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Prelingual deafness

prelingual deafness, prelingual deafness ans cafe au lait spots
A prelingual deaf individual is someone who was born with a hearing loss, or whose hearing loss occurred before they began to speak Infants usually start saying their first words around one year Therefore a prelingually deaf typically was either born deaf or lost their hearing before age one the age when most hearing loss in children occurs Congenital present at birth hearing loss is also considered prelingually, since a newborn infant has not acquired speech and language1


  • 1 Statistics
  • 2 Causes
  • 3 Treatment
  • 4 Social and cognitive impact
  • 5 Language acquisition and prelingual deafness
    • 51 Speech acquisition
      • 511 Cochlear implants
    • 52 Sign language acquisition
      • 521 Reading and short-term memory
      • 522 Children of deaf parents
    • 53 Neuropsychological function
    • 54 Sociocultural factors
    • 55 Early intervention
  • 6 See also
  • 7 References


Each year in the United States, approximately 12,000 babies are born with hearing loss Profound hearing loss occurs in somewhere between 4 to 11 per every 10,000 children2


Prelingual hearing loss can be either acquired, meaning it occurred after birth due to illness or injury, or it can be congenital, meaning it was present at birth2 Congenital hearing loss can be caused by genetic or nongenetic factors The nongenetic factors account for about one fourth of the congenital hearing losses in infants These factors could include: Maternal infections, such as rubella, cytomegalovirus, or herpes simplex virus, lack of oxygen, maternal diabetes, toxemia during pregnancy, low birth weight, prematurity, birth injuries, toxins including drugs and alcohol consumed by the mother during pregnancy, and complications associated with the Rh factor in the blood/jaundice Genetic factors account for over half of the infants with congenital hearing loss Most of these are caused by an autosomal recessive hearing loss or an autosomal dominant hearing loss Autosomal recessive hearing loss is when both parents carry the recessive gene, and pass it on to their child The autosomal dominant hearing loss is when an abnormal gene from one parent is able to cause hearing loss even though the matching gene from the other parent is normal3


Hearing aids and cochlear implants may make the child able to hear sounds in their hearing range—but they don't restore normal hearing Cochlear implants can stimulate the auditory nerve directly to restore some hearing, but the sound quality isn't that of a normal hearing ear, suggesting that deafness cannot be fully overcome by medical devices Some say that the benefits and safety of cochlear implants continues to grow, especially when children with implants receive a lot of oral educational support It is a goal for some audiologists to test and fit a deaf child with a cochlear implant by six months of age, so that they don't get behind in learning language In fact, there are expectations that if children get fit for implants early enough, they can acquire verbal language skills to the same level as their peers with normal hearing1

Social and cognitive impactedit

Children who are prelingually deaf and cannot hear noise beneath 60 decibels—about the intensity level of a vacuum cleaner4—don't develop oral language comparable to their peers Children born with profound hearing impairment, 90 decibels and above about the level of a food blender,4 are classified as functionally deaf These children do not develop speech and language skills without help from a speech pathologist Such children acquire language comprehension difficulties, even when other modes of language such as writing and signing are up to their age level standard1 Generally, prelingual deaf individuals have reading levels that do not exceed the level of a fourth grader's5 Children who lose their hearing after they have acquired some amount of language, even if it is just for a short while, demonstrate a much higher level of linguistic achievement than those who have not had any language exposure1

In children, this type of hearing loss can lead to social isolation for several reasons First, the child experiences delayed social developmentcitation needed that is in large part tied to delayed language acquisition It is also directly tied to their inability to pick up auditory social cues This can result in a deaf person becoming generally irritable A child who uses sign language, or identifies with the Deaf culture does not generally experience this isolation, particularly if he/she attends a school for the deaf, but may conversely experience isolation from his parents if they do not know, or make an effort to learn sign language A child who is exclusively or predominantly an oral communicator can experience social isolationcitation needed from his or her hearing peers, particularly if no one takes the time to explicitly teach them social skills that other children acquire independently by virtue of having normal hearing

Language acquisition and prelingual deafnessedit

Speech acquisitionedit

Deaf children do not acquire speech the same as hearing children because they cannot hear the language spoken around them In normal language acquisition, auditory comprehension precedes the development of language6 Without auditory input, a person with prelingual deafness is forced to acquire speech visually through lip-reading Acquiring spoken language through lip-reading alone is challenging for the deaf child because it does not always accurately represent speech sounds6 The likelihood of a deaf child successfully learning to speak is based on a variety of factors including: ability to discriminate between speech sounds, a higher than average non-verbal IQ, and a higher socioeconomic status7 Despite being fitted with hearing aids or provided with oral instruction and speech therapy at a young age, prelingually deaf children are unlikely to ever develop perfect speech and speech-reception skills8 Some researchers conclude that deaf children taught exclusively through spoken language appear to pass through the same general stages of language acquisition as their hearing peers but without reaching the same ultimate level of proficiency7 Spoken language that may develop for prelingually deaf children is severely delayed

