Deafness

from Wikipedia, the free encyclopedia

Deafness is the complete or extensive lack of hearing in people. According to the German Association of the Deaf , around 0.1% of the population in industrialized nations is affected by deafness.

term

The Latin medical term for deafness is surditas . The term deaf originated in the German-speaking area after the introduction of general schooling for deaf children in the last quarter of the 18th century (the Middle High German term for deafness or deafness was unauthorized ). If hearing damage does not occur until after the age of natural language acquisition, one speaks of "post-lingual" or "late deafness".

Around 98% of the so-called non-hearing people have residual hearing. The term deafness is synonymous with terms such as severe hearing loss , severe hearing impairment , residual hearing loss or deafness . These are hearing impairments in which acoustically either nothing at all or corresponding stimuli only with hearing aids such as a hearing aid or z. B. a cochlear implant can be perceived. Whether spoken words can be understood with these hearing aids varies from person to person.

The term deaf and dumb is perceived as discriminatory by deaf people , because the word part 'dumb' has a negative connotation and is often used against deaf people as meaning 'dumb' or 'incompetent'. Deaf people consider the ability to speak less important than the ability to communicate. You can communicate well, be it in sign language or in spoken language. That is why people who do not hear want to be called just that in German.

Oralism describes a communication education of deaf and hard-of-hearing children that is solely focused on language and in which sign language should be largely avoided.

Causes and Findings of Deafness

Classification according to ICD-10
H90 Hearing loss due to conductive or sensory sound disorder
H91 Other hearing loss
F44.6 Psychogenic deafness
F80.2 Word deafness
R48.1 Numbness of soul
ICD-10 online (WHO version 2019)

In the International Statistical Classification of Diseases and Related Health Problems ( ICD-10 ), deafness and other hearing loss are coded as hearing loss in sections H90 and H91.

Deafness can also be due to something other than impairment of the hearing organs . “Central deafness” describes the fact that the hearing organs are intact and functional, but the brain does not process the hearing impressions. This must be distinguished from psychogenic deafness, which is coded as a mental disorder in Chapter F.

With regard to deafness (Latin: surditas), a distinction is made between total deafness for all sound stimuli or the perception of individual tones that is still present. The physically defined degree of deafness is usually determined with an audiometric method, the result of which is the audiogram . From this, the degree of hearing impairment can be determined.

Acquired deafness ( inner ear damage ) may result from e.g. B. (Meningococcal) meningitis , encephalitis , scarlet fever , measles , tuberculosis , osteomyelitis , middle ear diseases, otosclerosis , (baro-) trauma and the like. a. (in the case of absolute deafness, the inner ear or auditory nerve is always involved ).

Congenital deafness can arise either prenatally from rubella embryopathy, Rh incompatibility with kernicterus, labyrinthitis connatal ( syphilis ) or heredity (usually autosomal recessive), as well as syndromes. Well-known syndromes include Usher syndrome (restriction of the field of vision) or Waardenburg syndrome (pigment anomalies in the skin, hair or in the eyes, for example different iris colors). Other syndromes are e.g. B. Alport , Jervell-Lange-Nielsen , Cockayne and Pendred syndromes.

Hearing impairment present from birth was often recognized late. Without appropriate newborn hearing screening programs, the statistical average age at which deafness is detected is a little over two years. Newborn hearing screening has been a service provided by statutory health insurance in Germany since 2009 . There are similar programs in Austria and Switzerland and other countries. With this procedure, the newborn is tested for hearing ability one or two days after birth (in the clinic) in order to detect a congenital hearing impairment as early as possible.

Diagnosis and differential diagnosis

The diagnosis is made through special hearing tests. In the past, acoustic signal generators were used in newborns and small children to trigger a reflective lid closure . If he did not attend, deafness was suspected. However, the method has considerable inaccuracies, which is why it is useless for a meaningful diagnosis of early childhood hearing damage. OAE procedures and BERA are standard today for newborns and patients who are unwilling or unable to cooperate , as well as different hearing test procedures depending on their age .

There are a number of disorders from which deafness should be clearly distinguished, such as: B.

These disorders can be z. As by other features (such as social behavior , communication , speaking differentiate or non-speaking).

Culture

Own language

The specific language of deaf people is traditionally the sign language of their respective sign language environment, which always develops where two or more deaf people meet. People for whom sign language is their mother tongue also think in that language.

Sign languages ​​are also used by hearing people, not only when dealing with deaf people, but also with one another, e.g. B. from relatives and friends of deaf people, sign language interpreters , educators or people interested in sign language in general and from one another among the North American Indians and Warlpiri Aborigines in Australia. In addition, due to their special features, sign languages ​​are a very interesting research area for linguists .

Sign languages ​​are full-fledged languages ​​that have all the characteristics of a spoken language. They have their own grammar, whereby the sign space - the space in front of the signer's body - plays a major role. Each individual sign can be phonologically broken down into phonemes, which are summarized in the four parameters hand configuration, hand orientation, movement and locality. Posture, movement dynamics, facial expressions and sometimes a word that is spoken silently also play additional roles.

