As a teacher of the deaf, I encounter students who have been impacted by Language Deprivation every single day. But, what IS language deprivation? How is it still so prevalent with deaf and hard of hearing children today even with all the technological advancements?
Language Deprivation: The Essentials
What is Language Deprivation? In order to fully understand this concept, we must examine several important definitions. I acquired these definitions from a simple wikipedia search. The definitions are listed below and I suggest digging further into these concepts if you are able. The concept is quite alarming as “inadequate language input during the critical period of language development can cause irreparable damage to the brain and have permanent, negative consequences”. (Sanjay Gulati)
The three important definitions include
- language acquisition
- language deprivation
- critical period
It is important to note that language deprivation is preventable. The first step is to be aware of its existence and prevalence with Deaf and Hard of Hearing children. The second step is to proactively and intentionally prevent it.
Language deprivation is also something that tends to happen to deaf and hard of hearing children born to hearing parents and does not seem to be at all present within the deaf community with deaf children born to Deaf parents.
Language acquisition is the process by which humans acquire the capacity to perceive and comprehend language, as well as to produce and use words and sentences to communicate.
Language acquisition involves structures, rules and representation. The capacity to successfully use language requires one to acquire a range of tools including phonology, morphology, syntax, semantics, and an extensive vocabulary. Language can be vocalized as in speech, or manual as in sign. Human language capacity is represented in the brain. Even though human language capacity is finite, one can say and understand an infinite number of sentences.wikipedia
Language deprivation is associated with the lack of linguistic stimuli that are necessary for the language acquisition processes in an individual. Research has shown that early exposure to a first language will predict future language outcomes.
Language Deprivation occurs when a child has experienced inadequate exposure and less than FULL ACCESS to language during the critical period and therefore the child receives incomplete language acquisition.
The following excerpts are taken from Sanjay Gulati’s chapter in the book Language Deprivation and Deaf Mental Health.
The critical period hypothesis (CPH) states that the first few years of life constitute the time during which language develops readily and after which (sometime between age 5 and puberty) language acquisition is much more difficult and ultimately less successful.
The hypothesis claims that there is an ideal time window to acquire language in a linguistically rich environment, after which further language acquisition becomes much more difficult and effortful.
The critical period hypothesis states that the first few years of life is the crucial time in which an individual can acquire a first language if presented with adequate stimuli. If language input does not occur until after this time, the individual may never achieve a full command of language—especially grammatical systems.
Language Acquisition in Deaf and Hard of Hearing Children
As babies, we begin acquiring language. Our sophisticated brains develop pathways and begin to sort out the structure and rules of language, by building our vocabulary and applying the rules accordingly. This is done in our brains without any conscious effort on our part. The capacity for our brains to develop in this way is limited to ages birth – 5. After this age, language learning becomes less automatic and requires much more intentionality.
How does this apply to deaf and hard of hearing children? The typical mode of language acquisition is through speech and audition. But what happens when a child has limited, intermittent or no access to speech. How is the language being conveyed? The brain is ready to receive the signals for language development, but if the signals are absent or limited, the brain simply does not develop the pathways or develops incomplete pathways. The mailability of the brain during the first 0-5 years is absolutely incredible, but as we age, the brain’s ability to complete pathways, and create new pathways becomes exponentially more difficult.
Therefore, children born with hearing loss, (or who develop hearing loss prior to age 3) are AT RISK of experiencing language deprivation due to an incomplete access to spoken language.
Language Deprivation is largely a disability of omission, meaning it is rarely, if ever done intentionally by professionals or caregivers.
Why is that? Our intention as caregivers and professionals is to provide language access, but often, it seems, we underestimate just how much a child is missing, how limited their access really is and how many gaps go unfilled with devastating consequences.
Auditory Access and Language Acquisition
Why are deaf and hard of hearing children at risk? For a child with hearing loss, who is born into a family using only spoken language, we must acknowledge that the child has limited access to the communication and language of the parent.
So, let’s talk about auditory access. For these purposes I will divide students into two categories as represented in the degree of hearing loss.
mild-moderate– receives auditory benefit with varied access to speech sounds from amplification (hearing aids)
Severe-profound– does not receive sufficient access to speech from amplification (hearing aids) and are candidates for cochlear implants.
Also, please note that hearing losses come in all shapes and sizes. Many children have a hearing loss in just one frequency or a fluctuating or unilateral loss. The examples below are not intended to be all inclusive, but just samples to be used for educational purposes.
Mild-moderate Hearing loss (15-60db loss)
In the case of a child with a mild to moderate or hearing loss, this child is missing verbal information but with amplification is able to access verbal language.(with varying levels) This is great, right? Problem solved! Well, not exactly. The process of determining hearing loss and getting the child appropriate amplification takes (at minimum) approximately 3-6 months. Well, that’s not too bad, right? Now the child has access to verbal language.
This brings up further questions. What is the quality of the access, and how often do they have access? The hearing aid technology these days is pretty miraculous. Through their digital nature, they are able to to be programmed to give good quality sound and access to speech. But be aware, hearing aids are amplifying ALL sounds including environmental sounds. So even with the best programming, the optimal distance for understanding spoken language when using hearing aids is 3-6 feet. That means for your baby or toddler to understand clearly what you and others in the environment are saying, the speakers must be within 3-6 feet.
Another VERY IMPORTANT factor is FULL TIME ACCESS. That means, to get FULL ACCESS, your child must be wearing their amplification ALL WAKING HOURS. Yes, all waking hours, even when they are tired, cranky, teething, sick, at daycare, at grandma’s house, with friends, at the park, well, you get the point. As you can well imagine, this is no easy task.
