Professionals and Organisations working with Deaf people

Traditionally the three great social institutions with an interest in “the deaf” and “deafness” have been the Church, the medical profession and the education profession.  Today we might add that social services also have an interest.  In a recent workshop the deaf facilitator asked all the participants the name of their social worker.  Many of the hearing participants looked bemused because they didn’t have a social worker.  Those who did have a social worker had one because they had a deaf child.  Most of the deaf participants mumbled something sheepish about knowing who it was but didn’t see them very often these days unless they had a problem.   The facilitator was impressed by this.   When he was growing up, all deaf people had a social worker to do all sorts of things for them, such as help them buy or sell their house or car, help them get a job, sort out their marital problems or get a loan. In those days the deaf people really believed they needed a social worker to do those things.   Today, all a deaf person needs is the interpreter (although some people might say that all the hearing estate agent/banker/solicitor needs is an interpreter…) and they can do all the same things as a hearing person can do.  They don’t need a social worker to do it all for them.  Perhaps the day will come when most deaf people are as surprised as hearing people when asked that question.

One bitter joke against cochlear implants runs that deafness must not be eradicated because if deaf people became just like hearing people, what would all the helping professionals do for a job?  Certainly there does seem to be a “deafness industry”.  

One large area of the “Deafness industry” is not in services at all but in technology provided for deaf people.  Some of this technology works to increase the amount of sound that deaf people can use (i.e. makes deaf people more like hearing people).  Some technology replaces sound and is perhaps more in keeping with the idea of deafhood than deafness from a hearingness perspective.

Considerable time and effort has been spent on the first type.  Again, is this because of an unquestioned agenda of "hearingness"?  Many of the developments in the second category have been developed by deaf people themselves.

Telephones were once the great piece of "excluding" technology for deaf people, and were often cited as reasons why a deaf person could not advance in their career.  Now, however, telephones can also be based upon the written word, so that people with no hearing and those who do not speak can use the phone.  Minicoms first became commercially viable for people in the early 1980s, when they were called Vistels, for a while.  (Before then there was a machine much like a teleprinter).  The term “minicom” is a trademark term for the more general idea of a “text phone”.  It’s a bit like calling a vacuum cleaner a “Hoover”. Minicoms have developed greatly since the 1980s.  Apart from the basic function of typing messages and receiving them on the running display screen, modern machines can also store the message so that it can be played back afterwards to check things and store a pre-prepared message that can be sent much more quickly than one that is typed "on-line".  This saves money because slow typing costs a lot in time.

Minicoms have made a tremendous impact on the deaf community.  Some people have claimed that they are contributing to the decline of the deaf club, because in the past deaf people had to go to the club to see people to give them a message, and now they can just ring them.  (Another "culprit" might be the introduction of 888 subtitles on television - why go out to the deaf club for your entertainment if you can stay home and watch TV?)

One drawback is that they can only be used in conjunction with another minicom.  For several years, now, Telecom and the RNID have run Type-talk.  This is an operator service, allowing people without text-phones to ring people with text-phones (and vice versa).  Calls are re-routed via Liverpool, where an operator acts as the go-between.  Some members of the deaf community object to the scheme because it means fewer hearing people will get minicoms.  Others are glad that they can ring numbers, especially of public institutions, that would otherwise be inaccessible.

Another major drawback is that minicoms need English, and typing skills.  Video phones do not, because people can sign into them.  They are still limited in numbers, much more expensive than minicoms, only good for phoning other signers, rather too small for the signing to be seen easily, and don't give a perfect signal.  But given time and demand, they will probably be the telephone success story of the next decade or so.   Over the last two years, video-phones have become a realistic commercial proposition.  Soon they will reach “critical mass” (i.e. enough people will have them to make them commercially viable) and we may expect deaf people to use them.  Trials are going on at CDS now to work out the most deaf-friendly way to use videophones. 

Faxes are also important long-distance communication devices.  Many deaf communities around the world do not use text phones but rely on faxes, instead.  Mobile phones such as the Nokia communicator can combine mobile text phones with short message systems and faxes.  These are also being developed at the Centre.

Alarms of many kinds can easily be provided to warn of fire, smoke, morning, babies crying and doorbells.  These may be vibrating or flashing.  The flashing lights can be rigged up to the house lights.  In the past, deaf people have had many ingenious methods of being alerted to things.  Some people balanced a ball on string on top of the bell, so when the bell rang, the ball fell off and swung back and forth.  Other people have engaged the services of cats, dogs and budgies to alert them.  In the war, people relied on neighbours to alert them to air-raid warnings and all-clear signals.  One story is of someone who tied string round her toe at nights and put the string out of the window, and the missioner for the deaf would tug on it on his way to the shelter.

