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Michailakis, D. 1997. Government Implementation of the Standard . Deaf-blind individuals form a Rules as Seen by Member Organizations of World Federation highly heterogeneous group that tends to have varying of the Deaf. Helsinki: World Federation of the Deaf. degrees of and visual impairments. Deaf-blind Miles, M. 2004. “Locating Deaf People, Gesture and Sign in African Histories, 1450s-1950s.” Disability & Society 19:531–545. individuals tend to prefer being referred to as Mponda Mission diary. [1889–1891] 1974. Part III: A Portuguese “Deafblind,” “Deaf-Blind,” “Deaf-blind,” “deaf- Mission in British Central Africa. Translated by I. Linden. blind,” or “deafblind.” As with other disability classi- International Journal of African Historical Studies 7:688–728. fications, can be viewed from two Mutwa, V. C. 1998. Indaba My Children, rev. ed., pp. 232–239, opposing perspectives: the medical model and the 261, 313, 414–415, 422, 574–576. Edinburgh: Payback. cultural or social model. The terms deafblindness or Nachtigal, G. 1971–1987. Sahara and Sudan. Translated by A. Fisher and H. Fisher. Vol. I, pp. 218; Vol. IV, pp. 4, 243. London: Hurst. deaf-blindness tend to emphasize the medical condi- Naniwe, A. 1994. “The Deaf Child in Burundi Society.” In The tion of the disability, whereas the terms Deafblindness, Deaf Way, edited by C. Erting et al. Washington, DC: Deaf-Blindness, or Deaf-blindness tend to focus on Gallaudet University Press. the cultural membership of the individuals with the Ngugi, J. 1971. A Grain of Wheat, pp. 6–7. London: Heinemann. disability. The labels deaf/blind and individuals with Nunn, J. 1996. Ancient Egyptian Medicine, p. 94. London: British a dual sensory impairment should be avoided because Museum. Odebiyi, A. and F. Togonu-Bickersteth. 1987. “Concepts of they are ambiguous. The term deaf/blind is ambigu- Management of in the Yoruba Medical System.” ous because it seems to refer to deafness or blindness Social Science & Medicine 24:645–649. instead of the combination of both impairments. The Ojile, E. 1999. “Education of the Deaf in Nigeria: Past, Present term dual sensory impairment leaves open to interpre- and Future. In Global Perspectives on the Education of the tation which two are actually impaired. Deaf in Selected Countries, edited by H. Brelje. Hillsboro, An individual is diagnosed with a hearing impair- OR: Butte Publications. Okyere A. and M. Addo. 1999. “Historical Development of ment if the individual has a greater than Education of the Deaf in Ghana.” In Global Perspectives on 30 db in the better ear. There are different types of the Education of the Deaf in Selected Countries, edited by hearing loss. A consists of H. Brelje. Hillsboro, OR: Butte Publications. damage to or obstruction of the outer or middle ear. A Oteng, F. S. 1988. Give Them a Name. Kumasi, Ghana: Kumasi sensorineural hearing loss is caused by damage to the Catholic Press. inner ear or the auditory nerve. A mixed hearing loss ———. 1997. Deaf Adwoa Benewaa. Kumasi, Ghana: Kumasi Catholic Press. is diagnosed when an individual has both a conductive Pahor, A. L. 1992. “Ear, Nose and Throat in Ancient Egypt.” Journal and a sensorineural hearing loss. is of Laryngology & Otology 106:677–687, 773–779, 863–873. caused by damage to the auditory cortex of the brain. Penn, C. and T. Reagan. 1999. “Linguistic, Social and Cultural A hearing loss of any kind can range from mild to pro- Perspectives on in South Africa.” Indian found. A conductive hearing loss can often be aided Journal of Applied Linguistics 25(1/2): 49–69. with hearing aids and/or surgery. A conductive and Sangaré, M. L. 1978. Sourd-muet: je demande la parole, pp. 120–122. Dakar: Nouvelles Editions africaines. a cortical hearing loss often cannot be improved by Sarr, S. 1981. “Handicap et société en Afrique.” Educafrica, hearing aids or surgery because of the nerve damage, pp. 153–164 (Special issue). which causes distortions of sound. Schmaling, C. 2000. Maganar Hannu. Language of the hands, A visual impairment is commonly defined as p. 17. Hamburg: Signum. poorer than 20/70 visual acuity after correction or a Sibree, J. 1884. “Notes on Relics of the Sign and Gesture Language restricted visual range of 45 degrees or less in the among the Malagasy.” Journal of the Anthropological Institute 13:174–183. better eye. A visual impairment can be caused by damage to the eye itself, damage to the visual nerve, or damage to the visual cortex. ᨘ DEAFBLINDNESS The causes of deafblindness vary greatly among the population of deaf-blind individuals. The potential The term deafblindness describes a disability in which causes of deafblindness include genetic syndromes an individual has both a hearing impairment and a (e.g., Usher’s syndrome, CHARGE Association, D-Albrecht-4690.qxd 8/27/2005 2:23 PM Page 358

