Journal articles on the topic 'Hearing impaired children Special education. Comparative studies Hearing impaired children Hearing impaired children Special education Special education'

Introduction. The article studies the development of special education degree courses based on modern multimedia technologies. The purpose of the research is to reveal the possibilities of using interactive resources in the context of special education degree programmes. Materials and Methods. The study utilized a systematic approach to understanding the concept of special education and employed retrospective and comparative analyses. An online questionnaire was used to collect empirical data in order to clarify the possibilities of using interactive technologies in special education degree courses. The study involved 156 university students pursuing their undergraduate degrees in the field of Special education (Deaf education), as well as 60 teachers from special education settings for deaf, hearing-impaired and late-deaf children. The study was conducted at Herzen University (Herzen Russian State Pedagogical University), special boarding schools №1 and №31 for deaf children, and special boarding schools №33 and №20 for hearing impaired and late-deaf children in St. Petersburg. Results. The study has revealed the possibilities and areas of using interactive resources and clarified the role of multimedia technologies in special education degree programmes. The authors have identified the most convenient and informative types of hyperlinks for special education. The research findings suggest that special education teachers working with deaf and hard-to-hearing students need interactive resources for the purpose of self-education and professional development. Conclusions. In conclusion, the main possibilities of using interactive resources in the context of special education degrees are summarized. The results obtained indicate the need for increasing the number of multimedia resources in the field of special education, which can be used in a blended learning environment.

The article presents the results of the analysis of the problem of creativity and creative work in children with disabilities having different impairments. This research serves as a basis for conducting a separate study aimed at researching the peculiarities of the search for creative solutions in the process of completing figure drawings in younger schoolchildren with hearing impairments compared to their peers with normal hearing. For this purpose, a comparative analysis of the drawings of hearing-impaired students and elementary school students with preserved hearing was conducted by the criteria of fluency, flexibility, elaborateness, and originality. The need for the present study is determined by the tasks of the modern system of special and inclusive education aimed at the optimal personal development of all children and the creation of psychological and pedagogical conditions for the successful development of different types of creative activity that positively affect their socialization. The study uses a set of theoretical and empirical methods of analysis of the studied problem, as well as a comparative study of general and specific features of creativity in children with preserved and impaired hearing. These specific features are determined by a disproportionate formation of different types of thinking, a delay in the development of figurative memory, verbal speech, and imagination in comparison with hearing children. The novelty of the study consists in the expansion of knowledge about the potential possibilities of creative decisions and creative abilities of persons with developmental disorders at different ages in special psychology and pedagogics. The results of the study of creativity of children with hearing impairments can be used in the educational system for professional orientation and creating conditions for persons with special educational needs to master creative professions.

Present study attempted to explore presence of social skills among hearing impaired students taking education from government special education schools and to compare different level of social skills based on different demographic variables. It is a descriptive study in nature and survey method is used to collect the data. Population of study is hearing impaired children living in division Faisalabad and Lahore. Sample of N=200 hearing impaired students are selected through convenient sampling technique. Responses of social skills are taken from mothers as mothers have better knowledge of proficiencies of their hearing impaired children’s social skills. Children’s age group was 05-20 years. Age range of mothers was 25-55 years. Social skills checklist was used to as tool of the study for collection of data. It is a mixed method approach and statistical measures were made via frequency distribution, t-test and ANOVA. Results of current study clearly depicted that 82% hearing impaired students have low level of social skills and 18% hearing impaired students have best level of social skills. Current study also find out that there is significant difference in social skills of students on the basis of living area and children age and there is no significant difference in presence of social skills in hearing impaired students based on mother’s working status (house wife and job holders) and mothers education level. Study also demonstrated that there was positive correlation among presence of social skills in hearing impaired students and their age. The study concluded that teachers should focus on individual differences while teaching social skills to hearing impaired children and should adopt different teaching methods and teaching strategies for every student. It was also recommended that job holder mothers should manage their time table and must spare their proper time for their special children to make them beneficial and socially adjusted child of community.

Attention Deficit Hyperactive Disorder (ADHD) is a common neuropsychological disorder. Current study focused on identifying ADHD among Hearing Impaired Disorder (HIC) and measuring its impact upon academic achievements of HIC. The study also found out the relationship of ADHD with degree of hearing loss. The target population of the study was all Government institutions of special education for HIC of Southern Punjab. 701 students and 292 parents of HIC participated in the study. Data collection tool was adopted from Diagnostic Statistical Manual (DSM-5) of Mental Disorder (Fifth Edition). One way ANOVA was applied to analyze collected data. ADHD (predominant impulsivity) was found 48% and ADHD (predominant inattention) was recorded 29%. Degree of hearing loss has no relation with ADHD. The ratio of ADHD was found high in males as compared to females HIC. Screening services, skilled staff and proper guidance to parents was recommended to deal students with ADHD.

Background: Parents of special children face physical, psychological and social impact of their child’s disability, including hopelessness and depression. This study is important as it will help professionals plan and provide effective coping strategies so parents could have a positive perception and behavior for disabilities (like hearing impaired and intellectual disability) in their children. The objective of this study was to analyze level of psychological stress among parents of children with hearing impaired (HI) versus intellectual disability (ID) and relationship between disability and psychological stress.Material and Methods: This cross-sectional study comprised of parents (n = 200) of 100 HI and 100 ID children, of both genders, aged 1 to 16 years. These were recruited by non-probability convenience sampling after taking consent from special education centers of Punjab (Pakistan), over a period of six months from May 2017 to October 2017. After collecting demographic details, quantitative assessment of parental stress was done using Parental Stress Scale (PSS). Statistical analysis was carried out using SPSS v21.Results: The sample population (n=200) consisted of 32.5% male and 67.5% female respondents, with a mean age of 41.23 ± 6.7 years. The mean of total parental psychological stress score was 61.85 ± 17.1 with significant association between disabilities (HI and ID) and psychological stress (p<0.01). In HI group, moderate psychological stress was seen (n=53, 26.5%), while in ID group, profound level of psychological stress was noted in majority (n=70, 35%) of participants.Conclusions: Parents of both HI and ID children showed psychological stress, however, parents of ID children suffered higher level of stress.

The government has established special schools to cater to the needs of children with disabilities but they are often segregated rather than receiving equitable opportunities. Artificial Intelligence has opened new ways to promote special education with advanced learning tools. These tools enable to adapt to a typical classroom set up for all the students with or without disabilities. To ensure social equity and the same classroom experience, a coherent solution is envisioned for inclusive education. This paper aims to propose a cost-effective and integrated Smart Learning Assistance (SLA) tool for Inclusive Education using Deep Learning and Computer Vision techniques. It comprises speech to text and sign language conversion for hearing impaired students, sign language to text conversion for speech impaired students, and Braille to text for communicating with visually impaired students. The tool assists differently-abled students to make use of various teaching-learning opportunities conferred to them and ensures convenient two-way communication with the instructor and peers in the classroom thus makes learning easier.

This article examines the current trends in the development and use of computer technology in special education, as well as provides the basic characteristics of the classification of TME. Technical meansoccupy a special positionin the system of education, as their use increases the effectiveness of education. The article states that teaching geography is impossible without the use of visual aids, as most of the objects and natural phenomena presented in the school course can not be observed in nature, and, in this sense, the study of geography requires students to have an advanced imagination and distraction techniques . The use of computer technologies in teaching geography to children with hearing impairment is difficult due to the lack of specially designed electronic aids, particularly taking into account the age and mental development of children in this category and guidelines for working with modern technical means of education. Using TME in a special (remedial) school is of great importance for the overall development of students with reduced motivation to learn. It should be noted that, over time, a number of technical means of educationin special remedial schools is becoming less relevantand is being replaced by modern technical devices, computer technology, for which the methods of operation are not well developedat the moment. The use of technical means opens up new opportunities for extra-curricular and leisure activities of environmental study nature with hearing-impaired students. The intensive nature of introducing computer technology in the educational process of remedial schools and the lack of special modern technical means of teaching geography to children with hearing impairmentare indicative of the need to establish the scientific concept of developing methodological support of technical means of education. The authors highlight the significant role of TME in the formation of knowledge on geographic objects and phenomena in students with hearing impairment.

Introduction. The article addresses the problem of bilingualism of deaf children in the educational process with the main focus on enhancing their creative abilities and socio-psychological adjustment. The purpose of the research is to study and describe the resource for the development of creative abilities and socio-psychological adaptation of children with hearing impairment. Materials and Methods. In this paper the authors provide a review of Russian and international studies into the role of bilingualism in deaf education. The evaluation of creative abilities and socialization of children with hearing impairment was conducted using the following projective methods: ‘Measurement of creative thinking’ (E. Torrance’s Incomplete figure test), N. V. Shaidurova’s measurement of older preschoolers’ creativity, ‘A picture of the family’ by T. G. Khomentauskas (adaptated by O. Y. Piskun and R. O. Agavelyan) as well as sets of survey methods including M. A. Panfilova’s “Sociometric questionnaire for children” and V. V. Tkacheva’s “Questionnaire for parents”. The sample consisted of 16 senior preschool age deaf children and their parents (n = 16). Results. Results. The authors identify the features of the development of creative abilities in children with hearing impairment: a slow formation of verbal speech, role-play interaction, and abstract thinking. The study reveals low socio-psychological adaptation, high parental deprivation and anxiety. In some cases, children are deprived of constructive interaction with their parents. It is emphasized that bilingual learning environment can be considered as a tool of deaf children’s social adjustment. The relevant learning environment can be created within the center of development and psychological and educational support for individuals with special education needs. Competent professionals (including those with disabilities) who use Russian sign language are motivated to communicate with deaf children and their parents for subsequent successful social integration and adjustment. Conclusions. The study concludes that within a personality-centered paradigm of a bilingual educational environment for creative development of children with hearing impairment and their socio-psychological adjustment, the leading factor is the bilingual approach to creating the center for psychological and educational support for families with the main focus on constructive interaction with deaf children.

Objective This study aimed at investigating motivational factors for improved job satisfaction of teachers working in special schools for hearing impaired children in the Punjab province of Pakistan. Study Design and Sampling Techniques Being qualitative in its nature, this study explored in depth responses of teachers selected purposively. Participants The participants comprised both genders with a teaching experience of more than ten years in any educational institute rendering services for education of hearing impaired students. Data Collection Tools Focus group discussions were arranged and a semi structured interview guide was used to elicit in-depth responses of the participants. These responses were then transcribed and thematically analyzed. Results Gazetted post, high pay scale, recognition, serving persons with disability and less working hours came out as the motivating factors, whereas improper student placement, lack of appreciation from administration, stress level, low job status, low respect level emerged as major job dissatisfying factors for the teachers of children with hearing impairment. Conclusion The stakeholders must be aware of top motivational factors and try to nourish them. Non motivating factors should be minimized for teachers of hearing impaired children for their retention and prosperous organizational atmosphere which will ultimately lead to better student achievement.

In the conceptual field of our research the methodological basis of principles of health formation in the course of adaptive physical education of children with hearing impairments is presented. We consider the general principles as the leading provisions, methodological ideas that determine the direction of the educational process of forming a value attitude to health in students with hearing impairments. The purpose of the research is to define and generalize the principles of health formation in the process of adaptive physical education of children with hearing impairments as a component of the theoretical basis of the author's concept developed and proposed for implementation. Methods and organization of research: analysis and generalization of data from special scientific and methodological literature; monitoring of information resources of the Internet; sociological methods (questionnaires); copying method; pedagogical methods (pedagogical testing, pedagogical experiment), methods of mathematical statistics. The research was conducted on the basis of the National University of Physical Education and Sports of Ukraine, as well as Special boarding schools for deaf and hearing-impaired children. The results of scientific research presented in the article have demonstrated a certain range of scientific developments in the direction of the implementation of correctional activities by various principles in the process of adaptive physical education of children with hearing impairments, according to topic 3.23 "Health-forming technologies of children and youth in the process of adaptive physical education".

Lag in the development of physical qualities of deaf and hard of hearing students cannot be considered as a consequence of their main defect, but rather as a result of imperfect process of adaptive physical education and insufficient scientific and methodological validity and development of a number of issues of physical education. The aim of the study is the study, development and implementation of innovative tools in the practice of adaptive physical education of children with hearing impairments and determine their effectiveness. Methods and organization of research: analysis and generalization of data from special scientific and methodological literature; monitoring of information resources of the Internet; sociological methods (questionnaires); copying method; pedagogical methods (pedagogical testing, pedagogical experiment), methods of mathematical statistics. The research was conducted on the basis of the National University of Physical Education and Sports of Ukraine, as well as Special boarding schools for deaf and hearing-impaired children. The results of scientific research presented in the article demonstrated a wide range of scientific achievements in the direction of corrective activities by various means in the process of physical education of children with hearing impairments, and developed and implemented technologies on topic 3.23: "Health technologies of children and youth in adaptive physical education" confirmed their effectiveness in health education among schoolchildren of the established nozology.

<p><em>The condition of special school for the deaf and the deaf itself are still apprehensive, especially in Bekasi, West Java. Meanwhile, deaf persons still need to get an education which equivalent to the education that normal children get. However, education for children with special needs, especially those with hearing impairment, requires special implementations based on deaf’s characteristics in some design aspects in order to improve physical and psychological comfort required by deaf students so they can be more comfortable adapting to school circumstances. Design method that seems appropriate to be applied to this special school for the deaf is psychological architecture approach that focuses on the characteristics of the deaf itself. Psychological architecture as design method that used in this special school is adjusted to the characteristics of hearing impaired in order to improve the quality of physical and psychological comfort of deaf students in the learning process and activities by applying the principles of psychological architecture on site analysis, school layout arrangement, and also the appearance of interior and exterior of special school for the deaf.</em></p>

OBJECTIVES:The objective of our study was to determine the prevalence of refractive errors among children of special education complex. METHODOLOGY:A cross-sectional study was conducted to determine refractive error among the children of special education complex Hayatabad, Peshawar. A total of 272 children were examined from age 5-19 years. Refractive errors were determined by doing retinoscopy, subjective and objective refraction, ophthalmoscope and, hand held auto refractors. Snellen’s charts, lea symbol chart and kay pictures were used for assessing the visual acuity in children who could cooperate. RESULTS:Among 272 children, 225 children were males (82.7%). 34(12.5%) were mentally retard, 182(66.9%) were hearing impaired and 56(20.6%) were physically handicapped. Children suffering from refractive errors were 47(17.3%). 11(4.0%) reported that they were using glasses. Squint was present in 5(1.8%). On examination status of right eye 5(1.8%) were with visual acuity 6/60 or less. For children who were unable to comprehend with Snellen visual acuity chart, they were be assessed by using other charts like Lea symbol chart or Kay pictures. 19(7.0%) were assessed by Lea symbol chart, 9(3.3%) by Kay pictures and maximum number of children easily understand Snellen visual acuity chart that was 244(89.7%). CONCLUSION:This study concluded that refractive errors were common in special children.

