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date: 30 March 2020

Paradigm Shifts, Difficult Truths, and an Increasing Knowledge Base in Deaf Education

Abstract and Keywords

Three major paradigm shifts or advances in knowledge have occurred in education and services for deaf and hard-of-hearing persons over the 20th and early 21st centuries: (1) sign languages have been recognized as complete and viable natural languages, leading to more appreciation for use in educational settings, as well as among deaf people; (2) technological advances, including more sophisticated hearing aids and cochlear implants, have increased access to sound and to spoken language; and (3) the identification of hearing loss in infancy and accompanying early intervention services have raised the rate and level of children’s developmental progress. Despite advances, significant problems remain to be addressed. These include a lack of information about the development and needs of hard-of-hearing persons—despite the fact that they compose the largest proportion of the population with hearing loss, and with persons using cochlear implants functionally increasing that proportion. In addition, persons with multiple disabilities and those living in nonindustrialized countries have been insufficiently studied, and appear not to be benefitting from the aforementioned advances. Information is also lacking on causes of and effective responses to specific cognitive profiles identified for students with hearing loss, on effects of specific educational intervention approaches, and on patterns of social-emotional development and their interaction with other developmental areas. Increased focus is needed on the development and evaluation of interventions designed to assure that the advances made are shared across the population and impact varied aspects of development and achievement.

Keywords: deaf, hard-of-hearing, advances, knowledge base, research needs

(p. 473)

Editors Note: As with the first Oxford Handbook of Deaf Studies, Language, and Education, the two ­editors initially wrote the first and last chapters of this volume independently (note order of authorship on each). The first chapter was intended to provide an overview of the state-of-the-art of the field, with a particular emphasis on our reasons for pursuing a second volume: the desire to provide an up-to-date perspective on where the field is and where it is going, to own up to our own shortcomings in bridging the research–practice divide, and the need to bring together diverse kinds and sources of information relevant to deaf studies, language, and education into a (somewhat) coherent, synergistic whole. The final chapter was planned as an epilogue, outlining ways in which the chapters of this volume have moved us ahead and identifying “holes” that we have not been able to fill in either volume. It was with considerable surprise that, when we exchanged drafts, we found that the two chapters had almost the same foci, even if they came from somewhat different perspectives. After debating whether one or the other chapter should be eliminated or changed, we arrived at the unanimous conclusion that such convergence was telling us something—something about the field, those who work in it, and those for whom the work is done. So be it.

Writing the final chapter of a volume like this one is a bit like cleaning up after a family reunion. First thoughts concern who got along and who didn’t, who brought what, and who was missing. (p. 474) The last of these invariably leads to discussion of how things have changed—and some ways in which they haven’t. With fond memories (and some regrets) everyone then comes back to the present and looks to the future. “There is no way we would do this again!” But, then, someone has to.

Despite the remaining unfulfilled promises (see Chapter 1, this volume), the field of education for and research involving deaf and hard-of-hearing (DHH) persons has shown great advances recently. The chapters in this volume document those advances and put them into context(s). Of course, not all the questions have been answered, and there are others begging to be asked. There is much to be learned about the foundations of language, learning, culture, and social-emotional processes in deaf adults and children, just as there is still a substantial gap in translating many lines of research into effective practice. But we have not been standing still. Since the middle of the last century, for example, three paradigm shifts have occurred in the field of research and practice with deaf children and adults. We remember clearly how our lives and our work were affected by all three, even if some of the changes may have preceded the professional careers of many readers.

The first of these revolutionary changes was the scientific recognition of natural sign languages as viable and complete members of the family of ­languages (Stokoe, 1960/2005). (Many deaf people knew this all along, of course—but it apparently came as a surprise to some of them, as well as to the primarily hearing world of linguistics and psychology.) This led to a return to promoting the use of signs, although often not fully expressed sign languages, in the education of deaf children and to increased research interest in the communities of Deaf persons around the world (Woll & Ladd, 2003). It also enlarged the scope of what was thought of as “normal,” and it without doubt enhanced the visibility and the stature of deaf persons in many, if not most, industrialized countries. This stature was confirmed, and the revolution was clearly underway, when fast-food and other entrepreneurial ventures began airing television advertisements with deaf, signing actors.

