Judy Sexton

CHOICES: Please paint a generic portrait of the child and family most likely to be successful in your program at Clarke School

JS: At Clarke, we respect each family’s ability to determine what is best for their child, and we recognize that every family is different. The portrait of a child and family most likely then to be successful in Clarke’s program is: a family whose desired outcome is listening and spoken language; the child is amplified (wearing either cochlear implants or hearing aids) with consistent use; and the family is part of the team.

We recognize that the development of listening and spoken language skills is not only influenced by the mode of communication used educationally but also by each educational setting. Children with hearing aids or cochlear implants who are in programs emphasizing listening and talking have higher speech production scores than children in programs that put less emphasis on these actions. Therefore, a family choosing a program such as Clarke can expect higher speech production scores.

A 2003 Moog and Greers study* indicates that parents and professionals can help a child achieve maximum benefit from hearing aids and cochlear implants by: (a) selecting an educational environment that provides a consistent emphasis on developing speech, auditory, and spoken language skills; and (b)making sure that the child receives audiological management that includes access to the most up-to-date speech processing strategies and careful monitoring of the amplification. In this study, all performance outcome measures were significantly higher for cochlear implanted children in educational environments emphasizing listening and speaking. Currently, the most comprehensive information using the oral approach in the educational environment is found in the pediatric cochlear implant literature.

*Moog, J.S. and Geers, A.E. (2003). Epilogue: Major findings, conclusions and implications for deaf education. Ear and Hearing Monograph, 24(18), 121S-125S.

CHOICES: Sign language has been part of the toolkit of educators of the deaf for many years. But there’s little or no evidence of sign language in use at Clarke School. Please explain.

JS: The mission at all Clarke School campuses is to teach deaf children to listen and talk through maximum use of hearing aids and cochlear implants and the auditory channel for learning. Children are prepared to mainstream into regular education alongside hearing peers without a sign language interpreter. Sign language is not taught in the school. The primary focus is for the child to learn to interpret the meaning of sound through listening. The curriculum at Clarke emphasizes listening and spoken language. The vocabulary and language of the curriculum are always paired with the auditory original stimulus for comprehension so that the information is learned and generalized to all environments.

Clarke has been in existence for over 140 years. The model has always stayed true to auditory oral education and has never waived over the course of time when other programs moved into Total Communication and ASL models.

Clarke’s commitment to auditory oral education is based in the belief that the possibilities for deaf and hard of haring children are endless. The fact that 92% of children with permanent hearing loss are born to two hearing parents is critical, as the family’s primary language in which they are proficient, is spoken English. Therefore the desired outcome for children is to be part of their communities and integrated into their school settings. In addition, most children with hearing loss who receive appropriate services from trained staff are able to progress at age-appropriate rates.

I would call your attention to the following research:

  • There is evidence that children prefer and encode auditory stimuli over visual stimuli. Sloutsky, V.M. & Napolitano, A.C. (2003). Is a picture worth a thousand words? Preference for auditory modality in young children. Child Development, 74(3), 822-833.
  • Data show that 90% of children born with a profound hearing loss who obtain a CI before they are 18 months old attain intelligible speech. If a cochlear implant is obtained between 2 and 4 years of age, about 80% of the children born with profound hearing loss will attain intelligible speech. Cole, E. & Flexer, C. (2007). Children with Hearing Loss Developing Listening and Talking Birth to Six. San Diego, CA: Plural Publishing.

CHOICES:What harm, if any, do you see in exposing a two-year-old to spoken English and ASL simultaneously?

JS: Clarke respects a family’s decision to choose what is best for their child. I wouldn’t say that exposing a two year old to spoken English and ASL simultaneously is harmful. A child enrolled in a program focused on listening and spoken language will show an average of one year of language growth for each year in the program. At the end of a four-year period, the gap between chronological age and language age was nonexistent. Rhoades, E. & Chisolm, T.H. (2000). Global language progress with an auditory-verbal approach for children who are deaf or hard of hearing. Volta Review,102,(1), 5-24.

Additional research shows:

  • Communication mode has been shown to have a highly statistically significant association with speech and language outcomes of children with cochlear implants. Children exposed to spoken language have a greater probability of scoring higher on speech and language assessments than children exposed to some degree of either sign support or sign language. Percy-Smith, L, Jensen, J.H., Caye-Thomasen, P., Gudman, M., & Lopez, A.G. (2008). Factors that affect the social well being of children with cochlear implants. Cochlear Implants International, 9(4), 199-214.
  • Recent data indicates that introducing sign language prior to cochlear implantation does not enhance outcomes compared to emphasis on spoken language alone. Nittrouer, S. (2008). For children with hearing loss: Effects of age of ID, sign support, and auditory prosthesis. A presentation to the National Early Hearing Detection and Intervention Conference, New Orleans, LA.

CHOICES: Do you find young teachers who come to work at Clarke to be prepared adequately for the methods you use in your school? If not, how do you train them in your methods?

JS: Most existing personnel preparation programs emphasize sign-language options even though most parents choose spoken language options when they are available. Teachers graduating from these programs are not adequately prepared, however, some Total Communication programs have a stronger listening and spoken language component than others. Students graduating from these programs choose to come to Clarke with a commitment to listening and spoken language development; they are assigned a mentor for a year and are immersed in an environment that supports development of these skills.