children in the SEE group achieved higher scores.
The performance of the SEE children was closer to
the English scores of hearing children. Nevertheless,
some researchers, while observing teachers who em-
ployed a signed English system, found that many of
the declarative statements and questions signed were
grammatically incorrect. This may occur when teach-
er training is not rigorous and may also occur simply
because of the increased number of signs required by
SEE compared with ASL. Some specialists reason that
it is not necessary to sign each and every morpheme
of oral English, because a child can infer the missing
elements from predictable structure and semantics, as
well as through lipreading and use of residual hear-
ing. A potential problem when SEE is used is that
some children may not have the necessary reasoning
and thinking skills to deduce from context the delet-
ed segments of a manual message. Young children
may be bombarded with too much information; they
can misinterpret a message because of stress.
Deafness in Relation to Language and
Social Development
Language deficits are the most serious conse-
quence of hearing impairment. The effects of deaf-
ness on language development are complex. Hearing
loss may vary across the range of frequencies. Chil-
dren with severe or profound hearing loss generally
have greater difficulty learning language. Children
‘‘who are born deaf, or who become deaf in the first
year of life, have considerably more difficulty in de-
veloping language than do children whose deafness
is acquired later in life’’ (Harris 1992, p. 96). Their
opportunities as infants for turn-taking talk with sig-
nificant caregivers are limited. Hearing parents use
far fewer signs with them than the number of words
used by hearing parents of hearing infants. Deaf tod-
dlers of hearing parents cannot carry on extended
conversations nor can they ask for clarifications, repe-
titions, or confirmations to repair frustrating commu-
nication breakdowns.
Whether a child has hearing or deaf parents is an
important influence on the effect of hearing loss.
Children born to deaf parents may be familiar with
sign language from birth. Often on developmental
tests they outperform their deaf peers born to hearing
parents (about 95% of deaf children), who may expe-
rience sign language only when they go to school.
Some studies show that deaf preschoolers lag about
two years behind on language development tests, but
they have similar categorization skills and similar
scores on tests of nonverbal cognitive ability as their
hearing peers.
The timing of diagnosis and intervention differs
quite widely for infants born deaf, and this timing af-
fects social and language development. Only about 10
percent of deaf infants are diagnosed in the first year,
and accurate diagnosis may not occur until three
years of age for up to 44 percent of deaf babies. Many
children do not have a chance at early intervention
because identifying hearing loss is not a regular part
of an early detection system in infancy. Yet, current
technology makes it possible in the earliest months of
life to confirm that infants with normal hearing re-
spond clearly to changes in phonemes, even when
these phonemes are confounded later in their cul-
ture’s language system (such as ‘‘l’’ and ‘‘r’’ in Japa-
nese); for example, by about ten months of age,
hearing Japanese infants no longer respond differ-
ently to the ‘‘l’’ and ‘‘r.’’ Thus, early diagnosis of hear-
ing can be accomplished and needs to become a
mandatory procedure included in pediatric care for
young infants. Legislation is beginning to mandate
screening for hearing in newborns.
Social skills and intimate interactions of deaf chil-
dren suffer when diagnosis is delayed. Adults may not
be sensitive to orienting the infant to watch for facial
expressions or to alert the child to visually relevant
and interesting events. Peers in nursery school may
shout at the deaf child who seems to be able to move
about the playroom with ease to get a preferred toy,
but who does not respond to invitations to play or to
cues for assuming a role in a pretend play scenario.
Sensitive teachers in inclusive preschool classrooms
help deaf children so they, too, can participate in the
world of imaginative play so typical of and so impor-
tant for preschoolers. The deaf child without a friend
in such a situation may shadow an adult teacher or act
lonely and withdrawn. Teachers can actively encour-
age play group entry skills and teach all the children
how to sustain sessions of play activity.
Training of early childhood educators should in-
clude ideas for activities and interactions that will in-
crease chances for deaf children to be included in
social play. In some inclusive classrooms, all the chil-
dren learn some signs in order to communicate with
children with hearing deficits. Finger plays and sing-
ing games that involve a lot of hand and body motions
are one way to promote inclusion in play.Language Assessment
Reasons for language assessment vary and be-
come particularly crucial if a child has reached school
age and has difficulties with lessons. Tests for measur-
ing receptive and expressive language in childhood
depend mainly on a tester using oral language. Thus,
even a receptive language test such as the Peabody
Picture Vocabulary Test (PPVT), which requires only
that a child listen to the examiner (‘‘Show me bed’’)
and then point to one of four pictured items on a
page, depends on a child’s hearing ability. The Gram-178 HEARING LOSS AND DEAFNESS