From the Ground Up: Promoting Literacy and Language With Infants and Toddlers Who are Deaf
Elizabeth Richardson, M.S.
Teacher of the Deaf & Special Instruction
Baltimore County Schools, Baltimore County Maryland
Infants & Toddlers Program
Abstract
Complete and continuous exposure to phonetic and phonemic information is essential for children to become articulate and literate individuals. Pairing Cued Speech with audition for our newly identified deaf/hard of hearing infants and toddler’s population provides this information at the most critical time in the child’s life. This article will address the importance of this constant and continuous stream for the development of language and will provide information about the research that supports these ideas.
Methods to help incorporate daily use of Cued Speech in the home environment will also be shared. Parents of newly identified infants and toddlers are so overwhelmed by the information necessary to help their child communicate and make use of their residual hearing that they may find it impossible to address this concern, the importance of new research findings in this area and incorporate Cued Speech to create a language and
literacy rich environment for the deaf/hard of hearing infant and toddler.
When a child is identified through the Universal Newborn Hearing Screening Process, amplification is often delayed for several months as testing confirms the existence of the hearing loss. Lack of awareness by professionals, myths regarding Cued speech, prohibitive costs to families desiring to learn to Cue, and limited resources for learning Cued speech remain obstacles to overcome. A discussion of solutions and the future of Cued Speech use with newly identified infants and toddlers follows.
From the Ground Up
Imagine the anticipation, the mother feeling the first stages of life inside. The eager mother pats her tummy, rubs and strokes the growing baby as it moves inside her. She talks to it. Some may place headphones on the belly and play music. Some may even read to it. The big day finally arrives and the child is born. The child is taken home nurtured and read to with joy.
Imagine in another family the baby growing inside his mother, talked to, read to, and wondered about as well. This time the baby is born deaf. The family finds out in the hospital even before they leave to go home. The newborn is screened using a probe. The parents can both hear, so they are shocked to find out their child has a hearing loss. They take their child home and make several more audiological appointments, only to confirm this same information. Their child is deaf. This time the baby may seldom be read to.
The parents do not know how to communicate to their deaf child, much less read to it. They may never have met a deaf person before. The parents are told to go home, read some information provided, and make a choice about how to communicate to their deaf child.
They will hear terms like Oralism, Auditory-Verbal, American Sign Language, Bi-Bi, Cued Speech, cochlear implants, hearing aids, and audiograms. The baby they dreamed of is not here, but a new baby they had not anticipated took its place in their lives. This is usually where the teacher of the deaf and hard of hearing enters their lives.
A referral is made to the local infants and toddlers program and the teacher will come to their home for scheduled visits. What this teacher brings to them will help them to help their child be an articulate and literate individual. How will the deaf child learn to talk? What methods will prove to be the most successful? When should the family make a decision about methods of communication? Why is reading to the deaf child so important and how can it be done?
The Deaf Child Learns to Talk
Daniel Ling once said that if a deaf child needs to learn to speak then that same child needs to learn to listen as well. Both listening and speaking are used together and occur concurrently. If speech is learned at a phonetic level, then listening is being learned at the phonemic level. Once the deaf child has been amplified in some way, either by hearing aids or cochlear implant, everyone involved will begin working with the child on his/her
beginning listening and speech skills (Ling, 1976).
Although this child may have been identified at birth as having a hearing loss, the child may not have been amplified until he/she was three to four months old. At three or four months of age a baby may not be willing to keep the hearing aids in placing, causing much frustration to the family who may not be able to see the results of their fruition for many months to come. Keeping the aids in place is essential for continued progress.
Families who do not feel their child is progressing adequately may opt to use a cochlear implant only to find the same frustration of trying to keep the implant device on the child. At this stage the families may be encouraged to consider many options such as the Oral method, Auditory-Verbal method, sign language or Cued Speech to be a method of communication for their child. Choosing a sole option now, however, may be detrimental
to a child’s key language learning years. Providing as much information, auditory, visual and tactile, is essential to providing key elements that may be necessary for comprehension and production of language.
