Furthermore, those children with a severe learning loss of 50-70 db HL will not develop language and speech spontaneously, but with early special education and amplification with hearing aids, these children may eventually function as well as other hard of hearing persons. Without amplification, children with severe hearing loss cannot hear sounds or normal conversations. They can hear their own vocalization, loud environmental sounds, and only the most intense speech when spoken loudly at close range. With the use of hearing aids, they can discern vowel sounds and differences in a manner of constant articulation. This degree of hearing loss gradually results in severe language problems, speech problems and learning dysfunction.
Profound hearing loss of 70-db HL or greater in children only allows them to learn language and speech with intensive special education and with hearing aids. With amplification, they may hear the rhythm patterns of speech, their own vocalizations, and loud environmental sounds. However profound hearing loss results in severe language retardation, speech problems and learning dysfunction in children and adults.
The effects of a hearing impairment can permeate all aspects of a child’s development, however the main focus of this assignment is on how hearing and speech impairment affects a child’s social development. Firstly, we will briefly look at what normal social development is and, compare it with that of a child with hearing and speech impairment.
In the first 0-3 months babies begin to recognise the people they know, and develop feelings for and relationships with them. They will smile and turn to familiar voices and will recognise their face and hands. Then, from five months onward, babies will show enjoyment by smiling and laughing when playing with familiar adults, which will be demonstrated by anticipation and excitement. It is at this stage that social interaction is centred on the use of objects which the infant may be reluctant to relinquish, often putting them in his or her mouth. (Meggit, & Bruce, 1999. P109)
From eight months onwards the child can differentiate between a stranger and a familiar person, and signs of shyness are obvious. Social relationships become initiated through play, for example by passing a toy to a friendly adult. There is fascination with the reflection of the child in a mirror, however this is reciprocal exchange with another friendly face, rather than self-recognition. These social skills continue to develop as the child matures and begins to be more active in his or her own care, for example when helping to dress and feed him or herself.
From the middle of the second year the desires for independence become apparent, children become more socially competent and begin to manage increasingly their own care. Needs are expressed through the use of gestures and verbalisation, play will often involve the imitation of everyday activities performed by others. A growing self-awareness enables toddlers to reflect more on their own behaviour and that of other people, which in turn helps them to become more socially accomplished. During this period children are becoming more influenced by each other. They begin to show interest in being a friend and having friends. At this stage they learn to negotiate, give and take through experimenting with feeling powerful, and having a sense of control through quarrels with other children. (Bossert, 1979, p51).
Making friends is very important; studies suggest that the first six or seven years of development are crucial for the development of social skills. By four years a child should easily be able to make friends and learn to deal with peer relationships. If a child fails during this time to learn to relate to other children this can lead to great unhappiness. Nurseries and schools are social communities; if a child is condemned to attend school daily without having the support of friends he/she is unlikely to learn well. Studies show that lack of friends can ultimately lead children to refuse to attend school.
(Dowling, 2001, p20).
Around the age of 4-6 years, playing with other children ibecomes increasingly important, as some children during this stage begin to make close friendships; they start to play with children of their own gender which may link to their understanding of gender roles. By the end of this stage at 6-8 years most children are skilled communicators and their social skills are well developed. This means that they often have stable friendships and are able to share, play and understand other’s viewpoints. They become more aware of their abilities and will enjoy taking on considerable responsibility, by helping younger children for example.
Harry Sullivan states: (1975) theorized that children in the 4-8 years range had a uniquely important need for playmates and for friends. At this stage, which he called the ‘juvenile period’ he suggested that friendships and peer relations were initiated mainly out of a need to enhance one’s own status and popularity. The child seeks competitively to gain personal prestige in the eyes of his or her peers. Sullivan stated that such relationships were crucial for feelings of self-esteem and self-worth. By developing awareness of others the young person is accepted at a more intimate level by friends and consequently feels surer of their own worth as a person. (Smith, & Cowie, 1992, p201)
However, the social development of a child with hearing and speech impairment will be affected in several ways, as interaction between two beings is something, which starts at birth and continues throughout life. It is learned by being in contact with others and depends upon the relationship of a child with others in the group. A major part of that interrelationship depends upon communication. Many aspects of social development can be learned by watching and imitating the behaviour of others. Furthermore, much more comes from direct communication between parent, teacher and child. For example soon after a child is born, all parents identify strategies that are effective in engaging their child in communicative exchanges. At the earliest stages, these routines consist of exaggerated facial expressions, eye widening, eyebrow lifting and head movement combined with vocalizations that vary in intonation contour. The visual aspects of these interaction strategies cause the child to react by smiling, establishing eye contact or vocalize. Since the infant’s vocalizations are reflexive crying & vegetative sounds in the early months and therefore less dependent on hearing, the child will respond equally as well as a normal hearing child.
