Deafness
Susan Gregory

For children, a major impact of deafness is on the ability to acquire, use and overhear spoken language and this has significant consequences for education. However, deaf pupils constitute a diverse group. As well as general factors relating to gender, ethnicity, socio-economic status and family structure, there are specific factors relating to personality, cognition and other abilities. They also differ with respect to their deafness, which can vary depending on the extent of the hearing loss, the type of hearing loss, whether the loss is permanent or fluctuating, whether it is bilateral or unilateral and whether it is congenital or acquired at a later age.
For the purpose of this chapter, attention is focused on those with permanent bilateral loss of a moderate degree or greater, which is an average hearing loss of greater then 40 dB in the better ear. The conventional classifications for this group are profoundly deaf, severely deaf or moderately deaf (British Association of Teachers of the Deaf 1997). It is estimated that 53 per cent of deaf pupils have a moderate loss, 21 per cent a severe loss and 25 per cent a profound loss (Fortnum et al. 2002). It would be possible to include in this chapter the group with lesser, acquired, unilateral or fluctuating losses. However, it is almost always assumed that unless there are additional difficulties (or particular severity such as that associated with acquired hearing loss due to meningitis) these pupils will cope in mainstream education with little or no support and share the same approach and follow the same curriculum as hearing pupils.
In 1998, in a survey of provision for deaf and hearing impaired pupils in England, the number of pupils notified was 12,063, of whom 30 per cent had an additional disability in that they were educated in special provision other than that intended for deaf children. Seventy-five percent of the total, or 89 per cent of those without additional disabilities, were being educated in mainstream schools (BATOD 2000).

A specialist knowledge base
The need for a particular pedagogy for this specific and distinct group has generally been seen as a function of the particular characteristics of deaf children, the main ones being the need for audiological support, and factors relating to language development, communication and pattern of cognitive abilities. These are usually described by reference to the knowledge, skills and understanding required by teachers of deaf pupils. In Europe there have been specialist teachers of the deaf since at least the eighteenth century and a discrete qualification has existed in the UK since 1885.
Major elements of the skills perceived as needed by teachers of the deaf are competence in the assessment of hearing loss plus an understanding of, and ability to explain, audiograms and the numerical representations of hearing loss. Teachers of the deaf need to understand the effect of losses of different degrees and in different frequencies. Some pupils will have an equivalent loss across the frequencies needed to hear speech, while others will have greater losses in some frequencies compared with others, greater losses in the higher frequencies being particularly common.
Various types of technological support can be given to deaf pupils, the main ones being hearing aids, both digital and analogue. Cochlear implantation is a surgical intervention that improves the ability to hear and requires special understanding about the nature and effects of the implant. Teachers also need skill in understanding and managing the acoustic environment in order to optimize the conditions for learning and teaching. In addition to understanding issues of audiology and technology, teachers of the deaf need to be able to communicate about hearing loss, technological support and environmental modifications to parents, other teachers and pupils.
The inability to hear , or to hear as well as others, results in difficulties in acquiring spoken language and a need for extra attention to be given to language acquisition. Deaf pupils differ from those with speech and language difficulties (see Chapter 8) as deafness is not a difficulty with language acquisition itself and virtually all deaf children can easily acquire sign language. Some deaf children acquire and use sign language as a first or preferred language. Deafness can mean that deaf pupils may have a comparatively small spoken language vocabulary and have difficulty with some syntactical constructions that can be taken for granted with hearing pupils. In addition, some, but not all, deaf pupils may find one to one interaction using speech problematic, and their deafness will mean that many will find interacting in group situations difficult.
Additional consequences of deafness can include a limited access to incidental knowledge, which is typically acquired through taking part in, or overhearing, general conversation as well as through incidental learning from the media. This has parallels with the situation for visually impaired pupils (see Chapter 3). There can be difficulties in developing literacy skills, due to limited access to sound and/or spoken language. This will, of course, vary for different deaf children. Moreover, deaf pupils who use sign language may not experience difficulties in the same areas as other deaf children, although there are other issues for this group.
It is thus suggested that teachers need an understanding of how to facilitate language development, whether it be spoken or involving the use of signs. Teaching deaf pupils or supporting those being taught in mainstream classrooms also requires an understanding of gaps in knowledge that can occur, and an ability to understand the need to compensate for these in the educational context. The need to create and maintain a social context for learning, where easy access to spoken language cannot be taken for granted, is also important.
In the UK, deaf pupils are subsumed under the general category of those with learning difficulties. It on this basis that they are given statements of special educational need. However, this is in itself controversial, as deafness does not lead to difficulties in learning per se, and the non verbal IQ of deaf people shows the same average intelligence and range of cognitive abilities as for hearing people (Braden 1994; Maller 2003). However, there can be a discrepancy between language and cognitive ability that needs to be recognized in the education of deaf pupils.
The debate about the cognitive abilities of deaf pupils has a long history (see, for example, Marschark 2003) but current thinking suggests that deaf pupils may function differently in some areas, but that different functioning does not necessarily mean deficit functioning. While short term memory and sequential learning may be particular areas of difficulty, a number of studies have demonstrated that deaf students who use sign language have enhanced visual spatial functioning in some domains.
There is a clear assumption in the publications on deaf education that deaf children require specialist teachers and this has been seen as self evident. This is independent of whether deaf children are seen as learning in a similar way to hearing children or perceived as needing different approaches. However, there has been little research that has examined the pedagogical basis of deaf education or the interventions of teachers of the deaf and evaluated their effectiveness, although a number of surveys of parents would endorse the value of the contribution of specialist teachers (see, for example, Powers et al. 1999).