Analysis of leading scientists scientific works, who simultaneously with the general problems of their field studied the methodological levels of research allowed to determine the content of the philosophical knowledge first higher level for theoretical substantiation of conceptual approaches to health education in the process of adaptive physical education of hearing impaired children. The aim of the study is to determine and generalize the methodological principles of health-promoting activities in the process of adaptive physical education of children with hearing impairments as postulates of the author's concept developed and proposed for implementation. Methods and organization of research: analysis and generalization of data from special scientific and methodological literature; monitoring of information resources of the Internet; The results of scientific researchers presented in the article demonstrated a narrow range of scientific achievements in the direction of definition on theme 3.23: "Health-forming technologies of children and youth in the process of adaptive physical education" of conceptual approaches of health-forming activity in the process of adaptive physical education of children with hearing impairments. our proposed concept.

Research has clearly demonstrated a link between the attitudes of regular education teachers and the success of inclusion of learners with special educational needs. Therefore, the present study aimed to investigate the attitudes of a group of junior primary school teachers from the Gauteng area towards the inclusion of hearing-impaired children into regular classes. A survey research design was employed which utilized a questionnaire as the research tool. Analysis of results indicated that the teachers surveyed were relatively positive in their attitudes towards inclusion. Greater exposure to disability in terms of training and experience was related to more positive attitudes. Similarly, more positive attitudes were related to greater perceived competence in teaching hearing-impaired pupils. All of the teachers surveyed felt that speech-language pathologists and audiologists (SLPs As) should be involved in facilitating inclusion of hearing-impaired children. Many of the respondents expressed concern regarding their lack of training, knowledge and skills. The findings from the research project highlight the need for an adequate training and support system for teachers prior to the implementation of an inclusive educati9nal policy, and the potential role of SLPs As in this regard.

Development of communication skills in children with hearing impairment (HIC) is one of the major goals of rehabilitation for these children. Information about current trends and communication status of HIC is a prerequisite for communication skill-building plan development. For the exploration of the current communication status of HIC studying in public special education institutes of Punjab, a survey was conducted. Two-stage cluster sampling was used to get data from teachers working in 30 randomly selected institutes. A self-developed questionnaire (Cronbach alpha, 0.8) was mailed to get data. SPSS was used for quantitative analysis of data obtained from 107 questionnaires containing information about 886 HIC studying in the special schools. Sign language was found as a common mode of communication. Those using an oral mode of communication were at the word level. The aural approach of teaching was getting acceptance from the teachers. Provision of hearing aid and improvement in speech therapy services were recommended.

The paper considers the current state of involvement of children with special educational needs in out-of-school education. The purpose of the article is to study the qualitative composition of groups of children with special educational needs who are involved in out-of-school education based on the type of developmental disorder; forms of involvement; areas of out-of-school education in which children with special educational needs are studied; determining the impact of out-of-school education on the development and socialization of children with special educational needs. At the first stage, the state of the problem development in domestic science was studied; at the second stage - the author's questionnaire and expert evaluation procedures were developed; a statement experiment was conducted using the survey method and the method of expert assessments; at the third stage, the analysis, systematization, processing of the accumulated empirical material is conducted. It has been determined that children with musculoskeletal disorders, mental disorders, autism spectrum disorders, mental retardation, severe speech disorders, hard of hearing, deafness, the visually impaired, and children with blindness are involved in out-of-school educational institutions. Children with special educational needs are involved in clubs (creative associations) of artistic and aesthetic, physical culture and sports, art, tourism and local lore, social rehabilitation, ecological and naturalistic, scientific and technical, health, humanitarian, research, and experimental and military-patriotic areas of out-of-school education.

The contemporary study was descriptive in nature and by method it was exploratory. It is primarily conducted to unfold diverse learning modalities of students with hearing impairment (SHI) at elementary grades level. The objectives of the study were to investigate (a) diverse learning modalities of the hearing-impaired students (b) learning modalities of hearing-impaired students from different socioeconomic status (c) learning modalities and difference in their age group (d) learning modalities and difference in their hearing loss (e) school wise difference in learning styles (f) grade-wise difference among learning modalities. For qualitative data, twelve teachers and administrators were interviewed in the first phase and in the second phase, quantitative data was collected through a questionnaire from 220 students with hearing impairment, enrolled in elementary grades in different special education schools of Lahore. Researchers collected data through convenient sampling. 220 students (male & female) were selected as a sample from seven schools of hearing-impaired children. The research tool were semi-structured interviews and a five-level Likert scale, both tools were constructed by the researchers that covered the following learning modalities, visual, aural, reading/writing & kinesthetic /tactile. For data collection from students, the researchers also took help from sign language interpreters for effective results. The researchers started this research with the vision that the results shall significantly help the academic instructors not only at the school level but also at higher education. Cronbach Alpha of the tool was .873. One Way ANOVA was used to find out the mean difference. The major finding was that visual and kinesthetic/tactile learning modalities for executing teaching and learning processes were practiced in all schools for the teaching and learning processes and socioeconomic status was not reflecting any key concern in determining the learning modalities.

This study aims to determine the management model and identify obstacles in the implementation of inclusive education programs at Junior High School 4 in Praya. This study uses a descriptive qualitative approach with a case study method (casy study). Data collection techniques are carried out using in-depth interviews, participatory observation, and document studies. Sources of research data are principals, deputy principals, special escort teachers and counseling teachers. Furthermore, data analysis is carried out through the steps of data reduction, data presentation, and conclusion drawing. The results of the research found in Junior High School 4 at Praya relating to the management of inclusive education there were 18 special needs students who had various abnormalities and obstacles, namely; 13 students were slow to learn, 1 low vision person, 1 mentally retarded person, 1 hearing impaired and 1 person had communication disorders. These problems often experience obstacles in the management of curriculum modification, between the curriculum of regular students with special needs students (PDBK), there is only 1 special assistant teacher who serves special needs students, lack of facilities and infrastructure that support the implementation of inclusive education programs in Junior High School 4 at Praya. The model of inclusive education applied in Junior High School 4 at Praya is a regular class model with full out, namely students with special needs learning with other children (normal) in the regular class and developing their talents and interests by special tutors so that students can develop optimally according to skills possessed.

The article presents some data on the growing role of a family as a customer of educational services as well as it shows the existence of a priority legal right for parents to choose an educational programme and organisation for their children. A comprehensive study that determines the individual educational route of a child with disabilities was carried out on the basis of the developed technologies of a special pedagogical questionnaire. The authors obtained new data on the opinions of parents on the issue of teaching the hearing impaired, the visually impaired and children with musculoskeletal disorders. In accordance with the selected criteria, the educational requests of parents of children with disabilities at the stage of completion of preschool and school education have been analysed. A detailed analysis of experimental data has made it possible to identify problem areas in planning and implementing of an individual educational route, to clarify features and patterns in the construction of an individual educational trajectory by a family of a child with disabilities. The dynamics of educational requests and expectations of parents raising preschoolers and senior school students with sensory and motor impairments has been traced. Conclusions have been made about the need to expand cooperation between the educational organisation, the psychological, medical and pedagogical commission and the family in the design and implementation of an individual educational route for a child with disabilities.

Abstract: This research is based on findings in the field regarding the existence of children with special needs in the regular classrooms where researchers teach. Students with special needs in the class show symptoms of forfeit and difficult to blend with normal friends in general in class. The situation that occurs is that students with special needs are very enclosed in class, not actively participating in lectures. The independence of students in doing assignments is very low. The existence of an inclusive education curriculum motivates researchers to continue to be able to provide educational services for all students without exception. Students with disabilities referred to in this study were one deaf student and one speech impaired student. This study will describe the independence and motivation of student learning in the classroom with the application of the cooperative model Think Talk and Write (TTW). The research method uses descriptive analysis. Data collection techniques by observation, interview and documentation. The collected data is then analyzed qualitatively including data reduction, data presentation and drawing conclusions. The results showed that the independence and motivation of student learning tended to be good with the active role of the teacher in applying the appropriate learning model. The communication difficulties that existed among students in the class were successfully overcome by the active role of all students in working together in discussion groups.  Keywords: hearing impaired, speech impaired, independence Abstrak: Penelitian ini didasari atas temuan di lapangan mengenai keberadaan anak berkebutuhan khusus di kelas reguler tempat peneliti mengajar. Mahasiswa berkebutuhan khusus di kelas tersebut menunjukkan gejala menarik diri dan sulit berbaur dengan teman-teman normal pada umumya di kelas. Keadaan yang terjadi adalah mahasiswa berkebutuhan khusus tersebut sangat tertutup di kelas, tidak berpartisipasi aktif dalam perkuliahan. Kemandirian mahasiswa berkebutuhan khusus dalam mengerjakan tugas sangat rendah. Adanya kurikulum pendidikan inklusi memotivasi peneliti untuk tetap dapat memberikan layanan pendidikan bagi seluruh mahasiswa tanpa terkecuali. Mahasiswa berkebutuhan dimaksud dalam penelitian ini adalah satu orang mahasiswa tuna rungu dan satu orang mahasiswa tuna wicara. Penelitian ini akan mendeskripsikan kemandirian dan motivasi belajar mahasiswa di kelas dengan penerapan model kooperatif tipe Think Talk and Write (TTW). Metode penelitian menggunakan analisis deskriptif. Teknik pengumpulan data dengan observasi, wawancara dan dokumentasi. Data yang terkumpul kemudian dianalisis secara kualitatif meliputi reduksi data, penyajian data dan penarikan kesimpulan. Hasil penelitian menunjukkan bahwa kemandirian dan motivasi belajar mahasiswa cenderung baik dengan adanya peran aktif guru dalam mengaplikasikan model pembelajaran yang sesuai. Kesulitan komunikasi yang ada diantara mahasiswa di kelas berhasil diatasi dengan peran aktif seluruh mahasiswa dalam bekerja bersama dalam kelompok diskusi. Kata kunci: tunawicara, tunarungu, motivasi, kemandirian

