• 
  About Makaton
• 
  Online shop
• 
  Training
• 
  Family advice
• 
  Fundraising
• 
  International
• 
  Research

•  Search

•  Contact us

•  User forums

•  Site map

•  Text size

•  For tutors

•  Home

Teaching Sign Language to the Deaf Mentally Handicapped

Cornforth, A.R.T., Johnson, K. & Walker, M.
Apex, 2 (1), 23-25. (1974)

The effects of mental handicap and institutionalisation on the development of language are well known by now, but the situation is aggravated considerably where there is the additional handicap of deafness.

In every large institution there is a small proportion of residents who are both mentally handicapped and deaf. Generally they are scattered throughout the hospital's wards among the hearing residents.

A barrier of silence divides these two groups and the deaf lead lives of isolation, unable to express more than their basic needs and unable to participate fully in the hospital's activities. This isolation frequently produces immense frustration which in turn engenders behavioural problems.

A preliminary study of the subject of subnormality and deafness was carried out by Cornforth and Woods (1972) during which the need for special tuition in communication for those residents became apparent. This report describes the teaching of sign language to groups of deaf residents in four large Surrey hospitals for the mentally handicapped.

In each of the four hospitals a list of deaf residents was compiled with the assistance of consultants, psychologists, speech therapists and nursing staff. Every resident on the list was then considered for the teaching programme.

A candidate was excluded only if additional handicaps, such as blindness or a gross motor problem, would prohibit the use of sign language, or if the degree of mental handicap was such that the patient was inaccessible. The possibility of deafness causing this inaccessibility was always carefully considered and, if there was any doubt, the resident was given a trial period of tuition.

Throughout the four hospitals the subjects offered a wide IQ and age range (Table 1). All the subjects had a severe hearing loss but, as is typical, in mentally handicapped populations, many had other handicaps in addition to deafness. A few subjects had rudimentary speech but this alone was an inadequate means of communication.

With the exception of eight (marked with asterisk), no subject had any previous knowledge of sign language, though the majority used crude natural gestures.

The method of training was similar in each hospital. Once a week there was a two-hour teaching session for each group. Throughout all training socialisation was emphasised and the teaching of sign language was carried out in a relaxed, happy atmosphere.

The British Sign Language for the Deaf was taught as it was considered to be ideally suited for this type of population. Many of the signs are ideographic, closely resembling the activity or function of the word they symbolise, for example, drink, sleep, and so on. Each sign represents a gross language concept and not a word as in grammatical English. For example:

1. Would you like to come out in the car tomorrow? - English.
   We car tomorrow? - sign language.
2. Do you want a cup of tea and a biscuit? - English.
   You tea biscuit? - sign language.

The vocabulary of signs taught was based on the teaching team's experience with severely subnormal populations' vocabularies, on other studies in the field (Mein & O'Connor, 1960; Mein, 1961) and on the authors' subjective assessment of the most essential concepts. One hundred and forty-five signs were taught.

Signs were initially taught from flash cards wherever possible and then reinforced by the use of appropriate objects and remedial language material. The teachers' signing was always accompanied by speech. Signs were taught in easy stages and then, as these were learned, new ones were introduced. During each session time was allocated for the revision of signs already taught.

A typical teaching session included a period when the whole group was taught together; this was followed by a period when the residents were divided into smaller groups, for further practice in signing at their own rate of learning. Signs were related to reality as soon as possible and every opportunity was taken to employ signs as means of communication.

The making and serving of drinks during the group's coffee-breaks provided stimuli for signing, as did walks in the hospital grounds and creative activities such as painting and cooking. The three teachers shared the group teaching and interchanged among the smaller groups of differing standards. Interest was encouraged from related disciplines within the hospitals, such as psychologists and nursing staff, and they were invited to join in the group's activities.

Between April 1973 and June 1973 the ability of each subject to comprehend and express the 145 signs was tested and the results are presented in Table I. It was impractical to test comprehension and expression of 145 signs at one time because of the possibility of low IQ and subject fatigue.

Key
* = Subjects with a previous knowledge of sign language.
WAIS = Wechsler Adult Intelligence Scale.
Mental Age is in years (y) and months (m)
Teach. = Period of teaching in years (y) or months (m)
Exp = signs learned, expression
Comp = signs learned, comprehension

The vocabulary was divided randomly into four groups. The subjects were then tested individually for both comprehension and expression of these four groups on four different days. It was necessary to test the entire 145 signs for both comprehension and expression as the test was not only to be used as a general assessment of progress but also as a record of teaching achievement upon which subsequent training was to be designed.

The results show the feasibility of teaching conventional sign language to deaf, severely subnormal patients. The assessment shows only the number of individual signs comprehended and expressed but, in practice, subjects in all the groups used signs to communicate with others. In each group several subjects spontaneously linked signs in short phrases.

It will be seen from the results that IQ does not correlate closely with success in signing. This was found by Sutherland and Beckett (1969) when patients with an IQ of 30 could be taught to sign successfully and it has been confirmed by Walker (1973).

A comparison between the results of Hospital I and Hospital IV shows that a nucleus of the 145 signs can be absorbed in a few months.

As a result of these findings and the experience gained so far, it is felt that there is a need to structure and improve the teaching method.

Based on the work described here a structured vocabulary - the Makaton Vocabulary ** - has been devised which is graded into stages of usefulness and complexity. It is hoped that this will provide an improved language model and allow those residents with limited learning ability to achieve a useful and manipulative basic vocabulary.

The efficiency of this new structured vocabulary will be tested in the near future under controlled conditions.

References

Cornforth, A. R. T. & Woods, M. M. (1972) Subnormal and deaf.
Nursing TImes, February 10. 1972.

Goodridge, E. (1966). Language of the silent world.
British Deaf and Dumb Association.

Mein, R. & O'Connor, N. (1960) Study of the oral vocabulary of severely subnormal patients. Journal of Mental Deficiency Research. 4, I30-143.

Mein, R. (1961) A Study of the oral vocabularies of severely subnormal patients. Journal of Mental Deficiency Research, 5, 40-5l.

Sutherland, G. F. & Beckett, J. W. (1969) Teaching the Mentally Retarded Sign Language. Journal of Rehabilitation of the Deaf, 2.

Walker, M. (1973) An experimental evaluation of the success of a system of communication for the Deaf Mentally Handicapped. Unpublished MSc. Thesis, Human Communication Studies, University of London.

Notes

** Available from the Royal Association in Aid of the Deaf and Dumb (RADD), 7-11 Armstrong Road, Acton, London W3. Tel. 01-743-6187.

*** Mr Cornforth and Miss Johnston are psychiatric hospital visitors, working for the Royal Association in Aid of the Deaf and Dumb. Mrs Walker is a speech therapist, Surrey AHA

GET INVOLVED

 Get our free newsletter

 Tell us your story

 Help Makaton users

 Comment on website