Deaf or hard of hearing Students This guide will provide information that will help staff understand the barriers Deaf or hard of hearing students face when they enter higher education. Many of the difficulties centre on the use and acquisition of language. What does it mean to be Deaf or hard of hearing? Hearing loss can occur at any time in a person’s life. Some people are born with no or little hearing whilst others lose their hearing over time. Over 9 million people in the UK are deaf or hard of hearing. There are two main types of hearing loss – conductive and sensorineural. Conductive hearing loss Conductive hearing loss is the result of sounds not being able to pass freely to the inner ear. This usually results from a blockage in the outer or middle ear, such as a build-up of excess ear wax or fluid from an ear infection (especially common in children). It can also happen as a result of some abnormality in the structure of the outer ear, ear canal or middle ear – or be due to a ruptured eardrum. In some cases, severe conductive hearing loss is due to excessive bone growth of the bone in the middle ear. In this type of hearing loss sounds become quieter, but not usually distorted. Depending on its cause, a conductive hearing loss can either be temporary or permanent. Conductive hearing losses can often be corrected with medical management, or minor surgery. Sensorineural hearing loss This type of hearing loss is sometimes referred to as sensory, cochlear, neural or inner ear hearing loss. A permanent sensorineural hearing loss is the result of damage to the hair cells within the cochlea or the hearing nerve (or both). Damage to the cochlea occurs naturally as part of the ageing process (age-related hearing loss is known as presbycusis) but there are many other things that cause sensorineural hearing loss, or add to it; such as regular and prolonged exposure to loud sounds, exposure to harmful drug that damage the cochlea, infectious disease e.g. rubella, a head injury, birth complications, benign tumours or a genetic predisposition. With this type of hearing loss, the ability to hear quiet sounds, understanding speech and a reduced quality of sound that can be heard are all affected. Once the cochlea hair cells become damaged, they will remain damaged for the rest of a person’s life. Therefore sensorineural hearing loss is irreversible and cannot be cured – at least at the present time. Cochlea implants Some people’s hearing loss makes them suitable candidates for a cochlea implant. A cochlea implant is a small electronic device that stimulates any functioning auditory nerves inside the cochlea with an electric field creating the sense of sound. Only those with sensorineural hearing loss are eligible candidates. Cochlear implants in children are still controversial in the Deaf community as ethically unjustifiable. A supplementary factsheet can be found in Appendix J with further facts and figures about deafness and the hard of hearing. Definitions of deafness Mild deafness People with mild deafness have some difficulty following speech, mainly in noisy situations. The quietest sounds they can hear in their better ear average between 25 and 39 decibels. Moderate deafness People with moderate deafness have difficulty in following speech without a hearing aid. The quietest sounds they can hear in their better ear average between 40 and 69 decibels. Severe deafness People with severe deafness rely a lot on lipreading, even with a hearing aid. BSL may be their first or preferred language. The quietest sounds they can hear in their better ear average between 70 and 94 decibels. Profound deafness People who are profoundly deaf communicate by lipreading and BSL may be their first or preferred language. The quietest sounds they can hear in their better ear average 95 decibels or more. How is hearing loss and deafness measured? Hearing loss and deafness is usually measured by testing to find the quietest sounds someone can hear using tones with different frequencies – which are heard as different pitches. The level at which a person can hear a tone is called the threshold. Thresholds are measured in units called dBHL (decibel hearing level). Anyone with thresholds between 0 and 20 dBHL across all the frequencies is considered to have ‘normal’ hearing. The greater the threshold level is – in dBHL – the worse the hearing loss. How does being hard of hearing affect language skills? For severely and profoundly deaf people, learning a language is a different process from the way that hearing people learn language. Having limited hearing significantly reduces a child’s opportunity to engage in meaningful communication and will ultimately affect the learning of language. As a result, for a deaf student, learning any spoken language is not a natural or automatic process and instead becomes a long and intensive task. For many deaf students British Sign Language (known as BSL) is their first language and English becomes their second. However, unlike hearing people who have a second language, deaf people have not had previous experience of learning a verbal and written language. They cannot immerse themselves in the language because they cannot hear it. This will present significant challenges for a