How hearing loss affects development of the mind
James Garrett
Excelsior College

PSY235
Dr. Victoria Ferrara
June 21, 2015

Abstract
Hearing loss can have a tremendous effect on the cognitive development of human beings. Erik Erikson’s psychosocial theory can be connected to this issue. Lev Vygotsky’s sociocultural theory can also be tied into the effects of hearing loss on development and the theory of mind is another theory that can help explain the why. Language development is one of the main reasons for a child’s mental growth and is also one of the main areas effected by a hearing deficit. There are many ways to combat the ill-effects of hearing loss including new technologies in hearing aids along with proactive parents, teachers, and healthcare professionals.

How hearing loss affects development of the mind
Pediatric hearing loss is not a low-incident disability with the educationally significant hearing loss being approximately 12 in 1000 children (Matkin & Wilcox, 1999). Anderson (2015) tells us that usually during the 24th week of pregnancy, an unborn baby begins to hear. Hearing is a vital means of interacting with the family and the world throughout life. A baby starts to distinguish sounds like human speech in the first months after birth. The foundations of language, both hearing and speaking, develop by age two. The development of language from the youngest age is directly tied to cognitive development, primarily affecting reading, learning, and social skills. Any issues with hearing urgently need to be addressed at the earliest possible time because of the snow-balling effect that will be created. If these issues are discovered and interventions put in place, children with hearing deficits can have wonderful opportunities to develop normally even if the hearing loss is profound. (p. 1).

Anderson (2015) continues that language is caught, not necessarily taught. Children with normal hearing tend to be their own best language teacher. They are watching, listening and absorbing everything that is happening around them. Much of this absorption is from the speech the children hear from family members. The listening is helping them develop their own language. Even if a child has hearing loss, they still want to absorb and form their own language. Though special efforts must be made to make language available to a child with hearing loss, the child’s process of forming their own language is the same as that of a normal hearing child. One particular thing that can be done is staying in your child’s listening bubble. This means that you have to understand how close you must be for the child to hear and understand your voice. Speaking directly to your child and letting them see your lips move is another way to make sure they are hearing the conversation. (p. 1).

Berk (2014) explains Erik Erikson’s psychosocial theory as a lifespan model of development. This theory includes five stages that lasts through the age of around 18 years with additional three stages occurring beyond and well into adulthood. Erikson proposed that there is always room for continued growth and development throughout a person’s life. Erikson was very focused on the adolescent period because he felt it was an essential stage for developing one’s personal identity. According Erikson’s theory, the successful completion of each stage results in a healthy personality and the gaining of basic qualities. The basic qualities are building blocks or specific strengths that the ego uses to resolve ensuing crises. If a failure to complete a stage successfully occurs, a domino type effect continues with a reduced ability to complete following stages. This can likely result in an unhealthy personality and sense of self, but Erikson believed that the stages could still be resolved later in life. (p. 16-17).

Children at the industry versus inferiority stage are aged five o twelve years old according to Berk (2014). This stage is where they will be learning to read and write, learn basic math and make things on their own. An important role is filled by teachers at this stage as the children begin to be taught specific skills. Also in this stage, a child’s peer group becomes more important and will help grow hat child’s self-esteem. Children feel the desire to gain approval by displaying particular skills that are important in society. As they gain approval, they also gain a sense of pride in what they have been able to do. This pride in accomplishment along with the encouragement that reinforces their initiative to continue to grow gives them a feeling of industriousness. The children become confident in themselves to achieve goals. On the other hand, if a child has a problem such as hearing loss, the accomplishments may be delayed or not realized. The lack of self-esteem will cause the child to feel inferior and doubting that they can reach the goals like the other children. The inability to develop language at the same pace as others and gain the communication skills necessary to be socially involved with peers can most likely create a sense of inferiority. The lack of competence caused by hearing loss in this stage will carry over into the adolescent stage of identity versus role confusion without some type of intervention. (p. 330-331).

Lev Vygotsky’s social development theory has become the cornerstone of research and theory in cognitive development over the past several decades. McLeod (2007) shows that Vygotsky's theories focus on the essential role of social interaction in cognitive development. Vygotsky stated that language develops through social interaction and is used for communication with the world. He saw language as the greatest tool of mankind. Language performs two extremely vital roles in the development of cognition according to Vygotsky. The first is that language is the primary way that adults give information to children and the second that language evolves into an indispensable tool of intellectual adaptation. He gave three forms of language being social speech, private speech, and finally inner speech. (p. 1).

