Sound Out: The connections between speech intelligibility and auditory input

Upon seeing Ella’s humorous vlog about her experience learning how to say “Merry Christmas,” I thought about how deaf adults might similar experiences with negative feelings in response to interacting verbally with hearing people. Historically the average deaf child received speech therapy since their auditory input was negligible. Today with the advancements of technology deaf children have been able to receive quality auditory stimulation through digital hearing aids and cochlear implants. As a result those children have the ability to perceive their own speech better than those who have no hearing.

Variety of Experiences with Speech Therapy

Many pre-lingually deaf adults will remember their experiences with speech-language therapists, feeling frustrated with the many hours they’ve had to endure sitting in a room having to “fix” their voice. I had the fortune of my mother requiring my first two speech therapists to be fluent in Cued Speech, which made the process easier and allowed for me to make personal connections that may not be typical of the average professional-client interaction. Others probably weren’t so lucky with their therapists having the inability to communicate visually.

I did have a lot of frustration with my last three speech therapists, which were provided by the school system. With those three professionals I don’t ever recall any constructive feedback and I would typically read from newspaper articles during each session. They were nice and meant well, but I felt as they didn’t really feel the need to push me to do better. As a result I told my mother I wouldn’t go to therapy anymore. After all I had to get to school forty-five minutes early for each session, indeed frustrating when I just wanted those extra few minutes of precious sleep.

Deaf and hard of hearing adults weren’t the only ones who had to go to speech therapy. While in Third grade I would go to speech therapy with other hearing peers who typically had trouble with speech pronunciations or reading, indicative of language issues. One boy in particular had a combination of both, so I had the perspective of observing the therapist not only with deaf or hard of hearing peers, but also hearing peers. The therapist typically used the same approach with both groups, but did go to further length when it came to certain issues I had with projection and pronouncing certain phonemes.

Self-Perception of Speech

What’s interesting is the issue of whether deaf adults have “good speech” or not. I’ve noticed that some oral adults have made statements such as “people tell me I have good speech” or “people ask me where I’m from instead of thinking I’m deaf.” To be honest, some of those people surprised me with those comments since in my mind their speech didn’t quite seem to be on par with hearing adults. There are deaf adults who do have clear speech with a slight accent, which doesn’t affect their oral communication in a significant way. Either way it boils down to how well those deaf adults communicate orally with hearing peers, setting the stage for the self-perception of their own speech.

On the other end of the spectrum, there are deaf adults who are not able to voice or lip-read with success so they rely on other forms of communication such as written form and sign languages. Some may take their inability to speak well in stride with their acceptance of their identity as a deaf individual. Others might feel frustration and wish they had better speech. They may find themselves in a position where they won’t be able to find jobs that require verbal communication. Either way, they are aware of their inability to voice out their thoughts and ideas clearly.

Perhaps the standards have historically been set lower for deaf individuals when it comes to speech, hence situations where some deaf adults were told their speech is good when they actually had difficulty being understood by others. Along with many others I have experienced this type of situation, feeling the frustration of having to make extra effort to repeat myself and be clearer in what I’m trying to say. In the end speech therapists shouldn’t go so far to make deaf clients feel that their speech sounds good when they eventually will find out that other people won’t necessarily understand them.

Speech’s Role in Mainstreaming Deaf and Hard of Hearing Children

Organizations such as AG Bell and the Central Institute of the Deaf have mission statements that include listening, talking, and thriving in mainstream society. From these statements one can assume that speech intelligibility has a direct role in a deaf child’s socialization within mainstream society. Through personal experience I know that without my good speech I probably wouldn’t have as easy a time socializing with hearing peers throughout high school and college. It also would have been more difficult for me to get good jobs that involve a lot of verbal communication.

Hearing parents often go to great lengths to ensure their deaf and hard of hearing children receive quality speech therapy, for they want their children to be able to communicate verbally with their family and friends. After all visual communication is not ideal in a society of hearing peers. I’ve met deaf parents who’ve told me that they employed speech therapists, explaining the importance of giving their deaf children the opportunity to interact with both deaf and hearing peers.

Today we see stories of children with CIs talking with their hearing peers just as if they didn’t have a hearing loss, exchanging thoughts and ideas quickly. The success of those children keeps motivating professionals further to pursue auditory input as a way of facilitating speech development, advocating the use of digital hearing aids and cochlear implants. Audiologists typically will be the first to recommend that parents fit their children with those devices so that their children will have the opportunity to be part of mainstream society.