In addition to social advances, the shift to recognition and appreciation of natural sign languages and Deaf communities also changed the direction of scientific research and led inexorably to greater numbers of researchers and greater diversity in their backgrounds. Linguists, neuroscientists, sociologists, and anthropologists, both deaf and hearing, joined those educators and psychologists whose interests had already directed them toward research on deaf-related issues. Researchers already working in the field found their efforts subtly refocused. Overall, there was a sense of change, a sense of increasingly positive expectations, and a heightened appreciation by professionals working in “deafness” for the contributions of professionals from varied and diverse disciplines—and, as well, for the contributions of deaf scientists and members of the Deaf community to research and practice. There can be no denying that this shift resulted in faster and often less-biased accrual of research data and in improvements in the life experiences of many children and adults with hearing loss.

Then, although there was some temporal overlap, came the second shift. Technological advances promised that at least some people who were deaf could begin to receive and process auditory (or, some would say, “auditory-like”) information (see Harkins & Bakke, 2003). Cochlear implants, at first designed for older persons who lost hearing fairly late in life, proved to be effective for many if not most children who had never heard or had heard only briefly before becoming deaf. At first, this seemed to be a direct challenge to the recognition that had by the late 20th century been accorded the Deaf community and the role of signing, if not sign language, in the lives of deaf people. Signing once again became a “straw person” against which those devoted to the development of spoken language skills could target their research and their practice. However, the very fact of the technical advance again widened the perspectives of professionals (not to mention parents) involved with deaf children and adults—and as any good teacher or cognitive scientist will tell you, encountering different views tends to result in a more complex and sophisticated zeitgeist. This, in turn, tends to lead to more advanced understandings and conceptual approaches to problem solving. Despite some initial discomfort in situations in which, for example, a neuroscientist, an engineer, a teacher, and a sociologist might enter into a discussion about research methods and results, original standpoints are often altered, and new and more cognitively sophisticated concepts can be generated. With luck and rational discussion, that may prove to be the outcome of this technological revolution (especially if we can get beyond the digging in of heels and gritting of teeth that has been commonplace in this field).

But wait, there’s more. About the same time as the emergence of advanced educational (see Chapter 7, (p. 475) this volume) and audiological (see Chapter 26, this volume) approaches, new cost-effective technologies were emerging that made the identification of hearing loss during early infancy more widespread. It soon became apparent that early identification followed by quality early intervention programming could significantly enhance both the rate and the sophistication of DHH children’s language development. These improvements quickly were recognized as influencing development in other domains as well (see Chapters 20 and 21, this volume). Invigorated by this progress, the field began to include professionals focused on early child development (yes, even infancy), cognitive as well as linguistic issues, family functioning and support (see Chapters 3 and 16, this volume) and, just as importantly, professionals in related medical and technological fields. Having facilitated meetings of hearing and deaf professionals from as many as 12 disciplines, as well as parents (themselves also often professionals in one field or another) of the children involved in such studies, we can state with confidence that the resulting discussions are lively. At the same time, although respect is shown and changes occur in individual’s knowledge and beliefs, “agreement” cannot be said to characterize many of these meetings. Differences in opinion still occur—some based on evidence, some on experience, and some on philosophy. Perhaps not surprisingly, then, the virtual meeting represented by the chapters in this volume can be similarly characterized. But as Jean Piaget noted, it is in disequilibrium that cognitive advances are made.

The mix of topics represented in these chapters, as well as the backgrounds of the contributors, exemplify the diversity of investigations occurring and of information becoming available about DHH persons, their experiences, their learning styles, and their accomplishments, as well as about the approaches being taken to answer questions and overcome challenges that still remain. Researchers and service providers, as well as parents of children with hearing loss and DHH persons themselves, should be excited to see that professionals can address issues—from basic cognitive science to educational practice to culture and identity—from the variety of perspectives that are represented in this volume. We hope and believe that these chapters are indicative of a new openness between and among disciplines and will help to move some of the emotionally charged beliefs in the field to a more evidence-based level of discussion.

