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What You Don’t Know Can Hurt You: The Risk of Language Deprivation by Impairing Sign Language Development in Deaf Children

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Abstract

A long-standing belief is that sign language interferes with spoken language development in deaf children, despite a chronic lack of evidence supporting this belief. This deserves discussion as poor life outcomes continue to be seen in the deaf population. This commentary synthesizes research outcomes with signing and non-signing children and highlights fully accessible language as a protective factor for healthy development. Brain changes associated with language deprivation may be misrepresented as sign language interfering with spoken language outcomes of cochlear implants. This may lead to professionals and organizations advocating for preventing sign language exposure before implantation and spreading misinformation. The existence of one—time-sensitive—language acquisition window means a strong possibility of permanent brain changes when spoken language is not fully accessible to the deaf child and sign language exposure is delayed, as is often standard practice. There is no empirical evidence for the harm of sign language exposure but there is some evidence for its benefits, and there is growing evidence that lack of language access has negative implications. This includes cognitive delays, mental health difficulties, lower quality of life, higher trauma, and limited health literacy. Claims of cochlear implant- and spoken language-only approaches being more effective than sign language-inclusive approaches are not empirically supported. Cochlear implants are an unreliable standalone first-language intervention for deaf children. Priorities of deaf child development should focus on healthy growth of all developmental domains through a fully-accessible first language foundation such as sign language, rather than auditory deprivation and speech skills.

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References

  • Adesope, O. O., Lavin, T., Thompson, T., & Ungerleider, C. (2010). A systematic review and meta-analysis of the cognitive correlates of bilingualism. Review of Educational Research, 80(2), 207–245.

    Article  Google Scholar 

  • Amraei, K., Amirsalari, S., & Ajallouiyan, M. (2017). Comparison of intelligence quotients of first- and second-generation deaf children with cochlear implants. International Journal of Pediatric Otorhinolaryngology, 92, 167–170. doi:10.1016/j.ijporl.2016.10.005.

    Article  CAS  PubMed  Google Scholar 

  • Anderson, M. L., & Leigh, I. W. (2011). Intimate partner violence against deaf female college students. Violence Against Women, 17(7), 822–834.

    Article  PubMed  Google Scholar 

  • Anderson, M. L., Wolf Craig, K. S., Hall, W. C., & Ziedonis, D. M. (2016). A pilot study of deaf trauma survivors’ experiences: Early traumas unique to being deaf in a hearing world. Journal of Child & Adolescent Trauma. doi:10.1007/s40653-016-0111-2.

    Google Scholar 

  • Bailes, C., Erting, C., Erting, L., & Thumann-Prezioso, C. (2009). Language and literacy acquisition through parental mediation in American Sign Language. Sign Language Studies, 9(4), 417–456.

    Article  Google Scholar 

  • Barnett, S., McKee, M., Smith, S. R., & Pearson, T. A. (2011). Deaf sign language users, health inequities, and public health: Opportunity for social justice. Preventing Chronic Disease, 8(2), A45.

    PubMed  PubMed Central  Google Scholar 

  • Black, P. A., & Glickman, N. S. (2006). Demographics, psychiatric diagnoses, and other characteristics of North American Deaf and hard-of-hearing inpatients. Journal of Deaf Studies and Deaf Education, 11(3), 303–321. doi:10.1093/deafed/enj042.

    Article  PubMed  Google Scholar 

  • Calderon, R. (2000). Parental involvement in deaf children’s education programs as a predictor of child’s language, early reading, and social-emotional development. Journal of Deaf Studies and Deaf Education, 5(2), 140–155. doi:10.1093/deafed/5.2.140.

    Article  CAS  PubMed  Google Scholar 

  • Davidson, L. S., Geers, A. E., Blamey, P. J., Tobey, E. A., & Brenner, C. A. (2011). Factors contributing to speech perception scores in long-term pediatric cochlear implant users. Ear Hear, 32(1 Suppl), 19 S-26 S. doi:10.1097/AUD.0b013e3181ffdb8b.

    PubMed  PubMed Central  Google Scholar 

  • Davidson, K., Lillo-Martin, D., & Chen-Pichler, D. (2013). Spoken English language development in native signing children with cochlear implants. Journal of Deaf Studies and Deaf Education. doi:10.1093/deafed/ent045.

    PubMed  PubMed Central  Google Scholar 

  • Duchesne, L., Sutton, A., & Bergeron, F. (2009). Language achievement in children who received cochlear implants between 1 and 2 years of age: Group trends and individual patterns. Journal of Deaf Studies and Deaf Education, 14(4), 465–485. doi:10.1093/deafed/enp010.

    Article  PubMed  Google Scholar 

  • Fellinger, J., Holzinger, D., Dobner, U., Gerich, J., Lehner, R., Lenz, G., & Goldberg, D. (2005). Mental distress and quality of life in a deaf population. Social Psychiatry and Psychiatric Epidemiology, 40(9), 737–742. doi:10.1007/s00127-005-0936-8.

