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This is to certify that the
thesis entitled
DEAF CHILDREN'S KNOWLEDGE OF THEIR
INTERNAL BODY PARTS

presented by
PATRICIA EVANS

has been accepted towards fulfillment
of the requirements for

M.A. . ANTHROPOLOGY
degree in

I

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DEAF CHILDREN’S KNOWLEDGE OF THEIR
INTERNAL BODY PARTS

BY

Patricia Evans

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Anthropology

1992

 

7ZUL {A

ABSTRACT

DEAF CHILDREN’S KNOWLEDGE OF THEIR
INTERNAL BODY PARTS

BY

Patricia Evans

In child developmental literature children's knowledge
of their internal body parts is placed within a Piagetian
framework. Comparison of deaf and hearing children’s
knowledge also occurs within this framework. Reframing the
comparison, with an understanding of the concept of Deaf
culture, affects the methodology and interpretation of
research studies. This study utilized a drawing test with
29 Deaf children and American Sign Language interviews with
half of these children.

Results from the drawing exercise suggest the children
know names for fewer body parts than would be expected for
their ages based on previous studies with hearing children.
The children were able to name a greater number of parts
during the interviews than on their drawings. The
children’s explanations regarding the function of the heart
and the movement of food through the body did not correspond
with previously generated developmental stages, based on

studies with hearing children.

 

ACKNOWLEDGEMENTS

Initiating and completing a research project
requires intellectual, emotional, and physical support. My
curiosity and intellectual growth has been fostered by
numerous individuals at the Michigan State University
College of Human Medicine, the Michigan State University
Department of Anthropology, the National Institute of Child
Health and Development, and the Gallaudet Research
Institute.

This work also could not have been accomplished without
the cooperation and support of the children, parents, and
staff at the school at which I did this research. A special
thanks to Peggy.

Intellectual, emotional and physical support
continually flows from my family of origin. A

My life adventure continues with my partner, Liz
Seaton. Without her constant challenge of my assumptions,
editing of my writing attempts, and celebration of life's
absurdities I know this work never would have been

completed.

 

TABLE OF CONTENTS

Acknowledgements..... ......... .............. ..... ..... i
List of Tables..... ........ . .......... ... ........ ..... iii
List of Figures ....................................... iv
Introduction...... ................. ................... 1
ASL and Deaf Culture ......... . ............ . .......... . 2
Discussion of Literature .............................. 11
Review of Literature ................................. . 13
Hypotheses ......................... . ................... 23
Methodology ........................................... 25
Results ....... ....... ............ ........ ........ ..... 30
Discussion of Results ........... ...................... 46

conc1uSionSOOOOOOOO00............OOOOOOOOOOOOOO0...... 53
Appendix A- Figure Provided for Drawing Test.......... 56
Appendix 8- Interview Format .......................... 57

Bibliography .......................................... 58

ii

LIST OF TABLES

Table 1......Results of Tait and Ascher Study.............15
Table 2......Age of Children..............................26
Table 3......Labeled Body Parts......... ........... .......32

Table 4 ...... Number of Body Parts Named ................... 33

iii

 

LIST OF FIGURES

Figure 1......Boundaries for the Deaf Population...........6

iv

 

Introduction

Medical school involves a certain enculturation
process. My experience has involved a transformation of my
framework for understanding the human body. I entered
medical school still equipped with vague ideas about the
function of various organs. For example, I was certain the
spleen had some other function aside from its ability to
"rupture". I have learned new stories about the body. As
they are repeated over and over again these new stories
become my story.

Children undergo a similar transformation in their
increasing understanding of human body structure and
functions. They may begin with initial observations: blood
coming from a wound, the sensation of a pounding heart, a
bowel movement, or the act of swallowing food, but the story
tying these observations together arises from their
particular culture. Initial idiosyncratic notions are
replaced as the culturally accepted story is repeated again
and again in different forms.

Language plays a central role in passing and
assimilating cultural information. In most situations a
common language is taken for granted. The child and adult
come from the same culture, a language is shared and ideas

are communicated in that language.

 

ASL and Deaf Culture

Deaf parents and their Deaf children share a common
language. In these situations deafness can be seen not as a
handicap, but as an ethnicity. In this environment the
child learns a native language, American Sign Language
(ASL). The parents and the child all use the same language
and ideas are communicated easily. Numerous authors have
discussed various aspects of Deaf culture including shared
values, the role of Deaf clubs and organizations, Deaf
humor, the high rate of intermarriage among Deaf
individuals, and American Sign Language as a natural
language with a grammar independent from spoken English.
Analyzing the Deaf community and redefining it as a culture
allows for a clearer recognition of different child- rearing
environments and the impact these environments have on
communication.