Approaches to Speech Development

Professionals have dedicated much effort to creating the best strategies and methods for facilitating speech developing in deaf and hard of hearing children over the years. In light of this, one factor still has a direct impact on speech development. It’s apparent that auditory input has a large role in a deaf child’s perception of his or her own speech. The Auditory-Verbal Therapy approach’s growing popularity can be attributed to the concept of facilitating speech development through constant stimulation of the auditory senses, enhancing self-perception and speech.

Because children with CIs typically have specialized habilitation services in regards to auditory training, it would be prudent to deduce that those children will have improved speech compared to profoundly deaf children who have no auditory input. Medical records I found in storage indicated that six months after my CI surgery my speech intelligibility improved 50%, indicating the CI had a profound impact on my speech. However in my case Cued Speech may have had a large influence on my ability to perceive and produce speech.

This is not to say that children without significant auditory input can have good speech too, it just will take more effort to develop that same level of speech as those who utilize their auditory senses. Being one of the few children who received cochlear implants at a later age, I underwent extensive speech therapy, often being taken out of class for less than an hour at least a few days every week. I also would have therapy outside school, visiting my therapist’s house. I can’t even begin to count the number of hours that I spent in speech therapy as a child.

Since I’m not a speech-language pathologist I don’t have firsthand experience of the various approaches to speech therapy. Yet I’m aware that there are differences in how each therapist approaches a deaf child. If a child has strong language skills, but poor pronunciation the therapist will focus on producing speech sounds. If a child has poor language skills, the therapist will have to go to greater lengths, focusing on language enrichment while facilitating speech development. In the face of all the work the therapist does, the parents have a crucial role in the deaf child’s language and speech development as the home is where the child receives the vast majority of language exposure, regardless of the type of auditory input.

Singling out the "deficit thinkers" - who decides?

John Egbert recently posted a call to action about deficit thinkers from DeafRead.

Most people attributed his remarks as being a form of censorship. In the back of my mind I knew that John wasn't necessarily implying that we go this far. His response to the latest comments confirmed my suspicions.

John has a point, however poorly framed it might have been, to make in regards to deficit thinking, which Mike McConnell explains very well in his own blog. There are people who will post irrational blogs about certain topics, making wild accusations and sharing their own conspiracy theories. However the reality is some of those people include pro-ASL advocates as well as pro-spoken language proponents.

Perhaps John would be able to provide the best examples of deficit thinking from the anti-ASL perspective, yet there are others from the pro-ASL side that fall into the deficit thinkers category. There are a few individuals on DeafRead that do seem to convey a lot of imputations on many different subjects from the "genocide" of Deaf Culture at the hand of cochlear implants to the brainwashing of America by AG Bell.

A while back I wrote a blog about derogatory comments on the YouTube video page of "Breaking the Code." Perhaps those people who left these comments would fall under the category of deficit thinkers, yet they never were reprimanded or censored. Their words still remain to highlight the ignorance that still persists about Cued Speech. Freedom of speech at its best. We just choose to ignore them.

Whether someone is a deficit thinker depends on the person who ends up with the responsibility of making that determination. Not everyone may have the same idea of deficit thinking, creating a issue for those who want to hold a discussion on how to "remove those deficit thinkers." This is the problem with censorship. Everyone may not see everything the same way, and each person may have their own interpretations.

DeafRead has established itself as a medium to exchange ideas and facilitate dialogue, leaving much room for the exercise of one's freedom of speech. While we have the freedom of speech, we don't have the freedom to falsely accuse people and make unsubstantiated claims. This everyone should agree on.

Both the public and the editors of DeafRead have the responsibility to single out those who dishonestly misrepresent themselves and publish libel and slander. Anything else may be considered freedom of speech, unless otherwise determined specifically by the editors of DeafRead. After all those human editors do make their own judgments as to what gets onto DeafRead.

I see no need to remove "deficit thinkers" from the website if the DeafRead editors allow them there in the first place.

Socialization Amidst Hearing People

"Socialization:” the process by which a human being beginning at infancy acquires the habits, beliefs, and accumulated knowledge of society through education and training for adult status (Merriam-Webster’s Medical Dictionary)

In the past few years I’ve found myself interacting with many individuals from many walks of life in the deaf community. The variety of experiences that I’ve had led me to make many observations about the differences between hearing and deaf people in terms of socialization. Hard-of-hearing people aren’t necessarily included in my analysis because any residual hearing might give them an advantage that profoundly deaf individuals may not have. These observations prompted me to ask how deaf kids with cochlear implants might interact with their hearing peers in an “oral” environment today.

Who would these CI users identify themselves more with culturally-wise, deaf or hearing people?