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Goldenhar syndrome), illnesses or diseases of the community. Most Deaf individuals are very proud of mother or child (e.g., , , cytome- their language (e.g., ), which galovirus, and tumors), or accidents (e.g., head injury). is commonly used in poetry and art. Deaf individuals A combination of any of the above causes is also pos- also display a number of culturally characteristic behav- sible (e.g., an individual is born deaf due to a genetic iors. The most pronounced are possibly the attention- syndrome and later loses her vision due to an accident getting behaviors, which include stomping feet, waving or illness). The most common genetic syndrome caus- arms across a large room, tapping on the shoulder, or ing deafblindness is Usher’s syndrome and the most even flashing lights. Deaf individuals tend to marry common disease to cause deafblindness is rubella. other Deaf individuals. Similarly to members of other Depending on the underlying cause of deafblindness, minority groups, Deaf individuals often experience the type of hearing and vision loss is also likely to oppression by mainstream society. vary. For example, individuals who experience a Individuals who were born blind or became blind vision and a hearing loss secondary to Goldenhar early and later became deaf are more likely to use spo- syndrome are most likely to have a conductive hearing ken language as their main means of communication. loss and damage to the eyes due to differences of the Due to their hearing loss, they might later add some structure of the skull, whereas individuals who had signs, , Tadoma, or other forms of man- meningitis tend to have a sensorineural hearing loss ual communication (e.g., printing on the palm) to aid and a vision loss due to damage to the visual nerve. in communication. These individuals tend to identify Deafblindness must definitely also be viewed from with and therefore associate primarily with the blind a cultural perspective. Similarly to the medical back- community, individuals from the mainstream culture, ground of deaf-blind individuals, deaf-blind individu- or the disabled community. Due to their deafness they als’ cultural identity varies greatly. Depending on the are later also likely to associate with the Deaf-blind age at which individuals became deaf and blind, they community where they are more likely to have more are more likely to associate and feel close to others equal access to communication. most similar to themselves. This similarity is often Individuals who are born or become deaf early and based on the preferred method of communication used later become blind are likely to use a signed language within the different groups. Individuals involved in the as their main communication method and therefore blind community and the mainstream community are associate with other members of the Deaf community likely to use spoken language as their main means of and be mostly involved in . Because of communication, whereas individuals involved with the their ties to the Deaf community, they are likely to Deaf community are likely to communicate by using remain involved with Deaf culture, but later also be a signed language. The Deaf-blind community is the involved with the Deaf-blind community. At least one community with the most diverse communication scholar has argued that a substantial number of deaf methods. Some may use a signed language, while individuals who become blind feel ostracized by the others may use a spoken language; others may use Deaf community and thus withdraw and associate writing, Braille, Tadoma (i.e., tactile speechreading), more with the Deaf-blind community. while still others may use a combination of all of these. The individuals who are born deaf-blind are likely For a number of decades, research on the Deaf to associate either with the Deaf community, the blind community has yielded a wealth of knowledge about community, the Deaf-blind community, the disability Deaf culture as a minority culture. Deaf individuals community, and/or mainstream society. It will most tend to view themselves as members of a linguistic likely depend on the severity of their hearing and minority within American society and often do not vision loss, on the community in which they grew up, view themselves as disabled. Members of the Deaf on the type of schools they attended, and on which lan- community tend to have a number of characteristics in guage they prefer to use. For example, individuals who common: They share a physical attribute (i.e., their consider their deafness to be the most important aspect deafness) and tend to identify as members of the Deaf of their identity and who use a signed language are D-Albrecht-4690.qxd 8/27/2005 2:23 PM Page 359

