"an intimate journey through the science of sound and language"
November 7, 2014 12:42 PM   Subscribe

The Mysterious World of the Deaf (Single Link The New York Review of Books)
posted by andoatnp (10 comments total) 15 users marked this as a favorite
 
I read I Can Hear You Whisper over the summer. It's pretty damn impressive.
posted by hopeless romantique at 1:11 PM on November 7, 2014


A nice review! Can I nitpick a thing?

It is true that the human ear (via the Basilar membrane of the cochlea) can resolve somewhere in the neighborhood of 1500 pitches. But just because the CI has 22 electrodes does not mean that with a CI you can resolve only 22 pitches. That just isn't how they work - there isn't a 1:1 correlation with 'notes' and the number of electrodes on the array. To be frank, we aren't entirely sure how the brain interprets pitches from the stimulation on the array, but it seems fairly certain at this point that the number of electrodes is relatively inconsequential. Different manufacturers (of which there are 4) use different numbers. Generally speaking, the sorts of signals your brain is getting from the array has much more to do with the processing algorithms of the device than the electrode number.

In fact, the near-future of CI implantation will be in hybrids, which are half the length of a typical CI and have around only 10 electrodes. These arrays only go halfway up your cochlea with the idea being that if you have normal thresholds in the lower frequencies, you don't need the full length CI, and you can preserve your low frequency hearing (most age-related loss tends to be limited to higher frequencies). Of course, most studies of hybrids thus far have shown that having that electrical stimulation on even just half your basilar membrane tends to kill off the hair cells on the rest of it too, making the hybrid technology a little moot (so maybe don't buy one yet...).

This is all important because it's really critical that people have the correct information about CI's both the good and the bad. Because CI's can be miracles - absolute life-changing miracles, but they also take a lot of work and dedication if you want yours to work, they do not restore normal hearing, and they require a degree of expectation management. There's a lot of misinformation floating out there that seems to fuel debates on CI's, so it's good to sort of be clear about the details.

Also, I really appreciated this: Applying the revelations from MEG scanners to the question of how children learn and acquire language has shown an intimate link not just between sound and learning to speak, but sound and literacy.

This is absolutely true, and this is where I usually start when I talk to and counsel people about implants. I obviously have an opinion on the issue colored by who I am, a hearing person who studies hearing, and I understand that there are cultural and deeply emotional issues at stake. But one of the things a cochlear implant will allow a child to do is become fully literate - they can have the same reading and writing ability as a hearing person, which opens the entire world to them. I like to frame it not as a debate about ability or disability, or Hearing vs. Deaf culture, but about a technology that can allow a child to fully utilize the limits of their mind and have every opportunity available to them.
posted by Lutoslawski at 1:34 PM on November 7, 2014 [8 favorites]


The article is interesting (disclosure: did not finish), but I'm not thrilled with the title -- Mysterious? Really? This seems very othering, to me.

I mean, most hearing folks don't know much about what it's like to be deaf (and I'm one of them), but if you read any memoirs of deaf people, or have deaf friends, the "world" of deaf people doesn't seem that mysterious, I don't think.

Also, I don't know what the data show about hearing and literacy; my boss is profoundly deaf and didn't even learn sign until she was an adult -- she learned to speak and to read speech at a school for the deaf and her mother was deaf -- and she has more than average reading and writing ability. In a couple different languages.

Clearly my boss is an extraordinary person in all kinds of ways, but is there really a lot of data that shows that "literacy" requires implants? Because it seems to me lots of deaf folk have fully utilized the limits of their minds even without them.
posted by allthinky at 3:24 PM on November 7, 2014 [4 favorites]


Clearly my boss is an extraordinary person in all kinds of ways, but is there really a lot of data that shows that "literacy" requires implants?

I think you're confusing a probabilistic statement with a deterministic one. Probablistic: "People who can hear have higher literacy on average than people who cannot." OR "It's easier to develop literacy skills if you can hear."
Deterministic: "Literacy requires hearing."

Probablistic statements are not less true than deterministic ones (e.g. it's no less true that smoking causes cancer just because not everyone who smokes get cancer and not everyone with cancer smokes). They're just a different kind of statement.

