On day two at the school, I started by learning some great new songs that I can’t wait to bring back and modify for English speakers! Then, I observed a reading lesson. It was very clear to me how much the teachers cared for their students, but it was equally clear that there are many factors stacked against them in their quest to teach these students to listen and talk.
As I mentioned earlier, hearing aid use is inconsistent, and the technology provided is not always adequate for children with substantial hearing losses to access sound for learning. They use many visual and tactile techniques because these children just cannot hear enough to learn to speak through audition alone. The teachers’ ability to use, implement, and adjust listening and spoken language teaching techniques is also low – as can be expected. How do you learn to be a great teacher/therapist with little training, no formal higher education, and few/no in-country models of success? Behavior management is also an issue. If children are hungry or they can’t hear the lesson, how on earth can they focus and learn? Other health problems, like chronic otitis media (middle ear infections) are common, and may prevent the children from using their hearing aids consistently. Many of the children appeared to have some craniofacial differences suggestive of various syndromes. Others showed behaviors that suggested that they had difficulty seeing well or visually tracking. Though only some of them appeared to be underweight, the quality of the food that they have may be poor. Children may be of adequate weight but still lack essential nutrients in their diet.
Much about the children’s hearing losses remains a mystery. Though their association with CASSA and other educational programs has reduced parents’ beliefs that hearing loss is a curse, due to supernatural forces, or other misconceptions, lack of prenatal care and overall poor preventative medicine makes it difficult, if not impossible, to determine the etiology of the children’s hearing losses. Obtaining an accurate audiogram is also difficult. There are few audiologists in the country, and many are using old, donated equipment that may not have been well-calibrated (or calibrated at all!). Due to the scarcity of audiological services, many children have only a few audiograms in their files – there is none of the constant checking, speech perception testing, aided testing, or other detailed measures taken many times a year as it would be for children in the United States.
We also spent a great deal of time helping the school staff with technology. The climate in the Dominican can be very hot and humid – that’s killer for hearing aids, and while the school does have a Dry&Store unit, static and other breakdowns are a constant problem with both hearing aids and FM equipment.
On Friday, we headed into the capitol of Santo Domingo to meet with representatives of the Ministry of Education’s
project on diversity and disabilities to discuss the possibilities for children with hearing loss as well as models of inclusion. As we drove into the city, I was struck by how LOUD everything was, and pulled out my phone’s handy decibel-meter. The average street noise was 85dBSPL, with periodic bursts up to 120dBSPL. Yikes! To give you a frame of reference, 120dB intensity would be like sitting next to the speaker at a rock concert, and you should limit exposure to noise at this level to a few seconds or no more than a minute or risk sustaining damage to your hearing. With that level of noise pollution, it’s no wonder that the incidence of noise-induced hearing loss is so high!
We took a quick taxi ride to visit Instituto de Ayuda al Sordo Santa Rosa (Intitute for Helping the Deaf Santa Rosa), an older, more established oral school in the capitol. The school building is larger and more removed from the street than CASSA, but is still far from noise-proof. The school does have one sound-treated therapy room that was built in previous missions and filled with all kinds of great educational materials. What I loved about the school was how it was decorated – every space on the walls was filled with either the children’s work or inspirational posters about the ABILITES of people with hearing loss or other disabilities. It was really beautiful to see how much the school supported the students’ self-worth and the potential of people with disabilities to be successful, integrated members of society. They also had a great display of photographs of the history of the school and important figures in deaf education.
The half-hour drive back to San Andres from Santo Domingo was a great chance to observe the country. Many people live in tin-roof shacks with dirt floors. There is no plumbing or sanitation in most of the houses. Rainwater is collected in tanks and houses may have a PVC pipe valve from the tank to use this water for washing, but it is not safe to drink. Drinking water has to be purchased or hauled from a community well. “Nicer” homes may have cinder-block walls and an in-home spigot (still not potable water). Lots of living is done outside – cooking, drying clothes, children playing or being bathed on front porches. For electricity in the homes, as well as in the CASSA school, car batteries are rigged up, which can release toxic fumes. Homes and buildings may have a toilet, but they are usually non-functional and must be flushed by pouring a bucket of water into the bowl.
On the drive back to San Andres, we also passed La Escuela Nacional Para Sodomudos. Yup, that’s right, the
National School for Deaf-Mutes. The building was complete with a huge picture painted on the side of the building emphasizing precisely what the students CAN’T do, not their many abilities and potential. The school has about two hundred students who are taught using sign. There is no parent choice of communication methods. If you want to attend the (free) government school, you sign. If that is the parents’ choice, it’s a fortunate coincidence, but parents who want any other options for their children are out of luck. Parents who want other options for their children must find one of the few other programs for students with hearing loss as well as the money to pay for it – a task that is too much for the vast majority of families.
Back at CASSA, we also had the opportunity to attend a parent meeting. Just as teachers around the world have much in common, the discussion, concerns, questions, trials, and triumphs of the parent of Dominican students with hearing loss mirrored those I hear from awesome parents of children with hearing loss from around the world. We spoke about the importance of consistent hearing aid use all waking hours, using natural language in the context of daily routines, and using positive discipline techniques to teach better behavior, not just to punish children for what they’ve done wrong. About twenty parents attended – and not just mothers! Grandparents and fathers attended as well, and participated actively in the discussion. These parents live in a society that tells them that their children are deaf-mute, stupid, and can’t learn. They are surrounded by attitudes that suggest that their children should remain hidden in the home, apart from their communities, and yet they have taken the positive steps to get help for their children, to wear hearing aids in public, to learn new ways to interact with their children to stimulate language. They have defied stereotypes to believe in the potential of their children, despite poverty, hunger, sickness, and stigma. It brought tears to my eyes.