The Value of Waiting
Choosing a method of communication is a daunting task for parents new to deafness. Although they may be given information from the audiologist, pediatrician, and teacher of the deaf, it can be overwhelming. Parents of newborns are just becoming aware of the child’s strengths and needs. They are adjusting to a new life style full of responsibilities. When they first find out their child has a hearing loss, they may even go through stages of loss and grief.
They have a mountain of information to learn in order to become their child’s best advocate. They must make initial choices about amplification system. (Schwartz, 1996) It is upon this time that we have begun to thrust the choice about communication. Is there value in waiting? Waiting can provide an opportunity for all methods to be tried and introduced by the teacher.
Reading about a method is helpful, but seeing it in action and seeing the required effort is essential to the success of the method by the parents. Waiting until the child transitions to preschool can provide a bridge to match a
child’s strengths and needs with program design.
Which Methods Prove to Be Most Successful?
Oralism verses sign language is to deaf education as whole language vs phonics is to regular education. The controversy over language exists in deaf education because it is at the very heart of survival for the deaf and hard of hearing population. As educators of deaf children, we have promoted what we thought was the most beneficial to providing the child with an education and a way to survive in a hearing world. Neither method, however, has sufficiently overcome the fact that children who are deaf continue to graduate high school with a third-fourth grade reading level. (Mindel & Vernon, 1987)
Recent research by LaSasso and Metzger support a Cued Speech approach because it provides a complete and continuous phonemic stream. (LaSasso & Metzger 1997, LaSasso & Crain, 2003) In 1989, Jean Wandel found that profoundly deaf students that used Cued Speech scored as well as their hearing peers on reading comprehension tasks. This research is promising and continues to support the value of visual information to support the understanding of speech.
A study completed in 1970 by Nicholls demonstrated that using Cued Speech paired with audition and lipreading gave children a 96% comprehension rate of spoken communication (Cued Speech Association UK, 2003)
We can no longer ignore these essential research findings. Used Cued Speech at the most critical time of the infant/toddler life is critical for complete comprehension. Another important thing to consider about the use of Cued Speech is the advantage it provides for hearing parents to learn a complete system quickly.
Hearing parents of deaf children would need to learn 18-20 signs per day in order to expose their deaf child to the same amount of language learned
by a hearing child of the same age. Learning Cued Speech, by comparison, takes an average of 12 hours to a few weeks (LaSasso & Metzger, 1997.)
Reading and the Deaf Infant and Toddler
For the deaf infant or toddler, a literature-rich environment is of the utmost importance. It is important for two reasons. The first is that literature will provide another opportunity for the parents to provide phonemic, phonetic and language information to their child. Secondly, it will serve as the foundation for early emergent literacy development: the first stage of formal reading development.
Infants and toddlers display early behaviors that lead to the development of early literacy skills. These behaviors are associated with how the infant/toddler handles the book, attends to the book, demonstrates recognition of pictures, imitations of actions in the story and increased verbal interactions (Zero to Three, 2003)
The following suggestions are opportunities to provide these essential experiences for the deaf infant or toddler.
• Incorporate literacy activities into your therapy sessions.
• Create picture books, using beginning speech and listening stages sounds, for the deaf infant and toddler to view and handle.
• Encourage parents to provide under ones a variety of sturdy books of different shapes, textures, and colors.
• Books about daily experiences provide verbal labels for events occurring in the child’s life.
• Utilize a variety of seating positions:
-Seat the child on your lap when maximizing auditory and tactile information.
-Seat the child in front of you when maximizing auditory and visual
information.
-When you are Cueing to the child on your lap, use a more tactile method, using the cues on the child’s body to help provide additional information.
-When Cueing to the child in front of you, draw attention to your face and
mouth by bringing the book up and toward your face and mouth.
-Get down on the child’s level; this will make it easier for the child to gaze
between the book and your face.
Pair objects and toys with the book to extend comprehension by incorporating the story into play activities.
