We began our trip today at Centeno, a school for deaf children in Costa Rica that uses sign language. The school is just one department on the campus of the Center for Inclusive Education in CR. I’m not so sure what they mean by “inclusive,” though, because it was a school of all deaf children, across the street was a school for all blind children, and next door was a school for all children who had developmental disabilities. Inclusive? Not quite. Maybe it’s because they the children at this school are “included” in education at all, but it was a very sad thing.
Let me make it very clear now that though it would not be my choice, I have no problem with sign language and all-deaf schools, with a few conditions. First, does the school provide children equal education to their hearing peers (and some would argue that separate is inhenently unequal). Second, I respect the decision to choose this path IF AND ONLY IF it is the PARENTS’ informed choice. If parents realize the outcomes of the various approaches, understand what they will need to do to help their child succeed, and understand the life-long ramifications of communication choices, then they are able to make the appropriate choice for their child and their family. In this case, however, parents do not have options for mode of communication, educational setting, or even the type or number of hearing aids or cochlear implants their children receive. Unfortunately, schools using sign language are the only option for public education for children with hearing loss. If parents want listening and spoken language, they must pay for private schools and therapies – obviously, this prohibits all but the most wealthy families from having free choice in their child’s education.
So, back to what we saw at the school… The school has always been total communication, but this year, they switched to a more Bilingual-Bicultural approach using LESCO (Costa Rican Sign Language) and written/oral Spanish. This change meant including more classes on the history of LESCO, of d/Deaf people in Costa Rica, and d/Deaf history in general. I learned all of this from the teacher who gave us our tour, but, honestly, I couldn’t tell much difference from a typical TC program when we observed the classrooms. Signs, sometimes key word signing, were mixed with gestures and spoken instructions, it was not pure, voices-off LESCO. Granted, the observation was very short and may not have been representative of the school’s overall curriculum.
When I asked what the school’s policy was on hearing aid use, the teacher who led our tour said that it is a school rule that children must wear their hearing aids all day long… however, I would say that about 50% of the students I saw at the school were wearing both hearing aids, maybe 10% more were wearing just one, and the remaining 40% did not have hearing aids (or at least were not wearing them). The teacher said that the rule is in place so that children can have auditory stimulation all day. In theory, this is good, but there were a few small problems. First, like most buildings in Costa Rica, the Centeno school is constructed of classrooms that branch off of an open-air lobby and breezeways. All of the floors are tile or concrete (easier to sweep or mop things right out the door!) and the walls are, too. Windows are left open for ventilation, and the classrooms are close to the music room, playground, and a very busy street. It’s an acoustic nightmare, so if the children are wearing hearing aids, and gaining some hearing with them, I don’t know if what they’re hearing is important classroom information, or lots of background noise garbage. It is, at best, a very difficult listening situation. Though the building itself cannot be changed, some simple and relatively inexpensive environmental modifications, like tennis balls on chair legs and acoustic panels on the walls could help. The second problem is this – if the children are ostensibly wearing their hearing aids for auditory stimulation, it would help if there was, well, some auditory input. I didn’t observe much input, auditory, signed, or otherwise, between adults and children. Again, our visit was short and may not have given me the whole picture, but that was my initial impression – not a lot of rich language input (spoken or signed).
I asked Andrea, my Costa Rican classmate who is a graduate student in Early Intervention for Deaf Education, about this. She had two interesting points. First, audiologists in Costa Rica will sometimes tell parents of a severe-profoundly deaf child that hearing aids are likely to be of no benefit (not true, even a little added hearing makes a LOT of difference!), and so the children do not end up receiving hearing aids. Then I asked Andrea if children with cochlear implants could, or did ever, attend this school. She said that the school does not accept children with CIs… “accept” in both senses of the word – children who come to the school with cochlear implants are either not granted admission or admitted and then treated in a way that makes it quite clear that they are not welcome, and quickly transfer out. On one hand, perhaps this is appropriate, because it is not the best environment for a child with a cochlear implant to learn to make full use of her device, but on the other hand, it is sad for children and their parents to face that kind of rejection from a public service, that their taxes support, that is supposed to help all children with hearing loss in Costa Rica.
Schools in Costa Rica are divided into birth-6/7yo (Kinder), grades 1-6 (Primary), and grades 6-11 (Colegio = High School, graduation is in 11th grade). Ceteno serves children with hearing loss from birth to sixth grade. After finishing grade 6, the children may enter a vocational program or attend a local high school with support services. We were able to pop in and chat briefly with a teacher and three students in her sixth grade class. The children introduced themselves, and I was so surprised at how easy LESCO was to understand – it is about 75% the same as ASL and 25% signs unique to Costa Rica. The teacher was a signing deaf adult. I learned that, while she a competent oral communicator and is not opposed to teaching the children spoken language, the powers that be at the school are opposed to having deaf people teach spoken communication, fearing that they will be “bad speech and language models.” This made me very sad. Unfortunately, spoken language programs in the United States have been guilty of this same bias in the past as well. If a language model with poor speech was the ONLY spoken language input these children would ever receive, yes, I might be worried. But in a world full of adult speakers, one slightly “imperfect” model is not likely to cause a child to develop poor speech and language habits. Instead, seeing a deaf adult use oral communication can be a great motivator and inspiration to students, parents, and coworkers alike. The children in the school receive “language therapy,” but we did not have a chance to observe this, so I do not know specifics – is it individual or group? Auditory or speechreading emphasis? Focus on spoken communication or written language? I don’t know.
One impressive thing about the school is that they offer really wonderful comprehensive services to children and families. There is a staff psychologist and a social worker, a clinic on-site for the children, and enrichment classes like music and library. Because many parents travel very far to bring their children to Centeno, there is a house on the property where parents can cook, watch TV, read, or relax and stay on the campus while their children are in school rather than traveling back and forth twice in one day.
Next, we went to observe a private therapist, and saw her sessions with a child of about seven years old with a CI, and then two adult CI users. The two adults were young men, both deaf since birth, who had been good hearing aid users until deciding to receive a cochlear implant, both about one year ago. They had therapy together, which was neat because they shared some of the same interests, were the same age, roughly the same listening experience level, and were able to share their experiences with the implant and have each other as support. Both were raised in regular public schools and did not learn sign language as children. Both wore hearing aids until receiving the CI, and, unlike the children we observed with cochlear implants, both continued to wear a hearing aid on their contralateral unimplanted ear. Another common factor in these young men’s success was parental involvement. One man’s mother even quit her job to provide listening and spoken language stimulation all day for him at home, because he only received therapy for one hour per week of early intervention. Now, one man has completed training and is working as a chef. He said his CI made a big difference in his confidence level at work. The other young man is studying to complete his high school exams. When asked how they feel about receiving the cochlear implant, one man said, “It’s a difficult topic, most Deaf people think it’s not good, but my opinion is that its really nice, and I don’t understand why others won’t try it,” and the other said something that will stick with me for a long time, “To understand language is to be close to people. To be far away [not understanding] is just to survive.”
After observing the private therapy sessions, we went to the children’s hospital in San Jose to present on newborn hearing screening and listening and spoken language to members of their staff (some audiologists/audiologists-in-training, a developmental pediatrician, members of the NICU staff, and others). Hopefully, we planted some seeds that will build a future full of opportunities for children with hearing loss in Costa Rica!
Elizabeth A. Rosenzweig 