However between four and six months, there is a change in the kind and use of the infant’s vocalization due to emergence of an auditory feed back loop. It is during this stage when the child’s vegetative/reflexive vocalizations decrease in favour of more intentional, auditorily monitored and propagated babbling. The parents of normal hearing infants begin to elicit reciprocal vocal responses as they continue their visual-non verbal exchanges.
Furthermore, hearing impaired children are unable to use hearing to monitor their own and others vocalizations. Their vocalizations thus stay at the rudimentary level established during the earlier period and only on rare occasions become balanced.
Studies by Bruner (1975) and Schaffer (1977) have shown that games which mothers play with their babies, such as “peek-a boo” or “this little piggy went to market”, have an important function. They are the first shared dialogues in which the child takes part, the first conversations, about shared experience, the first exchanges involving turn taking, when the mother and then the baby respond, and the earliest means by which the mother uses language gestures and tone of voice to signal coming events. It has been argued that these processes are the roots of early communication between a mother and their child. However it is not all the same for the hearing impaired child, because their disability will interfere with the process of sharing these very basic interactions between mother and the child, and will therefore have a damaging effect on their language development which is crucial for later learning and socialisation. (Webster, 1986, p80).
Between six and twelve months, children with normal hearing refine their communication to include long strings of reduplicated babbling used to express a variety of intents that are easily discernable to obtain and maintain the child’s attention to salient words and phrases; they rely less on the visual attention gestures and engagers. It is at this point that the differences in the interaction styles of two groups of parents become apparent. The parents of hearing impaired children maintain highly visual engagement strategies, while the parents of normally hearing children have adopted a more auditory based verbal interaction.
Hearing is one of the forms through which young babies discover themselves and other people, and it therefore contributes to the foundation of social and emotional development. Later hearing provides information about the approach or presence of other people even when they are not seen. It also serves to convey information about the emotional state of other people through intonation and tone of voice.
During the first two years of life, a lack of hearing can have significant effects on children’s perception of themselves and others. For example there are no auditory clues to their parents approach and unless warned by footsteps or shadows, they may repeatedly be surprised by the parents precipitous appearance. Similarly when parents leave, the children do not have auditory clues that reassure the normal child of their continued existence. The mother-child bond must develop without the benefits of acoustic contact.
Profoundly deaf children are not calmed by their mother’s voices, and they do not discover the power of control that comes from a normal baby’s first conversations. Hearing is a valuable factor in the early stages of social development (Boothyard, A, 1989, p61).
When profoundly deaf children reach the age at which verbal language would normally become the primary medium for interaction with their parents, the failure to acquire skills in this area has profound social and emotional effects. They are frustrated by their limited ability to externalise thoughts and wishes and by their lack of control over their social environment. They perceive themselves as being acted upon more than acting and may compensate by developing rigid and manipulative behaviours. It is important that at this stage the profoundly deaf child and his/her family establish an understanding, but in the absence of language its terms are likely to be extremely unfavourable to one or other of the parties concerned. This phenomenon will repeat itself as the child’s social environment expands to include other adults and children. (Quigley, & Knetschmer, 1982, p198).
This is the first stage of life when hearing and speech impairment become a hindrance between the interaction of parent and child. Sadly this continues further when the child enters school, as the disability becomes a major barrier, (depending on how serious it is) to the education of the child. The peers he/she socialises with in and out of the school environment; and the teachers and professional’s he/she comes in to contact with, especially if the child is attending a mainstream school where most of the population of children are able to hear.
According to Berg (1987), the management of the hearing impaired child in the normal, or regular, classroom is difficult, because the hearing child learns largely through speech and spends about half the time at school in listening. However for the hearing impaired child, teaching is generally more effective if it is attained by the use of more visual pictorial material supplemented with spoken information. (Bench, 1992, p248)
Socialisation and communication are a major source of concern for the hearing impaired child in the mainstream setting, as a child’s disability can hinder a child’s social development in several ways. The most important thing, children need in order to socialise with peers is the use of their language. However the way in which language comes easily to normal hearing children, is not all the same for the hearing impaired child. The process of developing language competency is very difficult for the child who has significant hearing impairment, and all children who are deaf will experience serious difficulties and delays in acquiring language skills.
