176 Chapter 9
approach note that children taught by both the oral and manual methods can develop optimal
abilities to interact with the hearing and verbal communities. Total communication also maxi-
mizes learning opportunities, and children can be mainstreamed.
Is deafness a disability, or are persons who use manual communication a linguistic minority?
Should profoundly hard- of- hearing and deaf children be taught only one method of aural habilita-
tion or rehabilitation? Should these children be given cochlear implants and amplification? These
are sensitive questions requiring re spect for parents’ and children’s rights and the beliefs of some
in the deaf community. However, technological, habilitative, and rehabilitative advances have dra-
matically changed those social and po liti cal issues. Cochlear implants, in par tic u lar, have created
opportunities for persons to hear, although with individual variations in sound quality and speech
discrimination abilities. The cochlear implant’s ability to provide sound and speech sensation,
perception, and discrimination has dramatically improved deaf and profoundly hard- of- hearing
children’s opportunities to communicate verbally. The cochlear implant is an evolving technol-
ogy that will likely continue to improve the quantity and quality of hearing for these individuals.
Hearing loss and deafness profoundly damage the person’s pres ent and future quality of life—in
par tic u lar, reducing opportunities to learn. According to Northern and Downs (2002), a child with
a severe hearing loss may incur a staggering economic cost over a lifetime: $2 million. Deafness is
a disability, and to refuse to provide optimal habilitative and rehabilitative opportunities for deaf
and profoundly hard- of- hearing persons is morally and ethically unacceptable. No one, including
deaf and hard- of- hearing children, should be forced into a minority culture and deprived of the
opportunity to interact freely with the larger verbal population. It should be noted that as children
mature, they can choose to revert to manual communication alone and embrace the manualist
deaf community.
Case Study 9-1: Industrial Hearing Testing and
Noise- Induced Hearing Loss
As someone who performs hearing testing in vari ous industries, you have been taught about
the role noise exposure plays in hearing loss and deafness, but nothing has prepared you for this
practical lesson. You know about temporary threshold shifts and have even experienced them
in loud bars and dance halls. You wear ear protection when shooting, riding motorcycles, and
running the chainsaw to avoid permanent threshold shifts. You are aware of the havoc noise can
wreak on hearing, but seeing worker after worker with the same type of audiogram drives home
the noise– hearing loss lesson.
The Inkom Nuclear Generating Plant has more than 200 employees and many subcontractors.
It is one of the largest generating plants in the nation, containing three large conical towers with
steam billowing from the reactors. Hundreds of gallons of water are pumped into the fa cil i ty each
day to cool the nuclear reactor and to produce electricity with the large turbines. The turbines cre-
ate a constant high- pitched scream as they convert nuclear energy into electricity. You drive your
van and hearing testing trailer into the parking lot. Today you will test the hearing of the first
shift of workers employed at vari ous sites in the plant. The com pany nurse will assist you and has
arranged the schedule. On this visit, each employee will receive a pure- tone evaluation.
The first group of employees to be tested is the security officers. Each employee enters the
portable testing booth, and you place the earphones over his or her ears. First, you test 1,000 Hz
at 30 dB in the right ear. When the tone is heard, the employee raises a hand. Then you use the