Teaching deaf pupils
A main focus of research in deaf education has been the characteristics of deaf learners and their attainments. This often includes discussion as to why attainments are low in particular curriculum areas. There is also a significant body of work that has compared different language and communication approaches to the education of deaf pupils. In the past, publications in deaf education have focused to a large extent on debates on methodology, some taking a theoretical perspective and some comparing how deaf children perform in the various approaches. However, such research studies are almost inevitably flawed because selection for the different approaches is not random. This means that the groups of children in each approach cannot be compared.
Language and communication is the critical issue for the education of deaf pupils. There are a number of educational approaches to take account of the difficulty that deaf pupils have with acquiring and using spoken language. A consideration of distinctive pedagogies differs somewhat for approaches based on English and approaches based on British Sign Language (BSL) as well as English (sign bilingual approaches). English based approaches usually emphasize the similarity between the education of deaf pupils and others, and follow the same curriculum with the same aims. The involvement of BSL, one of the family of sign languages, with its own lexicon and syntax, creates particular issues for education. While working towards the same goals, it acknowledges the need for a different classroom practice, using a different approach to achieve the same ends. It also recognizes the Deaf community, that group of deaf people who see themselves as a linguistic and cultural minority group rather than a disabled group. Sign bilingual approaches encourage the involvement of deaf as well as hearing people, and a recognition of the culture of deaf people (Gregory 1993).
English based approaches usually assume a similar pattern of development as for hearing pupils but with the possibility of some delay. Different degrees of classroom adaptations are suggested in order to accommodate these pupils. For example, with audiological support it may be assumed that with adequate hearing aids and the use of radio aids in the classroom, the pupils will cope with little additional support. However, it may be that class teachers need to adapt their practice: for example, always facing the class when talking, providing visual support for learning and perhaps providing handouts for lessons (Watson et al. 1999). For some pupils withdrawal from some lessons may be necessary and/or the provision of communication support in the classroom may be necessary. While this may meet curriculum needs, it has consequences for social needs and peer group learning (Edwards and Messer 1987).
Sign bilingualism is based on the idea that, as deaf children have difficulty in accessing spoken language, they should be given the opportunity to acquire sign language to give them a rich language for access to the curriculum and as the basis for the development of English (or their appropriate language). The relative use of the two languages (such as English and BSQ differs in different programmes but an essential feature is that each language is recognized as distinct and used differently. There are several reasons for this: two languages are involved, because English is often taught as a second language, and because BSL, like other sign languages, does not have a written form, this approach emphasizes the different needs of deaf children in particular ways with implications for pedagogy. While the goals of education for English and sign based approaches are for the most part similar, they differ in social aspects. Sign bilingual approaches emphasize pupil self esteem, the valuing of deafness and sign language, and a recognition of the unique and distinctive deaf culture (Pickersgill and Gregory 1998). English based approaches see participation and integration, into the hearing world as paramount.
The dominant educational approach to the education of deaf children is based on speaking and listening. This is achieved by exploiting the child's hearing through the use of effective and appropriate hearing aids (or a cochlear implant), through developing listening skills and providing a facilitative environment for the development of spoken language. This is known as the aural oral approach, although it takes a number of different forms (Watson 1998). The proportion of children being educated using this approach is 68 per cent (Fortnum et al. 2002).
A further English-based approach uses signs from BSL-together with spoken English. Critically, this is thus an English rather than BSL based approach. It is generally known as Sign Supported English (SSE) and retains English word order while providing extra information about the communication in addition to speech. It is difficult to state how many pupils are educated using SSE as they are subsumed within the category of 'total communication', which is used with 27 per cent of pupils, of whom some will be using SSE.
A small proportion of children (3 per cent) are educated through a specifically sign bilingual approach, although the group probably involves a larger proportion of pupils than this as some children in total communication programmes will be using BSL within their education.