Language is the main tool needed in order to interact with other social beings. However, when the main source of communication is affected by a disability, it becomes very hard for the communicator to interact with other children and adults in the same way, as normal hearing children are able to do so. This will start to affect the child’s social development, as they will find it extremely difficult to socialise and make friends with other children.
For example, hearing-impaired children often have difficulty in introducing a topic of conversation, or shifting from one topic to another during conversation, because they do not sufficiently consider the needs of the listener. Often, when the conversation breaks down because of say, a misunderstanding, hesitancy or interruption, then the listener should be able to seek clarification and the speaker should be able to repair the break, but children who experience conversational difficulties are rarely able to do this, as they rely on the more able conversational partner to recognise the breakdown and repair it. This is one of the reasons why normal hearing children avoid making conversation with the hearing impaired, because of the communication barrier they face. Evidence for this is presented in a study conducted by Arnold & Trembley (1979), in which they found that hearing children preferred to interact with other hearing children, presumably mainly because of greater ease of communication, which sadly left the hearing impaired children to play by themselves, and limited their chances of socialisation. (Bench, 1992, p207)
Another study conducted by Leob and Sarigini (1987 showed that orally educated hearing-impaired children in mainstream schools had self assessed problems of several kinds. They were not popular with peers, they found it hard to make friends and were not often chosen as play mates. They tended to be shy and lacking in confidence more than other children, an obvious impediment to the development of communication. Also they saw their ideal selves as less likeable than themselves, suggesting that they accepted their communication problems as a major obstacle in socialising with other members of the group. (Watson, 1996, p98).
Anita (1982) reports that these children tended to look up to teachers for positive interaction, but in fact were limiting their opportunities for peer-to-peer communication (cited in Maxon & Brackett, 1992, p35).
Interaction with peers is an important part of normal development, and it is critical that deaf children be able to communicate freely and easily with children of their own age range, as peer relationships serve as a model for appropriate behaviour and self-identity.
Language and communication barriers in the hearing impaired child are not the only obstacles, however, disrupt a child’s social development. Several other factors such as behaviour difficulties and the child’s academic level are some of the other reasons, which could also disrupt a child’s social development. For example behaviour problems may arise if a pupil with hearing impairment is placed in a situation in which it is very difficult for them to understand. For instance, a young hearing-impaired child with delayed language acquisition, may be required to sit and listen like any other normal hearing child to a story with few visual clues to assist comprehension. Often due to boredom and frustration the child is likely to disrupt other children’s attention and behave inappropriately. Although the teacher may understand the reasons for inappropriate behaviour, young children who are unaware of the disability, will perceive this child as a trouble maker, which in return may limit his/her chances of building a social relationship with other children as often young children don’t like socialising with a child who is disruptive and known as the troublemaker in class.
A study carried out by Silvia (1983) on a group of 5 year old children, with otitis media, (mean loss 20.2 decibels), found several patterns of adjustment subsequent to their hearing impairment. She reported that these children, were much more likely to be difficult to manage and had temper tantrums, they had short concentration spans, high dependence on adults and poor motivation. Mothers of these children described them as being restless, fidgety, destructive, disobedient and socially isolated. (Webster, 1986, p78).
Maxon (1991), using a self-report on social awareness test, found that severely to profoundly deaf children age 7-13 years, perceived themselves differently regarding items relating verbal aggression, physical aggression and social interaction, when compared with hearing children. The deaf children reported themselves as less verbally aggressive than the hearing children, possibly because of reduced verbal expression, but they saw themselves as more physically aggressive. Maxon (1991) indicates, initiations of social interaction could be more successful for hearing-impaired children if they were a little more verbally aggressive and less physically aggressive, as due to this aggressiveness they were profoundly limiting their chances of social interaction, because peers would be scared to approach them, due to the aggressiveness which they display. (Bench, 1992, p209).
The academic level of the child could also be another reason, which could affect the child’s social development. For example, many pupils with hearing impairment experience difficulties with reading. Firstly, if the pupil has delayed language acquisition it may well be the case that the language of the reading material is beyond their level of spoken language development. For this reason they may not be able to take part in activities such as reading, where members of the group interact with different children and hear each other read, and which is a good opportunity to build social relationships with these children.