    Article  PubMed  Google Scholar 

  • Fellinger, J., Holzinger, D., & Pollard, R. (2012). Mental health of deaf people. Lancet, 379(9820), 1037–1044. doi:10.1016/S0140-6736(11)61143-4.

    Article  PubMed  Google Scholar 

  • Fitzpatrick, E. M., Hamel, C., Stevens, A., Pratt, M., Moher, D., Doucet, S. P., … Na, E. (2016). Sign language and spoken language for children with hearing loss: A systematic review. Pediatrics, 137(1), 1–19. doi:10.1542/peds.2015-1974.

  • Glickman, N. S. (2007). Do you hear voices? Problems in assessment of mental status in deaf persons with severe language deprivation. Journal of Deaf Studies and Deaf Education, 12(2), 127–147. doi:10.1093/deafed/enm001.

    Article  PubMed  Google Scholar 

  • Glickman, N. S. (2009). Summary and conclusions. In N. S. Glickman (Ed.), Cognitive-behavioral therapy for deaf and hearing persons with language and learning challenges. New York, NY: Routledge.

    Google Scholar 

  • Gulati, S. (2003). Psychiatric care of culturally deaf people. In N. S. Glickman & S. Gulati (Eds.), Mental health care of deaf people: A culturally affirmative approach (pp. 33–107). Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Gulati, S. (Presenter). (2014). Language deprivation syndrome. ASL Lecture Series at Brown University. Retrieved from https://www.youtube.com/watch?v=8yy_K6VtHJw.

  • Hall, M. L., Caselli, N., & Hall, W. C. (2017). Sign language for deaf children with or without cochlear implants: Nothing to lose and much to gain. Manuscript under review.

  • Hall, W. C., Levin, L., & Anderson, M. L. (in press). Language deprivation syndrome: A possible neurodevelopmental disorder with sociocultural origins. Social Psychiatry and Psychiatric Epidemiology. doi:10.1007/s00127-017-1351-7.

  • Hassanzadeh, S. (2012). Outcomes of cochlear implantation in deaf children of deaf parents: comparative study. The Journal of Laryngology & Otology, 126(10), 989–994. doi:10.1017/S0022215112001909.

    Article  CAS  Google Scholar 

  • Henner, J., Caldwell-Harris, C. L., Novogrodsky, R., & Hoffmeister, R. (2016). American Sign Language syntax and analogical reasoning skills are influenced by early acquisition and age of entry to signing schools for the deaf. Frontiers in Psychology, 7, 1982. doi:10.3389/fpsyg.2016.01982.

    Article  PubMed  PubMed Central  Google Scholar 

  • Huber, M., & Kipman, U. (2011). The mental health of deaf adolescents with cochlear implants compared to their hearing peers. International Journal of Audiology, 50(3), 146–154.

    Article  PubMed  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Pollard, R., & Smith, S. R. (2014). What medical education can do to ensure robust language development in deaf children. Medical Science Educator, 24(4), 409–419.

    Article  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. (2012). Cochlear implants and the right to language: Ethical considerations, the ideal situation, and practical measures toward reaching the ideal. In C. Umat (Ed.), Cochlear Implant Research Updates (pp. 193–212). Available from: http://www.intechopen.com/books/cochlear-implant-research-updates/the-right-to-language-ethical-considerations-ideal-situation-and-practical-measures-toward-reachi.

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. R. (2012b). Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal, 9, 16. doi:10.1186/1477-7517-9-16.

    Article  PubMed  PubMed Central  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. (2014). Bilingualism: A pearl to overcome certain perils of cochlear implants. Journal of Medical Speech-Language Pathology, 21(2), 107–125.

    PubMed  PubMed Central  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. (2016). Language choices for deaf infants: Advice for parents regarding sign languages. Clinical Pediatrics, 55(6), 513–517. doi:10.1177/0009922815616891.

    Article  PubMed  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. R. (2016b). Avoiding linguistic neglect of deaf children. Social Service Review, 90(4), 589–619. doi:10.1086/689543.

    Article  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. R. (in press). Discourses of prejudice in the professions: The case of sign languages. Journal of Medical Ethics.

  • Hyde, M., Punch, R., & Komesaroff, L. (2010). Coming to a decision about cochlear implantation: Parents making choices for their deaf children. Journal of Deaf Studies and Deaf Education, 15(2), 162–178. doi:10.1093/deafed/enq004.

    Article  PubMed  Google Scholar 

  • Kral, A., Kronenberger, W. G., Pisoni, D. B., & O’Donoghue, G. M. (2016). Neurocognitive factors in sensory restoration of early deafness: A connectome model. Lancet Neurology, 15(6), 610–621. doi:10.1016/S1474-4422(16)00034-X.

    Article  PubMed  Google Scholar 

  • Lederberg, A. R., Schick, B., & Spencer, P. E. (2013). Language and literacy development of deaf and hard-of-hearing children: Successes and challenges. Developmental Psychology, 49(1), 15–30. doi:10.1037/a0029558.