Indeed, this is a time of hope and change. The old expectations about the potential for children and adults with hearing loss have undergone rapid change. We can both remember the electrifying moment in 1988 when I. King Jordan told the world that “deaf people can do anything except hear.” We suspect that Dr. Jordan would not at all mind the following, more recent comment from the father of a fluently signing child with an early-identified, profound hearing loss, now using a cochlear implant, who had just read aloud a passage from a textbook in clearly articulated speech: “Oh, yeah,” the father said. “She’s still deaf, but now she can hear.” But in some ways, such advances only make the problems, gaps in knowledge, and as-yet-unfulfilled promises that much more evident and therefore increasingly difficult to ignore. So, let us touch on a few difficult, or at least uncomfortable, truths.

First, an alert reader may have noticed use of the term “deaf” in many statements above instead of the term “deaf and/or hard-of-hearing” frequently used in research and practice literature. This is because it is the group that is deaf about whom we know the most. As the Jamieson, Antia et al., and Marschark et al. chapters of this volume all point out, we still lack much information about the developmental influences and outcomes for students who are hard of hearing. This is a critical shortcoming, given that children with mild to severe hearing losses comprise a larger group than those who are profoundly deaf, and many, if not most, children who use cochlear implants function as if they are hard-of-hearing children. The argument for increased focus on this group of children (and perhaps adults as well) has been effectively made by Moeller, Tomblin, Yoshinaga-Itano, Connor, and Jerger (2007), and is implicit in many reports of research on the functioning of audiologically deaf children using cochlear implants. Increasing attention by researchers to the needs of children (as well as older persons) who are hard of hearing leads us to hope that more resources and more research will be directed toward methods to assure that their full potentials are achieved. However, it is a “difficult truth” that this large, diverse part of the population has been largely ignored. Perhaps their very diversity—in hearing abilities, as well as in many other areas of development—has deterred researchers, who need to be able to control “extraneous” variables. Perhaps research with hard-of-hearing youth and adults simply has not been considered as exciting as that with young deaf children.1 Either way, the needs of hard-of-hearing persons can no longer be ignored.

Second, it should be noted that much of the research demonstrating positive results both for (p. 476) early intervention and for use of cochlear implants has highlighted children with average or above-­average cognitive functioning (e.g., James, Rajput, Brinton, & Goswami, 2008; Stacey, Fortnum, Barton, & Summerfield, 2006). The presence of social, cognitive, or motor disabilities has been shown to limit benefits from cochlear implantation, and, in fact, many studies of outcomes from cochlear implant use have specifically excluded children with multiple disabilities (see Beadle, McKinley, Nikolopoulos, Brough, O’Donoghue, & Archbold, 2005). Thus, despite advances in our knowledge about causes and responses to multiple disabilities (Chapters 12 and 28, this volume), individuals with such challenges often have not benefited from the advances described earlier. Further, the degree to which they benefit—as well as the conditions under which benefits are best promoted—are little understood and rarely investigated. Given repeated indications that this is a large and growing segment of the population of individuals who are deaf or hard-of-hearing, additional efforts in research and the evaluation of programming efforts are an absolute necessity. Like many early studies of deaf children without additional disabilities, studies of this more complex portion of the population could profit from qualitative, process-oriented research designs or single-subject studies assessing the effects of particular interventions. Practices of either ignoring the relatively high frequency of disabilities among DHH persons or of considering these diverse individuals as one amorphous group simply will not move understanding and services ahead.