Cochlear implants are now the treatment of choice for patients with severe to profound hearing loss. Inclusion criteria for cochlear implantation have expanded, and a whole array of implantable hearing devices have been introduced over the years. To date, more than 250 cochlear implantations have now been performed in the Philippines (Figure 1). In 2006, the first auditory brainstem implantation, and first vibroplasty or middle ear implantation in the country were done at the Philippine General Hospital (PGH). In 2008, the first electroacoustic stimulation or partial deafness cochlear implantation surgery in the country was performed at the Capitol Medical Center by Professor Joachim Müeller of the University of Würzburg and the author. This concept, that cochlear implantation can be performed for patients with residual hearing or only partial deafness, is quite novel. There are patients whose low frequency hearing below 1.5 kHz is still be quite good while high frequency hearing loss above 1.5 kHz is in the severe to profound range (Figure 2). For such patients speech discrimination scores will typically fall below 60% at 65 dB sound pressure level (SPL) in the best aided condition. This technological advancement, often called electroacoustic stimulation (EAS), was developed in 1999 after Christoph Von Ilberg demonstrated preserved residual low frequency hearing in a patient who underwent cochlear implantation such that the patient wore a hearing aid in the implanted ear.1 Currently, EAS devices are available from two manufacturers. Contraindications to the use of EAS are shown in Table 1. Candidates for EAS devices should have stable low frequency hearing. There should be no progressive or autoimmune sensorineural hearing loss. Also there should be no history of meningitis, otosclerosis, or any other malformation that might cause an obstruction. The patient’s air-bone gap should be < 15 dB. Finally, there should not be any external auditory canal problems that can impede placement of the ear mould for the acoustic component. There are two main components of the EAS system (Figure 3). The external component is made up of a microphone that picks up sounds and a processor that separately encodes low and high frequency energy. After processing, low frequency energy is converted into an acoustic signal via the loudspeaker located in the ear hook and delivered into the external auditory canal. This acoustic signal will vibrate the tympanic membrane and ossicles so that cochlear fluids as well as the relatively intact structures of the cochlea in the apical region are stimulated. In contrast, high frequency energy is coded into radio-wave-like signals which are transmitted transcutaneously to the internal receiver. There, electric signals are delivered to the electrode array that has been surgically implanted into the cochlea. Thus the auditory nerve receives information using two different pathways from low and high frequency sounds, and the auditory nerve signals are then transmitted to the brain. Our Experience: Of the more than 100 implantations done under the Philippine National Ear Institute “CHIP” or Cochlear and Hearing Implants Programme only one was a case of EAS implantation. This particular case demonstrates key principles and concepts that every otolaryngologist should consider. Among these are audiological evaluation, temporal bone imaging, surgical technique for hearing preservation and some quality of life issues. Audiological Evaluation A 33 year old man had been seen at the clinic for over 7 years, with serial audiograms (Figure 4-6) illustrating the presence of good and stable low frequency hearing while high frequency hearing loss increased somewhat. The patient had been continually advised to get the best hearing aids available. However, a series of high-end hearing aids did not solve his problem of poor hearing in noisy places nor his difficulty understanding words when watching television and movies. Figure 7A shows the speech perception scores of this patient obtained with a Word Intelligibility by Picture Identification (WIPI) test, a “closed-set test” using isolated words while Figure 7B represents speech scores when “open-set” Bamford-Kowal-Bench (BKB) Sentence Lists were presented to the listener in both quiet and noise prior to the implantation. Temporal bone imaging A combination of high resolution computerized tomography (HRCT) of the temporal bone with both coronal and axial cochlear views, and T2-weighted normal anatomic Fast Spin Echo (T2 FSE) or 3D Constructive Interference in Steady State (3D CISS) MRI sequences of the inner ear should be done. Results from both studies should ascertain whether the cochlear duct is patent, ruling out any cochlear fibrosis or obstructive pathology. This patient’s HRCT and 3-D CISS MRI studies showed no such cochlear obliteration that would have posed intraoperative difficulties and constituted contraindications to EAS surgery (Figure 8). Surgical Technique for Hearing Preservation A variety of techniques have evolved over the years into what is now commonly called minimally invasive cochlear implantation. Using minimally invasive techniques, residual hearing can indeed be preserved in over 80%-90% of patients 3,4 Initially, a “Soft Cochleostomy” technique was introduced. This entailed careful low-speed drilling of the promontory with a Skeeter® drill (Medtronic Xomed, Jacksonville FL, USA) followed by the use of a mini-lancet to make an opening in the membranous labyrinth. This method avoids direct suctioning and prevents ingress of blood and bone dust into the intracochlear compartment. Also, for this method, the endosteum is left intact after drilling a cochleostomy antero-inferior to the round window. This allows proper placement of the electrode into the scala tympani with less chance of injury to the basilar membrane. Later, a round window approach was introduced, and it also proved to be a reliable way to preserve residual hearing during cochlear implantation. For this method, a more direct round window approach is performed after careful drilling of the round window niche. A limited incision is made just large enough to allow the electrode to be inserted. For both methods, after the endosteal or round window membrane incision is made with a micro lancet, a very flexible electrode of 20 mm length is slowly inserted. During the insertion process, the cochleostomy or round window is kept under direct vision so that insertion forces are minimized. Topical antibiotics and steroids are applied at this time to reduce any inflammatory or apoptotic reactions related to the trauma of opening the cochlea and introducing an electrode. Finally, a soft tissue plug is placed tightly around the electrode entry point into the membranous labyrinth to prevent perilymph leakage. New electrode designs that are thinner and more flexible are important contributors to the preservation of hearing. Postoperative Outcomes and Quality of Life After about 4-6 weeks from the time of surgery the EAS implant is switched on. Based on our experience and that of others,3 speech perception performance improves with prolonged experience with the implant. Roughly 1 ½ years post-surgery this patient has achieved dramatic improvement in hearing both in quiet and in noise using the EAS compared to using only the hearing aid component or the CI component alone. Figure 9 shows this dramatic improvement in free-field pure tone thresholds. Figure 10 demonstrates the speech perception following EAS implantation compared to pre-EAS implantation. Audiologic evaluation done at the PGH Ear Unit using 20 phonetically balanced Filipino words familiar to the patient in quiet and with 55 dB masking noise in the side of the implanted ear clearly showed an advantage with the EAS configuration compared to either hearing aid or CI component alone. Even with noise, this patient actually performed better presumably because he may have concentrated more with the introduction of masking noise. Another factor of course is that the words have now become familiar to the patient with the previous testing done in quiet. Notably, he reported great subjective improvement after only 10 months post-surgery.5 Interestingly the patient’s only complaint during his last follow-up was that he had not been offered bilateral EAS implantation. It is always important for the otolaryngologist to consider the quality of hearing and quality of life of patients with hearing loss. Intervention should not end with a referral note to a hearing aid center or dispenser. It is important to request proof of improvement not only of hearing thresholds but of speech perception outcomes in quiet and in noise. That is, one should document actual performance with the device in place, regardless of the type of device (hearing aid, an EAS device, or a Cochlear implant). Minimal disturbance of the remaining intact structures of the cochlea of patients with low frequency residual hearing can be achieved by employing a meticulous surgical technique, by using the advanced and flexible electrodes developed by some manufacturers, and instilling intraoperative antibiotics and steroids. Thus when one is faced with a ski-slope type audiogram it is likely the patient with this audiogram will not benefit from hearing aids. Such patients should be offered the option of EAS implantation which combines good acoustic stimulation with electric stimulation using a shorter (than conventional cochlear implantation) but very flexible electrode system. Counseling must also be done with a special emphasis on the risk of losing residual hearing, and noting that post-operative rehabilitation may take a long period of time. This patient now has a better quality of life than was obtainable from the most expensive and advanced hearing aids in the market, and has demonstrated a new implantable solution to partial deafness. Truly, EAS technology has opened a new era in prosthetic rehabilitation for hearing impaired adults and children.5 Acknowledgement Dr. Maria Rina Reyes-Quintos is gratefully acknowledged for performing all the excellent audiological testing following the surgery while Susan Javier and Angie Tongko of Manila Hearing Aid Center performed all the audiological testing prior to the surgery. Ms. Celina Ann Tobias, Professional Education Manager of Med-El is also credited with thanks for preparing the figures, reviewing the manuscript and interviewing the patient regarding his hearing performance following the surgery.

Objective This update of the 2008 American Academy of Otolaryngology—Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidence-based recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include a consumer added to the development group; new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); enhanced information on patient education and counseling; a new algorithm to clarify action statement relationships; expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; an enhanced external review process to include public comment and journal peer review; and 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care. Purpose The primary purpose of this guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention and to promote evidence-based management. Another purpose of the guideline is to highlight needs and management options in special populations or in patients who have modifying factors. The guideline is intended for all clinicians who are likely to diagnose and manage patients with cerumen impaction, and it applies to any setting in which cerumen impaction would be identified, monitored, or managed. The guideline does not apply to patients with cerumen impaction associated with the following conditions: dermatologic diseases of the ear canal; recurrent otitis externa; keratosis obturans; prior radiation therapy affecting the ear; previous tympanoplasty/myringoplasty, canal wall down mastoidectomy, or other surgery affecting the ear canal. Key Action Statements The panel made a strong recommendation that clinicians should treat, or refer to a clinician who can treat, cerumen impaction, defined as an accumulation of cerumen that is associated with symptoms, prevents needed assessment of the ear, or both. The panel made the following recommendations: (1) Clinicians should explain proper ear hygiene to prevent cerumen impaction when patients have an accumulation of cerumen. (2) Clinicians should diagnose cerumen impaction when an accumulation of cerumen, as seen on otoscopy, is associated with symptoms, prevents needed assessment of the ear, or both. (3) Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as ≥1 of the following: anticoagulant therapy, immunocompromised state, diabetes mellitus, prior radiation therapy to the head and neck, ear canal stenosis, exostoses, and nonintact tympanic membrane. (4) Clinicians should not routinely treat cerumen in patients who are asymptomatic and whose ears can be adequately examined. (5) Clinicians should identify patients with obstructing cerumen in the ear canal who may not be able to express symptoms (young children and cognitively impaired children and adults), and they should promptly evaluate the need for intervention. (6) Clinicians should perform otoscopy to detect the presence of cerumen in patients with hearing aids during a health care encounter. (7) Clinicians should treat, or refer to a clinician who can treat, the patient with cerumen impaction with an appropriate intervention, which may include ≥1 of the following: cerumenolytic agents, irrigation, or manual removal requiring instrumentation. (8) Clinicians should recommend against ear candling for treating or preventing cerumen impaction. (9) Clinicians should assess patients at the conclusion of in-office treatment of cerumen impaction and document the resolution of impaction. If the impaction is not resolved, the clinician should use additional treatment. If full or partial symptoms persist despite resolution of impaction, the clinician should evaluate the patient for alternative diagnoses. (10) Finally, if initial management is unsuccessful, clinicians should refer patients with persistent cerumen impaction to clinicians who have specialized equipment and training to clean and evaluate ear canals and tympanic membranes. The panel offered the following as options: (1) Clinicians may use cerumenolytic agents (including water or saline solution) in the management of cerumen impaction. (2) Clinicians may use irrigation in the management of cerumen impaction. (3) Clinicians may use manual removal requiring instrumentation in the management of cerumen impaction. (4) Last, clinicians may educate/counsel patients with cerumen impaction or excessive cerumen regarding control measures.

social adaption, long-term relationships, and the development of cognition, emotion and personality in unique and important ways. Children with hearing impairment often have some degree of language and/or speech delay, which is a major factor affecting their social interaction with peers. The present research was aimed at the study of classroom social behavior of hearing impaired children at primary level. The research was descriptive and direct observation method was used to identify the positive and negative social behavior of hearing impaired children exhibited in the classroom and at playground. 50 hearing impaired children including male and female studying in classes I to V of special education centers for children with hearing impairment at Islamabad were selected randomly. A checklist was used to identify the social behavior. The items were developed on the indicators of classroom social behavior of hearing impaired children such as respect of elders, sharing, rebel, aggressive behavior, cooperation, fighting, calm and quiet, follow the instructions, teasing others, and friendly etc.On the basis of research findings it was concluded that most of hearing impaired children respect their elders, remain calm and quite during lesson, do not share their things with other students, do not rebel during lesson. Most of them cooperate with others during group activities, stay away from fighting during group activities, and follow the rules in playing group games. Some of them get angry when other students distract them from their studies, do not tease their friends. The male children immediately become frustrated when they can’t solve a problem and become aggressive (violent) when something goes against their will.It was recommended that creating awareness of classroom social behavior in hearing impaired children can change their behavior positively. Moreover, hearing impaired children should be motivated and encouraged to move in a positive social life.

Present study attempted to explore presence of social skills among hearing impaired students taking education from government special education schools and to compare different level of social skills based on different demographic variables. It is a descriptive study in nature and survey method is used to collect the data. Population of study is hearing impaired children living in division Faisalabad and Lahore. Sample of N=200 hearing impaired students are selected through convenient sampling technique. Responses of social skills are taken from mothers as mothers have better knowledge of proficiencies of their hearing impaired children’s social skills. Children’s age group was 05-20 years. Age range of mothers was 25-55 years. Social skills checklist was used to as tool of the study for collection of data. It is a mixed method approach and statistical measures were made via frequency distribution, t-test and ANOVA. Results of current study clearly depicted that 82% hearing impaired students have low level of social skills and 18% hearing impaired students have best level of social skills. Current study also find out that there is significant difference in social skills of students on the basis of living area and children age and there is no significant difference in presence of social skills in hearing impaired students based on mother’s working status (house wife and job holders) and mothers education level. Study also demonstrated that there was positive correlation among presence of social skills in hearing impaired students and their age. The study concluded that teachers should focus on individual differences while teaching social skills to hearing impaired children and should adopt different teaching methods and teaching strategies for every student. It was also recommended that job holder mothers should manage their time table and must spare their proper time for their special children to make them beneficial and socially adjusted child of community.

Abstract Objective: To develop a valid and reliable scale for measuring psychosocial issues of hearing-impaired school children. Method: The cross-sectional study with four stage model of scale development was conducted at Multan, Muzafargarh, and Dera Ghazi Khan Pakistan from August 2018 to January 2019. The four stages were item generation, expert validation, conversion of scale into sign language and psychometric study. The sample comprised hearing-impaired school children aged 18-23 years who were studying Special Education schools in Multan, Pakistan. Results: Of the 230 subjects, there were 110(47.8%) boys and 120(52.2%) girls. The overall mean age was 19.90+/-2.46 years.Exploratory factor analysis with varimax rotation revealed 26 items in ‘Depressive Affect’, ‘Social Isolation’ and ‘Feeling of Anger’ sub-scales with high internal consistency (r=0.85) and validity (r=-0.32). Conclusion: The internalised nature of psychosocial issues of children with hearing impairment needs timely identification and intervention so that silent suffering can be prevented to improve psychosocial functioning of such children. Key Words: Hearing impairment, Psychosocial issues, Gender, Age, Reliability, Validity. Continuous...

Background: Caregiver burden is a multidimensional response to physical, psychological, emotional, social and financial stressors, usually associated with the experience of caring and can be objective or subjective. The objective of current study was to explore the caregiver burden among parents of hearing impaired and intellectually challenged children in Pakistan. Methods: A Comparative cross sectional survey was conducted on n=162 parents of hearing impaired (HI) and intellectually challenged (IC) children from July 2018 to February 2019. Convenient sampling technique was used to collect the data from Parents of hearing impaired and intellectually challenged children with age range 1-16 years in National Institute of Rehabilitation Medicine and Al-Farabi Special Education Institute Islamabad. Caregiver Burden Inventory was used to assess the caregiver burden. Results: The results showed a greater need for respite and other services in both groups. Parents of intellectually challenged children need more respite and other services as compared to hearing impaired children (60.62±11.43 ver. 45.74±11.20, p<0.001). A total of 3 (4.0%) parents of hearing impaired children reported rare need for respite and other services, 32(42.7%) reported sometimes and 40(53.3%) reported frequent need. On the other hand 12(13.8%) parents of intellectually disabled children reported sometimes, 66(75.9%) reported quite frequently and 9(10.3%) nearly always a greater need for respite and other services. Conclusion: The parents of hearing impaired or intellectually challenged children face significant burden of their disabled child. In addition, due to cognitive deficits that lead to behavioural abnormalities the parents of intellectually challenged children face more burden and stress.

With the continuous development of the career of the disabled, special education has become an important part of the development of education in China. Therefore, it is particularly important to meet the needs of special children’s campus construction. However, China is relatively backward, and special education schools lack complete landscape design for special groups. Campus landscape carries many contents including education, leisure, communication and rehabilitation. At present, the landscape design of special education schools lacks the recognition of the particularity of special children, and ignores their demands for normal communication and interaction. Starting from the characteristics of special children, this paper analyses and studies the perceptual characteristics of hearing impaired students and visual impaired students respectively, and applies the concept of “interactive design” to the landscape design of special schools. Interaction design pays attention to the process of human experience, which coincides with the design idea of “people-oriented” emphasized in landscape design. Landscape interaction design is the design of human communication, communication and interaction space, so as to guide the campus landscape environment suitable for the barrier-free interaction of actors, make up for defects, provide safe activities, individualized education and living campus.

