read a very interesting article on “Language and Literacy Acquisition through Parental Mediation in American Sign Language” By Cynthia Neese Bailes, Carol Erting,Lynne Erting and Carlene Thumann-Prezioso. This article focuses on Parents who are deaf raising they newborn daughter in the deaf community and how ASL works for their family. The choice to use ASL was a very simple one for this family since ASL is their language but the article noted that sign language is typically framed as options for communication strategies versus choices. The article also noted that many parents, because of their lack of education in this area, believe that sign language can impede speech development. I learned that sign language can fulfill the visual language need that children who are deaf need from the moment they are born. This article opened my eyes a little bit more to the deaf community and their language but I am still pondering Dr. Panagos’s question of how parents who are not a part of the deaf community make the decision on what intervention will work best for their child who is born deaf or hard of hearing. Do those parents embed themselves in learning this visual language or pursue other options? I know that as a parent of a child with Autism and other disorders I have had to learn another language per say myself in order to communicate effectively with him so is that choice these parents make? What other options are out there for children born deaf? I know that there are options for children who have hearing impairments for instance the cochlear implant but is this an option for a child that is born deaf? I have many questions and would love to hear everyone’s input.
Thanks
Rachel Morgan
Graduate Student at Lindenwood
My questions are very similar to yours!! I read different articles as well as watched youtube video’s about parents with hearing impaired children and the parents almost had their own language created to communicate with the child like you are saying Rachel; as well as sign to for the “universal” way for deaf to communicate. Although, I do know Dr. Panagos had mentioned her parents did not have sign language a part of her education..? I can’t personally understand how much stress would be put on a parent that has to make all of these decisions! A “parent to parent” website had useful/general information about how parents feel when they descover their childs sensory impairment, feeling the need to be an expert on the topic. Makes since right? When I have kids, if my child is hearing impaired I would want to know everything I could to try to descover what the best decision for my child would be. However, this website had TONS of links to be able to read up information on professionals, parent views on coping with the diagnosis (including supports), what the future holds/successes, stories from parents, how to contact professionals, and other search topics. It was easy to navigate through as well as read! Babyhearing.org is where my search started, really great website and support! What is the most recommended support websites/groups for parents that have hearing impaired children?
What a great resource in “My baby’s hearing.org”. After reaading “All about hearing”, and clicking on “what is an audiogram”, I was able to hear what it sounds like to have a severe and profound loss. I believe that I described to the class what my audiogram looks like. Without my aids, I begin to hear 500 hz. at 90 decibells. My hearing aids give me 40-45 decibels of volume-amazing technology!
When I was an undergrad, I did a presentation on the Deaf/Hard of hearing. I watched a video that had most if not all the family members were deaf. One brother loved the deaf community and didn’t want his children to get a cochlear implant. His other brother and his wife where looking into getting the cochlear implant for their daughter. There was a big family feud and members of the deaf community were very upset to hear about this news. If I remember correctly, the girl did end up getting the implant done, it was years later after the first movie was made. Also with this presentation I went to tour the Central Insititute for the Deaf. They do not sign at this school, it is an oral school and the children have cochlear implants, and hearing aids. I found it very interesting and would love to go back to tour again.
I have mix views about this. I respect the deaf community and understand that they do not want to hear and love using sign language because it is their language. I love learning sign language and find it very interesting. I also think that they should want to hear as well. They are missing out on so much and it is a wonderful thing. I know that it is up to the parent to want their child to sign or to have a cochlear implant but I would like them to use both. It’s a great opportunity to expand their childs knowledge and life. However, the end result is the parents and what is best for their child. Do you have a deaf community hear in the St. Louis area? I know there is one out east, but wasnt sure here.
There definitely are strong communities in different areas of St. Louis/St. Charles. The communities that I know about center around various churches.
I read an article entitled “Early Language Outcomes of Early-Identified Infants With Permanent Hearing Loss at 12 to 16 Months of Age” by Betty Vohr, Julie Jodoin-Krauzyk, Richard Tucker, Mary Jane Johnson, Deborah Topol and Marianne Ahlgren. The article addresses the outcomes of identifying young children with hearing loss early and the effects of early intervention. It stated that if children were not identfied even as newborns and who did not recieve therapy for language development as young children, eventually struggled in the areas of: language, academics and literacy. The author stresses that early detection is crucial for these children. The article also compared a group of young children with profound hearing loss with a control group of young children who were typically-developing. I found it interesting that the studies showed that the child that commnicated with his hearing parents using American Sign Language had expressive language skills comparable to the children who were hearing in the control group. That brings me to a couple of questions: What are your thoughts on using ASL with young children? What are the pros and cons? I work with young children with special needs and we encourage any type of communication modality; verbal, the use of pictures to communicate (PECS), ASL, gestures, ETC…What are your thoughts?