Television is becoming more accessible to deaf people.  There are many gadgets for hard of hearing people, such as amplifiers, headphones and infra-red loops.  For deaf people, there is teletext, and especially subtitles on page 888. There is also interpreting, although this is only for a few hours each year.  It is cheaper than subtitling, and does not make the deaf person rely on English.  However, the audience for interpreting is much smaller than that for subtitling (because most people who cannot hear television use English as their first language) and there is no simple way yet to broadcast "closed interpreting" in the way that we can broadcast "closed captions".  With digital TV, however, this might soon be possible.

One large area of technology is “medical technology”, concerning hearing aids and cochlear implants.  We will consider cochlear implants in a later session but the whole area of audiology is one that employs large numbers of specialised medical and technical personnel.  These are listed and described in Martin and Grover, and also in McCracken and Sutherland.

Hearing aids come into the category of medical technology.  They can only amplify sound, and can't restore hearing at frequencies at which the person cannot hear.   They are not like glasses, which can correct abnormal vision and make it like normal vision.  Most people can hear something with a very powerful hearing aid, but for some people, it is so little, that it is irrelevant.

Hearing aids are often very useful for people with middle ear deafness, because that is basically a problem that the sound is not getting through to the inner ear.  Amplified sound stands a better chance of getting through.

They are also a great help for hearing people who start to lose their hearing.  Many deaf children are able to make use of the aids enough to acquire speech, because they can hear under perfect conditions, but the aids are useless in other day to day situations where there is background noise.  Other deaf children derive no benefit from them at all, hearing only buzzes and peeps which are meaningless.   Many deaf adults will say that they hated them.  They may itch, or cause pain if there is recruitment, and they may cause tinnitus.  Deaf people who were forced to wear powerful hearing aids as children often develop tinnitus, and hearing aids are blamed.  To my knowledge there is no formal research on this.  The powerful sounds may also further damage the ear.

The technology of hearing aids has developed rapidly, as may be seen in the description on the See Hear video (Series 5, programme 17).

Today, most NHS hearing aids are "behind-the-ear" models.  They consist of

a)     a microphone, to pick up the sound and change it to an electrical signal

b)     an amplifier, to increase and control the size of the signal

c)      an earphone (or receiver), to convert the signal to sound again

d)     a battery for the amplifier.

There are very sophisticated variations on this, so that certain frequencies may be filtered out, or amplified preferentially, or limits be put on the output to protect from recruitment, but basically they are the same.

A person's dB hearing loss is not directly related to the amplification needed because

a)     the natural amplification by the auricle is lost

b)     recruitment must be avoided.

The hearing aid usually amplify the range of 250-4,000 Hz (which is where most speech is).  Lower frequencies are amplified more to cut out background noise.

All the works are in a case tucked behind the ear, and the sound passes down a tube to the ear mould.  This is frequently "skin coloured" so that it is less noticeable.  It is only recently that "skin coloured" plastic has been anything but pinky-grey, but times are changing slowly.  Some deaf fashion designers have tried over the years to produce brightly coloured hearing-aids (to parallel fashion accessories such as red glasses or sunglasses worn after dark) but they don't appear to have taken off in a big way.  Another designer makes hearing aids that have a little "hair piece" attached to the mould so that the hearing aid is covered by little wig. (No jokes about earwigs, please!)

In-the-ear models are less obvious than behind-the-ear aids, because all the components are built into the ear mould and can be tucked into the ear.  However, they are not as powerful as behind-the-ear aids.  They have the advantage of being cheap to make and can be sold as a solution to some of the problems of people with mild or moderate hearing loss, a bit like off-the-peg reading glasses solve basic long-sight problems.

Body-worn aids are the most powerful, and have easily manipulated controls.  For this reason they are often used on small children, and for old people with arthritis.   Children now are less likely to use these body-worn aids, because the behind the ear ones are getting more and more powerful.

Radio aids convert sound from a microphone worn by the speaker into radio waves that are then picked up by a radio receiver worn by the deaf person.  These cut out all background noise, and enable the speaker to turn away from the deaf person or even be a long way off and still be heard.  They can be used by deaf children in mainstream schools, so that the child can hear the teacher.  However, it means that they can't hear the other children in the classroom.

Telecoils use magnetic fields, rather than sound.  They are found in loops.  Loops are basically a wire running around the room, with an amplifier that makes the magnetic field.   Like the radio aid, it makes the sound easier to hear.  The same telecoil is found in telephones, which can create a magnetic field around the earpiece, so sound can be amplified when the hearing aid is on "T".