In the previous paragraph a distinction between "deaf"
and "Deaf" has been introduced. In current writings
concerning Deaf culture this distinction has come in to use
permitting a differentiation between "deaf" (non-hearing)
and "Deaf" (relating to cultural aspects). Padden (1980)
contributes to the further understanding of this distinction
by discussing the differentiation between deaf community and
the culture of Deaf people. In making this differentiation
she uses a definition of community which incorporates common

goals, geographic location, and some degree of freedom.

 

3
Based on this definition the deaf community is viewed as
encompassing Deaf members, hearing people, and deaf people
who are not culturally Deaf. These groups may interact on a
daily basis and unite in working with Deaf people on various
common concerns. Padden then differentiates the deaf
community from Deaf culture explaining, "The culture of Deaf
people, however is more closed than the deaf community.
Members of the Deaf culture behave as Deaf people do, use
the language of Deaf people, and share the beliefs of Deaf
people toward themselves and other people who are not Deaf."
(Padden 1980, p.93)

To understand the trend towards self-definition of
Deafness as a culture, a brief review of the historical
context of deaf education is needed. As Beryl Lieff
Benderly (1980) points out, it is not the history of deaf
people that can be examined, for that is not part of
recorded history. Instead, "what has come down to us is the
history of their treatment at the hands of the hearing".
(Benderly 1980, p.106) Two main threads run throughout
recorded history: first a manualist tradition (focusing on
the use of sign language for communication), and,
alternately, an oralist tradition (focusing on speech and
lip reading for communication).

The manualist tradition in education finds its roots in
the return of Thomas Hopkins Gallaudet to the U.S. from an

investigation of the methods of deaf education overseas. He

 

4
brought with him Laurent Clarc, a French manualist deaf
educator, to begin a school.

Later in the eighteenth century a school centered on
oral training was formed. Students were taught to lip read
and communicate using speech. In this environment sign
language was viewed as a weakness and students were
discouraged from using this form of communication. The
oralist movement grew and educationally dominated the scene
until very recently.

Throughout the domination of the oralist method the
manualist tradition continued among many Deaf individuals.
In August 1880, a convention involving 250 to 300 Deaf
people initiated the National Association of the Deaf.
(Benderly 1980, p.129) This spark of solidarity grew, but
the influence of Deaf people on education practices was
negligible. For, example, in 1900 an international congress
of teachers of the deaf met in Paris. (Benderly 1980, p.129)
Hearing professors rallied in support of oralism. Deaf
professors met separately and agreed in favor of sign
language. The hearing congress refused to meet with the
Deaf teachers. In fact, "the chair rejected even a summary
of the [D]eaf section’s proceeding." (Benderly 1980, p.129)
In addition, the report favoring speech was released as the
resolution of the congress at large, rather than just the
resolution of the hearing group. Although hearing educators

were unprepared to accept the use of sign language in

 

5
education, the Deaf movement continued to grow.

In the mid-1960's changes appeared again. The idea
that possibilities existed beyond the white American norm
paved the way for a renewed examination of a Deaf culture.
Manual methods began to sweep through deaf school systems.

Each of these two traditions represents a different
approach to the rearing of deaf children. "Accepting sign
language implies accepting [D]eaf people as a distinct and
valid cultural reality." (Benderly 1980, p.133) Oralists
maintain that to participate fully in society a person must
know the English language and, that with proper training,
deaf people can master speech. Furthermore, "hearing
society is where deaf people should seek their personal
identity and most important relationships." (Benderly 1980,
p.144)

Societal norms define the boundaries within which
choices about self-definition may occur. The set of
boundaries for the deaf population is visualized by Jeffrey
and Adenith Nash as in Figure 1. (Nash 1981, p.81)

The continuum of normal socialization refers to how the
deaf person views her/himself, ranging from "normal" to
"abnormal". Weak normal socialization signifies an
acceptance of deafness as a stigmatism. Strong
socialization represents the individual who does not view
their deafness as an abnormality.

The continuum of acculturation deals with the

 

6

individual's involvement in Deaf culture. Unless an

individual is born to Deaf parents, this acculturation

process will generally occur among peers, as in a

residential school for the deaf.

denotes a person who

Strong
Normal
Socialization

Weak

Passive acculturation

 

 

 

 

4.
Passing Advocation
H— —t-
l. ________________________________________
Retreatism Membership
V
Passive Active
Acculturation

Figure 1- Boundaries for the Deaf Population

misses out on this Deaf socialization process. This

structure, which allows for the placement of individuals

within a framework of categories (passing, retreatism,

advocation, and membership), further emphasizes the effects

of different environments on deaf children.

