Effective social work practice with deaf and hard-of-hearing people requires a unique, and diverse, collection of knowledge, values, skills, and ethical considerations. Salient issues among this population are language, communication, and educational choices, interpreting, assistive devices, cochlear implants, genetics, culture, and access to community resources. Competencies at micro, mezzo, and macro levels with a deaf or hard-of-hearing population include knowledge of the psychosocial and developmental aspects of hearing loss, fluency in the national sign language, and an understanding of deaf cultural values and norms. In the United States, the use of American Sign Language (ASL) is the single most distinguishing factor that identifies deaf people as a linguistic minority group. This entry presents an overview of the practice competencies and intervention approaches that should be considered in working with deaf and hard-of-hearing people, their families, communities, and organizations. It introduces the knowledge base, diversity in community and cultural orientations, social constructions, and international perspectives, current research and best practices, interdisciplinary connections, trends, challenges, and implications for effective social work practice with this population. An integrative strengths-based transactional paradigm is suggested.
Deaf and Hard-of-Hearing People
Martha A. Sheridan and Barbara J. White
Gallaudet, Edward Miner
Edward Miner Gallaudet (1837–1917) founded the Columbia Institute for the Deaf and Dumb in Washington, DC, to provide college-level education for deaf people and was president of the Convention of American Instructors of the Deaf from 1895 until 1917.
Rodriguez Pastor, Soledad
John F. Longres
Soledad Rodriguez Pastor (1897–1958) was a pioneer in services for deaf and blind people and a leader in the development of professional social work in Puerto Rico. She became director of the Institute for Blind Children in 1936.
Gallaudet, Thomas Hopkins
Thomas Hopkins Gallaudet (1787–1851) and his two sons, Thomas and Edward Miner, are renowned for their commitment to the education of deaf people. In 1817 he established the first free American school for the deaf in Hartford, Connecticut.
Thomas Gallaudet (1822–1902) devoted his life to ministering to deaf people. He was ordained a priest in 1851 and in 1852 he established St. Ann's Church for Deaf Mutes, conducting regular services in sign language.
Matthew B. Winn and Peggy B. Nelson
Cochlear implants (CIs) are the most successful sensory implant in history, restoring the sensation of sound to thousands of persons who have severe to profound hearing loss. Implants do not recreate acoustic sound as most of us know it, but they instead convey a rough representation of the temporal envelope of signals. This sparse signal, derived from the envelopes of narrowband frequency filters, is sufficient for enabling speech understanding in quiet environments for those who lose hearing as adults and is enough for most children to develop spoken language skills. The variability between users is huge, however, and is only partially understood. CIs provide acoustic information that is sufficient for the recognition of some aspects of spoken language, especially information that can be conveyed by temporal patterns, such as syllable timing, consonant voicing, and manner of articulation. They are insufficient for conveying pitch cues and separating speech from noise. There is a great need for improving our understanding of functional outcomes of CI success beyond measuring percent correct for word and sentence recognitions. Moreover, greater understanding of the variability experienced by children, especially children and families from various social and cultural backgrounds, is of paramount importance. Future developments will no doubt expand the use of this remarkable device.
Literature and Disability in the English Renaissance
Disability—whether physical, mental, or sensory—is widely represented in Early Modern literature, and as such it has been attracting attention from 21st-century literary scholars, who apply the theoretical and critical tools of disability studies to Renaissance narratives and literary characters. Literary disability in its various forms can be analyzed in the light of various models of disability, including medical, social, moral, or cultural. This helps in understanding early modern representations and experiences of disability in culture and history and making sense of reactions to disability in the period: including stigma, mockery, proud identification with the disabled identity, or also a desire for it. Physical disabilities in the Renaissance encompass anything from deformity to bodily mutilation to dwarfism or monstrosity, and they are especially prone to be emphasized, explained, or scrutinized in search of their meaning. Sensory disabilities, including blindness, deafness, and mutism, prompt interpretations that connect physical impairment with the character’s inability or surprising ability to understand reality—whether in a pragmatic or spiritual sense. Intellectual and mental disabilities have many ramifications in early modern literature, some of which, such as fools and madmen, are staple types of drama. Intellectual and mental disabilities are often described in medical terms, but literary texts tend to differentiate between them, whether in technical or narrative terms. Foolishness normally turns into comedy, whereas madness is often connected with tragic characters undergoing mental breakdowns. Renaissance disability studies are also concerned with less obvious types of disability: disabilities that were disabilities in the past but not in the 21st century, concealed disabilities, and disabilities that are not actually disabilities but do foster a conversation that excludes the character who does not embody what society regarded as the ideal physical shape. Finally, instances of counterfeited disability and disability attached to concepts rather than people help understand how Renaissance culture often viewed the nonstandard body not only as something to beware of or reject but also as an image of empowerment.