Cochlear implantsedit

Speech perception can be corrected prior to language acquisition with cochlear implants After a year and a half experience, researchers found the deaf culture was able to identify words and comprehend movements of others' lips There is a greater opportunity to hear a sound depending on the location of electrodes compared to the tissue and the number of remaining neurons located in the auditory system9 In addition, individual capacities as well as the neural supply to the cochlea play a role in the process of learning with cochlear implantation

Research has continuously found that early implantation leads to better performance than older implantation9 Studies continue to show that children with prelingual deafness are able interact in society comfortably when implantation occurs before the age of five9 Speech production is a slower procedure in the beginning since creating words requires more effort Children who had almost two years experience with cochlear implants were able to generate diphthongs and sound out most vowels9 They develop skills to understand more information as well as put together letters

Cochlear implants give deaf individuals the chance to understand auditory messages7 Progress was analyzed after several groups of children were given vocabulary and language tests After three years of practice, the children with the devices did as well as children that had no previous issues with hearing Specifically, cochlear implants allow children with prelingual deafness to acquire skills similar to children with minimal or no residual hearing9

Sign language acquisitionedit

The ability to acquire speech is not the same as the ability to acquire language The population’s primary means of communication is produced orally; however, speech and language are dissociative factors10 Although we are biologically equipped to use language, we are not biologically limited to speech11 A child who has no access to a spoken language readily acquires a sign language, and children deprived of both oral and sign language sometimes invent their own gestural communication system11

There is an innate desire to produce language in both hearing and deaf population All babies vocalize to communicate7 Deaf children who have not been exposed to sign language create their own gesture communication known as homesign for the purpose of expressing what they are feeling This term refers to gestures that are being used by deaf individuals who were reared in isolation from other deaf signers Homesign is viewed as a biological component of language because it originates directly from the deaf child and because it is a global occurrence, transcending culture7

Sign language, such as American Sign Language ASL, is a well known form of communication that is linguistic for both hearing and deaf individuals7 Deaf children learning a sign language such as ASL go through a series of language milestones from birth through one year of age These milestones are similar to those of spoken language A deaf child is aware of his/her environment, enjoys human interaction, smiles, and enjoys hand play from birth to 3 months of age From 3–6 months a deaf child also begins to babble, referred to as finger babbling12 These gestures of the deaf children do not have real meaning, any more than babble noises have meaning, but they are more deliberate than the random finger flutters and fist clenches of hearing babies Angier, 1991 Between 6–12 months, deaf children use manual communication and communicate with gestures, such as pulling and pointing Many deaf children sign their first word around 8 months and up to 10 or more signs by 12 months12

Reading and short-term memoryedit

Learning three-dimensional grammar, such as in ASL, boosts the child’s visual and spatial abilities to higher than average levels7 However, the frequently documented difficulty of learning to read may result from the requirement of pre-existing oral language for literacy6 To succeed at learning to read, the deaf child must have a strong language to base it upon Additionally, communication difficulties with the teacher can impair reading

Additionally, deaf children performed more poorly in short term memory spans for written words in comparison to age-matched hearing children simple because they are not as familiar with English words7 Short-term memory spans for signs and fingerspelling are also reduced in comparison to age-matched hearing children’s span for spoken words Deaf children vary widely in their developmental experience with sign language, which affects development of short-term memory processes Children who begin language acquisition at older ages and/or have limited language input during early childhood have underdeveloped sign language skill, which, in turn, affects their short-term memory development11 However, with the linguistic element removed, deaf children performance is equivalent to age-matched hearing children on short term memory tasks

Children of deaf parentsedit

Mothers who are deaf themselves model signs during face-to- face interactions with their deaf babies They mold the hands of their babies to form shapes of signs They exaggerate their facial expressions and provide models in the direct line of vision of their deaf babies12 Caregivers of both hearing children and deaf children reinforce the child's early attempts at communication, thus encouraging further and more elaborate communication

Deaf students who have deaf parents outperform their deaf peers who have hearing parents on every subtest of the WISC-R performance scale7 This is due to the fact that deaf parents are better prepared than hearing parents to meet the early learning needs of the deaf child; thus, they acquire language ‘on schedule’ Additionally, deaf children of deaf parents pass through language development stages earlier because the visual pathways are fully myelinated at an earlier age than the comparable auditory pathways