Literacy
Literacy is a topic that receives the most attention of all curriculum areas in deaf education. Much of the published research confirms that deaf children are behind in their reading and writing compared with hearing pupils. The landmark study was probably that of Conrad (1979), who tested all deaf school leavers (aged 16 years) and found a median reading age of nine years. Later studies have been smaller in scale but have basically confirmed a significant delay, although with some suggestion that it is less now than in 1979 (Powers et al. 1998).
The literature contains extensive discussion as to why deaf children should perform badly in reading, together with suggestions for improving reading skills. The reasons suggested for poor performance can be seen in top down as well as bottom up skills. Both limited language competence and poorer understanding of the nature of story are seen as making it difficult to predict the next word or phrase. However, word building skills can also be limited by poor phonological awareness.
A study that looked at teaching reading. was that of Wood and his colleagues (1986). One of the team, Pat Howarth, recorded deaf children reading to their teacher at school. She then identified hearing pupils in other schools who were reading the same reading book and recorded them too. The study showed that, on average, deaf children were interrupted more frequently than hearing children, and that many more breaks with hearing children included an element of praise than did those for deaf children. Interruptions for hearing children were most often to clarify phoneme-grapheme correspondence, and it was assumed that the child knew the words and syntactic structures, whereas for deaf children the stops were to teach the meanings of words. Thus reading for deaf children also involved language teaching, while the necessary language ability could be assumed for hearing children. The reading rate for deaf children was 20 words per minute compared with 64 words per minute for hearing children. Based on this study, the team concluded, that the experience of learning to read is very different for deaf and for hearing children, and that the teacher performs a different function.
Gregory (1998), in a study of the writing of sign bilingual pupils, suggests that the errors they make often relate to the character of BSL grammar and that teachers, rather than seeing these as a problem, could use them for a contrastive analysis in developing written English skills (see Chapter 3 concerning Braille readers). Swanwick (1999), in her comparison of deaf children writing from a BSL story and a language neutral source (a sequence of pictures), endorsed this conclusion, but also suggested that a strong first language such as BSL could facilitate writing skills in the second language, English. Reading is a particularly useful area to examine in the context of this chapter, as it is an area where deaf children have considerable difficulty but it is also an area where there are a range of teacher aspirations. These range from getting deaf children to function as much like hearing pupils as possible to accepting that deaf children are different and require different approaches. Proponents of oral methods suggest that this provides the best approach to literacy because of its similarity to the learning process for hearing pupils. Watson (1998: 99-100) suggests that 'natural auralists believe that it [oralism] represents the best opportunity for deaf pupils to learn literacy in a way similar to hearing children'. However, from a sign bilingual perspective, Knight and Swanwick (2002: 78) suggest a model that accepts difference and looks at 'the process of literacy development from a bilingual perspective and explores the notion that sign bilingual children approach the learning of literacy with established sign language skills through which English language skills can be mediated'.