Less than ten percent of prelingually deaf children

7

Less than ten percent of prelingually deaf children
grow up in a family with older deaf relatives. (Meadow 1972,
p.19) For the majority of deaf children the situation
concerning the potential for language acquisition is less
than optimum. Johnson, Liddell and Erting explain:

Typically, a deaf child is the first deaf

person that the members of his [or her]

family have ever encountered. For such

parents, having a deaf child is generally

unexpected and traumatic. Furthermore, their

first advice usually comes from a

pediatrician or an audiologist, many of whom

do not understand the importance of early

sign language acquisition. Thus, the parents

and siblings of deaf children seldom have the

communication skills or the knowledge and

experience required to provide these children

with an accessible context for the

acquisition of either a natural language or

the cultural understandings and experiences

available to hearing children. (Johnson,

Lidell and Erting 1989, p.1)

Without a common language the passage of cultural
norms is partially blocked. Many kinds of cultural stories,
including stories about the body cannot be retold.

In this situation deafness acts as a handicap. The
child is unable to completely master the language of the
dominant culture. Usually hearing parents of deaf children
find their way to the deaf education system, whose goal has
historically been to teach the child the parent’s language.
Ideally, the child's handicap can be overcome through
specialized teaching methods. The parent(s) and the child
then share the same language and cultural stories presumably

flow freely.

 

8

In theory both parents and, later, teachers communicate
with the child using "oralist" or "total communication"
methods. Oralist methods focus on lip reading skills and
speech. The total communication method involves speaking
and signing simultaneously. However, since a large majority
of educators and parents are hearing, speech is the primary
signal and signs are generally made to conform to speech
patterns. The result is a simplification of both English
and American Sign Language (ASL). To comprehend the
language difficulties inherent in the Total Communication
environment the concept of American Sign Language as a
language distinct from English must be understood. William
Stokoe pioneered the linguistic analysis of American Sign
Language in 1960 with his publication Sign Langgage
Structure: An Outline of the Visual Communication Systems of
the American Deaf. This work led to a movement of further
linguistic analysis of ASL elucidating its unique morphology
and syntax.

Part of the difficulty in achieving the acceptance of
ASL as a language distinct from English lies in the absence
of a written form. When signs are represented by concepts
in capitalized letters the language appears simplistic.
Attempts to devise a system allowing a written translation
incorporating the complexities of ASL including facial
expression, space, directionality, and descriptor signs

often fall short. The more nuances that are captured, the

_ll

9
more unwieldly the text becomes. Translating a visually
based language into text will always insufficiently capture
the nuances of the language.

Another obstacle blocking the acceptance of ASL lies in
the search for a "pure" form of ASL (in many ways similar to
the concept of "proper" English). There is not one distinct
form of ASL. Many variations, including geographical and
subcultural variations (i.e. Southern ASL, African-American
ASL), exist.

This problem is exacerbated by intra-cultural
communications between Deaf and hearing individuals. Dennis
Cokely (1983) hypothesizes that the variations found in
signed communication between Deaf and hearing contacts are
best understood as an interplay between foreigner talk,
judgements of proficiency, and attempts of a learner to
master a target language. (Cokely 1983, p.20) When members
of the Deaf culture communicate with hearing people both
parties tend to alter their sign communications. Deaf
individuals will tend to do most of the alterations,
modifying signs into a more easily understood simplified
form.

Erting (1980) provides an example of a typical clip of
total communication found in her research (the child’s
responses have been eliminated from the interaction). In
this situation the teacher is mainly using her primary

language (English), and attempting to force signs to fit the

10

string of words.

Speech: Tell

Signs: TELL

Speech: tell the Easter Bunny...

Signs: SAY HORSE RABBIT

Speech: He said: "no", he's all out

Signs: NO ALL OUTSIDE

Speech: You can take a different color

Signs: DIFFERENT COLOR HIM (index)

Speech: You forgot to say you’re...

Signs: FORGET TELL

Speech: say thank-you

Signs: THANK-YOU

Speech: Ah, well go back and make him say thank-you...
Signs: COME BEFORE(past) MAKE TELL THANK-YOU

(Erting 1980, p.171)

Erting points out that not only do the signs and speech

not match in this communication, sometimes the meaning of

11

the teacher's signs contradict the meaning of her speech.
Note that the above example involves only a simple
communication. It is easy to imagine the further
complications involved in communicating increasingly complex
ideas, such as cultural stories about the body.

This paper describes research concerning a group of
Deaf children’s knowledge of human body structure and
function. These can be difficult concepts to communicate
about, even with a shared language. Although knowledge is
the focus of the research, methods of communication played a
crucial role in the design of the project, as well as in the
collection and evaluation of the data. Rather than viewing
the project as repeating previously completed research with
"normal" (i.e. hearing) children and comparing it to the
results of "handicapped" (i.e Deaf) children, the project is
best understood in the above context of ASL and Deaf
culture. The implications of this viewpoint will emerge

throughout the rest of this paper.

