I Can Hear You Whisper (24 page)

In an important study published in 2000,
Mario Svirsky and his colleagues at Indiana University, where he worked in the well-respected cochlear implant program before moving to NYU, showed exactly that. The researchers examined not just whether a child's language development improved after receiving a cochlear implant but also whether it improved
more
than it would have without an implant. “Language development” is an all-encompassing measure that goes beyond speech production (or intelligibility) and speech perception to include more sophisticated skills such as reading comprehension and grammar. In a normally developing child, chronological age and “language age” rise in lockstep, so that at one year of age a child has a language age of one year, at three years old he has a language age of three, and so on. A graph depicting the maturation of language will show a straight diagonal line from the bottom left corner stretching to the top right. Historically, profoundly deaf children developed language at half the rate of hearing children. “Without an implant, these children would be expected [in English] to speak like a two-year-old when they are four and so on,” explains Svirsky. So their language development sheared off from their hearing peers from the start, and the gap only widened over time. “What I found was once they received an implant,” he says, “their development started proceeding at a normal rate on average.” In other words, the gap stopped widening and the line of language development for a child with a cochlear implant now paralleled the diagonal for a typically hearing child.

In another study, Svirsky showed that the vast majority of children with cochlear implants eventually reach 80 percent or better on open-set tests of speech production. He tested this by taping kids saying a set of standard sentences and playing those recordings to a panel of “naive listeners” who had no experience listening to the speech of the deaf. In such a test, a typically hearing child will score 80 percent at the age of four, 90 percent at five, and then go higher. In Svirsky's study, children implanted in the first two years of life all achieved a score of 80 percent or better by the age of eight. Those who didn't get their implants until the age of three did not do as well.

It was a logical conclusion that age mattered and that the earlier a child received an implant, the less ground she would have to make up. A 2010 study headed by
Dr. John Niparko, who directed the cochlear implant program at Johns Hopkins University at the time (he is now at the University of Southern California), showed why earlier was better. It measured spoken language development in 188 children at six centers around the country. As with Svirsky's study, the children did better on spoken language development than they otherwise would have but did not catch their hearing peers. Those who got implants under eighteen months had “significantly higher rates of comprehension and expression” than those who were implanted between eighteen and thirty-six months, though not everyone succeeded to the same degree, and that second group did better than those implanted after thirty-six months. But Niparko found that several other things also helped kids do well, particularly strong parental involvement, higher socioeconomic status, and greater residual hearing.

Back in 2003, some of those factors showed up in an influential study by Ann
Geers and colleagues at the Central Institute for the Deaf in St. Louis. Geers studied 181 eight- and nine-year-old children who received implants between ages two and five. After testing comprehension, verbal reasoning, narrative ability, and spontaneous language production, either in speech or sign depending on the child's preferred language mode, Geers found that some of the same factors that predict success in hearing children were helping deaf children, too—greater nonverbal intelligence, smaller family size, higher socioeconomic status, and female gender all boosted performance. She also found that those who were educated in oral classrooms had better language development than those who weren't.

In 2008, Geers released a study of 112 of the same students, who were then in high school. It is one of very few studies to track students over such a long time, because researchers are still waiting for most implanted children to grow up. “Performance of these students far exceeds expectations for children in previous generations,” wrote Geers and colleagues. But academic difficulties remained. Speech recognition and intelligibility got worse for most students in noisy conditions like those of a classroom. Gaps in IQ scores—both verbal and nonverbal—persisted between deaf and hearing children. Most implanted children made consistent progress in reading that paralleled hearing peers, but 20 percent made minimal progress in the eight years between studies, staying at the “fourth-grade barrier.” And writing, including spelling and expository skills, was difficult for most of the implanted children; only 38 percent scored even close to the hearing students. Early implantation, parental involvement, higher socioeconomic status, and oral education all helped those who'd done best.

 • • • 

Who your parents are, when you get your implant, how you're educated—these are clearly determining factors of success. Yet there is still surprising variability in performance even for kids who start out in similar situations. According to David Pisoni, a cognitive neuroscientist at Indiana University who is particularly interested in why that variability persists, roughly 15 to 20 percent of cochlear implant recipients will not do well with the device. Nor have cochlear implants erased the problems of deaf education.

Despite a concerted effort to come up with educational solutions over the past few decades and reams of academic papers on a wide variety of classroom-related subjects, there has been distressingly little measurable progress, as if deaf academic achievement is a brick wall with no path over, around, or through. “The only thing we do know is that the median reading level of deaf eighteen-year-olds in the US has not changed in forty years,” Marc Marschark told me in 2012. As I had found back when I was searching the Internet, that median reading level, the middle ground, is stuck in the fourth grade.

At least we've moved past the restrictions of the oral-only era. As Andrew Solomon put it in his
New York Times
article, “The insistence on teaching English only . . . served not to raise deaf literacy, but to lower it. Forbidding sign turned children not toward spoken English, but away from language.” In that article, Solomon quoted a deaf woman named Jackie Roth: “
We felt retarded,” Roth said. “Everything depended on one completely boring skill, and we were all bad at it. Some bright kids who didn't have that talent just became dropouts. . . . We spent two weeks learning to say ‘guillotine' and that was what we learned about the French Revolution. Then you go out and say ‘guillotine' to someone with your deaf voice, and they haven't the slightest idea what you're talking about—usually they can't tell what you're trying to pronounce when you say ‘Coke' at McDonald's.”