Neuropsychological functionedit

Deaf children often have enhanced perceptual skills to compensate for the impaired auditory input, and this continues throughout adulthood Congenitally deaf adults who used sign language showed ERPs that were 5-6 times larger than those of hearing adults over the Left and Right occipital regions and ERPs 2-3 times larger than hearing participants over the left temporal and parietal regions which are responsible for linguistic processing13 Because both hearing and deaf adults using ASL showed larger ERPs occipital regions, the heightened response to visual stimuli is also due to knowing and using sign language and not only due to deafness

Both hearing and deaf adults using ASL also show larger ERPs over the left than right hemisphere Since the left hemisphere is responsible for language, this implies that sign movement is linguistically salient The movement processed on the left side language implies that the right visual field is stronger in deaf and hearing ASL due to the hemispheric association being contralateral13

Sociocultural factorsedit

Deaf children from a lower SES are at a high risk for not being exposed to accessible language at the right time in early childhood This is because in most countries poverty translates into a lack of access to the educational and clinical services that expose deaf children to language at the appropriate age7

Academic achievement of deaf students is predicted to a large extent by the same factors that predict the academic achievement of normally hearing students, such as social class and the presence of additional handicapping conditions This means that deafness, by itself, does not determine academic success or failure but rather interacts with many other factors in complex ways7

Early interventionedit

The deaf children of hearing parents may not have significant exposure to any language in early childhood Because of their sensory loss, these children perceive little of their parents’ speech Because in most cases the parents do not sign the children are also not exposed to a conventional sign language Meier Until recently, education of deaf emphasized speech training and the deaf children also were not exposed to sign language in school

Not being exposed to accessible language at a certain time in early childhood combined with lack of access to the educational and clinical services that expose deaf children to language at the appropriate age are all factors that contribute to language acquisition of prelingually deaf individuals7

See alsoedit

  • Congenital hearing loss
  • Deafness
  • Deaf history
  • Hearing impairment
  • List of notable deaf people
  • Models of deafness
  • The Language Instinct
  • The Butterflies of Zagorsk


  1. ^ a b c d Ratner, Jean Berko Gleason, Nan Bernstein 2009 The development of language 7th ed Boston: Pearson ISBN 978-0-205-59303-3 
  2. ^ a b "Deafness and HearingLoss" Retrieved 04/11/12  Check date values in: |access-date= help
  3. ^ "Hearing Loss at Birth Congenital Hearing Loss" Retrieved 04/11/12  Check date values in: |access-date= help
  4. ^ a b "Noise Sources and Their Effects" Retrieved 04/11/12  Check date values in: |access-date= help
  5. ^ Donohue, David A DeBonis, Constance L 2008 Survey of audiology : fundamentals for audiologists and health professionals 2nd ed Boston: Pearson/Allyn and Bacon ISBN 978-0-205-53195-0 
  6. ^ a b c Language development in exceptional circumstances 1 publ, reprinted in pbk ed Hove ua: Erlbaum 1994 ISBN 0-86377-308-7  |first1= missing |last1= in Authors list helpCS1 maint: Extra text: authors list link
  7. ^ a b c d e f g h i j k l Mayberry, Rachel 2002 Segalowitz and Rapin, ed Handbook of Neuropsychology 2 ed chapter 4 pp 71–107 
  8. ^ Margolis 2001 Implications of Prelingual Deafness 358: Lancet p 76 
  9. ^ a b c d e McKinley, A M; Warren, S F 1 January 2000 "The Effectiveness of Cochlear Implants for Children With Prelingual Deafness" PDF Journal of Early Intervention 23 4: 252–263 doi:101177/10538151000230040501 
  10. ^ Rosenburg 2006 Baby Sign Language 
  11. ^ a b c Meier, Richard 1991 "Language Acquisition by Deaf Children" American Scientist 79 1 JSTOR 29774278 
  12. ^ a b c Andrews, Logan, and Phelan 2008 "Milestones of Language Development" Advance for Speech-Language Pathologists and Audiologists 18 2: 16–20 CS1 maint: Multiple names: authors list link
  13. ^ a b Neville, H J; Bavelier, D; Corina, D; Rauschecker, J; Karni, A; Lalwani, A; Braun, A; Clark, V; Jezzard, P; Turner, R 1998 "Cerebral organization for language in deaf and hearing subjects: Biological constraints and effects of experience" Proceedings of the National Academy of Sciences 95 3: 922–929 PMC 33817  PMID 9448260 doi:101073/pnas953922 

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