deaf person. As BSL does not have a written form and signing does not follow grammar and syntax rules in the same way English does, linguistically, difficulties are most often seen in written work. Mistakes in tense, sentence structure and omission of words are most common. Having no auditory memory and lack of hearing means students are unable to practice what they are going to put down on paper. Reading a language that has never been heard also presents its own challenges. The vocabulary of some deaf students can be limited. If they have not been introduced to a word, they cannot lip read it. This will make reading a laborious task as they have to research not only the new technical language for their specialist subject but also research vocabulary that is more common place to hearing students at a higher education level. As a result, exceptionally long periods of time are spent on reading and preparing assignments, and may require the support of a language or learning support tutor. It is not just subject specific language that deaf students will experience difficulties learning, gaining general knowledge is also challenging. Hearing students absorb information through all sorts of mediums and conversation, including forums, social interactions, newspapers, TV and radio. This helps them to form opinions and skills for higher education. Deaf students can be denied access to this extensive range of knowledge and experience, which will significantly impact their understanding and self-expression. Their work may appear immature or uninformed. It could lack depth of knowledge and demonstrate problems with structure. Deafness can dramatically mask the intelligence and abilities of a student. What sort of academic difficulties will deaf students face? Deaf students studying at a University may show some, none or all of the following difficulties: Reading Difficulty in reading for meaning, including lecture notes, assignments and reference texts means: • It will take longer than average to read, understand and assimilate information. Prioritised reading list should be available. (This may also be true for students with SpLD) • Deaf students require access to dictionaries, references and tutors more often to check their understanding • Planning, formulating, producing and proofing written work takes longer Vocabulary Restricted vocabulary will be shown by: • Particular words may have a fixed meaning related only to previous experiences • Use of more limited range of words than one would expect • Difficulty and/or delay in absorbing and using 'new' technical terminology or apply everyday words to specific technical contexts • Misinterpretation of possibly ambiguous terminology or phraseology • Incorrect verb endings and spelling mistakes in written work • Errors in syntax – e.g. using incorrect word order, words are missed out, or included unnecessarily and other abnormalities in the use of English • Inappropriate or immature styles of writing • Difficulty in producing in-depth written discussion, particularly where the discussion depends upon abstract thinking rather than practical observation. What can be done to help? What follows is a suggestion of some teaching strategies that may help (See the chapter on inclusive teaching for additional guidelines, including marking work, and a more comprehensive discussion). Support plans may include some of these suggestions: • Handouts which are written in a clear, precise style • A glossary of subject specific terminology provided in advance of classes • Assignments that give clear information and state exactly what tasks are to be achieved • Non- ambiguous language in examination questions or assessment briefs and avoid using words that are not strictly necessary • Feedback on draft assignments to assist with relevance, structure, clarity, syntax and spelling where appropriate • Recognition that peculiar or reoccurring errors in a deaf student's written work is most likely to be a direct result of their deafness, not merely the result of carelessness • Credit correct content, but do not penalise peculiarities unduly All this can add up to frustration and feelings of inadequacy as they are awareness of their own limitations. This can lead to low confidence in the presentation of work. Some pastoral support is therefore often appropriate. Deafness is a hidden disability so how will I know if I have a Deaf or hard of hearing student? On first sight it is not always easy to tell if a person is deaf or hard of hearing. However once you begin communication with a deaf person there may be some indicators. They may need to move closer to you to hear you better. They may turn their head to move an ear with stronger hearing towards you. They may watch you mouth (lip read) when you speak. They may have a person with them to interpret what you say into British Sign Language. When a deaf person speaks their language may not always be very clear. This is not true in all cases however. It may depend on when the person lost their hearing or has had any at all. In most cases the deaf person will tell you how best to communicate with them and if you are unsure it is always best to ask rather than make an embarrassing mistake. Some but not all students will use hearing