So in conclusion: Your boss and other non-hearing people that you know are not an exception to the data. People like your boss are already built into the "average literacy for non-hearing people" calculations and when the same calculations are done for hearing and non-hearing, the hearing show higher literacy.

Finally, please be aware that non-hearing people who you know are not a random sample of non-hearing people. The better their literacy, the more likely they are to be employed in the kinds of jobs where literacy matters (presumably the place you're meeting them) and to be interacting with hearing people more generally.
posted by If only I had a penguin... at 3:35 PM on November 7, 2014 [4 favorites]


The article is interesting (disclosure: did not finish), but I'm not thrilled with the title -- Mysterious? Really? This seems very othering, to me.

Yeah, seconded. I was glad to see it wasn't the actual title of the book being reviewed.
posted by jaguar at 4:05 PM on November 7, 2014 [3 favorites]


The literacy claim is suspect to me as well. The data that I've seen (I got my MA in linguistics) is that the determining factor is not strictly access to sound, it's early access to language. Do you have exposure to language from a very young age, such that your cognitive and linguistic development is not delayed? Are you taught English through a medium you have access to, or are you expected to rely solely on limited hearing? Is your educational system focused on learning, or is it focused on things like which language modality you use, or having to deal with remedial language development because you didn't have full access to language for several years?

I say all of this as someone who has a CI; I grew up with a ton of hearing, though it was through hearing aids, and most of my hearing was lost later in life. So I'm not coming to this from a perspective where anything associated with CIs is inherently bad. I quite like my CI. Nor do I have strong feelings that childhood implantation is always inappropriate. What I *do* think is inappropriate, though, is that we leave to the side a known-successful mechanism for making sure kids have solid language skills (namely, ASL, and print-sign bilingualism), in favor of a mechanism that has non-trivial problems.

I've been asked what I'd do if I had a kid. And honestly, I'm not sure whether I'd implant them; it's a possibility. What I do know, with certainty, is that I would not raise them with only spoken English - exposure to ASL would be critical. I say that knowing that, for me, that's easier; ASL may not be a native language for me, but I know it, it is not a new language. But for families without that access, there's a long history (and a strong tendency in the present) of medical professionals telling them not to sign with their children, because of a claim (for which there are many counterexamples) that you can't raise a deaf child in a bilingual manner. And that has demonstrably resulted in language and literacy problems for deaf people.
posted by spaceman_spiff at 4:33 PM on November 7, 2014 [5 favorites]


Unfortunately, most of the data I have seen shows that Deaf and HoH individuals are indeed more likely to have low literacy levels.

Now - why this is is certainly up for debate, and is debated quite a bit in the literature these days. Of course access to language from birth is critical to any kind of language acquisition or literacy at all. I don't think that's questioned by anyone; what is still up in the air is whether or not aural language particularly is a factor in literacy levels after language acquisition has leveled off (say around 9), and the degrees to and ways in which aural language learning may contribute to language learning that are unique to aural language, as opposed to visual language. There is some theorizing that because of the more robust networks formed by visual-aural-language in the brain, there may be something significant going on there that is somehow unique. The answer is we don't really know - we just have this data about literacy levels among the Deaf, which are of course skewed by a number of factors.

Which makes it all quite hard to study, as there are lot of factors when working with the Deaf and HoH communities that are compounding and make it hard to isolate the role of aural learning specifically in language acquisition (hence the interesting bit about scanning and such). Deafness is often a comorbid condition with other disabilities, and access to services for Deaf children is widely variable, so it's been hard to make any definitive conclusions. Certainly it is totally wrong to say that Deafness itself means you will have low literacy, or that all Deaf people will have low literacy levels.
posted by Lutoslawski at 4:48 PM on November 7, 2014 [1 favorite]


This is an interesting article, thanks.

Certainly it is totally wrong to say that Deafness itself means you will have low literacy, or that all Deaf people will have low literacy levels.

Along these lines, I really liked this quote from the article:

“Deafness as such is not the affliction,” Oliver Sacks has pointed out, “affliction enters with the breakdown of communication and language.”