The aim of this study was to investigate the opinions of teachers of the hearing-impaired children about serving as a special education teacher. The research was designed as a descriptive case study within the framework of qualitative research methods. Two criteria that the participants to be included in the study should have were determined as follows: graduating from universities’ hearing-impaired teaching programs and serving as a special education classroom teacher in schools affiliated to the MNE. The participants consist of 51 teachers meeting the specified criteria. Semi-structured interviews were held with 5 of the participants, and data were collected from 46 of them through an open-ended questionnaire. Given the pandemic period conditions we currently experience, the e-interviews were conducted using Zoom, while open-ended questionnaires were collected via Google Forms. Descriptive analysis technique was used in the analysis of the research data. The descriptive analysis process consists of four stages: creating a thematic framework, processing of data according to the thematic framework, identification of findings, and interpretation of findings. Study findings revealed that the fact that teachers serve out-of-field they graduated from led them to feel insufficient in terms of professional knowledge and competency. Besides, it was observed that they failed to provide sufficient benefit to the students, they had difficulties communicating with families, they failed to cooperate with the school administrators or other colleagues and could not find the necessary support. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0798/a.php" alt="Hit counter" /></p>

Objectives: To determine the level of stress experienced and coping strategies used by parents of hearing impaired and autistic children. Methods: Using non-probability convenience sampling this cross sectional study recruited n =200 parents of hearing impaired (HI) and 100 parents of autistic children, of either gender, aged 20 to 60 years. Samples were recruited from Special Education Institutes of Islamabad and Rawalpindi, over a period of six months, from October 2018 to March 2019 and conducted at Isra Institute of Rehabilitation Sciences, Islamabad. Basic demographical sheet, Parental Stress Scale and Coping Strategies Inventory were used for data collection. Statistical analysis was done using SPSS 21. Results: In parents of hearing impaired the mean parental stress score was 47.44±12.85 and commonest coping strategy was problem focused engagement (26.03) followed by problem focused dis-engagement (24.25). In the autistic group the mean parental stress score was 48.92+11.22 with problem focused engagement being the most frequently used strategy (27.4) followed by emotion focused strategy. Conclusion: Different level of stress experienced by parents of autistic and hearing impaired children which is statistically significant and they employed different coping strategies. doi: https://doi.org/10.12669/pjms.36.3.1766 How to cite this:Ishtiaq N, Mumtaz N, Saqulain G. Stress and coping strategies for parenting children with hearing impairment and autism. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1766 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Children with hearing impairment may be at risk of not achieving the necessary school readiness because of the link between hearing impairment and academic achievement. However, early hearing detection and intervention (EHDI) can improve potential outcomes for these children.Aim: As part of a bigger study titled ‘Communication and school readiness abilities of hearing-impaired preschool graduates: Exploring outcomes of early intervention preschool programs in Gauteng’, the aim of this study was to describe the school readiness and academic achievement of children with hearing impairment through retrospective record reviews of EHDI preschool records and Grade 3 teachers’ survey.Setting: The study was conducted in Gauteng, South Africa, where two EHDI preschool centres participated in the study.Methods: Eight children identified with hearing impairment and enrolled in EHDI preschools were included in the study, along with their Grade 3 teachers. Data collection was conducted through a self-developed teacher questionnaire and record reviews of the children’s preschool files. Data were analysed using descriptive statistics.Results: Three children (n = 8) obtained age-appropriate school readiness results and were subsequently enrolled in mainstream schools. Five children (n = 8) did not exhibit age-appropriate school readiness and were subsequently enrolled in remedial schools and schools for Learners with Special Education Needs (LSEN).Conclusion: These preliminary findings demonstrate that through EHDI, children with hearing impairment are allowed to develop the school readiness required to experience academic success. Factors influencing outcomes within the South African context need to be explored in order for South Africa to benefit maximally from EHDI initiatives.

In Pakistan about 2.49% of population is with special needs (Govt. of Pakistan, 1998) including hearing, visual impairment, mentally challenged, physically handicapped and multiple handicaps. Only 1% of this population has access to education and higher education is almost not in access. Formal universities have no capacity, arrangements and skills to include the students with special needs. Open and Distance Learning is most suitable and accommodative mode for them so much of them are getting education through ODL mode. Allama Iqbal Open University is only public sector ODL University in Pakistan and providing free education to disadvantage group people included special need students. More than 400 special need students enrolled in different programs and most of them hearing impaired, visual impaired and physically disabled. But there are number of students emotional, social and behavioural disordered. The study aim was to determine the e-tutors/e-instructors arrogances to include students having emotional, social and behavioural difficulties (ESBD) seeing the impact of physical age, know-how, academic education/degrees and the help they had from AIOU. Additional it was explored the connection between willingness and attitudes to be with ESBD students at ODL classroom/system whereas exploring the obstacles in effective inclusion of ESBD. Researcher selected 200 e-tutors/e-instructors as sample (100 male, 100 female) volunteered to take part on the study and most of them from Islamabad region. The study was mixed design i.e. quantitative and qualitative methods. Data collected in the form of numbers was by questionnaire of two scale and the qualitative through open ended questions. Correlation was used to discover the relationship between physical age, professional practices (experiences), academic education and help they had with arrogances and readiness. The researcher used the thematic analysis to analyse the qualitative data/information. Findings of the study directed that physical age, experiences and help they had been significant predicators. Attitudes of e-tutors had good impact and relationship when they had help from the AIOU in the form training, assistant teachers and financial support. In interviews e-tutors responded that sometime they felt pre-service training programs didn’t equip them to accommodate needs of special students and how to include in ODL. Also they said resources should be available all the time rather than sometime available and sometime not. The study recommended that tutors should be trained to assess the special needs and characteristics of emotional, social and behavioural disordered students. Also modified teaching methods/pedagogies should be part of their pre and in-service teacher training progarmmes. Keywords: ODL Teachers/Tutors, Inclusion, Special Need Students

Introduction. This article discusses the problems of the readiness of university teachers to implement inclusive educational practice with the students with hearing disabilities.Materials and Methods. We used questionnaire on diagnostics of teachers' readiness for inclusion; "Scale of emotional response" (Ваlаnced Emotional Empathy Scale - BEES), (A. Mehrabien, N. Epstein); the questionnaire "Diagnostics of teachers' orientation towards the educational-disciplinary or personal model of interaction with children" (VG Maralov).Results. Thus, the results of the ascertaining experiment make it possible to identify the problems of personal readiness that arise among higher school teachers who have different experience of “implementing” an inclusive culture and practice, and on the basis of this to build programs of psychological (methodological, educational) support in accordance with their request. However, 80.8% of respondents do not see themselves as the center of changes in the educational space of higher education. Only 17.6% of the respondents demonstrate awareness in the aspect of psychological and physiological characteristics of development, the specifics of the communicative and cognitive activity of the deaf and hard of hearing people. 88.2% of the respondents could not name any special educational needs in means of adaptation and rehabilitation of the latter.Discussion and Conclusions. Problems were identified that hinder the development of teachers' readiness to work in an inclusive education. There was a fragmentation of knowledge in the aspect of psychological and physiological characteristics of development, a lack of understanding of the specifics of the communicative and cognitive activity of the deaf and hard of hearing people, pedagogical technologies of working with the hearing-impaired, special educational needs for means of adaptation and rehabilitation. The problems of implementation by teachers of a personality-oriented approach in education, which is a prerequisite for inclusion, have been diagnosed. Thus, the results of the ascertaining research make it possible to identify the problems of personal readiness that arise among higher school teachers who have different experience of “implementing” an inclusive culture and practice, and on the basis of this to build programs of psychological (methodological, educational) support in accordance with their request.