Most professionals working with deaf people come from a starting point of the idea of deficiency.

Psychologists who carry out pure research have a scientific theory that to know how something works, you should look at something that is broken and work out from there what the difference is.  Deaf people have often been used as "guinea pigs" in this way, because they have been seen as the "broken" version.  They have frequently been used in language studies as the control group "without language" to compare to hearing people who do have language.  This is not good for a deaf person's self-image.

Clinical psychologists often look at the deficiencies caused by deafness and attempt to cure them.  It is possible, though, that the psychiatric problems that deaf people have (and they do, there is no doubt) are not caused by deafness per se, but by being deaf surrounded by hearing people who are trying to change them from failed hearing people into hearing people.

Psychologists have a great deal of power in our society, and many of them still fundamentally misunderstand deaf people.  It would be nice to think that this was a thing of the past, but (apart from some notable exceptions) psychologists still do not understand what they are doing wrong.  Recent accounts of a deaf man released from a mental institution after 16 years when people realised he was only deaf, are continuing a long, sad tradition of such cases.

Psychological tests are not designed for deaf people, and yet are used with deaf people.  Chapter 11 in Lane, Hoffmeister and Bahan provides a very useful critique of psychological testing of deaf people.  Firstly, communication between the testing psychologist and the deaf person is often very poor, and the deaf person usually needs to use English, which may mean that they don't understand the question.  The language used in many of these tests might also be too difficult to understand.  They might also give false results for deaf people.  For example, a deaf person who is asked if they like group discussion will want to know if the group is deaf or hearing, but the question won't tell them this, because the hearing people who designed the test never thought about this.   Many items on routine tests suppose that a person is hearing.  You could ask a hearing person "do you feel people stare at you when you enter a restaurant?" or "do you often think that people might be talking about you behind your back?"   If they say yes, you might think they are a bit paranoid because probably no-one is staring or talking about them.  But if a deaf person says yes, it needn't mean they are paranoid because people will stare at them if they are signing, and probably do talk about them behind their backs!

Audiologists measure the lack of ability to hear.  For most hearing people with hearing loss, this is understandable, but for deaf people, again, it reinforces the idea of loss and deficiency.

Surgeons and doctors try to cure deafness.  This is good if it is possible and if the person wants to be "cured".  But often the goal to achieve some hearing becomes the only aim, and other factors are not considered, so that many risks are taken with the person's health in order to effect a cure.  Deaf people who become hearing can feel devastated by the change in identity.  Arden Neisser (in “The Other Side of Silence”, on your reading list) describes a woman who grew up deaf and became hearing as an adult.  She was miserable and eventually rejoined the deaf world when the operation’s effects were reversed.  There are also accounts of people with cochlear implants switching them off when they realise that they don’t actually like the sound that they are receiving.

Teachers usually aim to teach children about their world and society.  Most teachers of deaf children, though, teach about the hearing world and society, not the deaf world and deaf society.  There are some exceptions, such as at the Royal School for the Deaf at Derby, but they are exceptions, and as more children are mainstreamed, they will only learn about the hearing world.   There are too few deaf teachers.

Teachers' aim is often to make the children as much like hearing children as possible, especially in the teaching of English.  They often expect low ability because the child lacks English or an ability to communicate with the teacher.  There is often less emphasis on the teacher's lack of ability to communicate with the child.  British teachers, particularly, have had a low expectation.  In other countries, this is less true.  For example deaf people in the Nordic countries have very good English skills, because everyone is expected to.  No-one assumes that the deaf will be an exception.  the introduction of the national curriculum in Britain has meant that many teachers who had low expectations of deaf children have found that they have had to teach to a certain level and found that the children can cope after all.

There are many tests to show children's reading skills (or lack of them!), and there are many remedial programmes to teach deaf children better English.  Yet, there are very few good tests for children's sign language skills, and there are even fewer remedial programmes to teach deaf children better BSL.  Tutors of BSL are all trained to teach adults, and mostly hearing adults.  There are also no tests to check a teacher's skills in BSL.  CACDP exams and the courses that lead to CACDP qualifications all expect learners of BSL to communicate with adult deaf people, not children. 

Social Welfare workers can actually encourage dependence by doing things for deaf people, instead of showing them how to do it themselves

It would be a mistake to think that these people are bad.  Many of them devote their lives to trying to help deaf people, and do it with the best of intentions.  The problem comes from an inability to understand the way that hearingness influences the way they see the situation.

The course is copyright
to the Centre for Deaf Studies and the Lecturers named above
and should not be used for any other purpose than personal study.
© 2000

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This page was last modified January 25, 2000
jim.kyle@bris.ac.uk