McLeod (2007) goes on to say Vygotsky believed that thought and language were separate systems from the beginning of life but merged to be interdependent around the age of three. Thought now turns verbal and speech transforms to be representational. During this change, children's speech is internalized and becomes inner speech which is very important due to its promotion of cognitive development. (p. 1). When a hearing deficit is present in a child, none of these vital functions take place at the proper times, if at all. Children can become outcasts and be isolated from the rest of society. This, according to Vygotsky’s theory, would virtually shut down any cognitive development that would occur in a normally hearing child.

Sundqvist, Lyxell, Jonsson, & Heimann (2014) concluded in their study of early cochlear implants in children with profound hearing loss that an articulate and consistent verbal interface with their mother, from birth, sets the foundation of social cognitive development and the theory of mind skills seen later during the preschool years. Theory of Mind is a cognitive science that examines the way we assign mental states to others. It also helps us use those states to explain and predict the actions of others. Basically this science examines the way we use our mental abilities to read others and understand why they do certain things and when they will do those things. Nearly all humans share this ability after initial development during childhood. Those people that do not develop this ability to read others and anticipate their actions may have had some type of barrier interfere with that development. Hearing loss would be a primary contributor to an ill-formed ability to do this. If a child cannot hear properly, the communication from mother to child is nonexistent causing a tremendous roadblock in cognitive development from the earliest stages of life.

When talking about hearing deficiencies in children, the linguistic environment must be considered according to Popa & Cucerzan (2014). If the poor hearing child grows up in a deaf family, they will automatically learn sign language just as a normally hearing child learns to speak in a normal hearing household. This ability to communicate will start the child down the path of normal development. On the other hand, if the child with poor hearing grows up in a normally hearing family than the child may have serious developmental issues. These issues begin with the speech not being able to develop properly and possibly causing relationship issues in the family, which in turn lead to psychological problems. Between the relationship issues and any possible psychological problems, a tremendous amount of stress can form in the home. Once the stress level in the home rises, problems can begin to flow out into the social and community setting. (p. 646).

Kemmery & Compton (2014) found that a children may categorize themselves as being deaf during the early school years but then they may identify as being hard of hearing during high school. This change can be due to different situations in their social and educational interactions and experiences. The degree of hearing loss, type of hearing loss, family history, age of onset, lifestyle, community context, and mode of communication impact how a person with hearing loss perceive or identify themselves. Those with hearing loss may also categorize themselves as something that is completely different from others with a similar type of hearing loss. Various factors are involved in the adoption of an individual identity. (p. 160).

Tye-Murray, Hale, Spehar, Myerson, & Sommers (2014) completed a study on lip reading in children between ages of 7 and 14. The results of their study showed that lip reading ability was not fixed, but that it improved between the ages of 7 and 14. They also found that children with hearing loss were able to lip read much better than the children with normal hearing. This finding suggests plays a very important role in developing this lip reading ability. Lip reading ability can be predicted in both children and adults by considering age, hearing status, and dizzy visuospatial working memory. (p. 564).

Tye-Murray, Hale, Spehar, Myerson, & Sommers (2014) show us that lip reading can be a tremendous tool for children with hearing loss. The problem with lip reading is that you must first be up to see the lips of the person speaking. In classroom settings, auditoriums and various other places, it may be impossible to position oneself to read the lips of a speaker. Another problem may arise when trying to lip read someone that does not move their lips normally when speaking. Though the above team proved that lip reading can play a vital role in the development of someone with hearing loss, there are many issues that must be overcome in order to use this on a regular basis and in the real world.

Torres, et al. (2013) tells us how important the quality of life in adolescents with disabilities is due to adolescents being a key phase for interventions and modifications. Regardless of the disability, these adolescents deserve the attention of not only educators, but the community as a whole because poor quality of life in this stage can affect their identity and create serious issues in the future of these children. During their study, this team primarily looked at adolescents with hearing and visual impairments. (p. 139).

Torres, et al. (2013) contend that most students with disabilities that are put in regular classrooms have a better quality of life and therefore do better in academic and social situations. This sense of inclusion promotes the exchanging of experiences, actively engaging in the learning process, and creating bonds with other students. The results of the study verify that students with disabilities do indeed score higher in the psychological and quality of life fields when integrated into regular classrooms. Social relations were also noted as being much better with the students. Education and social development rely tremendously on the school environment. Children and adolescents with disabilities must have this environment for socialization development and the positive aspects of the adolescent’s health and well-being. (p. 143).