Introduction Films with deaf characters often do not focus on the condition of deafness at all. Rather, the characters seem to satisfy a role in the story that either furthers the plot or the audience’s understanding of other hearing characters. The deaf characters can be symbolic, for example as a metaphor for isolation representative of ‘those without a voice’ in a society. The deaf characters’ misunderstanding of auditory cues can lead to comic circumstances, and their knowledge can save them in the case of perilous ones. Sign language, because of its unique linguistic properties and its lack of comprehension by hearing people, can save the day in a story line. Deaf characters are shown in different eras and in different countries, providing a fictional window into their possible experiences. Films shape and reflect cultural attitudes and can serve as a potent force in influencing the attitudes and assumptions of those members of the hearing world who have had few, if any, encounters with deaf people. This article explores categories of literary function as identified by the author, providing examples and suggestions of other films for readers to explore. Searching for Deaf Characters in Film I am a sign language interpreter. Several years ago, I started noticing how deaf characters are used in films. I made a concerted effort to find as many as I could. I referred to John Shuchman’s exhaustive book about deaf actors and subject matter, Hollywood Speaks; I scouted video rental guides (key words were ‘deaf’ or ‘disabled’); and I also plugged in the key words ‘deaf in film’ on Google’s search engine. I decided to ignore the issue of whether or not the actors were actually deaf—a political hot potato in the Deaf community which has been discussed extensively. Similarly, the linguistic or cultural accuracy of the type of sign language used or super-human lip-reading talent did not concern me. What was I looking for? I noticed that few story lines involving deaf characters provide any discussion or plot information related to that character’s deafness. I was puzzled. Why is there signing in the elevator in Jerry Maguire? Why does the guy in Grand Canyon have a deaf daughter? Why would the psychosomatic response to a trauma—as in Psych Out—be deafness rather than blindness? I concluded that not being able to hear carried some special meaning or fulfilled a particular need intrinsic to the plot of the story. I also observed that the functions of deaf characters seem to fall into several categories. Some deaf characters fit into more than one category, serving two or more symbolic purposes at the same time. By viewing and analysing the representations of deafness and deaf characters in forty-six films, I have come up with the following classifications: Deafness as a plot device Deaf characters as protagonist informants Deaf characters as a parallel to the protagonist Sign language as ‘hero’ Stories about deaf/hearing relationships A-normal-guy-or-gal-who-just-happens-to-be-deaf Deafness as a psychosomatic response to trauma Deafness as metaphor Deafness as a symbolic commentary on society Let your fingers do the ‘talking’ Deafness as Plot Device Every element of a film is a device, but when the plot hinges on one character being deaf, the story succeeds because of that particular character having that particular condition. The limitations or advantages of a deaf person functioning within the hearing world establish the tension, the comedy, or the events which create the story. In Hear No Evil (1993), Jillian learns from her hearing boyfriend which mechanical devices cause ear-splitting noises (he has insomnia and every morning she accidentally wakes him in very loud ways, eg., she burns the toast, thus setting off the smoke detector; she drops a metal spoon down the garbage disposal unit). When she is pursued by a murderer she uses a fire alarm, an alarm/sprinkler system, and a stereo turned on full blast to mask the sounds of her movements as she attempts to hide. Jillian and her boyfriend survive, she learns about sound, her boyfriend learns about deafness, and she teaches him the sign for orgasm. Life is good! The potential comic aspects of deafness may seem in this day and age to be shockingly politically incorrect. While the slapstick aspect is often innocent and means no overt harm or insult to the Deaf as a population, deafness functions as the visual banana peel over which the characters figuratively stumble in the plot. The film, See No Evil, Hear No Evil (1989), pairing Gene Wilder with Richard Pryor as deaf and blind respectively, is a constant sight gag of lip-reading miscues and lack-of-sight gags. Wilder can speak, and is able to speech read almost perfectly, almost all of the time (a stereotype often perpetuated in films). It is mind-boggling to imagine the detail of the choreography required for the two actors to convince the audience of their authenticity. Other films in this category include: Suspect It’s a Wonderful Life Murder by Death Huck Finn One Flew over the Cuckoo’s NestThe Shop on Main StreetRead My Lips The Quiet Deaf Characters as Protagonist Informants Often a deaf character’s primary function to the story is to give the audience more information about, or form more of an affinity with, the hearing protagonist. The deaf character may be fascinating in his or her own right, but generally the deafness is a marginal point of interest. Audience attitudes about the hearing characters are affected because of their previous or present involvement with deaf individuals. This representation of deafness seems to provide a window into audience understanding and appreciation of the protagonist. More inferences can be made about the hearing person and provides one possible explanation for what ensues. It is a subtle, almost subliminal trick. There are several effective examples of this approach. In Gas, Food, Lodging (1992), Shade discovers that tough-guy Javier’s mother is deaf. He introduces Shade to his mother by simple signs and finger-spelling. They all proceed to visit and dance together (mom feels the vibrations on the floor). The audience is drawn to feel ‘Wow! Javier is a sensitive kid who has grown up with a beautiful, exotic, deaf mother!’ The 1977 film, Looking for Mr. Goodbar presents film-goers with Theresa, a confused young woman living a double life. By day, she is a teacher of deaf children. Her professor in the Teacher of the Deaf program even likens their vocation to ‘touching God’. But by night she cruises bars and engages in promiscuous sexual activity. The film shows how her fledgling use of signs begins to express her innermost desires, as well as her ability to communicate and reach out to her students. Other films in this category include: Miracle on 34th Street (1994 version)Nashville (1975, dir. Robert Altman)The Family StoneGrand CanyonThere Will Be Blood Deaf Characters as a Parallel to the Protagonist I Don’t Want to Talk about It (1993) from Argentina, uses a deaf character to establish an implied parallel story line to the main hearing character. Charlotte, a dwarf, is friends with Reanalde, who is deaf. The audience sees them in the first moments of the film when they are little girls together. Reanalde’s mother attempts to commiserate with Charlotte’s mother, establishing a simultaneous but unseen story line somewhere else in town over the course of the story. The setting is Argentina during the 1930s, and the viewer can assume that disability awareness is fairly minimal at the time. Without having seen Charlotte’s deaf counterpart, the audience still knows that her story has contained similar struggles for ‘normalcy’ and acceptance. Near the conclusion of the film, there is one more glimpse of Reanalde, when she catches the bridal bouquet at Charlotte’s wedding. While having been privy to Charlotte’s experiences all along, we can only conjecture as to what Reanalde’s life has been. Sign Language as ‘Hero’ The power of language, and one’s calculated use of language as a means of escape from a potentially deadly situation, is shown in The River Wild (1996). The reason that any of the hearing characters knows sign language is that Gail, the protagonist, has a deaf father. Victor appears primarily to allow the audience to see his daughter and grandson sign with him. The mother, father, and son are able to communicate surreptitiously and get themselves out of a dangerous predicament. Signing takes an iconic form when the signs BOAT, LEFT, I-LOVE-YOU are drawn on a log suspended over the river as a message to Gail so that she knows where to steer the boat, and that her husband is still alive. The unique nature of sign language saves the day– silently and subtly produced, right under the bad guys’ noses! Stories about Deaf/Hearing Relationships Because of increased awareness and acceptance of deafness, it may be tempting to assume that growing up deaf or having any kind of relationship with a deaf individual may not pose too much of a challenge. Captioning and subtitling are ubiquitous in the USA now, as is the inclusion of interpreters on stages at public events. Since the inception of USA Public Law 94-142 and section 504 in 1974, more deaf children are ‘mainstreamed’ into public schools than ever before. The Americans with Disabilities Act was passed in 1993, opening the doors in the US for more access, more job opportunities, more inclusion. These are the external manifestations of acceptance that most viewers with no personal exposure to deafness may see in the public domain. The nuts and bolts of growing up deaf, navigating through opposing philosophical theories regarding deaf education, and dealing with parents, siblings, and peers who can’t communicate, all serve to form foundational experiences which an audience rarely witnesses. Children of a Lesser God (1986), uses the character of James Leeds to provide simultaneous voiced translations of the deaf student Sarah’s comments. The audience is ushered into the world of disparate philosophies of deaf education, a controversy of which general audiences may not have been previously unaware. At the core of James and Sarah’s struggle is his inability to accept that she is complete as she is, as a signing not speaking deaf person. Whether a full reconciliation is possible remains to be seen. The esteemed teacher of the deaf must allow himself to be taught by the deaf. Other films in this category include: Johnny Belinda (1949, 1982)Mr. Holland’s OpusBeyond SilenceThe Good ShepherdCompensation A Normal Guy-or-Gal-Who-Just-Happens-to-Be-Deaf The greatest measure of equality is to be accepted on one's own merits, with no special attention to differences or deviations from whatever is deemed ‘the norm.’ In this category, the audience sees the seemingly incidental inclusion of a deaf or hearing-impaired person in the casting. A sleeper movie titled Crazy Moon (1986) is an effective example. Brooks is a shy, eccentric young hearing man who needs who needs to change his life. Vanessa is deaf and works as a clerk in a shop while takes speech lessons. She possesses a joie de vivre that Brooks admires and wishes to emulate. When comparing the way they interact with the world, it is apparent that Brooks is the one who is handicapped. Other films in this category include: Sympathy for Mr. Vengeance (South Korea, 1992)Liar, LiarRequiem for a DreamKung Fu HustleBangkok DangerousThe Family StoneDeafness as a Psychosomatic Response to Trauma Literature about psychosomatic illnesses enumerates many disconcerting and disruptive physiological responses. However, rarely is there a PTSD response as profound as complete blockage of one of the five senses, ie; becoming deaf as a result of a traumatic incident. But it makes great copy, and provides a convenient explanation as to why an actor needn't learn sign language! The rock group The Who recorded Tommy in 1968, inaugurating an exciting and groundbreaking new musical genre – the rock opera. The film adaptation, directed by Ken Russell, was released in 1975. In an ironic twist for a rock extravaganza, the hero of the story is a ‘deaf, dumb, and blind kid.’ Tommy Johnson becomes deaf when he witnesses the murder of his father at the hands of his step-father and complicit mother. From that moment on, he is deaf and blind. When he grows up, he establishes a cult religion of inner vision and self-discovery. Another film in this category is Psych Out. Deafness as a Metaphor Hearing loss does not necessarily mean complete deafness and/or lack of vocalization. Yet, the general public tends to assume that there is utter silence, complete muteness, and the inability to verbalize anything at all. These assumptions provide a rich breeding ground for a deaf character to personify isolation, disenfranchisement, and/or avoidance of the harsher side of life. The deafness of a character can also serve as a hearing character’s nemesis. Mr. Holland’s Opus (1995) chronicles much of the adult life of a beleaguered man named Glenn Holland whose fondest dream is to compose a grand piece of orchestral music. To make ends meet he must teach band and orchestra to apparently disinterested and often untalented students in a public school. His golden son (named Cole, in honor of the jazz great John Coltrane) is discovered to be deaf. Glenn’s music can’t be born, and now his son is born without music. He will never be able to share his passion with his child. He learns just a little bit of sign, is dismissive of the boy’s dreams, and drifts further away from his family to settle into a puddle of bitterness, regrets, and unfulfilled desires. John Lennon’s death provides the catalyst for Cole’s confrontation with Glenn, forcing the father to understand that the gulf between them is an artificial one, perpetuated by the unwillingness to try. Any other disability could not have had the same effect in this story. Other films in this category include: Ramblin’ RoseBabelThe Heart Is a Lonely HunterA Code Unkown Deafness as a Symbolic Commentary on Society Sometimes films show deafness in a different country, during another era, and audiences receive a fictionalized representation of what life might have been like before these more enlightened times. The inability to hear and/or speak can also represent the more generalized powerlessness that a culture or a society’s disenfranchised experience. The Chinese masterpiece To Live (1994) provides historical and political reasons for Fenxi’s deafness—her father was a political prisoner whose prolonged absence brought hardship and untended illness. Later, the chaotic political situation which resulted in a lack of qualified doctors led to her death. In between these scenes the audience sees how her parents arrange a marriage with another ‘handicapped’ comrade of the town. Those citizens deemed to be crippled or outcast have different overt rights and treatment. The 1996 film Illtown presents the character of a very young teenage boy to represent the powerlessness of youth in America. David has absolutely no say in where he can live, with whom he can live, and the decisions made all around him. When he is apprehended after a stolen car chase, his frustration at his and all of his generation’s predicament in the face of a crumbling world is pounded out on the steering wheel as the police cars circle him. He is caged, and without the ability to communicate. Were he to have a voice, the overall sense of the film and his situation is that he would be misunderstood anyway. Other films in this category include: Stille Liebe (Germany)RidiculeIn the Company of Men Let Your Fingers Do the ‘Talking’ I use this heading to describe films where sign language is used by a deaf character to express something that a main hearing character can’t (or won’t) self-generate. It is a clever device which employs a silent language to create a communication symbiosis: Someone asks a hearing person who knows sign what that deaf person just said, and the hearing person must voice what he or she truly feels, and yet is unable to express voluntarily. The deaf person is capable of expressing the feeling, but must rely upon the hearing person to disseminate the message. And so, the words do emanate from the mouth of the person who means them, albeit self-consciously, unwillingly. Jerry Maguire (1996) provides a signed foreshadowing of character metamorphosis and development, which is then voiced for the hearing audience. Jerry and Dorothy have just met, resigned from their jobs in solidarity and rebellion, and then step into an elevator to begin a new phase of their lives. Their body language identifies them as separate, disconnected, and heavily emotionally fortified. An amorous deaf couple enters the elevator and Dorothy translates the deaf man’s signs as, ‘You complete me.’ The sentiment is strong and a glaring contrast to Jerry and Dorothy’s present dynamic. In the end, Jerry repeats this exact phrase to her, and means it with all his heart. We are all made aware of just how far they have traveled emotionally. They have become the couple in the elevator. Other films in this category include: Four Weddings and a FuneralKnowing Conclusion This has been a cursory glance at examining the narrative raison d’etre for the presence of a deaf character in story lines where no discussion of deafness is articulated. A film’s plot may necessitate hearing-impairment or deafness to successfully execute certain gimmickry, provide a sense of danger, or relational tension. The underlying themes and motifs may revolve around loneliness, alienation, or outwardly imposed solitude. The character may have a subconscious desire to literally shut out the world of sound. The properties of sign language itself can be exploited for subtle, undetectable conversations to assure the safety of hearing characters. Deaf people have lived during all times, in all places, and historical films can portray a slice of what their lives may have been like. I hope readers will become more aware of deaf characters on the screen, and formulate more theories as to where they fit in the literary/narrative schema. ReferencesMaltin, Leonard. Leonard Maltin’s 2009 Movie Guide. Penguin Group, 2008.Shuchman, John S. Hollywood Speaks. Urbana and Chicago: University of Illinois Press, 1988. Filmography Babel. Dir. Alejandro Gonzalez Inarritu. Central Films, 2006. DVD. Bangkok Dangerous. Dir. Pang Brothers. Film Bangkok, 1999. VHS. Beyond Silence. Dir. Caroline Link. Miramax Films, 1998. DVD. Children of a Lesser God. Dir. Randa Haines. Paramount Pictures, 1985. DVD. A Code Unknown. Dir. Michael Heneke. MK2 Editions, 2000. DVD. Compensation. Dir. Zeinabu Irene Davis. Wimmin with a Mission Productions, 1999. VHS. Crazy Moon. Dir. Allan Eastman. Allegro Films, 1987. VHS. The Family Stone. Dir. Mike Bezucha. 20th Century Fox, 2005. DVD. Four Weddings and a Funeral. Dir. Mike Newell. Polygram Film Entertainment, 1994. DVD. Gas, Food, Lodging. Dir. Allison Anders. IRS Media, 1992. DVD. The Good Shepherd. Dir. Robert De Niro. Morgan Creek, TriBeCa Productions, American Zoetrope, 2006. DVD. Grand Canyon. Dir. Lawrence Kasdan, Meg Kasdan. 20th Century Fox, 1991. DVD. Hear No Evil. Dir. Robert Greenwald. 20th Century Fox, 1993. DVD. The Heart Is a Lonely Hunter. Dir. Robert Ellis Miller. Warner Brothers, 1968. DVD. Huck Finn. Stephen Sommers. Walt Disney Pictures, 1993. VHS. I Don’t Want to Talk about It. Dir. Maria Luisa Bemberg. Mojame Productions, 1994. DVD. Knowing. Dir. Alex Proyas. Escape Artists, 2009. DVD. Illtown. Dir. Nick Gomez. 1998. VHS. In the Company of Men. Dir. Neil LaBute. Alliance Atlantis Communications,1997. DVD. It’s a Wonderful Life. Dir. Frank Capra. RKO Pictures, 1947. DVD. Jerry Maguire. Dir. Cameron Crowe. TriSTar Pictures, 1996. DVD. Johnny Belinda. Dir. Jean Nagalesco. Warner Brothers Pictures, 1948. DVD. Kung Fu Hustle. Dir. Stephen Chow. Film Production Asia, 2004. DVD. Liar, Liar. Dir. Tom Shadyac. Universal Pictures, 1997. DVD. Looking for Mr. Goodbar. Dir. Richard Brooks. Paramount Miracle on 34th Street. Dir. Les Mayfield. 20th Century Fox, 1994. DVD. Mr. Holland’s Opus. Dir. Stephen Hereck. Hollywood Pictures, 1996. DVD Murder by Death. Dir. Robert Moore. Columbia Pictures, 1976. VHS. Nashville. Dir. Robert Altman. Paramount Pictures, 1975. DVD. One Flew over the Cuckoo’s Nest. Dir. Milos Forman. United Artists, 1975. DVD. The Perfect Circle. Dir. Ademir Kenovic. 1997. DVD. Psych Out. Dir. Richard Rush. American International Pictures, 1968. DVD. The Quiet. Dir. Jamie Babbit. Sony Pictures Classics, 2005. DVD. Ramblin’ Rose. Dir. Martha Coolidge. Carolco Pictures, 1991. DVD. Read My Lips. Dir. Jacques Audiard. Panthe Films, 2001. DVD. Requiem for a Dream. Dir. Darren Aronofsky. Artisan Entertainment, 2000. DVD. Ridicule. Dir. Patrice Laconte. Miramax Films, 1996. DVD. The River Wild. Dir. Curtis Hanson. Universal Pictures, 1995. DVD. See No Evil, Hear No Evil. Dir. Arthur Hiller. TriSTar Pictures,1989. DVD. The Shop on Main Street. Dir. Jan Kadar, Elmar Klos. Barrandov Film Studio, 1965. VHS. Stille Liebe. Dir. Christoph Schaub. T and C Film AG, 2001. DVD. Suspect. Dir. Peter Yates. Tri-Star Pictures, 1987. DVD. Sympathy for Mr. Vengeance. Dir. Park Chan-wook. CJ Entertainments, Tartan Films, 2002. DVD. There Will Be Blood. Dir. Paul Thomas Anderson. Paramount Vantage, Miramax Films, 2007. DVD. To Live. Dir. Zhang Yimou. Shanghai Film Studio and ERA International, 1994. DVD. What the Bleep Do We Know?. Dir. Willam Arntz, Betsy Chasse, Mark Vicente. Roadside Attractions, 2004. DVD.