Plasticity of Information Processing in the Auditory System
Andrew J. King
Information processing in the auditory system shows considerable adaptive plasticity across different timescales. This ranges from very rapid changes in neuronal response properties—on the order of hundreds of milliseconds when the statistics of sounds vary or seconds to minutes when their behavioral relevance is altered—to more gradual changes that are shaped by experience and learning. Many aspects of auditory processing and perception are sculpted by sensory experience during sensitive or critical periods of development. This developmental plasticity underpins the acquisition of language and musical skills, matches neural representations in the brain to the statistics of the acoustic environment, and enables the neural circuits underlying the ability to localize sound to be calibrated by the acoustic consequences of growth-related changes in the anatomy of the body. Although the length of these critical periods depends on the aspect of auditory processing under consideration, varies across species and brain level, and may be extended by experience and other factors, it is generally accepted that the potential for plasticity declines with age. Nevertheless, a substantial degree of plasticity is exhibited in adulthood. This is important for the acquisition of new perceptual skills; facilitates improvements in the detection or discrimination of fine differences in sound properties; and enables the brain to compensate for changes in inputs, including those resulting from hearing loss. In contrast to the plasticity that shapes the developing brain, perceptual learning normally requires the sound attribute in question to be behaviorally relevant and is driven by practice or training on specific tasks. Progress has recently been made in identifying the brain circuits involved and the role of neuromodulators in controlling plasticity, and an understanding of plasticity in the central auditory system is playing an increasingly important role in the treatment of hearing disorders.
Evidence-Based Practices for Teaching Learners who are Deaf or Hard of Hearing in Regular Classrooms
Greg Leigh and Kathryn Crowe
The question of how best to teach learners who are deaf or hard of hearing (DHH) is perhaps the oldest topic in any area of education for children with diverse learning needs. Developments in a number of fields have accounted for more DHH learners achieving educational outcomes commensurate with their hearing-age peers than at any point in that long history. Efforts to further develop and implement effective educational practices with these learners continue, with an abundance of interventions proposed in the literature and in practice. Despite this, evidence for their efficacy remains limited. Such evidence as there is tends to be drawn from observations of professional practice and not always from the outcomes of high-quality research. This is not to say that a lack of research evidence for a particular educational practice means that it is necessarily ineffective or should not be used. Rather, it is to acknowledge the preeminence of quality research outcomes as the cornerstone of an evidence-base for educational practice with DHH learners while recognizing that contributions can come from two other sources: the expertise and experiences of professionals involved in the education of DHH learners in educational settings, and the views and preferences of DHH learners and their families about how the best educational outcomes can be achieved. The vast majority of DHH learners are educated in regular classrooms alongside their hearing peers, including a significant minority whose primary or preferred language is a signed language. Questions of how best to facilitate access to regular classrooms for those DHH learners are inextricably linked to issues in three areas: (a) communication, language, and literacy; (b) classroom access; and (c) pedagogical practices and other educational supports. The first area covers the unique set of challenges that relate to DHH learners acquiring a language (i.e., whether that be spoken or signed) and how best to support their ongoing development and use of their communication, language, and literacy skills in the classroom. The other two sets of issues, relate to the difficulties that are typically encountered by DHH learners in gaining access to the regular classroom curriculum through their preferred language and mode of communication (i.e., how best to access the auditory and visual environment of the classroom on an equitable basis with their hearing peers), and how best to support that access through instructional techniques and/or specialist support services. In all three areas there remains the challenge of assembling an evidence base for practice from quality research evidence.
Bicultural, Bilingual, and Bimodal Deaf Education
Deaf education, particularly in the United States, is an ongoing and controversial conundrum. The term “deaf” applies not only to a medical diagnosis that defines hearing loss and speech ability but also to a cultural and linguistic recognition of a way of life that is deeply rooted in deaf community practices often unknown to “hearing” communities. The tension between these different philosophical and epistemological worldviews starts the moment a baby is identified as “deaf.” This identification affects language and modality choice, school placement, literacy instruction, curriculum, academic achievement, marriage partners, social groups and organization, and even meaningful and equitable employment. The inherent struggle in deaf education is the desire on the part of monolingual, hearing-centric educators, professionals, and parents to rely on technological solutions or therapeutic interventions to produce “hearing” speaking citizens. These participants are expecting the same outcomes from deaf children as they are from hearing children, emphasizing auditory/oral learning without understanding the sociocultural, linguistic, and biological challenges experienced by deaf children. While inclusive education may seem to “accommodate” the idea of equality, perversely those who experience the process can vouch for the inequalities, inequity, and injustice in monolinguistic deaf education. Most of society has yet to recognize that education of deaf children is necessarily embodied in a far more complex cultural and linguistic ecosystem. For American deaf persons, this ecosystem involves American Sign Language, visual learning strategies within culturally and linguistically driven content instruction, and cultural traditions and experiences that are indigenous to deaf communities. How are best practices addressed when the medium of instruction differs in modality and structure (i.e., spoken language vs. signed language); when reading instruction involves a different mapping process; when school assessments are only available in a spoken language; and when lack of teacher qualifications may hinder learning. Historically, conflict over language ideologies has dominated academic discourse about classroom pedagogy, literacy, teacher training, and educational research. Issues of power and language dominance emerge around curriculum instruction and assessment, as deaf individuals struggle to take their rightful place in a largely hearing deaf education environment. However, both hearing and deaf scholars in the field of neuroscience, child development, and Deaf studies have contributed to critical understanding about a bilingual-bimodal ecosystem in deaf education. This research has set the stage for reevaluating systematic, linguistic, and pedagogical traditions and has raised ethical questions regarding education and sign language research with deaf participants. By including members of the deaf community in the discourse, the emergence of a new practice of bilingual-bimodal education for deaf children secures a sociocultural and sociolinguistic foundation for all deaf children. Research findings support the veracity of a bilingual-bimodal deaf education classroom.