Ita & Friedman (1999) show us some suggestions for educators, parents, and psychologists working with children who are deaf or have hearing loss. Children who are deaf or have hearing deficiencies and in general education programs may have some real concerns with their peer relationships. These children have reported difficulties, not only in the classroom, but also in social interactions that need to be seriously taken into account. Increased sensitivity needs to be applied to these children’s self-evaluations in the classroom setting that deals with their academic and social abilities. These children desperately need ongoing support of parents and professionals. This is especially important as their personal identities change through normal development. (p. 179).

Sebastian, Varghese, & Gowri (2015) tell us that the emotional, psychological, communicative, and social areas of a person’s life are greatly influenced by normal hearing sense. Not only is it needed for a full meaningful life, but is a vital safety issue as well. Normal hearing in children is of utmost importance in speech and language development. If identification and intervention are made early enough, hearing loss has much less of an impact on the development of communication skills. Those with hearing loss present with many psychosocial issues. These issues can include rejection by others, and restricted social life, job effectiveness, isolation, and withdrawal just to name a few. As children grow into adults, the effect of hearing loss will be different if the problem was identified before the critical age and some sort of intervention took place. The effect will also be different on adult who loses their hearing in early adulthood and has few options for rehabilitation to more normal hearing. Still yet, the adult that loses their hearing later in life has already developed their personality and has a lifestyle that does not incorporate the hearing loss. (p. 29).

Today’s technological advancements have given people with hearing deficits the ability to regain lost hearing or hear for the first time in their lives. Two types of hearing aids that are helping these people hear better are a CROS (Contralateral Routing of Signals) hearing aid or a BAHA (Bone Anchored Hearing Aid). The CROS hearing aid is comprised of two devices, one worn on each ear. The transmitter is worn on the ear with the hearing deficit to collect sounds and send them to the receiver worn on the good ear. The receiver collects the signal and feeds the sounds into the good ear thus tricking the mind into thinking it is actually hearing sounds in both ears. The BAHA works in a similar way but requires minor surgery. With the BAHA device, the person does not have to wear anything on their ears because the device is anchored to the skull just behind the ear.

However, it is not only technology that can the educational and cognitive growth for people with hearing issues. Special education classes can be used when one is unable to keep up in a regular classroom setting. These classrooms can feature a much quieter environment for students or special amplification through the use of headphones. If a child prefers a regular classroom setting and does well with their academics, a special seating arrangement can be made to make sure the child can focus on instruction. With the parent, teacher, and healthcare professionals all working together with the person, any roadblock that used to be impassable can easily be overcome today.

References
Anderson, K. l. (2015). Hearing loss and cognitive development. Retrieved June 15, 2015, from successforkidswithhearingloss.com: www.successforkidswithhearingloss.com
Berk, L. E. (2014). Development Through the Lifespan (Sixth ed.). Upper Saddle River, New Jersey: Pearson.
Ita, C. M., & Friedman, H. A. (1999). The psychological development of children who are deaf or hard of hearing: a critical review. Volta Review, 101(3), 165-181.
Kemmery, M. A., & Compton, M. V. (2014). Are you deaf or hard of hearing? Which do you go by: Perceptions of identity in families of students with hearing loss. Volta Review, 114(2), 157-192.
Matkin, N. D., & Wilcox, A. M. (1999, February 1). Considerations in the education of children with hearing loss. Pediatric Clinics, 46(1), 143-152.
McLeod, S. (2007). Lev Vygotsky. Retrieved June 10, 2015, from simplypsychology.org: http://www.simplypsychology.org/vygotsky.html
Sebastian, S., Varghese, A., & Gowri, M. (2015, Jan). The impact of hearing loss in the life of adults: A comparison between congenital versus late onset hearing loss. Indian Journal of Otology, 21(1), 29-32. doi:10.4103/0971-7749.152857
Sundqvist, A., Lyxell, B., Jonsson, R., & Heimann, M. (2014, March). Understanding minds: Early cochlear implantation and the development of theory of mind in children with profound hearing impairment. International Journal of Pediatric Otorhinolaryngology, 78(3), 538-544.
Torres, F., Marques, V., Marinho, A., Lidianne, C., de Oliveira, G., Gabriela, C., . . . Conceicao, S. (2013, Apr-Jun). Quality of life in adolescents with hearing deficiencies and visual impairments. International Archives of Otorhinolaryngology, 17(2), 139-146. doi:10.7162/S1809-97772013000200005
Tye-Murray, N., Hale, S., Spehar, B., Myerson, J., & Sommers, M. (2014, Apr). Lipreading in school-age children: The roles of age, hearing status, and cognitive ability. Journal of Speech, Language & Hearing Research, 57(2), 556-565.