Introduction: How Do We Learn What We Know? “Deaf.” How do we learn what we know about being deaf and about deafness? What’s the difference between “being deaf” and “deafness” as a particular kind of (non) hearing? Which would you rather be, deaf or blind: children commonly ask this question as they make their early forays into imagining the lives of people different from them. Hearing people cannot know what it is like to be deaf, just as deaf people cannot know what it is like to hear ... or can they? Finally, how can we tell fresh and authentic stories of “being deaf” and the state of “deafness” that disrupt our familiar—perhaps even caricatured—patterns of understanding? In this special “deaf” edition of M/C Journal we wanted to create a body of work in which deaf writers and thinkers would have their say. Mindful that "Deaf history may be characterized as a struggle for Deaf individuals to 'speak' for themselves rather than to be spoken about in medical and educational discourses" (Bauman 47), we were particularly keen to place the contributions of deaf writers and thinkers alongside the mainstream hearing culture. This is why we have chosen not to identify each writer in this edition as deaf or hearing, preferring to leave that biographical auditory detail to the writers themselves. We already knew that "there isn't a large body of literature about the deaf by the deaf" (Henry Kisor 3). Thomas Couser writes that "this should not be surprising, for a number of factors militate against deaf autobiography ... making them unlikely and rare entities" (226). And so we welcomed the diversity of topics and range of genres to this edition: they included a playful ficto-critical exploration of deafness; personal reflections on deafness (ranging from regarding it as a condition of hearing loss to a state of being); poetry; a filmography; and several fresh analyses of representations of deafness, hearing technology and deaf people’s lives in theatre, film and television (this was a particularly popular theme); the poetics of embodiment (indeed, embodiment was a recurring theme across many of the submissions); a commentary on the role of interpreters in deaf-hearing relationships; and an analysis of the role of the Web 2.0 and other technology in deaf people’s communications. However, we noted that most of the uncommissioned submissions in response to our call for papers came from hearing people. We had to seek out contributions from deaf writers and thinkers and wondered why this was so. Mainstream publication avenues for writing by deaf people on the topic of deafness are rare in Australia: perhaps deaf writers lack the necessary confidence or belief that they would be read? In this edition, they certainly reveal that they have much to say ... and inspire us to lean in and think carefully about their words. A Deaf Knowingness In writing her poem “The Triton”, Sandra Hoopman was inspired by her frequent visits to her deaf grandmother at her old Lambert Street, Kangaroo Point home, where she had a huge triton on her wrought iron veranda. Her grandmother would put the triton up to her ear and show Sandra how to 'listen' to it so that she could ‘hear’ the sea. Her poetry recalls to mind Robert Panara's most-quoted poem, “On His Deafness”, in which he imagined that he might even hear 'the rustle of a star!' Following Sandra Hoopman’s poem, we are pleased to feature the essay “Body Language” by Jessica White, shortlisted for the ABR 2010 Calibre Prize, and Sydney Morning Herald Best Young Novelist for 2008 for her first novel A Curious Intimacy (Penguin 2008). In her essay, Jessica playfully explores the idea of not having a singular fixed identity by traversing a dialogue between the imagination and the character of Jessica, showing different selves at play and in conversation, and again in conversation with others at the ficto-critical room and with the ideas articulated by different authors. As with post-structuralist explorations, the essay emphasises the active and formative nature of language, story and ideas, which help us to deconstruct and reformulate versions of our lives and its possibilities. Play is a device that enables people to move beyond the confines of the social world. The joyful spirit of White’s essay is signalled when she writes: For example, there are still immense possibilities thrown up by theorising a jouissance, or pleasure, in the disabled body. As Susan Wendell points out, “paraplegics and quadriplegics have revolutionary things to teach us about the possibilities of sexuality which contradict patriarchal culture’s obsessions with the genitals” (120). Thus if there were more of a focus on the positive aspects of disability and on promoting the understanding that disability is not about lack, people could see how it fosters creativity and imagination. White’s essay is a ‘picaresque’, following a traveller who narrates her adventures and encounters. It is a wonderful model for narratives of difference as it departs, refreshingly, from mainstream Hollywood-style plot conventions, i.e of progress through conflict towards a climax and resolution. Instead, the picaresque allows for a variety of roles, settings and pathways for the wanderer, multiple characters and illuminating dialogues. It demonstrates literally as well as figuratively, productive encounters with the Other, jolting us into new understandings, ways of knowing and possibilities of being. In this way, White’s essay “Body Language” sets a thematically rich tone for this special “deaf” issue of M/C Journal. Through her essay and the following narratives, commentaries, articles and essays, we are immersed in the theme of the importance (and liberating possibilities) of contesting fixed and limited images, disrupting the representations and labels that are so readily assigned to the deaf or deafness. Different strategies and styles are employed, from figurative creative writing or life narrative to the critical essay or media analysis. Yet all contributions emphasise shifting perceptions, commence from a position of not being comfortable with the given representations or ideas that surround deaf identity. The personal narratives and essays assert a strong sense of disjuncture between deaf reality and common representations and ideas of deafness. Reading these contributions, we gain an acute sense of not being at one with the image or idea of a deaf person, not being at one with the social world, not being any one thing but rather many different and varying things and roles. The conditions of possibility are touched upon in the personal reflective pieces, resonating with the critical essays in their exploration of the possibilities of destabilizing hegemonic representations. For example, in “Becoming Deaf”, Karen McQuigg’s personal reflective essay, she describes several stages of the deaf experience. Her description of her son’s responses and adaptations is moving, and Karen mines a range of emotional responses to deafness. She shares with the reader the advice and support she received from other people: some readers will remember with affection the role of Elizabeth Hastings and John Lovett in the Australian Deaf community. McQuigg’s reflections sharply highlight the fluid nature of our individual experience and understanding of deafness. She (and we do too) shifts from what was experienced and understood initially as a blank, a not-comprehending—a ‘blank’ that is linked with loss and constraints, grief, suffering and isolation—to a discovery of how those views and experiences can change, along with changing environment and opportunities. This comes across also in Christy L Reid’s piece “Journey of a Deaf-Blind Woman”: possibilities are linked with where the narrator is living, with life events as varied as training and job opportunities, changes in health, marriage, the birth and development of children, child rearing, and of personal triumphs. Michael Uniacke’s personal essay “Fluid Identities: A Journey of Terminology” has much in common with Jessica White’s essay as he too engages playfully with his ideas. He uses language and figurative play to challenge the reader’s understandings of deaf identity, and to demonstrate the fluid and multiple nature of identity. For example, his opening anecdote about the Hearing Impaired Businessman plays to an embodiment of the idea that many people have, through categories and labels, of a deaf person, as Other, a caricature figure with no interiority or humour or nuanced life. Uniacke engages with this figure in a kind of dialogue, making him surreal, highlighting his typecast nature. By the end of his essay, Michael has shown us how identity can be context-specific and composed of many parts. In “Interpreters in Our Midst”, Breda Carty takes us on a jaunty, personal and engaging commentary that provokes the reader into taking a fresh look at the role of interpreters in mediating/translating relationships between deaf and hearing people. She asks, ‘When interpreters are in our midst, whose interests are they representing? And why are those interests not always clear to the observer?’ Originally written as a short piece for the Australian Sign Language Interpreters' Association (ASLIA), the article is informed by Breda’s immersion in particular professional and personal communities and experiences. While the tone of her commentary is light-hearted, using film screen representations of interpreters to illustrate her points, Breda nevertheless succeeds in politicizing the subject of interpretation and interpreters. She makes us aware of the social assumptions and hierarchies that structure our understanding of interpreting, which, if left unexamined, might seem a neutral and apolitical practice. Rebecca Sánchez makes an exciting contribution to the field of poetry. In her paper “Hart Crane's Speaking Bodies: New Perspectives on Modernism and Deafness”, Rebecca writes about looking for ideas about deafness in unexpected places, namely the poetry of hearing modernist Hart Crane. Taking up the theme of embodiment, evident in several other papers in this edition, Rebecca offers an interesting connection between a poetics of embodiment—Crane was influenced by Walt Whitman, a trail-blazer in embodied language in American poetry—and the more literal embodiment of manual languages. Although Hart Crane was not writing about deafness per se, his work explores the potential of embodied languages to alter the ways in which we interact with one another. When asked to define deafness, most people’s first response is to think of levels of hearing loss, of deficiency, or disability. By contrast, Crane’s non-literal approach provides a more constructive understanding of what communicative difference can mean, and how it can affect our und,erstanding of language itself. Rebecca’s essay's strength arises from its demonstration of Crane's desire to imagine the possibility of a language that lives within the body as rich and enabling, as are manual languages. Miriam Nathan Lerner’s professional training as a librarian is evident in her filmography “The Narrative Function of Deafness and Deaf Characters in Film”. During 2010, she is collaborating with a technical support faculty member at the Rochester National Technical Institute of the Deaf to design a website with quick-time windows so that the reader can click on and watch film clips of the works she references in her filmography. A lively, chatty introduction to some forty-three films with deaf characters and deafness, in which she provides her admittedly quirky approach to categorisation, Miriam Lerner’s filmography will one day be recognised in the same breath as Jonathon Miller’s “Rustle of a Star: An Annotated Bibliography of Deaf Characters in Fiction.” (Miller was also a librarian: they obviously possess the requisite skills of categorisation!) Pamela Kincheloe’s article “Do Androids Dream of Electric Speech? The Construction of Cochlear Implant Identity on American Television and the ‘New Deaf Cyborg’” offers an important analysis of popular (mis)conceptions of deafness and ‘assistive technologies’ as is evident from American television representations of deaf people with Cochlear Implants. She notes the prevalence of cochlear implants in television drama, identifies a couple of very limited narrative frames that dominate such representations, and discusses their implications. In her discussion of the ‘abject’ horror associated in television series with the cochlear implant recipient (often already a corpse) Kincheloe asserts that the Cochlear Implant technology is increasingly used in such narratives to convey intensified anxieties, not only about the deaf Other, but also about technology and the emergent ‘cyborgs’, humans modified by technology. Sharon Pajka-West’s well-researched article “Deaf Characters in Adolescent Fiction”, excerpted from her doctorate thesis, originated in a request from a young deaf reader for a book with which she could connect. Pajka-West takes us on her pursuit to fulfil this request, giving us many fascinating insights along the way. Her blog is essential reading not only for anyone interested in the field of adolescent literature, but also for those who understand the significance of providing young deaf readers access to literature in which the multiple possibilities for deaf lives, deaf identities, and deafness are canvassed. In her article “Marginalising the Mainstream: A Signed Performance of The Miracle Worker”, Caroline Heim places deaf issues centre-stage. Her thesis is that a way needs to be found to increase access to theatrical events for the deaf. She tackles this by viewing a Crossbow Production performance of The Miracle Worker (the story of the teaching relationship between Helen Keller and Annie Sullivan from different perspectives: accessibility, funding, plot construction and actors’ interpretation, the detail of production design (sound, colour and tactile) and the use of theatrical device, and post performance discussion. Arguably, Heim’s article might have benefited from more focus on the concept of inclusion, rather than exclusion. The claim that not enough money is given to providing ‘access’ for the deaf to mainstream productions may be difficult to uphold as a stand-alone argument when the budget of the majority of Australian theatre companies would highlight the fiscal difficulty they have just getting productions on the stage. All the same, Heim’s article provokes us, the reader, into investigating the many layered meanings of ‘access’ and also reminds us, yet again, of theatre’s potential magic in engaging audiences across all spheres of life. In her essay “Looking across the Hearing Line”, Nicole Matthews has written a stimulating paper on youth, Deaf people, and new media. Her paper is especially interesting as an exploration of the intersection between disability and Web 2.0 technologies. In particular, Matthews picks up a thread of Web 2.0 technologies relating to visual communication and expression to provide some insights into the emerging, complex nature of Deaf users’ engagement with digital media in contrast with the continuing problems of inaccessibility and exclusion in the mainstream world. Conclusion: Learning Our Knowingness from What We Don’t Know This special “deaf” issue of M/C Journal is not a “project”, in the Modern sense of that word, i.e. a unified collective effort to define identity, in this case deaf identity, or to consolidate and express a unique world view. Nor does it seek to enlighten the public about what it is to be deaf. Such a totalising project would inevitably suppress heterogeneity and the specificities of people’s lives. Rather, this collection offers many different particular and localised accounts - some personal and poetic, some analytical, some working through critique - which explore the conditions of possibility for human subjects, and in particular, people who are deaf. The contributions highlight in very different ways the complex and shifting fields within which people’s lives and experiences are formed. These works give us insight into the varied and changing social and environmental conditions that not only shape our lives but are in turn shaped by who we are and by our practices and choices. The constraints and possibilities of people’s lives change significantly and differ widely. They are linked inextricably with where people are, in terms of geography or location, and with the circumstances they find themselves in or create for themselves: circumstances of gender, family, social networks, economics, education, work, lifestyle, health or illness, physical abilities, differences and limitations. These works stress the highly contingent nature of human social development and the fluidity of deaf experience rather than identity. Identity shifts and takes on meaning in relation to others and situations; we come to know who we are through a process of differentiating ourselves from others and from identities that we do not feel comfortable with. In almost all of these accounts here experiences of deafness are not the same those conjured up by labels or stereotypes. This act of disassociation from the usual notions of deafness, highlights that our received language and labels do not give us knowledge. Disavowal reminds us that we do not know, except through some disruptive encounter with the Other, whether that is the otherness of our own deafness or the deafness of others. These writings that demonstrate the particularity and detail of deaf people’s experiences, enable us to know the limits and inaccuracies of the labels and identities so commonly assigned to deafness and the deaf. Thus, we come back to the beginning and find our equivocal, tentative answers to the question, ‘how do we learn what we know about being deaf and deafness?’ We learn what we know in various ways, yet hearing or deaf, we are exposed to particular ideas of deafness, limiting labels and assumptions that reinforce ‘ableist’ values. These writings have demonstrated the proliferation of limited stereotypes; they recur in narratives, news stories, television and films, and have power regardless of their disconnection from the real, and from the lived experience of deafness. It is a significant starting point to recognise the limitations of what we think we already know, through our media and social institutions, of deafness. These essays and writings represent a different epistemology; they explore not what deafness is or how it can be defined, but different ways of knowing deafness. References Couser, G. Thomas. “Signs of Life: Deafness and Personal Narrative” Ch. 6 in Recovering Bodies: Illness, Disability, and Life Writing. Wisconsin: University of Wisconsin Press, 1997. Bauman, H-Dirksen L. “Voicing Deaf Identity: Through the ‘I’s’ and Ears of an Other.” In S. Smith, and J. Watson, eds., Getting a Life: Everyday Uses of Autobiography. Minneapolis: University of Minnesota Press, 1989. 47-62. Kisor, Henry. What’s That Pig Outdoors? A Memoir of Deafness. New York: Hill and Wang, 1990.