    Article  PubMed  Google Scholar 

  • Leybaert, J., & D’Hondt, M. (2003). Neurolinguistic development in deaf children: The effect of early language experience. International Journal of Audiology, 42 (Suppl 1), S34–40.

    Article  PubMed  Google Scholar 

  • Luk, G., De Sa, E., & Bialystok, E. (2011). Is there a relation between onset age of bilingualism and ennhancement of cognitive control? Bilingualism: Language and Cognition, 14(4), 588–595.

    Article  Google Scholar 

  • Lund, E. (2015). Vocabulary knowledge of children with cochlear implants: A meta-analysis. Journal of Deaf Studies and Deaf Education, 21(2), 107–121. doi:10.1093/deafed/env060.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lyness, C., Woll, B., Campbell, R., & Cardin, V. (2013). How does visual language affect crossmodal plasticity and cochlear implant success? Neuroscience and Biobehavioral Reviews, 37, 2621–2630.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mayberry, R. I., Chen, J. K., Witcher, P., & Klein, D. (2011). Age of acquisition effects on the functional organization of language in the adult brain. Brain and Language, 119(1), 16–29. doi:10.1016/j.bandl.2011.05.007.

    Article  PubMed  Google Scholar 

  • McKee, M. M., Barnett, S. L., Block, R. C., & Pearson, T. A. (2011). Impact of communication on preventive services among deaf American Sign Language users. American Journal of Preventive Medicine, 41(1), 75–79. doi:10.1016/j.amepre.2011.03.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • McKee, M. M., & Paasche-Orlow, M. K. (2012). Health literacy and the disenfranchised: the importance of collaboration between limited English proficiency and health literacy researchers. Journal of Health Communication, 17 (Suppl 3), 7–12. doi:10.1080/10810730.2012.712627.

    Article  PubMed  PubMed Central  Google Scholar 

  • McKee, M. M., Paasche-Orlow, M. K., Winters, P. C., Fiscella, K., Zazove, P., Sen, A., & Pearson, T. (2015). Assessing health literacy in deaf american sign language users. Journal of Health Communication, 20 (Suppl 2), 92–100. doi:10.1080/10810730.2015.1066468.

    Article  PubMed  PubMed Central  Google Scholar 

  • Penicaud, S., Klein, D., Zatorre, R. J., Chen, J. K., Witcher, P., Hyde, K., & Mayberry, R. I. (2013). Structural brain changes linked to delayed first language acquisition in congenitally deaf individuals. NeuroImage, 66, 42–49. doi:10.1016/j.neuroimage.2012.09.076.

    Article  PubMed  Google Scholar 

  • Schenkel, L. S., Rothman-Marshall, G., Schlehofer, D. A., Towne, T. L., Burnash, D. L., & Priddy, B. M. (2014). Child maltreatment and trauma exposure among deaf and hard of hearing young adults. Child Abuse Neglect, 38(10), 1581–1589. doi:10.1016/j.chiabu.2014.04.010.

    Article  PubMed  Google Scholar 

  • Skotara, N., Salden, U., Kugow, M., Hanel-Faulhaber, B., & Roder, B. (2012). The influence of language deprivation in early childhood on L2 processing: An ERP comparison of deaf native signers and deaf signers with a delayed language acquisition. BMC Neuroscience, 13, 44. doi:10.1186/1471-2202-13-44.

    Article  PubMed  PubMed Central  Google Scholar 

  • Smith, S. R., Kushalnagar, P., & Hauser, P. C. (2015). Deaf adolescents’ learning of cardiovascular health information: Sources and access challenges. Journal of Deaf Studies and Deaf Education, 20(4), 408–418. doi:10.1093/deafed/env021.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sugar, M. (2016). Dispelling myths about deafness. http://www.agbell.org/in-the-news/response-nyle-dimarco/.

  • Sugar, M., & Goldberg, D. M. (2015). Ethics rounds needs to consider evidence for listening and spoken language for deaf children. Pediatrics, 136(5), e1487. doi:10.1542/peds.2015-3106A.

    Article  PubMed  Google Scholar 

  • Tobey, E. A., Geers, A. E., Sundarrajan, M., & Shin, S. (2011). Factors influencing speech production in elementary and high school-aged cochlear implant users. Ear Hear, 32(1 Suppl), 27 S–38 S. doi:10.1097/AUD.0b013e3181fa41bb.

    Article  PubMed Central  Google Scholar 

  • Tobey, E. A., Thal, D., Niparko, J. K., Eisenberg, L. S., Quittner, A. L., Wang, N. Y., & Team, C. D. I. (2013). Influence of implantation age on school-age language performance in pediatric cochlear implant users. International Journal of Audiology, 52(4), 219–229. doi:10.3109/14992027.2012.759666.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported by Grant no. K12 GM106997 from the National Institute for General Medical Sciences of the National Institutes of Health.

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Correspondence to Wyatte C. Hall.

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Hall, W.C. What You Don’t Know Can Hurt You: The Risk of Language Deprivation by Impairing Sign Language Development in Deaf Children. Matern Child Health J 21, 961–965 (2017). https://doi.org/10.1007/s10995-017-2287-y

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