Mathematics
Deaf pupils are behind their hearing counterparts in mathematics, although the delay is not as great as for literacy skills. Studies vary in the extent to which they see deaf children as functioning differently mathematically. Wood et al. (1986), looking at mathematics performance for a large number of deaf school leavers in oral settings, found that although they were delayed by an average of three years, their pattern of mistakes was similar to that of hearing pupils. They found the same problems difficult and they made similar errors. Thus pupils did not seem to be using different strategies. However, other studies have found systematic errors in the performance of deaf pupils that can be related, in particular, to the language used in presenting the problems. For example, Pau (1995) found a relationship between reading competence in deaf pupils and their ability to solve mathematical problems. He suggested that problems were easier if the data and the unknown factors were presented in problems in the order in which they were used, and thus the presentation was critical.
Sign bilingual approaches present particular issues for mathematics. As with many curriculum areas, the necessary sign vocabulary does not exist. This is not because BSL is unable to address such mathematical concepts: like any living language it has the potential to evolve and develop. However, the suppression of sign languages until the 1980s has meant that they were only used in a limited context, within the Deaf community, and use in educational settings was rare.
A more basic issue is related to mathematical thinking in sign itself, which may be different. Nunes and Moreno (1998), in a study of mathematical development of deaf pupils, showed that in the early stages of computation, signing and counting may be confusing for deaf children because of the simi larities in use of the fingers. However, sign language may also confer advantages because, as a visual spatial language, it conveys much more information about mathematical concepts such as size and shape in the ways in which problems are presented.

Language and interaction
A small number of studies have looked at classroom interaction in Englishbased approaches. An influential study was that by Wood et al. (1986), which looked at teachers' contribution in classroom interactions in oral settings. They found that the higher the level of teacher control in interaction - for example, asking closed questions that demand a particular response - the less the child's contribution to the dialogue. They found that teachers could change their style and become less controlling, gaining greater responses from pupils. Based on their findings, they suggested that deaf children's difficulties might be exacerbated by teachers who were over controlling. The group repeated this study with pupils using SSE with similar findings.
Other studies have looked at the interaction of deaf pupils specifically in mainstream classes. Gregory and Bishop (1989) looked at the strategies the deaf pupils and teachers employed to maintain the interaction. Pupils would repeat the last phrase they heard or use standard answers, while teachers would pretend to understand when they had not, or, in response to a patently wrong answer, pretend the child was 'teasing' them. These strategies probably function well with hearing children in maintaining interaction but can be counterproductive for deaf pupils. Hopwood and Gallaway (1999) used a similar approach (but with only one child) and suggested that when there is a major discrepancy between the deaf child's linguistic ability and that of the rest of the class, the pupil is severely limited in what they can gather from the lesson. The pupil in this case received essential support by being withdrawn from some lessons for extra tuition by a teacher of the deaf.
There are fewer studies of the interaction of sign bilingual children in the classroom. However, Knight and Swanwick (2002), looking at interaction in classrooms, have analysed the nature of the demands made of pupils in sign bilingual programmes. Observations of classroom interactions demonstrated that adults working with sign bilingual pupils switch between English and BSL with little formal marking, often to maintain communication and interest. They comment: 'Learning English in a bilingual context requires the pupils to move automatically across languages and modes unless the languages are kept strictly separate, and we have so far seen that this is not practical' (ibid.: 74). Thus, in addition to a knowledge of sign language itself, teachers have to be skilled in the differential use of two languages in the classroom.

How different is the teaching of deaf children? The unique differences versus group (general) difference position
In terms of the distinctiveness of the group of deaf pupils, opinions differ, from those who minimize any difference and point to overriding similarities of deaf and hearing children, to those who see deaf children as significantly different and requiring different educational procedures. At one level this is inevitable because of the heterogeneity of the group. Children with lesser losses can be significantly assisted by hearing aids such that they can cope in mainstream classrooms, although they may be disadvantaged by poor acoustics, noisy environments or working in large and lively groups. English-based approaches exemplify a unique differences position in that they point to a whole range of different provision to meet educational need. These include adaptations that can be seen as benefiting all pupils, such as good acoustics and attention to visual as well as spoken representations of ideas, or special provision such as communication support in the classroom and withdrawal.
Although numerically the numbers of deaf children being educated through a sign bilingual approach are small, they are an important group because they constitute a clear example of a group difference position. Deaf pupils learning through sign require a different pedagogy in order to achieve some of the same goals. They require the use of sign in the classroom, some modified and specially developed materials and a recognition of different ways of teaching subjects using a visual spatial language, sign language, compared with a linear oral language, spoken language. In order to achieve a classroom where they are can participate fully they require the presence of other deaf children and deaf adults, in recognition that the classroom is a social context for learning, not simply a teacher-pupil learning situation.
Of course the position is not this clear cut. Where significant changes are made for pupils using English, such as the introduction of a communication support assistant in the classroom, issues similar to those for sign bilingual pupils arise. While the pupils are not using a different language, their access to English in the classroom situation may be limited, which raises questions about the extent of their participation with other pupils as well as the teacher, and their own learning style, which may be more visually based. The distinction introduced between the two groups may not be as robust as may appear, and deaf children have both group and unique needs. Thus there is a tension between the two positions in considering the pedagogical needs of deaf pupils.

