What the Mother of a Deaf Child Ought to Know — Chapters 1-3

FACING THE FACTS

While deafness is a serious misfortune, it is neither a sin, nor a disgrace, to be ashamed of.

It is a handicap, to be sure, but one to be bravely and cheerfully faced, for it does not destroy the chances for happiness and success.

It is cause for neither discouragement nor despair.

It will demand patient devotion and courageous effort to overcome the disadvantage, but what mother is not willing to show these in large measure for her child when the future holds assurance of comfort and usefulness?

The earlier that the facts are known and squarely faced, the better.

It is always wiser in life to prepare for the worst and gratefully accept the best, than to refuse to acknowledge the possibility of the worst until it is too late to remedy it, or at least to reduce it to its lowest terms.

When a mother first suspects that her child's hearing is not perfectly normal, what should she do?

Of course, first of all, the best available ear specialist should be consulted at once in order to determine whether the cause can be removed and normal hearing restored.

Sometimes, however, the specialists are uncertain of the outcome, and sometimes their hopes are not realized.

In the meantime, precious days and weeks are passing in which something could be done for the little one educationally, without in any way interfering with the medical efforts at relief.

The two things can be, and should be, carried on simultaneously.

If normal hearing is restored no harm has been done by the educational training; in fact, the development of the child has been advanced.

On the other hand, if the hopes that were entertained are disappointed, then precious and irrecoverable time has not been lost.

The title presupposes that the mother has already accepted the fact that her child's hearing is not perfect, and, for the sake of the child, it is to be hoped that this knowledge came to her very promptly after the occurrence of the deafness.

One would naturally expect a mother, of her own accord, to carefully test all the senses of her child by many simple and repeated exercises during the first few months of its life.

The many cases, however, in which deafness on the part of a child has not been recognized, or at least not acknowledged, by the mother till the third, fourth, or even fifth year, show a strange neglect of a highly desirable investigation, and a natural unwillingness to accept a truth, the possibility of which must certainly have occurred to her long before.

If she could only realize that she need not feel downcast and heavy-hearted by reason of her little one's imperfect hearing; if she could only know that she need not look forward to a life for him different from that of other children; if she could understand that training and education can enable him to overcome to an extraordinary degree the disadvantage of deafness, she would set about the task with cheerfulness and hope, and if she knew that the sooner she began, the better it would be for the little one, she would not stubbornly refuse for so long to acknowledge even the possibility of deafness.

II HOW SHALL THE MOTHER BEGIN HER PART OF THE WORK?

First of all, something like an inventory should be taken of the faculties possessed by the child which he can use in working out his problem.

Has he good sight, normal smell, taste, muscular sense, and memory?

To what extent is his hearing impaired?

Is there any possibility of restoring it to normal acuteness, or of improving it, or of preventing any further impairment?

The completeness with which these questions can be answered depends, to a considerable extent, on his age and his physical condition.

We will suppose that he is about fifteen months old and in good bodily condition.

If he is older, the same tests would be used to begin with, though we could at once pass on to more complicated and difficult ones that cannot as yet be used with the fifteen-months-old baby.

First, with regard to sight.

We wish to know if he can distinguish reasonably small objects at reasonable distances; whether he can see moderately small things at short distances; whether the angle of his vision is normal.

In other words, whether his range and angle of vision are sufficient for all ordinary purposes.

If he can recognize his father or mother or brothers and sisters at a distance of a hundred feet he can see far enough for all practical purposes.

If he readily finds a small object like a pin or a small black bead when dropped on the floor, his sight is sharp enough at short range to serve his purposes.

If his attention can be attracted by waving a hand or a little flag or a flower fifty or sixty degrees on either side of the direction in which he is looking, that is, two-thirds of the way to the side of his head, his angle of vision is sufficiently wide.

If he can pick out from seven balls of worsted of the seven primary colors--red, orange, yellow, green, blue, indigo, and violet--the ball that matches another of the same color, he is at least not color-blind and has a sufficient sense of color for the ordinary purposes of life.

It may be necessary to wait till eighteen months for a satisfactory color test.

Color blindness, when present, is usually most apparent in a failure to distinguish between red and green, these two widely differing colors seeming to produce the same impression upon the color-blind eye.

The child will be just as likely to choose a red ball to match the green one in his hand as to select another red ball.