A third difficult and regrettable truth is that, as Leigh et al. (Chapter 23, this volume) point out, the advantages and advances of early identification of and intervention for hearing loss remain unavailable to the majority of the world’s population of DHH children. Developing nations are estimated to have much higher rates of child hearing loss than more developed, industrialized countries, largely the result of ­differences in health-related conditions and the availability of medical services. Meanwhile, services in even some of the more developed countries remain far behind what is possible, and many questions remain about best, or at least most efficient methods of both identification and intervention for hearing loss in vast areas of the world. These questions need to be addressed systematically and energetically. Advances implemented in the most affluent and developed areas of the world should not allow us to forget that such advances need to be extended in ways that are appropriate for cultures and realities that differ from those in which they were initially developed.

Fourth, identification of differences in subcomponents of cognition (see Chapters 9, 29 and 30, this volume) between students with and without hearing loss lead to two associated questions: What is their source? What kind of interventions can best support learning by either taking advantage of or by remediating these differences? Answers proposed for the first question include the presence or absence of hearing experience and associated effects on neural development (Nicholas & Geers, 2007), secondary effects of levels of language use and ages at which they are attained (Hauser, Lukomski, & Hillman, 2008), and differences in interactive experiences during the early years (Marschark & Wauters, 2008).

It is probable that the primary source(s) will be found to differ depending upon the specific cognitive skill or ability being addressed—but to our minds, satisfactory answers are not available about causal factors for the learning differences that have been identified. That does not mean that answers to the second question need wait until investigation of causes is further along. It is time to begin systematically applying evidence-based intervention and remediation approaches that are aimed at matching the profiles of cognitive abilities as they are identified, not just for large groups of DHH students but for individuals. Such interventions could make use of a response-to-intervention (RTI) approach, an educational and assessment practice that is similar in structure to single-subject research designs in which an individual serves as his or her own control (and is also similar to the “diagnostic-teaching” model that was prevalent in some deaf education settings in the 1970s and 1980s). Systematically designed and evaluated interventions focused on individuals can provide a first step toward acting on rather than simply discussing learning and cognitive patterns of students with hearing loss. Specific approaches toward promoting both literacy and mathematics achievement of DHH students (Chapters 8, 10 and 11, this volume) that are already being implemented might be enriched by specifically targeting interventions to cognitive profiles (Akamatsu, Mayer, & Hardy-Braz, 2008).

Finally, although there has been considerable research and theoretical conceptualizing about identity formation in deaf as well as hard-of-hearing persons (Chapters 13 and 14, this volume), a stronger database is needed on social-emotional strengths and needs, as well as on patterns of development in (p. 477) children with hearing loss. In what way might psychosocial aspects of development reflect or potentially influence patterns of cognition and learning abilities? What long-term psychosocial effects will result from the technological advances and the changes in (or at least the increased options for) educational placements and communication being experienced (see Chapters 6, 15 and 17, this volume)? How does culture mediate development in various developmental domains?

Work on aspects of social-emotional development also needs to proceed with recognition that teachers and others who are directly engaged with DHH students continue to comment about an apparently high prevalence of behavioral and related difficulties. This situation continues in spite of all of the other advances that have been noted here and in other publications. Yes, prevalence and origins of social-emotional and behavioral difficulties must be systematically investigated to a greater extent. But identifying sources for such difficulties in patterns of parent–child interaction, language delays, peer experiences, or even alleged but not always clearly diagnosed organically based disabilities (e.g., autism and attention-deficit disorders) may not be sufficient. At best, such determinations would be only half the job. As with all the other areas we have discussed, systematic implementation of alternative interventions and nonbiased evaluation of results are required. Recognizing and validating the difficult truth of social-emotional and behavioral problems in the population of DHH children and adolescents is needed. To do otherwise benefits no one.

Despite these difficult, uncomfortable truths about gaps in knowledge and practice, the chapters of this volume remind us of all that has been learned and all that we are in the process of learning. Formerly contentious issues (e.g., effectiveness of intervention during infancy, benefits of cochlear implants, and effectiveness of sign languages to support development) can now be discussed with reference to burgeoning databases—and in most company, the discussion can be amicable. Much more is known now about language development across modalities and over time (see, for example, Chapters 18, 19, 21, 22 and 24 in this volume). Although it remains an area in need of intense research, significant amounts of data are available about educational approaches and outcomes (e.g., Chapters 11, 15 and 18 this volume), and researchers focused on basic cognitive processes have begun generating testable hypotheses that have the potential to affect educational interventions (e.g., Chapters 9, 29 and 30, this volume).