Maria,
Excellent question (and one that I’m hoping everyone will be reviewing the research and share here with us) and outstanding article that you presented. I’ve got several thoughts to add on this. First, while all of my youth I have no memories of hearing my parents, I lost my hearing after I had acquired “typically expected” language for a 3 year old. Experts say that I had “innately” learned speech reading skills. My earliest memory of hearing was “feeling” my Mom talking to my Dad while resting my head on her chest while she was holding me.
Prior to wearing hearing aids, I learned two foreign languages and travelled to five European and South American countries. I always felt that I had an advantage when I didn’t know the native language because I knew what it felt like to “search” for the context of the conversation and “guess” what the speakers were saying. The point is that babies who haven’t acquired any language, have limited hearing, and have not been diagnosed, could easily become unresponsive to their environment if the caregivers don’t “connect”.
Secondly, for your question about ASL with young children…What if every preschool and early intervention program taught sign language to all children?
I think ASL is helpful to all young children. We are currently teaching my nephew (at 9 months old) different signs and he is beginning to learn all of them. It seems that he is starting to associate the sign for “more” with getting more of what he needs/wants. As far as we know, he has no hearing difficulties, but it has been helpful for him and the rest of us to see what he needs, though he may not be able to verbally express it yet. ASL is just another language for young children to learn just as Spanish or French would be. I know some high schools already offer it as a foreign language credit and others are pushing for it to become one.
My daughter is using sign with my 8 month old grandson. It seems that “more”, particularly when associated with food when he is eating, is the sign that he seems to understand. Just as with learning any language, the window of highest acquisition for learning another language is 3 to 5 years old. At the conference today, I spoke with representatives from the MO Commission for the Deaf and Hard of Hearing and The School for the Deaf from Fulton, MO. The Missouri School for the Deaf has a Resource Center on Deafness with its own Families First: Early Intervention Program. They have parent advisors in different parts of the state who conduct home visits, strategies, and information and support. They also offer sign language classes for hearing parents. I haven’t had a chance to look at the website yet.
I also agree teaching ASL is helpful in teaching young children a way to communicate. I work in an Autism program with a few children who have great difficulty communicating, and some have been taught ASL as an early intervention, andthose children seem to have a easier time communicating needs and wants better than those not taught the skill.
I read two articles one entitled “Educating Children Who Are Deaf or Hard of Hearing: Total Communication” by Larry Hawkins and Judy Brawner and the other “Educating Children Who Are Deaf or Hard of Hearing: Bilingual-Bicultural Education” by Sharon and Keith Baker. The first explained what Total Communication (TC) was. The theory behind this philosophy of communication is that parents and educators should use whatever means of communication works best for their child, whether it be manual, oral, auditory, or written, at different stages of development. So theoretically, a child could use many different means of communication throughout his life (but don’t we all?). The main benefit of this theory is “that it can open all avenues and modes of communication for the deaf child.”
The second article explained the bilingual-bicultural education approach to teaching children who are deaf/hard of hearing. This theory believes ASL should be the very first language children who are deaf/hard of hearing should learn because it is easier to acquire than any other form of English. After ASL is learned it serves as a stepping stool for the child to then learn spoken English(the bilingual part). This program advocates that children should also be able to move fluidly and freely between the deaf culture and hearing culture (the bicultural part). This raises their self-esteem and enables them to function effectively in both bilingual and bicultural environments. However, I was surprised to hear that this approach does not support mainstreaming deaf children in regular education settings (this seems to be the opposite of what everyone talks about for all children with disabilities). This is because many deaf adults have said they felt isolated and “academically deprived” when they attended school with hearing children.
For my part, I can see the pros and cons of each side. I think teaching sign to any child- whether deaf/hard of hearing, autistic, developmentally delayed, or even normally developing children is beneficial because it does help foster the language piece. Using signs can also greatly help visual learners (which many of may language impaired students are). I also believe though that more opportunities may be present for those children who can speak English- not a lot of people know sign language.
Good choice of articles, Amelia. As you can see, this is a highly controversial and emotional topic. Interesting point that you mention from your article’s statement about lack of support for inclusion of deaf children in gen. ed schools/classrooms, even though the bilingual approach supports learning to speak after learning ASL. I would love to learn more about the bilingual-bicultural approach.
There are definitely more options today for parents in deciding the mode(s) of communication for teaching language. I know of some preschool teachers who teach ASL to all children to improve their communication skills.