But repeated tests should be made before accepting color blindness as a fact, since sometimes the brain can be educated to discriminate between red and green even when the impressions have not the normal degree of difference.

The tests for taste, smell, muscular sense, touch, and memory cannot be made with much thoroughness or satisfaction till two years of age, though observation will show a recognition by taste and smell of that which is agreeable and that which is disagreeable.

Accurate tests of hearing cannot be made till the child is three or four, but it is possible when he is twelve months old to determine whether the hearing is normal or is seriously impaired, and it is very desirable that this should be done.

The expression "seriously impaired," when applied to the hearing of a little child, must be given an entirely different interpretation than it would have if used with reference to an adult who had previously had normal hearing.

A degree of impairment that would be unimportant in an adult is a very serious matter in the case of a child.

This is because the ear is the natural teacher of speech and language.

If the sounds of speech are not clearly heard the imitation of them will always be imperfect, and the acquisition of language will be impeded.

If deafness is so great that spoken words are not heard at all, then the child will not learn to speak and to understand when spoken to unless specially taught.

A much slighter degree of deafness will prevent the proper acquisition of speech and language than would in later life prevent the comprehension of conversation in a familiar language.

As even the child of fifteen months would benefit from some modifications of the ordinary treatment of a baby, if his hearing was not normally acute, it is to his advantage to have the fact of his deafness known at once by those in charge of him.

It is not as easy as it might seem to the inexperienced to determine even approximately the situation of a fifteen-months-old baby with respect to its hearing.

Our interest here is, of course, in the tests of hearing that do not require special apparatus and special training.

In the case of a child less than two years of age we must rely upon merely attracting his attention by various sounds, judging the effect upon him by his expression and actions.

We cannot, at that age, establish a system of responses, nor expect him to imitate the sounds he hears.

Sounds should be used for testing that disturb only the air, and are not sufficiently low and powerful to set in vibration the floor, chair, or any other object with which he may be in contact.

Deaf children rapidly become abnormally sensitive to vibrations, which are to them what noises are to us.

A rather smooth, not too shrill, whistle is one excellent sound to use.

Not a fluttering whistle like the postman's, nor a heavy tone like an organ pipe or bass horn.

Clapping the hands is a good initial test of a crude nature; then a moderate whistle, varying the pitch, for sometimes high sounds are perceived, but not low ones, or vice versa.

Then a bell, such as a small table bell, the telephone, electric door bell, etc. Lastly, the human voice in various pitches, volumes, distances, and vowels.

Little by little it can be determined whether the child hears all the sounds, and if not, then which, if any, he perceives.

A totally deaf child may often deceive the investigator by turning his head at the critical moment, apparently in response to the sound that was made, while, on the other hand, a child very slightly deaf, or not deaf at all, may completely ignore the sounds made for the purpose of attracting his attention.

Therefore, it takes time and repeated tests under varying environments to gradually eliminate possible errors and coincidences.

It must be remembered that the intensity with which a sound affects the ear varies inversely as the square of the distance from the ear to the source of the sound.

That is to say, if exactly the same sound is repeated at half the distance, the intensity with which it reaches the ear is four times as great as before, and if the distance is quartered, the intensity is sixteen times as great.

In other words, if "ah" is spoken with a certain loudness eight inches from the child's ear, and then again with exactly the same pitch and volume only two inches from his ear, it will be sixteen times as loud to him as it was the first time.

These simple tests will serve to determine whether the child has, or has not, a normal acuteness of hearing.

They will not serve to determine with any accuracy the degree of impairment, if it is found that the hearing is impaired at all.

More thorough tests will have to be postponed till the child is two years old or more.

But the moment that impaired hearing is suspected, the best available ear specialist should be consulted in order to determine whether the cause can be removed, or measures taken to prevent a progressive increase in deafness.

The visit to the otologist should be repeated at intervals of not more than eight or ten months, even where there is no question of treatment, in order that any change in the physical condition of the organs may be promptly detected.

III

HOW SHALL THE MOTHER GET INTO COMMUNICATION WITH HER DEAF CHILD?

Let it be assumed that when the child is fifteen months old it is fairly well established that his hearing is somewhat below normal.

Between fifteen months and two years of age all that is said in this section will apply equally to the child who is _feared_ to be _totally_ deaf and to one who is known to possess some sound perception, though not a normal degree of hearing.