I sat alone on the beach under the shade of a big umbrella. My husband, Bill, and our three children were in the condo taking a break from the Florida sunshine. Dreamily, I gazed at the vast Gulf of Mexico, the brilliant blue sky stretching endlessly above. I was sitting about 50 feet from the surf, but I couldn't actually see the waves hitting the beach; I was almost blind. It was a windy day in late May and I loved feeling the ocean breeze sweeping over me. I imagined I could hear the waves crashing onto the surf, but the sound was only a memory. I was totally deaf. Although I had a cochlear implant and could hear the waves, the cry of sea gulls, and many other sounds with the technology, I wasn't wearing it at the moment and everything I heard was in my mind. As a child, my understanding of speech was better and my vision was clearer. My diagnosis was optic atrophy at age 5 and my vision gradually degenerated over the years. For unknown reasons, nerve damage caused hearing loss and during my teens, my hearing grew worse and worse until by the time I was ready for college, I was profoundly deaf. I chose to attend Gallaudet University because my high school teachers and my parents felt I would receive better services as a deaf and blind student. I feel it was a very good decision; when I entered Gallaudet, it was like entering a new and exhilarating world. Before attending Gallaudet, while I struggled to cope with hearing loss combined with severely low vision, my world grew smaller and smaller, not being able to communicate efficiently with others. At Gallaudet, I suddenly found I could communicate with almost anybody I met on campus using sign language. Thus, my self-confidence and independence grew as I proceeded to get a college education.It wasn't an easy route to follow. I didn't know Braille at the time and depended on using a CCTV (closed captioned television) electronic aid which magnified text, enabling me to read all my college books. I also relied on the assistance of a class aid who interpreted all my teachers' lectures and class discussions because I was unable to see people's signing unless they signed right in front of my face. It was slow going and often frustrating, trying to keep involved socially and keeping up with my coursework but when I was 13 years old, my vision specialist teacher who had worked with me from 5th grade until I graduated from high school, wrote a note for me saying, "Anything worthwhile seldom comes easy." The phrase stuck in my mind and I tried to follow this philosophy. In 1989 after 7 years of persistence, I graduated with a Bachelor's of Arts degree in psychology. With the B.A. in hand and having developed good communication skills with deaf and deaf-blind people using sign language and ASL (American Sign Language), I was ready to face the world. But I wasn't exactly ready; I knew I wanted a professional job working with deaf-blind people and the way to get there was to earn a master's degree. I applied for admission into Gallaudet's graduate school and was accepted into the vocational rehabilitation counselling program. While I thoroughly enjoyed graduate school experience, I got to work with my class mates one-on-one more often and there were a lot more hands-on activities, it became obvious to me that I wasn't prepared for graduate school. I needed to learn Braille and how to use Braille technology; my vision had worsened a lot since starting college. In addition, I needed a break from school and needed to gain experience in the working world. After completing one and a half years and earning 15 credit hours in the master's program, I left Gallaudet and found a job in Baltimore, Maryland.The job was with a new program for adults who were visually and hearing impaired and mentally disabled. My job was assisting the clients with independent living and work related skills. Most of the other staff were deaf, communicating via ASL. By then, I was skilled using tactile signing, putting my hand on the back of the signer's hand to follow movements by touch, and I made friends with co-workers. I felt grown up and independent working full-time, living in my own apartment, using the subway train and bus to travel to and from work. I didn't have any serious problems living on my own. There was a supermarket up the road to which I could walk or ride a bus. But I needed a taxi ride back to the apartment when I had more groceries than I could carry. I would leave a sign I made out of cardboard and wrote my address in big black numbers, on my apartment door to help the driver find my place. I used a white cane and upon moving to Baltimore, an Orientation and Mobility (O and M) teacher who worked with blind people, showing them how to travel in the city, taught me the route to my work place using the subway and bus. Thus, I was independent and knew my way to work as well as to a nearby shopping mall. One day as I stood on the subway station platform holding my white cane, waiting for my train, the opposite train pulled in. As I stood watching passengers hurrying to board, knowing my train would arrive soon on the other side, a woman ran up to me and started pulling my arm. I handed her my notebook and black marker I used for communicating with people in the public, telling her I couldn't hear and would she please write in large print? She frantically scribbled something, but I couldn't read the note. She then gave me back the pen and pad, grabbed my arm again and started pulling me towards the train. I refused to budge, gesturing towards the opposite tracks, clearly indicating I was waiting for the other train. Finally, she let go, dashed into the train before the doors closed. I watched the train pull away, sadly reflecting that some people who wanted to help, just didn't understand how to approach disabled people. As a deaf-blind traveller, it was my duty to help educate the general public how to assist disabled persons in a humane way. After I established my new life for a few months, Bill was offered a position in the same program and moved to Baltimore to join me. He had worked at the Helen Keller National Centre in New York where I met him while doing a summer internship there three years before. I was thrilled when he got the job working beside me and we got to know each other on a daily basis. We had been dating since we met although I was in college and he was working and living in New York and then Cleveland, Ohio. Bill being hearing and sighted, was skilled in sign language and communication techniques with deaf-blind people. He had a wonderful attitude towards disabled people and made me feel like a normal person who was capable of doing things. We shared a lot and were very comfortable with each other. After nearly six months together in Baltimore, we married in May 1992, several weeks before my 28th birthday.After our first year of marriage living in Maryland, Bill and I moved to Little Rock, Arkansas. We wanted to live closer to my family and parents, Ron and Judy Cummings, who lived in Poplar Bluff, Missouri, 176 miles north of Little Rock. I wanted to go back to school and entered the deaf education program at the University of Arkansas at Little Rock with the goal of becoming a teacher for deaf-blind students. I never dreamed I would have a deaf-blind child of my own one day. My vision and hearing loss were caused by nerve damage and no one else in my family nor Bill's had a similar disability.I was pregnant with our first child when I entered UALR. In spite of my growing belly, I enjoyed the teacher training experience. I worked with a deaf-blind 12-year-old student and her teacher at the Arkansas School for the Deaf; observed two energetic four-year-olds in the pre-school program. But when my son, Joe was born in June 1994, my world changed once again. School became less important and motherhood became the ultimate. As a deaf-blind person, I wanted to be the best mom within my abilities.I decided that establishing good communication with my child was an important aspect of being a deaf-blind mom. Bill was in full agreement and we would set Joe on the kitchen table in his infant carrier, reciting together in sign language, "The three Bears". I could see Joe's tiny fists and feet wave excitedly in the air as he watched us signing children's stories. I would encourage Joe to hold my fingers while I signed to him, trying to establish a tactile signing relationship. But he was almost two years old when he finally understood that he needed to sign into my hands. We were sitting at the table and I had a bag of cookies. I refused to give him one until he made the sign for "cookie" in my hand. I quickly rewarded him with a cookie and he got three or four each time he made the sign in my hand. Today at 16, Joe is an expert finger speller and can effectively communicate with me and his younger deaf-blind brother, Ben.When Joe was two and a half, I decided to explore a cochlear implant. It was 1996 and we were living in Poplar Bluff by then. My cousin, who was studying audiology, told me that people using cochlear implants were able to understand sound so well they didn't need good vision. I made an appointment with the St. Louis cochlear implant program and after being evaluated, I decided to go ahead. I am glad I have a cochlear implant. After months of practice I learned to use the new sound and was eventually able to understand many environmental sounds. I never regained the ability of understanding speech, though, but I could hear people's voices very clearly, the sound of laughter, birds singing, and many more. Being able to hear my children's voices is especially wonderful, even when they get noisy and I get a headache. That fall I went to Leader Dogs School for the Blind (LDSB) where I met Milo, a large yellow Labrador retriever. At LDSB I learned how to care for and work with a dog guide. Having Milo as my companion and guide was like stepping into another new and wonderful world of independence. With Milo, I could walk briskly and feel secure. Milo was a big help as a deaf-blind mom, too. With Milo's guiding help, it was wonderful following my children while they rode tricycles or bikes and the whole family enjoyed going out for walks together. Our second son, Ben, was born in February 1999. He was a perfectly healthy little boy and Bill and I were looking forward to raising two sons. Joe was four and a half years old when Ben was born and was fascinated in his new brother. But when Ben was 5 months old, he was diagnosed with Langerhans Cell Histiocytosis (LCH), a rare childhood disease and in some cases, fatal. It was a long, scary road we followed as Ben received treatment at the children's hospital in St. Louis which involved making the 150 mile trip almost weekly for chemotherapy and doctor check-ups. Through it all, Ben was a happy little boy, in spite of the terrible rash that affected his scalp and diaper area, a symptom of LCH. Bill and I knew that we had to do everything possible to help Ben. When he was a year old, his condition seemed stable enough for me to feel comfortable leaving my family for two months to study Braille and learn new technology skills at a program in Kansas City. My vision had deteriorated to a point where I could no longer use a CCTV.Bill's mom, Marie Reid, who lived in Cleveland, Ohio, made a special trip to stay at our home in Poplar Bluff to help Bill with the boys while I was gone. I was successful at the program, learning Braille, making a change from magnification to Braille technology. Upon returning home, I began looking for a job and found employment as a deaf-blind specialist in a new project in Mississippi. The job was in Tupelo and we moved to northern Mississippi, settling into a new life. We transferred Ben's treatment to St. Judes Children's hospital located in Memphis, 94 miles west of Tupelo. I went to work and Bill stayed home with the boys, which worked well. When Ben had to go to St. Judes every three weeks for chemotherapy, Bill was able to drive him. The treatment was successful, the rash had disappeared and there were no traces of LCH in Ben's blood tests. But when he was almost 3 years old, he was diagnosed with optic atrophy, the same eye disease I suffered from and an audiologist detected signs of inner ear hearing loss.Shocked at the news that our little son would grow up legally blind and perhaps become deaf, Bill and I had to rethink our future. We knew we wanted Ben to have a good life and as a deaf-blind child, he needed quality services. We chose to move to Pittsburgh, Pennsylvania because I knew there were good services for deaf-blind people and I could function independently as a stay-home mom. In addition, Cleveland, Ohio, where Marie Reid and several of Bill's siblings lived, was a two hour's drive from Pittsburgh and living near family was important to us. With regret, I left my job opportunity and new friends and we re-located to Pittsburgh. We lived on a quiet street near Squirrel Hill and enrolled Joe into a near-by Catholic school. Ben received excellent early intervention services through the Pittsburgh public school, beginning Braille, using a white cane and tactile signing. The Pennsylvania services for the blind generously purchased a wonderful computer system and Braille display for me to use at home. I was able to communicate with Joe's and Ben's teachers and other contacts using e-mail. Ben's Braille teacher provided us with several print/Braille books which I read to the boys while Ben touched the tactile pictures. I made friends in the deaf and deaf-blind community and our family attended social events. Besides the social benefits of a deaf community, Pittsburgh offered a wonderful interpreting service and I was able to take Ben to doctor appointments knowing an interpreter would meet me at the hospital to assist with communication. I also found people who were willing to help me as volunteer SSPs (support Service Providers), persons whose role is to assist a deaf-blind person in any way, such as shopping, going to the bank, etc. Thus, I was able to function quite independently while Bill worked. Perhaps Bill and I were a bit crazy; after all, we had enough on our plate with a deaf-blind son and a deaf-blind mom, but love is a mysterious thing. In October 2003, Tim was born and our family was complete. Having two school-aged children and a baby on my hands was too much for me to handle alone. Bill was working and busy with culinary arts school. We realized we needed more help with the children, plus the high cost of living in the city was a struggle for us. We decided for the family's best interest, it would be better to move back to Poplar Bluff. After Joe and Ben were out of school in June, my mom flew out to Pittsburgh to escort them back to her home while Bill finished his externship for his culinary arts degree and in the late summer of 2004, we packed up our apartment, said good-bye to Pittsburgh, and drove to Missouri. The move was a good decision in many ways. Poplar Bluff, a rural town in south-eastern Missouri, has been my hometown since I was 10 years old. My extended family live there and the boys are thriving growing up among their cousins. Ben is receiving Braille and sign language services at public school and reads Braille faster than me!While both Bill and I are deeply satisfied knowing our children are happy, we have made personal sacrifices. Bill has given up his career satisfaction as a professional cook, needing to help look after the children and house. I have given up the benefits of city life such as interpreting and SSP services, not to mention the social benefits of a deaf community. But the children's well-being comes first, and I have found ways to fulfil my needs by getting involved with on-line groups for deaf-blind people, including writers and poets. I have taken a great interest in writing, especially children's stories and hope to establish a career as a writer. While I work on my computer, Bill keeps busy engaging the boys in various projects. They have built a screened-in tree house in the backyard where Ben and Tim like to sleep during warm summer nights.“It's almost 5 o'clock," Bill signed into my hand, rousing me from my thoughts. Time to prepare for our homeward journey the next day to Poplar Bluff, Missouri.Christy and Family