Whole class discussions or situations where pupils are asked to converse in small groups could be particularly difficult for hearing impaired children, especially when they can not understand what is being discussed, for which reason they are unable to make a contribution to the discussion taking place. Often as hearing children don’t see it from this point of view, they may put the child down by saying such things “as we don’t want this person in our group, he/she is dumb and leaves us to do all the work”. Or they may simply just leave the child out, and continue to get on with the activity by themselves. This in return can affect the child’s self-image and self-confidence and make them think they are no better than the rest of the group. Having a good image of oneself, and high self -confidence is very important at this age; in order to build social relationship’s with other children.
Evidence collected by Levis (1990) on peer group reaction to children with hearing and speech impairment, shows that in the classroom, peers who embark on communicating with children with hearing impairment, when they receive no response, or a response they have difficulty in understanding, will react in one of two ways. They either dominate the communication, giving the partner little opportunity or need to reply, or they stop communicating altogether and continue the activity in silence.
(Martin & Miller, 1996, p 36)
It is not appropriate in the context of this paper to comprehensively describe the philosophy, policy and practice of nursery education but to highlight the general aims of nursery provision and emphasise the fact that it is probably the first experience a child has of a social setting outside the home. It is an environment where the complex needs of the 'whole' child are continually addressed but for the purposes of this paper the focus of the child's development within the nursery setting has been divided into four areas. (See appendix 1)
For most deaf children then the primary aim of their nursery experience may be to develop linguistic skills so that they may then develop the social interactive skills necessary to access fully the social setting of the nursery. This would then encourage the comfortable emotional development and social repertoire which leads to a greater sense of identity. This is not here an issue about deaf identity or hearing identity but the identity of self which in turn leads to greater independence and autonomy.
Parents play several important roles when their children are enrolled in mainstream school placements. They act as a liaison between the classroom teacher and the provider. Parents need to be informed periodically of their child’s progress, as they will be able to provide information regarding how the child performs communicatively outside of the school environment. In return this will inform the teacher and other professionals, how best to meet the educational needs of this child and what suitable strategies need to be adapted in order to provide the best possible education for this child.
All children in special education, including those with multiple disabilities, follow a written contract called the Individualized Education Plan (IEP) that is developed by the parents, school personnel, and the child. Deaf children with multiple disabilities require unique educational plans. Usually, teachers of deaf and hard of hearing students are responsible for planning for their pupils. However, this is not realistic for deaf children with multiple disabilities, because no teacher (no matter how skilled or how well trained) can have the expertise to meet all the needs of all types of deaf children with multiple disabilities. A coordinated effort is required to establish a team responsible for educational planning and instruction. This team should consist of parents, teachers, support personnel, and other professionals in direct contact with the child. A complete pinpointing of the child's skills and weaknesses (academic, physical, and social) should be done, along with an analysis of the settings in which the student is functioning or should be functioning. The goal should be to develop the student's ability to function as independently as possible in the place of residence, the community, the classroom, and eventually on the job.
Besides other professionals, which mainstream teachers may also come in contact with, due to having a hearing impaired child in their class may be teachers of the deaf who are qualified teachers with additional training in the field of deaf education. The role of the supporting teacher of the deaf is to give advice and support to mainstream teachers about hearing aids, about managing the listening and about the educational and social implications of deafness. Working directly with pupils, either in or out of the mainstream class, checking hearing aids, developing language and speech skills, teaching literacy, supporting the school curriculum and monitoring general progress, also liasing with other professional’s and the child’s family.
As well as liaising with the parents of the child and outside professionals in order to best manage the education of the child, some possible strategies that could be adopted to deal with the child’s pro-social behaviour in the school environment could be, to create opportunities for successful and enjoyable learning and interaction allowing them to work in a variety of settings and situations which will increase their confidence. This could involve small group work in which they are able to hear and be heard easily which will increase self-confidence.
Making sure that the child is seated as near to the teacher as possible, so that he/she can listen and understand properly what is being taught. As mentioned earlier in the assignment when the child doesn’t understand what is being said, this causes frustration and causes the child to behave inappropriately. The teacher can also later on ask the child whether he/she has understood, and may be go over anything which they haven’t quite got the grasp of.
Providing extra support to build on language development, by not only checking that a pupil knows certain items of vocabulary, but also getting them to suggest alternative words, or seeing how many words they can think of to describe things. Giving extra time and attention to talking things through will help the pupil with hearing impairment to express themselves. It is important to give them extra time to think, as it can take longer for them to process what they have heard and formulate a reply.