We have all seen the cute videos of babies having their hearing aids turned on, awwwww… but have you seen the video of the toddler tearing off their hearing aids and throwing them out the window or flushing them down the toilet, or who went outside with the aids on and came in without them after playing all over the yard for an hour? It’s often a struggle to get your toddler to put on (and leave on) pants, let alone hearing aids.
Lastly, remember, this is also highly dependent on fully functioning technology and we all know that despite the sophistication of the technology, batteries die, hearing aids, tubes, and ear molds break and unfortunately get lost. There will be times that the child is without their technology, even with our best systems and intentions in place.
Without FULL adherence to those two principles (high quality sound access and Full time use), the child is AT RISK for language deprivation. The child is getting an interrupted, intermittent signal and that signal is what their brain is using to make language pathways.
Severe to Profound Hearing Loss (60-90+ db loss)
Secondly, let’s discuss the child with an identified severe to profound hearing loss. In this case, you have a child that, even with the most powerful hearing aids/amplification, still does not have consistent, quality access to conversational speech. These children are often candidates for cochlear implants. The process for determining eligibility for cochlear implants is somewhat lengthy. It often requires a child to trial hearing aids for 3-6 months. After this trial period, the team decides whether or not the child receives acoustic benefit from amplification or if cochlear implants will give the child better access to hearing. The current best practice for children with a hearing loss is for implantation to occur between 12 -24 months of age. However implantation in one or both ears is common to occur up to or after 5 years of age.
Cochlear implants do not amplify sounds but instead use implanted electrodes that represent sounds and can allow children to access environmental and speech sounds. However, with implantation, the brain must interpret this new sound machine. It requires frequent mapping of the device and training for the child, and their brain, to recognize and make sense of the new sounds.
Even in the best case scenario (the child was implanted at 12 months and attended all mapping appointments and therapies) this child has had limited or no access to sound for at least a full year. Then, spends the next years learning how to listen. So already, this child is AT RISK of losing brain pathways for developing language.
I am in NO WAY advocating that children don’t use hearing technology, but simply pointing out that there are gaps that occur that significantly impact language acquisition during the critical period. In fact, I am advocating that we give deaf and hard of hearing children MORE. More access to language in every possible way.
How can we ensure the brain develops the necessary pathways for language acquisition?
What can we do to help the child’s brain develop the necessary pathways for language acquisition?
The key to success is AWARENESS that the child IS MISSING some aspects of language and intervening where necessary to ensure FULL ACCESS is obtained as much as possible.
Does the child have access to face to face language, incidental language, language with peers or family members? If the answer is NO or sometimes, to any of these questions, then you know that intervention needs to take place. What can you do, as the caretaker, parent, professional or other person in the child’s environment, to ensure that the child has access to language?
American Sign Language is a visual language that is 100% accessible to all sighted deaf and hard of hearing children regardless of their hearing status. However, just using some sign language, some of the time is not going to give enough benefit either. Learning and using consistent Signed Language to give the brain consistent language access is key. Will every deaf and hard of hearing child grow up to exclusively use sign language? No. You are, however, giving them access to language, rather than accepting that they are missing out on language. As children grow they will have the option to choose the communication that works best for them. Without full access to language, this choice is taken from the child, with ultimately life-altering consequences.
Studies demonstrate that the brain shows no preference to visual or spoken language, but that the pathways, rules and structures of language are developed in the same manner. When children are surrounded by an accessible, robust language environment they lower their risk for language deprivation and increase their brain’s ability to create the necessary pathways to ensure natural language acquisition.
This is really not a debate between speech and sign, but a plea to create awareness that a child with a hearing loss is not naturally getting full access to language. This is a plea for parents, caregivers and professionals to recognize that there is a deficit taking place with a deaf or hard of hearing child. We must be diligent in seeking opportunities to ensure that the child has as close to FULL ACCESS as possible at all times.
What we currently know about language deprivation.
- Children born with hearing loss are AT RISK for language deprivation, due to limited access to spoken language.
- Providing visual language can help the brain develop the natural pathways for language acquisition
- Hearing Aids and Cochlear implants are great technology tools but are not a substitution for intentional language development
- Intentionality of parents, caregivers and professional to ensure the child has the best access to language at all times (especially during the critical period) will reduce the risk of language deprivation and increase the likelihood of natural language development.
Many well meaning professionals council parents not to use sign language with their infants and toddlers. They fear that this will delay the development of speech. Unfortunately, this advice is not only untrue but can actually worsen the effects of language deprivation. Thus, making the situation worse and setting cognitive limits to the language development of the child. Language is language and the brain WANTS it in any form it can get it.
Denying access to accessible language causes harm.
To learn more about Language Deprivation please check out the following resources.
Grab my FREE teaching guide for working with students who have experienced Language Deprivation HERE
Many of the quotes in this post are from Sanjay Gulati in his chapter in this book. You can grab a copy on Amazon. Here is the link Language Deprivation and Deaf Mental Health
Another mandatory article is this one. Early Cognitive and Language Development and Education of Deaf and Hard of Hearing Children
What is Language Deprivation? by the Nyle DiMarco Foundation
This book discusses how a baby’s brain develops and the process in which we learn language. I highly recommend it. Brain Rules for Babies
Thank you so much for taking the time to read about language deprivation. We must first start with awareness if we are to see change.