Introduce rhyming using stories, nursery rhymes, and finger plays. Cued speech can be used to convey rhymes and rhyme patterns.
Pair nursery rhymes and finger plays with pictures, toys, objects, or act out the rhyme to increase the meaning for the child.
Participate in community story times. If a Cued Speech transliterator is not provided, request one in advance of the date to ensure a transliterator can be scheduled.
Model good reading and writing habits. Encourage the parent to allow the child the opportunity to see the parent reading for information and pleasure.
Encourage the parent to allow their child to see him/her writing letters, lists, and e-mails.
Allow the child to scribble with crayons. Ask him/her about their picture.
Share information about early literacy development, with the parent, from the internet, recent journal articles, pamphlets and books.
As you read to the toddler, ask questions: Where is the ___? What happened to the ___? Who is in the ___? Encourage the child to point to pictures upon request.
Practice with and without cues and lipreading.
Provide parents with lists of ways to promote book, literacy, and language
activities.
Provide parents with ways of introducing auditory, verbal, visual, and tactile information for total comprehension.
In addition, these suggestions may help make professionals more aware of the benefits of Cued Speech and its impact on literacy development:
• Share information about Cued Speech with professionals: pediatricians,
audiologists, teachers of the deaf, school administrators, speech language
pathologists, and auditory rehabilitationists.
• Request the use of Cued Speech transliterators.
• Schedule monthly events with your local Cued Speech Association.
• Support monthly Cued Speech Association events by your active
participation.
• Provide Cued Speech classes on an ongoing basis.
• Make the state department of education aware of ongoing research being
done with Cued Speech.
Conclusion
Preparing the deaf child to be a literate and articulate individual is a challenge. But as educators of the deaf, it is imperative that we provide these opportunities at the most critical stages of language and literacy development…. the early years of infancy. Utilizing beginning listening skills and speech skills, paired with visual input from objects, toys, lipreading, Cued Speech and books can increase the opportunity for the child’s language and literacy skills to grow and develop together.
Providing information to the parents through demonstration can make their ability to advocate and nurture their child easier and clearer. Helping parents to wait until the child enters preschool to choose communication methods provides an opportunity for the parent to become an educated advocate for their child’s best interest.
References
"Cued Speech Complete Spoken Language Through Vision", Cued Speech
Research Findings Information Sheet 10.” January 2003. The Cued Speech Association UK with financial assistance from the Department of Health, The Freemasons’ Gand Charity, The Esmee Fairbairn Foundation and Lloyds TSB Foundation for England and Wales. 2-05-05
“Early Literacy.” Zero to Three. 2003. Brainworks, a project of Boston University Medical Center, Erikson Institute, and Zero to Three to Three. 2-28-05. www.zertotothree.org/Braindwonders
LaSasso, Carol and Crain, Kelly Lamar. “Research and Theory Support Cued Speech.” KidsWorld Deaf Net. Fall 2003. Gallaudet University Laurent Clerc National Deaf Education Center. 2-05-2005.
LaSasso, Carol J., Metzger, Melanie A. “Partners for Preparing Deaf Students for Bi-Bi Educational Programs.” ERIC Document ED 406 778. March 1997. ERIC
Database. Department of Education. Institute of Education Sciences. 2.05.05.
Levi, A., McClatchie, A., Robbins, A., & Therres, M. The Guide to Cochlear Implants for Parents and Educators. CA: Advanced Bionics Corporation, 2003.
Ling, Daniel. Speech and the Hearing Impaired Child: Theory and Practice. Washington, D.C. The Alexander Graham Association of the Deaf, Inc. 1976
Mindel, Eugene D. and McCay Vernon, eds. They Grow in Silence Understanding Deaf Children and Adults. College Hill Press, 1987.
Schwartz, Dr. Sue., ed. Choices in Deafness. Bethesda, MD: Woodbine House, 1996
http://www.cuedspeech.org/PDF/From_the_Ground_Up-Richardson.pdf