Apparently some people upon coming across [Down Syndrome dolls] were offended. […] Still, it’s curious, and telling, what gives offense. Was it the shock of seeing a doll not modeled on the normative form that caused such offense? Or the assumption that any representation of Down Syndrome must naturally intend ridicule? Either way, it would seem that we might benefit from an examination of such reactions—especially as they relate to instances of the idealisation of the human form that dolls […] represent. (Faulkner) IntroductionWhen Joanne Faulkner describes public criticism of dolls designed to look like they have Down Syndrome, she draws attention to the need for an examination of the way discourses of disability are communicated. She calls, in particular, for an interrogation of people’s reactions to the disruption of the idealised human form that most dolls adopt. The case of Down Syndrome dolls is fascinating, yet critical discussion of these dolls from a disability or cultural studies perspective is conspicuously lacking. To address this lack, this paper draws upon theories of the cultural construction of disability, beauty, and normalcy (Garland-Thompson, Kumari Campbell, Wendell), to explore the way ideas about disability are communicated and circulated. The dominant discourse of disability is medical, where people are diagnosed or identified as disabled if they meet certain criteria, or lists of physical impairments. These lists have a tendency to subsume the disparate qualities of disability (Garland-Thompson) and remove people considered disabled from the social and cultural world in which they live (Snyder and Mitchell 377). While Down Syndrome dolls, produced by Downi Creations and Helga’s European Speciality Toys (HEST) in the US and Europe respectively, are reflective of such lists, they also perform the cultural function of increasing the visibility of disability in society. In addition, the companies distributing these dolls state that they are striving for greater inclusion of people with Down Syndrome (Collins, Parks). However, the effect of the dominance of medicalised discourses of disability can be seen in the public reaction to these dolls. This paper seeks also to bring an interrogation of disability into dialogue with a critical analysis of the discursive function of lists.The paper begins with a consideration of lists as they have been used to define disability and organise knowledge within medicine, and the impact this has had on the position of disability within society. In order to differentiate itself from medical discourses, the emerging social model also relied on lists during the 1980s and 1990s. However, these lists also decontextualised disability by ignoring certain factors for political advantage. The social model, like medicine, tended to ignore the diversity of humanity it was apparently arguing for (Snyder and Mitchell 377). The focus then shifts to the image of Down Syndrome dolls and the ensuing negative interpretation of them focusing, in particular, on reader comments following a Mail Online (Fisher) article. Although the dolls were debated across the blogosphere on a number of disability, special needs parenting, and Down Syndrome specific blogs, people commenting on The Mail Online—a UK based conservative tabloid newspaper—offer useful insights into communication and meaning making around disability. People establish meanings about disability through communication (Hedlund 766). While cultural responses to disability are influenced by a number of paradigms of interpretation such as superstition, religion, and fear, this paper is concerned with the rejection of bodies that do not ascribe to cultural standards of beauty and seeks to explore this paradigm alongside and within the use of lists by the various models of disability. This paper interrogates the use of lists in the way meanings about disability are communicated through the medical diagnostic list, the Down Syndrome dolls, and reactions to them. Each list reduces the disparate qualities and experiences of disability, yet as a cultural artefact, these dolls go some way towards recognising the social and cultural world that medicalised discourses of disability ignore. Drawing on the use of lists within different frameworks of disability, this paper contrasts the individual, or medical, model of disability (that being disabled is a personal problem) with the social model (that exclusion due to disability is social oppression). Secondly, the paper compares the characteristics of Down Syndrome dolls with actual characteristics of Down Syndrome to conclude that these features aim to be a celebrated, not stigmatised, aspect of the doll. By reasserting alternative notions of the body, the dolls point towards a more diverse society where disability can be understood in relation to social oppression. However, these aims of celebration have not automatically translated to a more diverse understanding. This paper aims to complicate perceptions of disability beyond a rudimentary list of characteristics through a consideration of the negative public response to these dolls. These responses are an example of the cultural subjugation of disability.Lists and the Creation of Normative Cultural ValuesFor Robert Belknap, lists are the dominant way of “organizing data relevant to human functioning” (8). While lists are used in a number of ways and for a variety of purposes, Belknap divides lists into two categories—the practical and the literary. Practical lists store meanings, while literary lists create them (89). Belknap’s recognition of the importance of meaning making is particularly relevant to a cultural interrogation of disability. As Mitchell and Snyder comment:Disability’s representational “fate” is not so much dependant upon a tradition of negative portrayals as it is tethered to inciting the act of meaning-making itself. (6)Disability unites disparate groups of people whose only commonality is that they are considered “abnormal” (Garland-Thompson). Ableism—the beliefs, processes, and practices which produce the ideal body—is a cultural project in which normative values are created in an attempt to neutralise the fact that all bodies are out of control (Kumari Campbell). Medical models use diagnostic lists and criteria to remove bodies from their social and cultural context and enforce an unequal power dynamic (Snyder and Mitchell 377).By comparison, the social model of disability shifts the emphasis to situate disability in social and cultural practices (Goggin and Newell 36). Lists have also been integral to the formation of the social model of disability as theorists established binary oppositions between medical and social understandings of disability (Oliver 22). While these lists have no “essential meaning,” through discourse they shape human experience (Liggett). Lists bring disparate items together to structure meaning and organisation. According to Hedlund, insights into the experience of disability—which is neither wholly medical nor wholly social—can be found in the language we use to communicate ideas about disability (766). For example, while the recent production of children’s dolls designed to reflect a list of the physical features of Down Syndrome (Table 2) may have no inherent meaning, negative public reception reveals recognisable modes of understanding disability. Down Syndrome dolls are in stark contrast to dolls popularly available which assume a normative representation. For Blair and Shalmon (15), popular children’s toys communicate cultural standards of beauty. Naomi Wolf describes beauty as a socially constructed normative value used to disempower women in particular. The idealisation of the human form is an aspect of children’s toys that has been criticised for perpetuating a narrow conception of beauty (Levy 189). Disability is likewise subject to social construction and is part of a collective social reality beyond diagnostic lists (Hedlund 766).Organising Knowledge: The Social vs. Medical Model of DisabilityDisability has long been moored in medical cultures and institutions which emphasise a sterile ideal of the body based on a diagnosis of biological difference as deviance. For example, in 1866, John Langdon Down sought to provide a diagnostic classification system for people with, what would later come to be called (after him), Down Syndrome. He focused on physical features:The hair is […] of a brownish colour, straight and scanty. The face is flat and broad, and destitute of prominence. The cheeks are roundish, and extended laterally. The eyes are obliquely placed, and the internal canthi more than normally distant from one another. The palpebral fissure is very narrow. The forehead is wrinkled transversely from the constant assistance which the levatores palpebrarum derive from the occipito-frontalis muscle in the opening of the eyes. The lips are large and thick with transverse fissures. The tongue is long, thick, and is much roughened. The nose is small. The skin has a slight dirty yellowish tinge, and is deficient in elasticity, giving the appearance of being too large for the body. (Down)These features form what Belknap would describe as a “pragmatic” list (12). For Belknap, scientific classification, such as the description Langdon Down offers above, introduces precision and validation to the use of lists (167). The overt principle linking these disparate characteristics together is the normative body from which these features deviate. Medicalised discourses, such as Down’s list, have been linked with the institutionalisation of people with this condition and their exclusion from the broader community (Hickey-Moody 23). Such emphasis on criteria to proffer diagnosis removes and decontextualises bodies from the world in which they live (Snyder and Mitchell 370). This world may in fact be the disabling factor, rather than the person’s body. The social model emerged in direct opposition to medicalised definitions of disability as a number of activists with disabilities in the United Kingdom formed The Union of Physically Impaired Against Segregation (UPIAS) and concluded that people with disability are disabled not by their bodies but by a world structured to exclude their bodies (Finkelstein 13). By separating disability (socially created) from impairment (the body), disability is understood as society’s unwillingness to accommodate the needs of people with impairments. The British academic and disability activist Michael Oliver was central to the establishment of the social model of disability. Following the activities of the UPIAS, Oliver (re)defined disability as a “form of social oppression,” and created two lists (reproduced below) to distinguish between the social and individual (or medical) models of disability. By utilising the list form in this way, Oliver both provided a repository of information regarding the social model of disability and contextualised it in direct opposition to what he describes as the individual model. These lists present the social model as a coherent discipline, in an easy to understand format. As Belknap argues, the suggestion of order is a major tool of the list (98). Oliver’s list suggests a clear order to the emerging social model of disability—disability is a problem with society, not an individual. However, this list was problematic because it appeared to disregard impairment within the experience of disability. As the “impersonal became political” (Snyder and Mitchell 377), impairment became the unacknowledged ambiguity in the binary opposition the social model was attempting to create (Shakespeare 35). Nevertheless, Oliver’s lists successfully enforced a desired order to the social model of disability. The individual modelThe social modelPersonal tragedy theorySocial oppression theoryPersonal problemSocial problemIndividual treatmentSocial actionMedicalisationSelf helpProfessional dominanceIndividual and collective responsibilityExpertiseExperienceAdjustmentAffirmationIndividual identityCollective identityPrejudiceDiscriminationAttitudesBehaviourCareRightsControlChoicePolicyPoliticsIndividual adaptation Social changeTable 1 The Individual v Social Model of Disability (Oliver)The social model then went through a period of “lists,” especially when discussing media and culture. Positive versus negative portrayals of disability were identified and scholars listed strategies for the appropriate representation of disability (Barnes, Barnes Mercer and Shakespeare). The representations of impairment or the physical markers of disability were discouraged as the discipline concerned itself with establishing disability as a political struggle against a disabling social world. Oliver’s lists arrange certain “facts” about disability. Disability is framed as a social phenomenon where certain aspects are emphasised and others left out. While Oliver explains that these lists were intended to represent extreme ends of a continuum to illustrate the distinction between disability and impairment (33), these are not mutually exclusive categories (Shakespeare 35). Disability is not simply a list of physical features, nor is it a clear distinction between individual/medical and social models. By utilising lists, the social model reacts to and attempts to move beyond the particular ordering provided by the medical model, but remains tied to a system of classification that imposes order on human functioning. Critical analysis of the representation of disability must re-engage the body by moving beyond binaries and pragmatic lists. While lists organise data central to human functioning, systems of meaning shape the organisation of human experience. Down Syndrome dolls, explored in the next section, complicate the distinction between the medical and social models.Down Syndrome DollsThese dolls are based on composites of a number of children with Down Syndrome (Hareyan). Helga Parks, CEO of HEST, describes the dolls as a realistic representation of nine physical features of Down Syndrome. Likewise, Donna Moore of Downi Creations employed a designer to oversee the production of the dolls which boast 13 features of Down Syndrome (Velasquez). These features are listed in the table below. HEST Down Syndrome Dolls Downi CreationsSmall ears set low on head with a fold at the topSmall ears with a fold at the topEars set low on the headSmall mouthSmall mouthProtruding tongueSlightly protruding tongueShortened fingers Shortened fingersPinkie finger curves inwardAlmond shaped eyesAlmond-shaped eyesHorizontal crease in palm of handHorizontal crease in palm of handGap between first and second toeA gap between the first and second toesShortened toesFlattened back of headFlattened back of headFlattened bridge across nose Flattened bridge across noseOptional: An incision in the chest to indicate open-heart surgery Table 2: Down Syndrome Dolls (Parks, Velasquez) Achieving the physical features of Down Syndrome is significant because Parks and Moore wanted children with the condition to recognise themselves:When a child with Down’s syndrome [sic.] picks up a regular doll, he doesn’t see himself, he sees the world’s perception of “perfect.” Our society is so focused on bodily perfection. (Cresswell)Despite these motivations, studies show that children with Down Syndrome prefer to play with “typical dolls” that do not reflect the physical characteristics of Down Syndrome (Cafferty 49). According to Cafferty, it is possible that children prefer typical dolls because they are “more attractive” (49). Similar studies of diverse groups of children have shown that children prefer to play with dolls they perceive as fitting into social concepts of beauty (Abbasi). Deeply embedded cultural notions of beauty—which exclude disability (see Morris)—are communicated from childhood (Blair & Shalmon 15). Notions of bodily perfection dominate children’s toys and Western culture in general as Cresswell comments above. Many bodies, not just those deemed “disabled,” do not conform to these cultural standards. Cultural ideals of beauty and an idealisation of the human body according to increasingly narrow parameters are becoming conflated with conceptions of normality (Wendell 86). Recognition of disability as subject to cultural rejection allows us to see “beauty and normalcy [as] a series of practices and positions [taken] in order to avoid the stigmatization of ugliness and abnormality” (Garland-Thompson). The exaggerated features of the doll problematise the idea that people with disability should strive to appear as nondisabled as possible and in turn highlights that some people, such as those with Down Syndrome, cannot “pass” as nondisabled and must therefore navigate a life and community that is not welcoming. While lists of the features of Down Syndrome store associated medicalised meanings, the discussion of the dolls online (the medium through which they are sold) provides insight into the cultural interpretation of disability and the way meaning is made. The next section of the paper considers a selection of negative responses to the Down Syndrome dolls that followed an article published in Mail Online (Fisher). What Causes Offence? Prior to Down Syndrome dolls, the majority of “disability dolls” were constructed through their accessories rather than through the dolls’ physical form and features. Wheelchairs, white canes, guide dogs and harnesses, plastic walkers, leg braces, and hearing aids could be purchased for use with dolls. Down Syndrome dolls look different as the features of impairment are embedded in the dolls’ construction. While accessories have a more temporary feel about them, the permanence of the impairments attributed to the doll was problematic for some who felt it projected a negative image of disability. Listed below are several negative comments following an article published in Mail Online (Fisher):What a grim world we are living in. No longer are dollies for play, for make believe, or for fun. Now it all about self image and psychological “help.” We “disabled” know we are “disabled”—we don’t need a doll to remind us of that! Stop making everything PC; let children be children and play and laugh once again!I think it’s sick and patronising.Who on earth are those education “experts?” Has nobody told them that you don’t educate children by mirroring their defects/weaknesses/negative traits but by doing exactly the opposite, mirroring back the BEST in them?The Downs Syndrome doll looks like they took the physical traits and presented them in an exaggerated way to make them more noticeable. That doll does not look attractive to me at all. If someone has a child that WANTS such a doll, fine. I can’t really see how it would help many of them, it would be like a huge sign saying “You are different.”The terminology used (grim, sick, patronising, defect, weak, negative, unattractive, different) to describe disability in these posts is significant. These descriptions are ideological categories which disadvantage and devalue “bodies that do not conform to certain cultural standards” (Garland-Thompson). Implicit and explicit in all of these comments is the sense that disability and Downs Syndrome in particular is undesirable, unattractive even. When listed together, like Belknap’s literary lists, they are not random or isolated interpretations; they form part of a larger system of meaning making around disability.These responses are informed by the notion that in order to gain equality in society, people with disability must suppress their difference and focus instead on how they are really just like everybody else. However, this focus ignores barriers to inclusion, such as in the rejection of bodies that do not ascribe to cultural standards of beauty. An increasing visibility of impairment in popular culture such as children’s toys advances an understanding of disability as diversity through difference and not something inherently bad. ConclusionPeter Laudin of Pattycake Doll, a company which sells Black, Hispanic, Asian, and Disabled dolls, has found that children “love all dolls unconditionally whether it’s special needs or not” (Lee Adam). He suggests that the majority of the negative responses to the Down Syndrome dolls stem from prejudice (Lee Adam). Dolls popularly available idealise the human form and assume a normative representation. While this has been criticised for communicating damaging standards of beauty from childhood (Levy, Blair and Shalmon), critiques about disability are not as widely understood. The social and medical models of disability focus attention on certain aspects of disability through lists; however, the reduction of diagnostic criteria in the form of a list (whether medical or social) decontextualises disability from the social and cultural world. Thus, the list form, while useful, has elided the disparate qualities of disability. As Belknap argues, lists “ask us to make them meaningful” (xv). Although the dolls discussed in this paper have been criticised for stereotyping and emphasising the difference between children with disability and those without, an inclusion of the physical features of Down Syndrome is consistent with recent moves within critical disability studies to re-engage the body (Shakespeare 35). As Faulkner notes in the epigraph to this paper, an examination of negative reactions to these dolls reveals much about the cultural position of people with disability. References Abbasi, Jennifer. “Why 6-Year Old Girls Want to be Sexy.” Live Science 16 July (2012). 30 Aug. 2012 ‹http://www.livescience.com/21609-self-sexualization-young-girls.html›. Barnes, Colin. Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People. 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