aids, or other devices to support their learning and hearing. Details on an individual student’s level of hearing and preferred method of communication will be in the support plan. Hearing dogs for the Deaf Students or visitors may also use hearing dogs. The dogs are trained to alert the deaf person to specific sounds, such as a door bell, traffic at road crossings or a fire alarm. They help deaf people to lead independent lives. It should be remembered that these dogs are working and should not be distracted from their work. More information is available from the organisation www.hearingdogs.org.uk. What support is available for Deaf and hard of hearing students? When a student identifies themselves to the Disability Service as having a hearing loss, the Disability Service will co-ordinate the support the student will require whilst they are studying at Salford. If you believe a student you teach has a hearing loss but does not appear to have a support plan, they can be referred to the Disability Service, if they want support. Many students who are hard of hearing but not completely deaf may decide they do not need additional support and they are coping well. If this is the case, a student does not have to come to the Disability Service for support. Some people are not aware of the breadth of support available or even that their level of hearing loss would qualify so it can be useful to refer in any case so the student can find out more and make an informed decision. Student Support Plans At a support plan meeting, the student and the Disability Adviser will meet to discuss the student’s individual needs. The Disability Adviser will assess the support the student needs and make reasonable adjustment recommendations. These recommendations are made based on a number of factors including ensuring the reasonability of the adjustment and the need of the student. Once the student and the Adviser agree on the nature of the adjustments, the Adviser will write a student support plan, which is distributed to the School so that those involved in the teaching and learning of the student can begin to make necessary adjustments. Further information on support plans is available in the next chapter. Disabled Students’ Allowance In addition to a support plan, the student will be supported in making an application to Disabled Students’ Allowance from their funding body, if they are eligible. This is funding to help pay for the cost of additional support needs, such as assistive technology and communication support such as interpreters or language support. This process can take two to three months to complete so students are advised to apply as soon as possible to ensure the support can be put in place for the start of each semester. Study time Note takers and/or interpreters may be present in lectures to take notes or interpret what is being said. All support staff should be accommodated by lecturers. The timetabling office is advised to make space for these extra people in the classroom. Assistive technology software may also be useful for deaf students to assist in the production of text, or to support language development. Some students also received language support workers to support them with written text. The appropriateness of these support workers will depend on the student’s level of hearing loss or deafness and whether having this support levels the playing field or gives an advantage. What additional arrangements exist around the University to support Deaf and hard of hearing students? Loops and Infrared Systems A loop system helps deaf people who use a hearing aid or loop listener, hear sound more clearly by reducing or cutting out background noise. A loop system can be used to pick up sound in a range of situations, such as a television, conversations or lectures. Anyone sitting in the area of the loop can pick up sound if they switch their hearing aid – or loop listening aid – to the 'T' setting. Counter loop systems can also be installed at reception desks to provide hearing support for visitors. Infrared systems provide an alternative to loops and reduce the problems of sound signals 'spilling over' into adjoining areas. The deaf learner will need an infrared receiver (which you will need to supply and maintain). Infrared systems are not usually prone to interference unless the receivers are in direct sunlight. Unlike loops, several systems can be used at the same time in adjacent rooms. Infra red and hearing loops are fitted in lecture theatres, conference rooms and reception areas within the University. A hearing loop sticker is displayed on the wall to inform users of their presence. Portable and infra red systems work in the same way as permanently fitted loop systems. They cover a smaller area and can be packed away after use. They are useful if a permanent system is not necessary or possible, or if the loop is needed in different rooms. The signal quality provided by a portable loop may not be as good as that from a professionally fitted system. Portable loops are available on loan from AV services in the University or the Disability Service may help you to source them. Deaf Alerter Fire Alarms Deaf and hard of hearing staff and students have access to Deaf Alerters (available