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likely to associate with the Deaf community, whereas Deafblindness is likely to affect cognitive, language, individuals who have significant amounts of residual social, and emotional development. Individuals who hearing and vision and primarily rely on spoken lan- are born both deaf and blind commonly experience sig- guage will associate mostly with mainstream society. nificant delays because they are not able to observe and The individuals who spent most of their lives as thus learn about the world as readily as sighted and/or sighted and hearing individuals and then all of a hearing infants. According to Piaget, whose research sudden became Deaf-blind are most likely to feel the focused on cognitive development, individuals need to most disoriented regarding culture and community gain experience within their environment to acquire membership. They are most likely to have spent most the skills and the knowledge necessary to successfully of their lives in mainstream society and to have used complete the tasks for each of the four developmental spoken language to communicate. As Deaf-blind indi- stages. The sensorimotor period, the stage between viduals, they are likely to need to learn alternate meth- birth and two years of age in which infants learn about ods of communication and depending on which of the the basic properties of objects, progresses through a plethora of options they choose and prefer they may series of substages, and culminates in the infant’s abil- join any of the communities. This group is especially ity to mentally represent objects. Infants acquire object likely to be drawn to either the Deaf-blind community permanence, the knowledge that objects continue to or the disability community because in both of these exist even when they are hidden. This is considered a communities a diversity of communication options difficult task for blind and deaf-blind infants because seems to be accepted allowing these individuals full they only learn about the world within their reach. participation and access. There are limited or no visual and/or auditory clues to When considering deafblindness from a develop- provide them with information. Interesting objects mental perspective, it is possible to consider deaf- within the environment encourage infants to investigate blindness from both the medical and the cultural or their surroundings. For blind and deaf-blind infants, social perspectives. Researchers following the med- this is not the case. Therefore, they spend a lot of time ical perspective, the most common point of view in the position they were put down in often resorting to within the field of developmental science, tend to self-stimulating behaviors. Similar observations can be focus on the deficits of deaf-blind children and on made throughout deaf-blind children’s development. the delays they experience in comparison to their With increasing age, the delays become greater and it typically developing peers. Within the developmental becomes difficult for them to catch up to their peers. science framework, the cultural model, however, It is therefore beneficial for the development of deaf- allows researchers to study the plasticity of develop- blind infants that they are diagnosed and that age- ment in general and to learn about the development of appropriate stimulation is started young. identity and cultural affiliation of minority groups. Deaf-blind children’s language development is From a developmental medical point of view, the also at risk for significant delays. First, deaf-blind most important aspects of deafblindness are the age children, as blind children in general, are likely to of onset and the severity of the hearing and visual be delayed in their mental representation abilities and impairments. According to the developmental model, subsequently in their language development because the two sensory impairments multiply the effects of language requires mental representation and actually one another and intensify the impact each one has on is considered a complex form of mental representa- an individual. Having two impairments likely inhibits tion. Second, deaf-blind children with a significant the compensation of one impairment through the use hearing impairment tend to be delayed in their lan- of the other (e.g., compensating for deafness by guage development because they are likely to not have lipreading). Consequently, the earlier the auditory and access to language. They cannot hear spoken language the visual impairments occur and the more severe and they cannot see and thus imitate gestures or signs. the level of each impairment is, the greater are the Some deaf-blind infants, similarly to deaf infants, consequences on development. may develop their own rudimentary gestures for certain D-Albrecht-4690.qxd 8/27/2005 2:23 PM Page 360