I read an article in the Odyssey: New Directions in Deaf Education journal entitled Addressing Students’ Language Needs in a Bilingual ASL and English Classroom. This article discussed the difficulties of incorporating ASL and English within a classroom that has children of all abilities: hearing, hearing impaired, memory processing problems and autism spectrum disorder. The suggestion of incorporating ASL either after English is spoken or have an interpreter to work alongside of the English speaking teacher. This is a way to include both hearing impaired and hearing students in the lessons and meeting their needs, however combining the learning process by teaching ASL to all students could really enhance the learning process for all students. It is often expressed how students feel excluded or separate from their classmates due to the limited or no understanding of ASL. The article states how the students were growing and appreciating the art of language through English and ASL once being exposed and completing the school year. The students that were hearing acquired ASL and started communicating with their hearing impaired peers. Based on this article and past experiences I find teaching ASL only a positive thing because it helps communication.
Emily,
You raised an interesting point about hearing students learning ASL. Just think that if we taught ASL in every preschool for everyone, sign would be naturally acclimated and used as the preschoolers grew up, teaching even their families how to sign. (Sesame Street follows this premise.) It would be wonderful to be proficient in Spanish as well, the fact is that in Missouri, more individuals speak ASL than any other foriegn language.
That is really interesting that ASL is more prevalent that Spanish. I guess I highly underestimated the number of people that know ASL. I would like to know the statistics of ASL and how many people know it and use it on a regular basis.
Emily,
Apparently, ASL is the third most used non-English language in the US overall with around 1/2 million households using ASL as their main form of communication. More recent statistics show ASL in Missouri as being a close second to Spanish. Data from the 2000 census showed that in St. Louis there are 147,076 households using ASL, out of which 25.4 % have children under the age of 18 living with them.The website below shows the national data:
Click to access ASL_Users.pdf
Emily-I would love to read your article! I am fortunate enough to work alongside a Speech and Language Pathologist who encourages any communication modality with all of our students. She has taught me what Total Communication is all about. Although ASL is not her first choice for many children (and her reasoning is because many people do not understand ASL and she is afraid that if we are teaching a child to use it, peers will not respond and give them the satisfaction they are looking for), it is something we use often in a very natural way in my classroom (i.e. our hello song and good bye incorporate ASL). All kids just love it…we also use it when we sing the ABCs. My students who are typically-developing (I have an integrated classroom) will ask often what sign goes with what word and they love that we incorporate it. When a child in my classroom only uses ASL to communicate (that is the communication modality they choose to use over anything else), we ALWAYS honor it and try to teach the other children how to understand that child. I truly believe that we should give all children a way to communicate that best meets their needs, whether that is verbally, with gestures, using ASL, using PECS (Picture Exchange Communication Systems), ETC…
I read the article “Considering Placement and Educational Approaches for Students who are Deaf and Hard Hard of Hearing” by Barbara Casson Fiedler. (TEACHING Exceptional Children, Vol. 34, No. 2, pp 54-59 Copyright 2001 CEC)
This was a very interesting article that touches on three possible educational approaches for students who are deaf and hard of hearing. Oralism, Bilingual-Bicultural (Bi-Bi), and Total Communication. I liked that the article stressed that there was no one universal method that works for all students, but rather we need to focus on the family’s choice of communication combined with a careful examination of each individual students needs to provide a language rich environment that works for that child.
Wendy,
All the more reason to first listen to what our parents’ priorities, needs, and concerns are. With that being said, how can we be sure as Early Interventionists that our families have all the information about Oralism, BI-Bi, and total communication so that they feel comfortable with the decision that they make?
Also, although I learned a lot from this article too, it was published in 2001. I wonder if there are more options for families that this article states that have been recommended since 2001?
I am very interested in learning ASL and only wish that I had started sooner, so I was researching on how to learn when I came upon http://www.deaflinx.com/Children/family.html. It’s a website that I think has several resources for a parent of a child with a hearing impairment. At first, I was a little turned off by it because it didn’t seem very warm and welcoming, but as I dug further, it’s actually got a lot of great information! They have links to everything, including a link to My Baby’s Hearing. The website includes school information and what your child could be eligible for, parent support groups, volunteer opportunities, different events to attend to support the deaf community, and loads of other great info. The part that I found most interesting was that I could learn ASL through their web videos. There is a ton of info and links to many different ways to learn ASL, and one of the best ones I found was the ASL browser. It is set up like a dictionary with hundreds of different words for you to scroll through and then watch a video of someone showing the sign and read a description of exactly how it’s done.
That website you posted was AWESOME Dana, just incase anyone was wondering… I spent almost 30 min navigating it and then awhile reading differnet topics/articles on it!!
I’m sorry for it taking me so long to reply, it seems I have not as technologically savvy as I thought.