As discussed in the above essay hearing and speech are the means which we need in order to communicate to other people and to understand communication from others. However, when the main source of communication is affected by hearing loss and speech impairment, it becomes extremely difficult to communicate in a normal manner. Hearing plays an important role in the later stages. The greater the loss of hearing (and speech impairment) in a child, the greater is the degree of relative social isolation, because this will effect the child’s language development, which is the primary medium for social interaction. It first becomes evident at about age two when proper social development is entirely dependent on the acquisition of adequate language skills, and becomes a major hindrance by the time a child starts school, especially if they are attending a mainstream school where most of the population of children are able to hear.
During the 1980’s there was a shift to integrated education, not only for deaf pupils but also for all those with special needs, formalised in the 1981 Education Act, which was implemented in 1983. It established the principle that all children for whom the local education authority (LEA) decides to determine special educational provision be made to determine special educational provision be made to be educated in ordinary schools so far as reasonably practicable. While in the 1970’s it was unusual for a deaf child to be integrated, a survey for NDCS in 1987 showed that nearly three quarters of deaf children of school age, supported by teachers of the deaf in England and Wales, were educated in mainstream schools (Gregory, et al, 1995, p8)
Certain critics argue that placement of hearing impaired children in mainstream schools is beneficial as it provides them with the benefits of exposure to normal social, academic and communication behaviour. However, others argue it is also important that hearing impaired children be exposed to role-models who are also deaf, as recognition of deafness in others provides a sense of belonging rather than, total isolation in a world of hearing people. (Maxon, et al, 1992, p88)
Those in favour of an oral communication approach acknowledge that it is undoubtedly difficult to be deaf in a hearing society but argue that an oral education offers the best preparation for participation in the hearing world. Acquiring an education through oral means is not easy, but, so far, the oral approach seems to offer the widest educational opportunities in terms of academic achievement. Testimony from a profoundly deaf young person, reporting on her success in higher education, offers support for an oral education:
Indeed, it is true that if I had not been educated orally, I would not be where I am now. This is sad but a fact of life, which perhaps British Sign Language supporters do not recognise. We must be realistic as deaf people do form a minority in society and thus we cannot expect all hearing people to learn Sign Language for the benefit of a few deaf people whom they may never encounter anyway. (Briggs, 1991, p. 109)
Being in with a crowd of people who are similar to one self, can be advantageous and can provide opportunities of building social relationships with one another. However when the majority of the population is able to hear, and being the odd one out of the crowd, can be very isolating and challenging for the hearing impaired child to build relationships with the other children. The effects on social development not only discourage a child from wanting to come to school, but it also starts to effect their education. For which reason it is extremely important that teachers are able to provide as much opportunities as possible with in the curriculum for the hearing impaired child, which will encourage to build positive social relationships. As well as making other children aware of disability in a positive manner so that they don’t see it as a obstacle as a means to socialise with this child.
Appendix 1
The nursery can be considered as :-
1. A learning environment - where children have the opportunity to learn through play and through an exploration of their surroundings. Nursery, with its planned range of activities, provides a broad and appropriate setting for this to happen. It is accepted that most active and productive learning takes place when this play and exploration is accompanied by interaction with a more sophisticated learner; either adult or peer group learners. The curriculum in the nursery is flexible enough to allow children to explore their environment and the activities at a level appropriate to their own cognitive and learning development.
2. A physical environment - where children can explore and develop their own physical potential . Healthy bodily development and physical growth can influence the way a child will interact with and operate in his/her physical environment
3. A linguistic environment - where the environment will give children the opportunity to continue to develop their already established linguistic skills. There is an underlying assumption, in the context of an educational nursery, that children do not come to nursery to acquire language but that they come with language already developed in a context of age appropriateness and within the nursery setting they are able to develop those skills further.
There are many professionals involved in nursery education who maintain that they can no longer assume that this is true but it still seems to be the fact that nurseries are organised on the basis of an already established linguistic base. Children who come to nursery with poorly developed linguistic skills are an 'issue' for nurseries. Nursery is a place for language which is developing 'normally' to continue to develop. What is well established is that language development is at its most productive again through interaction with more sophisticated language users, be they adults or peers with a more developed linguistic base.
4. As a social environment - where children have the opportunity to transfer the linguistic and social skills they have developed in the home setting with parents, siblings and extended family (appropriate interaction, sharing, functioning as part of a small group), into the broader social world. The nursery setting is a world where there is likely to be a proportionately larger peer group and smaller adult group. Within that group children have the opportunity to 'practice' their social skills in a wider social setting. Their social and emotional development will enable them to move gradually from a dependent state both functionally and emotionally towards independence. It could be argued that the most important and unique aspect of nursery is the social setting.
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