When I was a late teenager, I became friends with a Deaf guy and learned passable sign language. Through him, I also became friends with a fair number of other Deaf people in my city. One of those people I'm still in touch with today and we became pretty good friends at the time though he moved away later to attend Gallaudet. He is profoundly deaf and used to talk to me a lot about what it was like to be Deaf and the Deaf /HoH community and everything else. I asked a lot of questions and he was always happy to answer them. He went to a public (Hearing) school and always had an interpreter and from what I could tell he fit in well and was pretty well-liked there. Most of his friends were Hearing and they also communicated with him using rudimentary sign language. I remember him telling me that he thought that the type of schools that Deaf kids go to make a big difference. He didn't think that Deaf schools were good for Deaf kids, though I don't really remember the details why (it was a long time ago). I'm wondering how much of a difference this makes and if it's an issue at all within Deaf and HoH communities or just a random opinion of my friend.
posted by triggerfinger at 5:43 PM on November 7, 2014 [1 favorite]


Clearly my boss is an extraordinary person in all kinds of ways, but is there really a lot of data that shows that "literacy" requires implants? Because it seems to me lots of deaf folk have fully utilized the limits of their minds even without them.

I have just been studying this in my Aural Rehabilitation class!

Academically, kids with about a 30dB hearing loss (considered mild) tend to be about a year behind their non-HOH (hard of hearing peers), and how far behind kids fall tends to be pretty well correlated to degree of hearing loss, with a 50bB HL leaving kids about 3 years behind. The average level of academic ability in people with moderate-to-severe hearing loss is about 3rd or 4th grade for literacy.

Kids with impaired hearing miss out on a lot of input that helps infants, toddlers, and preschoolers develop language and speech. Language skills are strongly connected to literacy, because English orthography, for all its sloppiness and "more exceptions than rules," builds on spoken language skills.

This is a problem with deaf education more than deafness per se. Parents rarely get the information they need to support literacy in a child's early years, and many deaf and HOH kids are educated in public schools where they may be one of a very few kids with hearing impairments (especially if they have a hearing impairment without any co-morbid conditions). They don't have access to teachers who are experienced in working with deaf and HOH kids, or ways to accommodate them effectively in the classroom.

Where and how to educate Deaf and HOH kids is a big conundrum, and it's not clear what the best options are. Kids who go to Deaf schools (many of them residential) can develop fluency in ASL and participate in Deaf culture, but can end up isolated from family and from their local community. I was astounded by how few parents of Deaf and HOH kids who use ASL develop any real facility with ASL; something like 2%? I've studied ASL and, like any second language, it's challenging, so I don't want to sound like I'm blaming parents. But a big question about educating Deaf and HOH kids is the trade-off that exists over whether the goal is to participate in Deaf culture, or to be as much a part of the hearing community as possible. All of my professors have bemoaned the distrust that exists between many Deaf adults and hearing people who work with Deaf/HOH people, which can prevent the development of a good understanding of what best practices really are.

I've also been taken aback by the work that has to be done post-implant. Lutoslawski could certainly speak more to this than I could. But it can be months and years of intensive therapy, and it doesn't create normal hearing. As a parent of three kids, I found myself wondering whether I'd have the discipline and commitment to do what really needs to be done to help a child with a cochlear implant make the best possible use of it. We're good parents, my partner and I both know some ASL, we both have experience with Deaf and HOH people, but whether we'd really be good candidates as a family for a child with an implant, I honestly couldn't say for sure.

Thirding the reaction to the problematic title.
posted by not that girl at 6:18 PM on November 7, 2014 [1 favorite]


Academically, kids with about a 30dB hearing loss (considered mild) tend to be about a year behind their non-HOH (hard of hearing peers), and how far behind kids fall tends to be pretty well correlated to degree of hearing loss, with a 50bB HL leaving kids about 3 years behind. The average level of academic ability in people with moderate-to-severe hearing loss is about 3rd or 4th grade for literacy.

Are there studies about whether ASL from birth (or close) mitigates or eliminates this disparity, though?
posted by jaguar at 6:44 PM on November 7, 2014 [2 favorites]


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