Howe, Samuel Gridley
Larraine M. Edwards
Samuel Gridley Howe (1801–1876) was a noted philanthropist, educator, and advocate for the physically and mentally handicapped. He was director of the New England Asylum for the Blind and served on the Massachusetts State Board of Charities from 1863.
Sign Languages in the Romance-Speaking Countries
Sign languages in the Romance-speaking countries constitute a rather representative sample of the languages in the visual–gestural modality documented to date throughout the world in many respects. The types of historical and thus linguistic relations that exist among them have to do with the history of education for the deaf, colonization, and missionary work. Contact phenomena with spoken languages are attested in certain parts of the grammar and the lexicon, but they also arise among sign languages. The existing language types can be classified into urban versus rural sign languages, which determines certain aspects of the languages and their sociolinguistic setup. The transmission patterns rely on educational institutions and Deaf organizations because most deaf people are born into hearing and non-signing families. Despite non-negligible differences among regions in the world (e.g., between European and West African countries), the underlying sociolinguistic issues in Deaf communities are similar, and the cross-linguistic and typological variation and similarities observed among them are comparable to those found in other sets of sign languages but also reflect the range of variation found across spoken languages. The state of research, still incipient but steadily growing, also reflects the overall situation of the field more generally.
Reading Comprehension, Language, and Theory of Mind Skills in Deaf and Hard-of-Hearing Children
Kaye Scott and Louise Paatsch
Learning to read is a complex process that is a fundamental skill essential for life in the 21st century. Historically, the reading comprehension skills of many deaf and hard-of-hearing (DHH) children have lagged significantly behind typically hearing children of the same age. In recent years, advances in hearing assistive devices, the introduction of newborn hearing screening, and earlier fitting of appropriate devices leading to earlier intervention have impacted positively on the language and reading comprehension skills of DHH children. Many DHH children, however, still do not develop reading comprehension skills commensurate with their peers. While much is known about how children learn to read, research continues to advance the understanding of these complex and nuanced skills. Recent research supports the inference that Theory of Mind (ToM) skills contribute to reading comprehension development in DHH children. This research emphasizes the interplay between ToM skills and the ability to understand emotional state terms and mental state words, as well as answer “why” questions. Interventions designed to develop ToM skills have been useful in supporting the development of DHH children’s ToM and reading comprehension skills, and this has implications for teachers. Some simple to implement strategies that may contribute to the development of ToM skills in DHH children include the use of “why” questions and the integration of emotional state terms and mental state words into the student’s program. The paucity of research regarding the interplay between ToM and reading comprehension, however, highlights the warrant for further research in this area.
Disability Inclusion in Sexual and Reproductive Health in the United States
Despite the passage of the Americans with Disabilities Act (ADA) more than 30 years ago, people with disabilities experience significant barriers to exercising their right to sexual and reproductive health throughout their life course. The historical segregation and stigmatization of disabled individuals has created the conditions in which members of this population experience persistent disparities in the prevalence of adverse health conditions and inadequate attention to care, along with disparities in preventive care, health promotion, and access to health care services. These disparities manifest in social services and health care generally and also in the sphere of sexual and reproductive health. Among many direct care workers, health care providers, and family members, assumptions persist that individuals with disabilities are asexual, unable to exercise informed consent to sexual activity, and unable to carry a pregnancy to term or to parent successfully. These assumptions adversely affect the ability of individuals with disabilities to access basic information about their sexual health and function in order to make informed decisions about their sexual activity, and also impact their access to preventive health screening, contraception, and perinatal care. Inadequate transportation and physically inaccessible environments and equipment such as examination tables pose additional barriers for some disabled individuals. A lack of training in disability-competent care among health care professionals is a pervasive problem and presents yet another challenge to obtaining appropriate and necessary information and care. Despite these barriers, the research shows that more and more women with disabilities are having children, and there is an increasing recognition that people with disabilities have a right to sexual expression and appropriate sexual and reproductive health care , accompanied by a gradual evolution among social services and health care providers to provide the necessary information and support.