For, until he is old enough to respond to more complete and accurate tests, we must not give up the idea that he may have a sufficient remnant of hearing to be of great assistance to him in the acquisition of speech and language, if it is only developed and trained.

Between the ages of twelve months and twenty-four months the child with perfect hearing makes rapid progress in learning to understand what is said to him, and by the time he is two years old has usually begun to speak many words and sentences in a more or less imperfect way.

This has been accomplished principally by the mother's constant talking to her baby.

If she has had the good sense to always speak in simple but complete sentences, and to avoid the foolish "baby talk" unfortunately affected by some people in addressing little children, the results of her daily and hourly talk is the possession by the child of a considerable vocabulary of words whose meaning he knows, and a less number that he is able himself to speak in a rather imperfect way.

In what respects should the mother modify her treatment of the baby if she suspects that his hearing is defective?

She should not talk to him any the less on this account, but, on the contrary, she should talk to him more.

She should, however, speak a little louder, a little nearer to him, possibly a little more slowly and distinctly, exercising the greatest caution, however, not to exaggerate speech into unnatural facial contortions, or to accompany it by gestures.

To fall into the habit of mouthing and gesticulating, making faces and motions, will defeat entirely the purpose of all efforts to develop an understanding of speech by the child.

Unfortunately, such exaggerated and absurd speech is a natural and very prevalent fault.

To avoid it is absolutely necessary, but requires constant watchfulness, as there is a strong temptation to try to make speech-reading easy for the child by opening the mouth wide and making extraordinary movements of the tongue.

The object aimed at is to lead the child to interpret natural, everyday speech, and such facial contortions and exaggerations cut him off from practice in reading natural speech.

This point cannot be too strongly emphasized.

Speak naturally and normally _always_ to the deaf child.

Above all, the mother should form the habit of watching his eyes and of speaking as often as possible when his gaze is fixed upon her face.

The habit on his part of looking at the face of a speaker, and the habit on his mother's part of observing his gaze and, when it wanders, of pausing in her talk till he is looking at her again, are two very valuable aids in the language development of the deaf child.

In addition to always raising her voice a little in speaking to her baby, the mother should several times a day take him in her lap and sing to him, and talk to him with her lips not far from his ear.

Talk to him just as all mothers do to their babies (but not with the mangled and distorted words called "baby talk"), about the pussy, the dog, the bird, his foot, his toes, his arms and hands and fingers; about his papa, brothers, sisters; about the flowers, the grass, the trees, and a thousand other things.

Say the good old Mother Goose rhymes of "Patty Cake, Patty Cake, Baker's Man," "This little pig went to market," etc. , etc. But in all your frolics and stories and songs, take the greatest care that he shall hear or see, or better still, _both_ see _and_ hear, what you are saying.

Gradually he can be taught to understand many simple commands and questions just as hearing babies learn them, by constant repetition at times and under circumstances when the meaning is obvious.

Such as "come," "go," "go to papa," "come to mamma," "jump," "stop," "kiss mother," "pet pussy," "pick up," "put down," "milk," "water," "bread" (the later in life that he learns the meaning and taste of "candy" the better), "do you want some bread?"

"milk," "water," etc. "Bring my slippers," "bring my shoes," "put on your hat," "take off your mittens," "wash your hands," etc. , etc. , throughout the whole day.

Very early the mother should learn to consider the direction from which the light comes, and should be careful to take her position _facing_ the main source of light which should come from _behind the child_.

The eye can be trained from the very beginning of attention to unconsciously supplement an imperfect ear in comprehending spoken words.

It is even possible for the eye to perform the entire task of interpreting speech, and, if the hearing is entirely lacking, the course outlined will result in training the brain to interpret the movements of speech as seen by the eye, as it would have been trained by the same procedure to interpret the sounds of speech had the organ of transmission not been injured.

But the idea must be constantly in the mind of the mother that her boy needs to _see_ the spoken word at the very moment _when the idea that it represents is in his mind_, AS OFTEN as he would hear it if his hearing were perfect.

This one suggestion, if faithfully lived up to from the age of one year to that of two years, would be almost enough.

But there are other things that the mother can do as the mental development of the baby increases with each month of life.

She should encourage him to babble and gurgle and murmur, as much as possible, to laugh and crow and make all the various baby noises that will train and develop his voice.

Encourage noisy, romping, rollicking games as he gets older, that make him shout and call, for they are the natural and best voice exercises.

IV