Deafness Signed Language and Cochlear Implants

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Deafness Signed Language and Cochlear Implants David P. Corina Ph.D. Center for Mind and Brain Departments of Linguistics and Psychology University of California. Davis National Science Foundation

Outline Introduction to deafness Approaches and Interventions ASL as a natural language Neural representation of signed languages Bilingualism and the Deaf community Neural Representation of language in ASL-English Bilinguals Deaf Hearing Bimodal bilingualism Concluding Remarks

What is deafness? deaf Audiological condition someone who is partially or wholly lacking hearing, either when they were born, through pernicious disease early in life, or later in life Deaf any person or persons who "identifies him/herself as a member of the Deaf community, and other members accept that person as a part of the community" Many Deaf perceive their community akin to other language minority communities and share a sense of Deaf Culture.

Deafness The global deaf population is roughly estimated to be 0.2% of the total population (2 in 1000) Approximately 50% is inherited.

Type of Deafness Conductive hearing loss: results from abnormalities of the external ear and/or the ossicles of the middle ear. Sensorineural hearing loss: malfunction of inner ear structures (i.e., cochlea). Mixed: combination of conductive and sensorineural hearing loss. Central auditory dysfunction: damage or dysfunction at the level of the eighth cranial nerve, auditory brain stem, or cerebral cortex.

Severity of hearing loss. Hearing is measured in decibels (db). Conversational speech 50-60dB hearing level Mild (26-40 db) Moderate (41-55 db) Moderately severe (56-70 db) Severe (71-90 db)* Profound (> 90 db)* *Typical candidates for cochlear implants

Childhood Deafness Congenital Deaf from birth Acquired Lost hearing due to sickness (e.g. meningitis, rubella)

Onset of deafness Onset Prelingual hearing loss is present before speech develops. All congenital (present at birth) hearing loss is prelingual, Postlingual hearing loss occurs after the development of normal speech*. *may have partial effects (e.g. meningitis when infant 2.5 years. Some spoken language have taken place, but not complete).

Impact on Society $300,000/individual (U.S. Dollars) 67% reduced productivity 21% additional special education costs Lifetime costs/prelingual congenital deafness $1 million USD /individual Impact on Individuals Academic achievement Poorer career and financial achievement (Mohr et al 2000)

BUT Many deaf are highly successful Better education Better access to services Improvement in audiological and linguistic interventions

What to do?

Audiological Interventions: hearing aids Hearing aids As early at 4 weeks of age. Non-invasive Amplify sounds Fit to children ear Customizable FM systems

Audiological Interventions: Cochlear implant is a surgically implanted device that helps overcome problems in the inner ear, or cochlea Cochlear Implant Completely bypassing the damaged part of the cochlea, the cochlear implant uses its own electrical signals to stimulate the auditory nerve, allowing the person to hear. 12months of age.

Linguistic Interventions Accessible Language Cued Language A mean to differentiate phonemes by giving additional visual hand cues. Visual Language e.g. American Sign Language, Hong Kong Sign Language etc.

Cued Language Can be quite successful, but not widely used. It s a code for English not a language.

Sign languages are natural languages. Signed Languages ASL is not an invented language Sign language is not universal. There are many distinct sign languages Acquisition milestones similar to spoken language. Brains treat signed languages just as they treat spoken languages

Children are language ready Children able to acquire any language that they are exposed to in a consistent manner. Innate predisposition to learn LANGUAGE not just speech. Experimental evidence Preferential looking studies

Early Language Early Language Social-emotional development labeling ones emotion Cognitive Development Labeling work around us Reading Must have foundation to read.

Preferential looking paradigm Hildebrandt & Corina (2007) Dev. Science

Looking times for sign language and pantomime in hearing 6 and 10-month-olds Sign Pantomime * p <.05 n.s. 6 month olds 10 month olds 6 month olds look significantly longer at the ASL 10 month olds do not show a preference. Hildebrandt & Corina (2007) Dev. Science

ASL versus gesture A replication Gestures Signs Structured and rhythmic properties of natural languages are important Bosworth, Hwang & Corina (in prep)

Percent Looking Time Figure 1 Signs Gestures 100% 90% 80% 5-6 Month Olds * * 100% 90% 80% * 10-12 Month Olds ** 70% 70% 60% 60% 50% 50% 40% 40% Forward Reversed Forward Reversed Figure 1. Average percent looking time for the midline collapsed. Two-tailed t tests were used to compare signs vs. gestures. * p < 0.05, and ** p < 0.005

Early Language is Vital Cognitive Development Social-emotional development Memory Executive function Sequence learning Pisoni et al 2010; Calderon & Greenberg, 2003

Early language (including signed languages) provides a foundation for reading

Relationship between ASL Phonological Awareness and English Phonological Awareness Performance on English PA 100 90 80 70 60 50 40 30 20 10 0 Native Deaf Signers (n = 10) R² = 0.6627 70 80 90 100 Performance on ASL PA

Human Languages Importance of communities of users.

Human Language Spoken Languages Signed Languages Human languages are not limited to the vocal modality

Neural Processing of Signed Languages Left hemisphere Right hemisphere

Sentence processing in Sign (BSL) and Speech (English) activates highly similar areas in left and right hemisphere (MacSweeney et al 2010)

Lexical Production Data from deaf signers and hearing non-signers Overlapping activation during sign and speech naming Emmorey, Mehta & Grabowski (2007)

Discourse Production: Braun et al (2001)

Meta-Linguistic Tasks DEAF: BSL DEAF:RHYME HEARING:RHYME Highly similar systems engaged during meta-linguistic phonological judgments. MacSweeny et al (2009)

Brain distinguishes ASL from gestures Non-language actions ASL Signs Corina, Chiu, Knapp et al ((2007)

Language selectivity in posterior STS Sign versus Gesture Voice versus Non-Language Belin et al. Voice-selective areas in human auditory cortex. Nature 403, (2000) Sign Gesture Words versus laughs, sighs, grunts, onomatopoeia, and other non-vocal sounds

Brain representation in bimodalbilinguals Bonjour Hola Bonjour HELLO

Bimodal Bilinguals: Braun et al (2001)

Hearing English-ASL Bilinguals Written English American Sign Language

Neural Organization: English-ASL Oral Deaf Bilingual Inferior frontal regions show a mix of overlapping as well as language specific responses Corina et al 2006

Neurolinguistics of ASL Rare Opportunities

Neural Organization ENGLISH-ASL Oral Deaf Bilingual Subtle differences in ECOG during sign versus speech naming Corina et al 2006

Bilingual Neuroplasticty Increased reliance upon executive control networks Anterior cingulate DLPC/IFG Caudate Abutalebi et al., 2008; Ali, Green, Kherif, Devlin, & Price, 2010

Could learning a signed language interfere with learning a spoken language?

Children learning speech and sign Language CODA Hearing children with deaf signing parents No competition between language modalities Sign doesn t displace speech Visual language not antagonistic How about deaf children with CI?

Native ASL-Users versus KODA Davidson, Lillo-Marting & Pichler (2013) HERE--

Performance on Tests of English

Role of Language Experience? studies of deaf children have demonstrated that (when) CI is less effective (it) appears to be related at least in part to communication though sign language, because of cortical reorganization of the auditory cortex (Charroo -Ruiz et al 2013).

Scale Slide Here Balance between visual and auditory processing

Providing Linguistic Intervention Natural Visual Language input ASL, HKSL etc Affords early language benefits Best achieved through consistent and community based usage. Bilingual benefits