Such frustrations led students of Jackie Roth's all-
oral
era—
who
are in their fifties or older today—
to
become leaders of the Deaf culture
movement. But the younger generation that protested at Gallaudet
in 2006 was educated differently, because the
philosophy
underlying deaf education had changed. Even before the Americans
with Disabilities Act became law, separate was no longer deemed
equal for any child with special needs, and a push for mainstreaming began in 1975, when Congress passed Public Law 94‑142, a landmark
piece of legislation that guaranteed free, appropriate public education
for all children with disabilities. That law was amended in 1986 and
again in 1990 with the Individuals with Disabilities Education Act
(IDEA). By 1986, only three out of ten deaf children still attended specialized
schools like the residential ones that predominated in earlier
times. Most of the rest were in public school classrooms of one sort or
another, either in separate classes for deaf students or in mainstream
classes with interpreters or resource teachers. But they still weren't
succeeding. A 1988 Federal Commission, assigned to investigate deaf
education, declared in its report: “The present status of education for
persons who are deaf in the United States is unsatisfactory. Unacceptably
so. This is [our] primary and inescapable conclusion.”

By then, many students were getting at least some of their education in ASL. Beginning in the 1970s, deaf educators adopted
“total communication.” The idea was that deaf students should learn through whatever means possible—spoken English, ASL, fingerspelling, writing, anything that worked. It was a wary compromise that seemed like a good idea in theory, but in practice this either/or approach left students fluent in neither English nor ASL, satisfying no one. The signing of many teachers in such classrooms was often what the deaf call
“shouting”—throwing in a sign for a prominent noun or verb here or there. Or it was SimCom, for “simultaneous communication,” which requires teachers to speak and sign at the same time—a difficult trick to pull off because the syntax of ASL and English are not the same. Or, worst of all to proponents of ASL, there was Signed Exact English, which is not ASL at all. On the other hand, from the point of view of parents interested in oral education, some total communication classrooms seemed like very quiet places without enough speech, where good oral role models were in short supply.

For a time, a system called
Cued Speech seemed promising. A set of hand signs flashed near the face to indicate phonemes, it was expressly designed to help with literacy but has worked less well with English than with other languages.

A new approach, known as
bilingual-bicultural, emerged in the 1990s. In such schools, face-to-face interaction is in ASL; English is taught for the purposes of reading and writing. “Bi-bi” is popular in the Deaf world and Gallaudet has recently declared itself a bilingual-bicultural university. Here, too, success depends at least in part on the quality of the signing.
The question is no longer “about whether deaf children can be appropriately educated in sign (at least within educated circles),” wrote Marc Marschark and Peter Hauser, but about “the subtle and not-so-subtle implications of varying degrees of sign language fluency.”

 • • • 

When I first read Marschark's 2007 book,
Raising and Educating a Deaf Child
, it was a vast relief. It seemed remarkably fair and balanced, mostly by being willing to speak bluntly to both sides of the deaf education debate. In the first chapter, Marschark tackled two common beliefs that hung around like persistent storm clouds. “
First, there has never been any real evidence that learning to sign interferes with deaf children's learning to speak,” he wrote. “Second, there is no evidence that deaf children with cochlear implants will find themselves, as some had warned, ‘stuck between two worlds,' (hearing and deaf) and not fully a member of either.” His message was that deaf children need full exposure to a language—any language—from their earliest years and that parents need to be the ones providing it. “
Effective parent-child communication early on is easily the best single predictor of success in virtually all areas of deaf children's development.”

Marschark, who is hearing, began his career as a cognitive psychologist interested in language and metaphor. As a side project, he got interested in the way deaf kids used figurative language. Intrigued by the results, he retrained himself in child development and the issues of deaf children. Part of that effort involved reading all of the existing research literature, which he compiled into his first book,
Psychological Development of Deaf Children
, published in 1993.

On the strength of that book, Marschark was recruited by the National Technical Institute for the Deaf. NTID was a daunting prospect for someone who didn't really know any deaf people or any sign language, but Marschark has been there for two decades and is now proficient in ASL. And yet, he has written, “
as a hearing person I can never truly understand what it means to be Deaf or to grow up (deaf or hearing) in the Deaf community. I may be welcomed, and I may know more about deafness than many other people, but I still have to understand Deaf people and the Deaf community from my hearing perspective.”

That was just one of the things we talked about when I spent the afternoon in his office in Rochester. Bearded and bespectacled, Marschark looks like an academic. But he's an academic on a mission. He speaks regularly around the country. Lately, he's been giving a lot of presentations that all have the same theme: What We Know, What We Don't Know, and What We Only Think We Know About ——. Fill in the blank with whatever subject Marschark's been asked to tackle: cochlear implants, ASL, literacy, school placement, you name it. He's managed to offend both sides, including his colleagues. “I warn everybody at the outset: Each of you is going to be upset. But I say, Don't leave! Don't get too upset, because in five minutes you'll be happy and the person next to you will be upset.”

This series of talks is based on an epiphany Marschark had after a major research project in 2009. “I discovered that a lot of what we do in deaf education doesn't have any evidence to support it, or people are cherry-picking,” he said. Since then, he has been on a crusade to force people to question the “religious” convictions they have of what they think they know is true. Take for example that question of whether sign language gets in the way of learning English. People regularly send him e-mails with lists of research citations ostensibly proving him wrong when he says there's no evidence that sign language interferes. But if you read the studies, he says, “what the research says is that if you want a child to be oral, if you want them to speak, they need to be exposed to spoken language.” That is not the same thing as saying that sign language poses a problem, nor is there any established threshold of how much oral experience is enough. “The data's not wrong, but the conclusion is drawn from one side of the coin,” he says. Yes, it's true that children in oral programs tend to speak better than children who are not in oral programs but, Marschark points out, “they're not randomly assigned.” Children who are likely to do well in oral programs—for instance, those like Alex with some residual hearing—go into those programs. Children who are not likely to do well tend not to go into those programs or to drop out of them along the way.