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objects or events. However, due to the likely lack of ᨘ DEAFNESS, MILAN mental representation skills, infants born deaf-blind are CONGRESS OF 1880 ON even less likely than deaf infants to be able to string together individual gestures to form complete thoughts In 1880, a congress for the Deaf was held in Milan. or express desires. On the other hand, those young The delegates saw an attack on sign language and children who either became deaf-blind after already thereby on the possibilities for their emancipation. acquiring mental representation and those who have sig- Even for some years previously, the “oral method” for nificant residual vision and/or hearing are likely to learn the instruction of the deaf had predominated in state mental respresentational skills more easily than their institutions and private schools in Europe. Yet there peers who were born completely deaf-blind. was still not unanimity in the matter. Some schools When discussing the medical model within the field remained faithful to the French method inherited from of developmental psychology, it is important to ask Abbé de l’Épée, which consisted of gestural signs and whether this model provides a complete picture with all writing. And within certain national institutions, some the answers. Most likely this is not the case. As research teachers, deaf and hearing, defended the use of signs studies have shown, the environment is essential to the despite the increasing hegemony of partisans of the prediction of later outcomes in children. This is partic- oral method. Among the latter are some of the hearing ularly the case for deaf-blind children. If deaf-blind teachers at schools in Paris, Bordeaux, and Chambery; children are provided with an accessible language and the instructors in the schools created by the Pereire an accessible environment in which they are stimulated family; the Brothers of St. Gabriel, a religious order and encouraged to investigate their surroundings, they devoted to the education of the deaf; and the learn at a similar rate as their hearing and sighted peers. Protestant teachers of St. Hippolyte du Fort in the In summary, deaf-blind individuals represent a highly Cévennes in the south of France. diverse group of individuals. Deaf-blind people can All these educators wished to ratify the dominance acquire their impairments at different ages. They have of the oral method and make it exclusive. Debates varying degrees of hearing and vision impairments, took place at the Milan congress, and they were at which can affect their developmental pathways. They times quite fierce, especially on the part of Italian del- may communicate in a plethora of ways. They can iden- egates, who advanced religious arguments: the need tify as members of a variety of cultural groups. Each one for communication in order to confess and be of these factors can have an impact on the individual who absolved, or the fact that, since God had given man is deaf-blind. As will all people, it is important to view the faculty of speech, all good Christians ought to and respect each deaf-blind person as an individual. speak whereas signing was proof of mental retarda- tion or degeneration. —Ingrid C. Hofmann A vote was taken, and an overwhelming majority of See also Blind, History of the; Laura Dewey Bridgman; Helen delegates (almost all hearing; France had only one Keller. deaf teacher as representative) passed resolutions that all had the same orientation: The oral method was to Further Readings be preferred over mimicry. Since deaf signing had the Aitkin, Stuart, Marianna Bultjens, Catherine Clark, Jane T. Eyre, disadvantage of being detrimental to speech and even and Laura Pease. 2000. Teaching Children Who Are to the precise expression of ideas, it was preferable Deafblind: Contract, Communication, and Learning. to suppress sign language. Yet all deaf-mutes needed to New York: David Fulton. be educated and governments were encouraged to take Goode, David. 1994. A World without Words: The Social the necessary steps. Not all participants supported these Construction of Children Born Deaf and Blind. Philadelphia: resolutions and the American representative, Edward Temple University Press. McInnes, J. M. and J. A. Treffry. 1993. Deaf-Blind Infants and Miner Gallaudet, criticized them sharply, arguing Children: A Developmental Guide. Toronto: University of that the country with the greatest number of deaf Toronto Press. pupils, the United States, had only 5 delegates at the