Defining Socialization

What exactly is socialization anyway? According to Wikipedia, sociologists might divide socialization into six categories, with the five main forms being developmental, primary, secondary, anticipatory, and resocialization. Developmental socialization consists of learning behavior and social skills. Primary socialization involves the various aspects of culture such as attitudes, beliefs, and values. Secondary socialization is typical of smaller groups within society, such as cliques or professions. Resocialization is the process of throwing away old patterns and taking on new ones during a transition to a new part of one's life.

Wikipedia also describes the agents of socialization to be the family, the school, peer groups, and the mass media. Religion, the government, and the workplace can also serve as agents. In the end socialization essentially is the process of an individual forming his or her own social identity as compared to others.

Socialization of the Deaf

Historically there has been a communication gap between the hearing and the deaf, either because the deaf would use a form of visual communication or their speech intelligibility hindered any real sense of interaction on a personal level. Today with the advent of cochlear implants, more kids are finding themselves with improved speech and auditory perception. As a result there is an increase in children who don’t use visual communication as much as they communicate verbally.

Mainstreaming has been on the rise since the inception of the Individuals with Disabilities Education Act, with more parents opting to have their deaf children grow up out of isolation from their hearing peers. Typically hearing parents will push for speech therapy and auditory training for their deaf children so they can fit in better in the society that they were born into. At the same time, there are still children who attend residential schools of the deaf who don’t get to have the same experience as their hearing peers. The difference in experiences would seem to lead to different types of primary socialization.

I have no experience with residential schools as my parents chose to mainstream me in the public school system in Wilmington, NC. Yet, I have heard stories from other deaf and hearing adults who either work there or have some personal experience. Perhaps the most extreme case that I came across was when my dad’s girlfriend told me of the time she went along with a close friend of hers who interviewed for a job at the Eastern NC School of the Deaf. She explained that while she sat in the waiting area of the administrative office she heard some teachers screaming at the students, describing it as “very disturbing”. Another incident took place at a school of the deaf in New York City, where a Teachers College graduate student was making observations. This deaf student (studying Teaching ASL as a Foreign Language) stated that some teachers would make fun of the children in various ways. I find it difficult to recall a very positive story out of all those experiences.

From listening to those stories, the idea came to me that those who grew up in schools of the deaf might experience a different type of developmental socialization. Instead of the typical experience of growing up with hearing peers and developing “street smarts” or knowledge of culture and social skills, those children could have a limited and convoluted perspective of the ways and mannerisms of society. The idea alone that deaf children might have more difficulty communicating with hearing people verbally could hinder their ability to socialize with their hearing peers outside the residential school setting. This may not necessarily be the case for each deaf child as there are other agents of socialization besides the school.

A Sense of Identity

Advocates for the cochlear implants may outline the idea that deaf children will have the ability to communicate with their hearing peers on a personal level that wouldn’t be possible with visual communication (assuming that those peers aren’t fluent in ASL or Cued Speech). From experience, I have to say that this is not entirely invalid. I’ve observed deaf children with CIs talk to siblings and friends on a level that twenty years ago would have been deemed extraordinary. Some of these children used Cued Speech while others grew up under the AVT/oral approach. This is not to say that there are still children out there who won’t benefit from the cochlear implant and will undergo a different process of socialization. The point to make is that as more deaf children are being mainstreamed they will go through the same experience as their hearing peers, living the psychological roller-coaster that is their childhood.

However the question remains in how these CI users will identify themselves. There is the issue of making the connection that they have a hearing loss. There is one particular case that comes to mind. A mother of a deaf CI user told me of a time when she asked her son about what it was like being deaf. A supporter of the Auditory-Verbal approach, she expressed delight when she stated that her son simply stated he was not deaf. There are other cases where I've seen children take their CIs off in response to incessant nagging by parents or siblings.

My Experience

I have a mixed experience. In high school I rejected the notion that my deafness defined me. I fired my transliterators and refrained from enforcing my Individualized Education Plan (IEP). In college, despite being reminded on the first day of classes each semester, I refused to register for disability services. Yet, at the same time I would use my deafness against my mother whenever we got into arguments.

Communication-wise I am more at ease with hearing people as I grew up mainstreamed and the vast majority of my friends were hearing. I've worked in positions that involve a lot of verbal communication, including cooks and servers in the food industry. Yet, don't make the assumption that I don't communicate with deaf people. In the past few years I've found myself more involved in the deaf community than ever before. Consequentially I'm making efforts to learn ASL and contribute to the education of deaf and hard of hearing children. I've managed to find a balance between the two cultures, embracing ideas and values in each culture, creating a good example of resocialization.

Maybe the next generation of deaf CI users might do the same thing and become more involved in the deaf community as they grow older. Only time will tell.