The information presented in this volume is only a sampling of that being generated in the field. If our current pace can be maintained, it is almost impossible to envision the outcome of research and practice over the rest of this new century. Even given this rate of progress, however, we are confident that more than a few questions will remain. We are, however, equally confident that the diligent work of researchers, educators, and DHH persons themselves will have resulted in resolving most of the difficult issues and truths we have outlined here. It is our hope that this volume and the efforts of all the authors whose work is included will prove to contribute significantly to such a resolution … and to the raising of new questions that must be answered.


Akamatsu, C. T., Mayer, C., & Hardy-Braz, S. (2008). Why ­considerations of verbal aptitude are important in educating deaf and hard-of-hearing students. In M. Marschark & P. C. Hauser (Eds.), Deaf cognition: Foundations and outcomes (pp. 131–169). New York: Oxford University Press.Find this resource:

Beadle, E. A. R., McKinley, D. J., Nikolopoulos, T. P., Brough, J., O’Donoghue, G. M., & Archbold, S. M. (2005). Long-term functional outcomes and academic-occupational status in implanted children after 10 to 14 years of cochlear implant use. Otology & Neurotology, 26, 1152–1160.Find this resource:

Harkins, J. E., & Bakke, M. (2003). Technologies for communication: Status and trends. In M. Marschark & P. E. Spencer (Eds.), Oxford handbook of deaf studies, language, and education (pp. 406–419). New York: Oxford University Press.Find this resource:

James, D., Rajput, K., Brinton, J., & Goswami, U. (2008). Phonological awareness, vocabulary, and word reading in children who use cochlear implants: Does age of implantation explain individual variability in performance outcomes and growth? Journal of Deaf Studies and Deaf Education, 13, 117–137.Find this resource:

Marschark, M., & Wauters, L. (2008). Language comprehension and learning by deaf students. In M. Marschark & P. C. Hauser (Eds.), Deaf cognition: Foundations and outcomes (pp. 309–350). New York: Oxford University Press.Find this resource:

Moeller, M. P., Tomblin, J. B., Yoshinaga-Itano, C., Connor, C. M., & Jerger, S. (2007). Current state of knowledge: Language and literacy of children with hearing impairment. Ear & Hearing, 28, 740–753.Find this resource:

Nicholas, J. G., & Geers, A.E. (2007). Will they catch up? The role of age of cochlear implantation in the spoken language development of children with severe to profound hearing (p. 478) loss. Journal of Speech, Language, and Hearing Research, 50, 1048–1062.Find this resource:

Stacey, P. C., Fortnum, H.M., Barton, G.R., & Summerfield, A.Q. (2006). Hearing-impaired children in the United Kingdom, I: Auditory performance, communication skills, educational achievements, quality of life, and cochlear implantation. Ear & Hearing. 27, 161–186.Find this resource:

Stokoe, W. (1960/2005). Sign language structure: An outline of the visual communication system of the American deaf. Studies in Linguistics, Occasional Papers 8. Buffalo, New York: University of Buffalo, Department of Anthropology and Linguistics. (Reprinted in Journal of Deaf Studies and Deaf Education, 10, 3–37).Find this resource:

Woll, B., & Ladd, P. (2003). Deaf communities. In M. Marschark & P.E. Spencer (Eds.), Oxford handbook of deaf studies, language, and education (pp. 151–163). New York: Oxford University Press.Find this resource:


(1) In the late 1980s, for example, a proposal by Spencer to present data on interactive behaviors of hard-of-hearing infants was rejected by a committee of a national research and practice organization, which stated that “This is just not a very interesting population.”