at every reception desk of university buildings). This equipment will alert the user when a fire alarm is activated, to ensure they know to evacuate the building. These are particularly useful to for overnight stays. Deaf Community Network The Deaf Community Network was established by the staff in the Disability Service to bring the existing Deaf community to the University and vice versa. Its activities are outlined further in part one. What is the best way to communicate with a deaf student? Mobile Phones Text messaging is a useful method of communication between the University and students. It is limited by the number of words that can be sent in one message however. It is a useful way to get a quick short message to a student about appointments or room changes. Many services in the University, including the Disability Service, now employ the technology to do this via outlook or other software. It may be wise to check with the School Office to see if this is supported before you use your own mobile. The School Office should also keep mobile contact details on record for quick and easy access. Lip readers Some people who have partial or no hearing can lip read. They usually have some training to be fully competent but to some degree we all lip read when communicating verbally. Lip readers will recognise certain mouth shapes and patterns of mouth movement as representing certain sounds and words. When talking to someone who lip reads, you do not need to slow down your speak or over emphasis your words. In fact this will distort your mouth patterns and make you harder to lip read. Avoid covering your mouth with your hands when you talk and keep your hands lower than your face when gesturing. It can also be helpful to keep your hair tied back and avoid distracting jewellery, like lip or tongue piercings or big earrings or necklaces. Working with BSL interpreters British Sign Language (BSL) is a language in its own right and is not just a version of English with signs. A BSL/English interpreter can help a deaf sign language user and a hearing person to communicate with each other. They interpret from one language to the other. In the UK this will usually be from British Sign Language (BSL) to spoken or written English, or spoken or written English to BSL. Interpreting is a recognised profession and interpreters train for many years. They need a good level of English, relevant qualifications in BSL, and they should have completed approved interpreter training. Sometimes it is appropriate to have two interpreters for one lecture. This is often the case if the lecture is lengthy or contains complex vocabulary. Some people use Sign Supported English (SSE). SSE is not a language in its own right, but more a kind of English with signs. Some countries have their own form of BSL and within a country there are regional variations just as there is in the spoken English language. BSL/English interpreters are used by deaf people: • whose first or preferred language is BSL, or • who use Sign Supported English (SSE). Lecturing staff should speak with the interpreters (who will be hearing) in their classes and find out if there is anything helpful they could be doing to facilitate interpretation of their spoken word for the Deaf or hard of hearing students. Effective communication relies on the sign language user and interpreter seeing each other clearly. The interpreter and anyone relying on spoken English will need to hear any conversation clearly. Interpreters will advise on the best place for them to sit or stand and will take into account lighting and visibility. If you are using flipcharts, an overhead projector, handouts, film clips or practical demonstrations, they must be positioned near to the interpreters so that the BSL user does not have to change the direction of his or her attention between what is being shown and the interpreter. It is good practice for only one person to speak at a time. It is impossible to interpret two people speaking simultaneously. Avoid jargon and abbreviations Allow plenty of time when using visual aids as it will not be possible for the BSL user to study visual aids and to watch the interpreter at the same time. The interpreter needs time to comprehend and reproduce in English what has been signed in BSL and vice versa, so expect short time delays as this happens. This is especially important during questions or discussions. Talk at a reasonable, normal speed and talk directly to the people you are communicating with and not to the interpreter. Basic British Sign Language and Deaf Awareness courses are run by through the Staff Development Unit at the University of Salford and the DCN also has involvement in the provision of BSL for staff in Student Life. A summary • Hearing loss can affect anyone. Some people are born Deaf and other lose their hearing over time. • Learning a language is hard if you’ve never hear it. • BSL can be a Deaf person’s first language. • Learning to read can take a long time and familiar vocabulary can be limited. • University of Salford uses deaf alerters and hearing loops to support those who are hard of hearing. • Some students will use hearing aids, some can lip read, and others will use interpreters when communicating with the hearing.