Potential for research and development in this field
The account of research given in this chapter makes it clear that the majority of the research in deaf education looks at pupil differences in language, in learning ability and in access to classroom discourse etc. Relatively little attention is paid to differences in classroom practice or what happens when additional support is given. The studies reported here that do focus on classroom activity would seem to demonstrate that to be an effective teacher of deaf pupils, special knowledge and skills are necessary. This would suggest a need for further research that looks at classroom strategies and, in particular, what constitutes good classroom practice.
Deaf education is undergoing rapid changes. The development of cochlear implantation means that in developed countries significant numbers of profoundly deaf children will receive implants and thus are likely to function more as severely deaf pupils, resulting in a greater move towards more auraloral approaches. Newborn screening for deafness, resulting in intervention starting at an earlier age, will also have an impact. However, by contrast, the recognition of sign languages as full languages and the beginning of bilingual education has focused attention on the use of sign language in deaf education. This has been more marked in countries with a flexible attitude to language learning in general and thus the Scandinavian countries tend to be leaders in this area, while English-speaking countries lag behind.
The role of teacher of the deaf is also changing, as more deaf pupils are educated in mainstream schools. For pupils educated through an aural oral approach, there is a shift from teaching groups of children to supporting pupils in mainstream, and often this is done by working with mainstream teachers and schools rather than individual pupils. It could therefore be argued that for this group the specialist skills required are not necessarily in terms of classroom practice but relate to the management of the learning environment for deaf pupils.
For sign bilingual pupils the situation may be different. Where education is predominantly in sign language, effective teaching will need to be in groups, whether they be in specialist or mainstream schools. However, the aspiration of the approach is that older pupils will be educated in their appropriate mainstream schools through the use of interpreters, and it may be that here too the skill of the specialist teacher will be in supporting the learning environment, including interpreters and skills in learning through interpreters, rather than direct teaching.
There emerges an argument for both a unique difference and a general difference position with respect to deaf pupils, but developments in the management of deafness together with changes in educational policy mean this situation is fluid rather than fixed.

Summary

Nature of the group
o Heterogeneity of the group, including by social, emotional, cognitive and familial differences, as well as degree of hearing loss.
o Criterion for definition: permanent bilateral hearing loss of moderate, severe or profound degree (excludes here children with lesser, acquired, unilateral or fluctuating hearing loss).

Pedagogy
o Weak research base through absence of randomized allocation of pupils to methods.
o Distinction between approaches based on English, sign-supported English, sign bilingual approaches.
o English-based approaches reflect delayed, rather than different, perspective.

Curriculum
o Distinction between approaches based on English, Sign Supported English and sign bilingual approaches.
o Deaf culture and self-esteem are highly significant for sign bilingual approaches.
o In contrast, aural-oral approaches (based on English) stress the development of speaking and listening skills.
o Conflicting evidence about mathematics and deaf pupils as same/different, regarding error strategies, compared with hearing peers.
o Classroom culture/organization as enabling or otherwise (e.g. noise control).

Knowledge
o Assessment of hearing loss.
o Differential impact of varying degrees and frequencies of hearing loss.
o Technological support (including cochlear implants).
o Impact of deafness on communication/language and access to information.
o Relationship between cognition and deafness.
o Consequences of deafness for literacy.

Unique versus general differences position as pedagogic base
o Deaf pupils may function differently in some areas but different functioning does not mean deficit functioning.
o Sharp differences of view concerning deaf culture (with repercussions for knowledge, curriculum and pedagogy). Advocacy of BSL reflects a strong 'general differences' position.
o Modifications to classroom environment may benefit all pupils, e.g. noise reduction (i.e. direction of change from special as benefiting all), reflecting a unique differences' position.
o Concludes that both individual and general differences positions are needed (compare Chapter 6 on macro/micro levels of strategies).

Notable aspects introduced
o Disability culture as impacting on pedagogy.
o Polarization/diversity of teacher beliefs about deafness/difference and hence appropriate curricula /pedagogies.

in A. Lewis e B. Norwich (2005), Special teaching for special children?, Berkshire (England), Open University Press, pp. 15-25.