Sign language is not universal. They can be incomprehensible to one another. A convention has been established that each country has its own sign language with its own abbreviation (ASL for North America, LSF for France, DGS for Germany, ÖGS for Austria, etc.).

The development of a sign language always took place independently of the surrounding spoken language. But there is also a sign code of the spoken language surrounding the sign language, which is common in German-speaking countries as spoken language accompanying signs (LBG), but is usually referred to elsewhere as signed English, Spanish, Russian, etc. There are also local dialects, for example the German-speaking Swiss Sign Language (DSGS) is divided into five different dialects: Zurich, Bern, Lucerne, Basler and St. Gallen sign language. The most widely used sign language is likely to be American Sign Language (ASL), which is not only common in North America, but also in most of the Caribbean islands, some Central American, African and Asian nations.

Sign language is recognized as a minority language in some countries , for example in Austria by the Federal Constitution (Art. 8, Paragraph 3). Sign language in Uganda is constitutionally recognized and New Zealand Sign Language (NZSL) is an official language of New Zealand . In the Swiss canton of Zurich , sign language is constitutionally recognized in terms of freedom of language . In some countries, laws or regulations mandate sign language interpreting services when dealing with authorities or courts. Sign language is increasingly being taught as a foreign language in universities and adult education centers.

Spoken language

Some of the hard of hearing and deaf people do not understand the spoken language and thus often also the written language as well as people with normal hearing. Texts should therefore be barrier-free and use simple language .

In German-speaking Switzerland deaf people is Swiss Standard German taught this rule in the episode badly to no Swiss German , unless the Swiss German is taught at the private level. This leads to the situation that Standard German is spoken in dealings with hearing people, which the Swiss often only passively master. This makes communication even more difficult. As a result, the mother tongue of Swiss Codas is not Swiss German, but Swiss Standard German, in addition to the sign language. A similar situation is known from Luxembourg and South Tyrol, where deaf children are taught German as their first language, the other common languages ​​are consequently poorly or not at all mastered.

School registration and education

Art class for women at the State School for the Deaf, Wisconsin, USA, circa 1880

Deafness in early childhood affects language acquisition because around 90% of deaf children have parents who can hear and who have no sign language skills. Their upbringing and schooling are mostly monolingual in the national language and orally oriented, often avoiding or suppressing sign language.

The special schools, which are dedicated to the upbringing of deaf children, thus gained a significance that goes far beyond education as the origin of a cultural community of deaf people.

As early as the 18th century, two opposing teaching approaches emerged as to whether deaf children should be taught monolingually in the national language or bilingually with the addition of sign language: the French method by Abbé de l'Epée and the German method by Samuel Heinicke . A dispute arose over the effectiveness and usefulness of the two approaches that continues to this day. It has come to be known as the " method controversy " between the "German" or "oral" method and the "French", sign language method.

The dispute culminated at the Congress of Milan in 1880 . There leading educators decided in a resolution that all deaf children should only be trained in spoken language. Further developments in medicine and technology suggested that deafness could soon be cured and also had a beneficial effect on the “oral” method. In the 1950s, the so-called auditory-verbal method was finally developed, in which deaf children no longer only learn to articulate and lip-read, but - if there were any residual hearing - should also train to hear. The debate at the special schools has now shifted to the polarity between purely spoken language-oriented monolingualism and bilingualism , which advocates parallel teaching and use of spoken language in addition to the use of sign language.

The current approaches to school education for deaf children have become very differentiated. In German-speaking countries , schooling in a special school for the deaf or - if there is greater residual hearing ability - a school for the hard of hearing was the standard . Around the year 2000, around 60 special schools were available in Germany for an estimated 10,000 to 20,000 deaf or severely hard of hearing pupils. The Rheinisch-Westfälische Vocational College for the Hearing Impaired in Essen is the largest special school for the hard of hearing and deaf in Germany and offers courses up to the technical college entrance qualification and the general university entrance qualification . The school is attended by around 900 pupils from all over Germany, some from German-speaking countries . The world's only comprehensive university specifically for the hard of hearing and the deaf is Gallaudet University in Washington, DC , which has around 1700 students and has been run by the deaf since 1988.

Because of the low number of classes in local schools, the weaker children in particular determined the level at the special schools. This initially led to a migration from schools for the deaf to schools for the hard of hearing. In the meantime, starting with the physically handicapped children, the idea of integration has also spread to the field of the hearing impaired, with the consequence of a trend towards migration to mainstream schools .

This diversification in Germany is also favored by the fact that ultimately the parents can determine which school their child goes to and they try to choose what they consider to be the optimum. With the school authorities in Germany, regular school attendance is also actively promoted with the argument of "integration" on various occasions, although in the background there is often the expectation of cost containment through savings from special school teachers and separate schools.

The “integrative” school attendance at a regular school does not have a uniform version; in addition to the special education completely unaccompanied regular school attendance, there is also the special education and / or school attendance accompanied by a sign language interpreter and, very occasionally, the concept of “reverse” integration, in which not in a special school disabled children are accepted.