I read an article by Cynthia Neese Bailes, Carol J Erting, Lynne Erting and Carlene Thumann-Prezioso entitled Language and Literacy Acquisition through Parental Mediation in American Sign Language. In this article is followed a child named Anne 6 weeks old through preschool and described her parents interactions with her to describe her success. In this article both parents were deaf as well as many of the extended family. They described how they started by watching their child’s eye gaze and signing what she is looking at. They did a lot of repetition involving Anne looking at an object and then the parents signing the description. Eventually, Anne would look at her parents as soon after she looked at something for clarification. Once she got a little older she would point and then look to her parents for a description of what she is looking at. As she grew older her parents taught her letters, shapes, and objects through repetition and correcting mistakes. This process is not so different than many parents with children who are not deaf to get them to understand their shapes, letters and sounds. This article showed that by early intervention by the parents their child was able to make tremendous strides and be able to be on grade level with her peers. Unfortunately so many parents aren’t able to start as early and as a result their children fall behind during formative years.
I found this article to be very insightful into the lives of parents with deaf children, but it really made me realize how hard it would be for a parents who were not deaf to go through this process. The parents would not only have to learn a new language but teach it to their child. It would require a lot of time and sacrifice in order to keep their child on course. I’m interested in finding articles that share what those families have done and what tools they have used to make their child successful.
Also in response to an earlier post, I really wonder why a parent wouldn’t want their child to have a cochlear implant. I understand the deaf community is a close one, but if I had a tool that would help my child be even more successful in the world I would want them to have that tool. I know I’m very naïve on this subject but it just blows my mind to imagine not at least trying it.
The method described in this article makes sense, Jen. Great choice of article to share with us!
Dr. Panagos,
I have a question for you or any one that knows about ASL. What is the difference between ASL and Signed English? I have a book, I like to use in the classroom. (It was a gift from our hearing impaired specialist.) It is a quick easy reference designed sign language book that I thought was basic sign language. I went to type the name and I discovered it was Signed English not ASL. It is still an awesome book I would like to share with everyone to have as a quick handy reference in the classroom or at home. The signs are categorized by home, school, food, function, feature, and etc. It is designed and very well thought out by educators and parents to help toddlers that are deaf, hearing impaired or are challeneged at learning. Signing Signed English: A Basic Guide By Harry Bornstein And Karen L. Saulnier
Signed English has a different syntax thatn ASL, more like the grammar that we use in our language. ASL has a very different order of the parts of speech, e.g., “red ball” is signed “ball” “red” in ASL. Great question and one that everyone should research and be able to explain to parents who may ask! I encourage everyone to “chime in” with what they learn about Signed english.
To add to a previous comment about ASL in an Early Childhood Special Education classroom. We used ASL as the common link of communication at circle time with the children. Between the children we had one child with a cochlear implant, another one with autism, Down syndrome, developmentally delayed, and one that was language impaired. It was a lot of work but very rewarding for the children as the year went on. I felt it built up their confidence the most.
I found a supporting article named THE BENEFITS OF SIGN LANGUAGE FOR DEAF BABIES AND CHILDREN on http://www.learnbabysigning.com. It talks about how sign language jumpstarts brain development by establishing connections between auditory and visual input. By utilizing sign language like fingerspelling alphebet it can enhance reading and writing or visual-spacial aspect of signing supplements the spatial skills needed for various math concepts provide skills that are vital to academic success of a child. Signing also cuts down frustration and boost confidence because communication becomes easier and more natural. The social circle gets bigger and the child starts reaching out to socialize more. Signing stimulates social connections by reinforcing verbal communication. Studies have shown that sign language strengthens connections in the brain that are used for speech development. Sign language boost speech development.
Really neat wedsite as well… I think I’v been spending more time on these than I do face book! There is so much out there it is amazing! Other collleges’ offer sign classes/programs, will Lindenwood some day reach that point in expanding the education program?
Very cool comment, Stephanie! Share with us specifics of what has been intriguing you.
I’m so sorry this last comment above is from Susan. I did not do this right.
I like that website a lot. It has great information on what you can do with autistic kids. Thank you for sharing Dr. Panagos!
As I was surfing, I found http://www.rit.edu/ntid/educatingdeafchildren
It comes from Rochester Institute of Technology / National Technical Institute for the Deaf
The Web site focuses on Raising and Education a Deaf Child. There are many categories for example: cochlear implants and hearing aides, social emotional and behavior development, culture and communities etc. It is designed for questions to be submitted in english, spanish, or ASL and international experts will answer your question about the chioces, controversies, and decisions faced by the parents and educators of deaf and hard of hearing children. You have access to all of the questions and answers. It is very user friendly and it sucked me in. I read a lot of the questions and wanted to know what advise would be given. I thought that would be good if someone needed personal advise for an IEP concern or classroom situation.
Hopefully, in tonight’s class we will learn a lot from our guest speakers re: cochlear implants.