The less special educational or linguistic support there is in an “integrative” mainstream school, the more the success of this school visit depends on the child's particularly highly developed skills and talents. In the discussion of integrative schooling, the “emotional state” of the child, who has more or less a special position in the class of the other children, which has to be dealt with psychologically in addition to the subject matter, is usually not taken into account.

Leisure, sports and cultural associations

Since deaf people are often isolated in society due to their communication impairment , social contacts are often cultivated within deaf groups. The community with similarly affected people, cultivated over centuries, led to the development of its own culture , at least in the non-professional, private sector .

In addition to sign language , the special culture of the deaf includes, for example, that there is a club and a fixed meeting point, often called a “clubhouse”, in all larger cities. Deaf sports are also well developed . The Deaflympics are held worldwide one year after the Olympic Games.

Structures of their own have also formed in the “fine arts”; B. with the deaf theater , sign language choirs and the culture days of the deaf .

An important part of the deaf culture are also their mostly hearing children, who often remain connected to the community for life and also have their own associations. They are known internationally under the acronym CODA - Children of Deaf Adults.

Deaf people living in the Deaf and Sign Language communities reject medical and legal definitions of deafness that claim they are incomplete, in need of repair, and disabled. According to their self-image, the deaf community is a linguistic and cultural minority.

Advocacy groups

The German Deaf Association, the Austrian Deaf Association (ÖGLB), the Swiss Deaf Association (SGB) and the World Association of the Deaf (WFD) consider themselves to be political, social and cultural representatives of the deaf in German-speaking countries .

The German Förderverein LKHD - Lautsprachlich Kommunizierende Hörgeschädigte Deutschland e.V. , see themselves as a political and social - but not cultural - interest group in German-speaking countries for the hearing-impaired and hearing-impaired who communicate in spoken language. V. (short form Förderverein LKHD or LKHD ) and the Swiss self-help organization lkh.ch, Verbal Communicating Hearing Impaired ( lkh.ch , formerly LKH Switzerland ).

Communication with spoken language

In order to understand spoken language information , deaf people rely on lip reading and / or technical aids. Both spoken tones that can be visually perceived by the lip positions and the tones that may be heard with aids are only partially perceptible to them. The transmitted information therefore has to be “guessed” in part, using references from the context of the environment and from previous sentences. With larger scope or depending on the complexity - z. B. in a lecture - that is very exhausting or even impossible.

A technical hearing aid is often prescribed or used as a medical measure for deafness that cannot be directly treated. Technical hearing aids are the hearing aid and the surgically inserted cochlear (CI) and brain stem implants (Auditory Brainstem Implant, ABI). The success of these technical aids varies greatly from person to person. In the case of severe hearing impairment or deafness, the currently known hearing aids cannot convey the range and differentiation of tones and noises that a person with normal hearing ability has.

As a result, hearing aids alone provide a listening experience, but are usually not sufficient to directly understand spoken language . To do this, the use of hearing aids usually has to be accompanied by special training . The hearing-impaired child is therefore not only dependent on technical aids, but also on special listening and speaking training , with which - depending on talent and practice  - the spoken language can be learned. The auditory feedback is often not nuanced enough for one's own speech training and the complex control of the speech apparatus is difficult.

Thanks to better funding opportunities, more and more deaf people are able to master the spoken language to such an extent that permanent social contact with the majority society is established. To this end, in the German-speaking area, among these so-called " speech-language communicating hearing impaired people ", their own associations with internal activities have been founded.

Movies / music in context

literature

  • Bernd Ahrbeck: Deafness and Identity: Problems of Identity Formation of Deaf People from the Perspective of Sociological and Psychoanalytic Theories Signum Verlag, Hamburg 1992, ISBN 3-927731-37-4 .
  • Oliver Sacks: Mute Voices: Journey into the world of the deaf. 6th edition. Rowohlt, Reinbek near Hamburg 2001, ISBN 3-499-19198-9 .
  • Susann Schmid-Giovannini : From stethoscope to cochlear implant. History and stories from sixty years of professional life . Verlag S. Schmid-Giovannini, Meggen 2007
  • Fiona Bollag: The girl who came out of silence . Verlag Ehrenwirth, Bergisch Gladbach 2006, ISBN 3-431-03685-6 (life story of a former student of Susann Schmid-Giovannini)
  • Manfred Spreng: Physiological basics of child hearing development and hearing education . Biocybernetics working group, University of Erlangen [1]
  • Eckhard Friauf: Neural foundations of perception - the "critical period" in early childhood development . University of Kaiserslautern [2]

Web links

Commons : Deafness  - collection of pictures, videos and audio files
Wiktionary: Deafness  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. Jürgen Martin: The 'Ulmer Wundarznei'. Introduction - Text - Glossary on a monument to German specialist prose from the 15th century. Königshausen & Neumann, Würzburg 1991 (= Würzburg medical-historical research. Volume 52), ISBN 3-88479-801-4 (also medical dissertation Würzburg 1990), p. 181.
  2. ^ Siegfried Priglinger , Josef Zihl: Visual disorders in children: Diagnostics and early intervention . 1st edition. Verlag Springer, Vienna 2007, ISBN 978-3-211-83608-8 , p. 113, 169ff.