Discussion of Literature

Relevant literature concerning deaf children’s
knowledge of their internal body parts comes from many
fields. The first is studies that have been done with
hearing children. A simple Piagetian framework provides the
basis for many of these studies. In this type of framework

the pre-operational child, age 5-6, perceives the body in a

12

global, undifferentiated manner. The concrete operational
child begins to integrate and/or connect parts. The formal
operational child of 10-11 years organizes the body into
systems.

The major drawback to this structuralist approach is
that it imbues the developmental process with an underlying
evolutionary drive. Children begin with primitive,

undifferentiated ideas and rise towards higher thinking. In

 

the discussion of her findings Gellert, one of the first
investigators to explore children’s awareness of their body
parts, reminds the reader that:

[i]t must be kept in mind that the term,

correct answers, refers to probable adult

norms, rather than to a comprehensive,

scientific understanding of human anatomy or

physiology. If they were explored, many

conceptions lay adults have about the body

probably would be found to be fragmentary and

inaccurate indeed! (Gellert 1960, p.388-9)

It is not likely that the majority of adults are
developmentally stunted. Cultural norms exist concerning
ideas about the interior of the body. Most adults learn
these norms, incorporate them, and pass them along. This is
not to dispute the role of cognitive development; clearly if
a child does not develop cognitively there will be a limit
to the depth of cultural information the child will
assimilate. In addition to cognitive development, the role
of culturally determined stories must be taken into account

when considering children’s knowledge of the inside of their

bodies. The "correct answers" will vary from culture to

13
culture.

A second group of pertinent studies concerns similar
investigations with deaf children. These are also based on
a Piagetian foundation, imposing the framework and
methodologies used with hearing children onto deaf children.
A third set of data concerns deaf children's cognitive
development compared to that of hearing children. This set
of studies raises issues about linguistic skills and
cognitive development.

In the first two sets of studies the importance of the
cultural environment and communication is not addressed. In
the first group of studies conducted with hearing children,
a similarity of cultural backgrounds and easy communication
is assumed to exist between parents and children. Although
this assumption does not remain true for the second cluster
of studies conducted with deaf children, the assumption
remains unchallenged. The third set of studies struggles
with the idea of interactions between linguistic skills and
cognitive development, but the question of how they interact

for the deaf child remains unanswered.

Review of Literature

Tait and Ascher conducted an investigation in 1955 to
developing a psychiatric screening test based on an
individual’s drawing of the inside of their body.

Individuals were asked to draw the inside of the body,

14
including all internal organs, to draw a line from each
organ to the outside, and to label the organ. This research
is of interest due to its inclusion of both adult and child
subjects.

The groups tested included 100 Naval Academy candidates
(all men), 150 patients from psychiatric, medical, and
surgical wards of a naval hospital, and 22 sixth grade
students. The results of the 100 Naval Academy candidates
and the 22 sixth grade students as well as the
investigator's framework of body parts and systems is shown
in Table 1. The number of internal organs named by the
participants is tabulated, and the twelve most popular
organs from each group are depicted in the table. In
addition, the authors analyzed the drawings according to
organ systems. For example, if someone labeled the heart or
blood vessels they would be categorized as having included
the cardiovascular system in their drawing.

The researchers found that adults labeled the heart
most often and the most frequently represented systems for
adults were the cardiovascular and gastrointestinal systems.
Among the children the single most often mentioned organ was
the brain, and skeletomuscular responses predominated.
Respiratory and urinary responses ranked seventh and ninth
for the children compared to third and fourth for the
adults. Identical instructions to draw and label the body’s

internal organs resulted in different portrayals by children

 

15

Table 1- Results of Tait and Ascher Study

 

 

ideas about the body change.

they change.

Naval candidates Sixth-graders
Organs
Heart 91 14
Lung 86 **
Stomach 74 11
Intestines 81 7
Kidney 44 **
Brain 38 16
Ribs ** 11
Liver 44 **
Penis 18 **
Trachea 16 **
Esophagus 29 **
Pancreas 28 **
Appendix 20 **
Eyes ** 12
Nose ** 12
Knee ** 10
Teeth ** 8
Mouth ** 8
Neck ** 8
"Bones" ** 8
Ear ** 7
Systems
Cardiovascular 92 14
Gastrointestinal 93 18
Respiratory 85 7
Urinary 47 1
Central Nervous 41 16
Skeletomuscular 17 19
Genital 34 0
Regional 17 13
Special Senses 14 12
Skin 1 3
Hematopoietic 7 0
Endocrine 7 0
and adults. Eventually children become adults and their

The mystery is how and why

As previously mentioned, a simple

16
developmental framework is often applied to interpret the
changes in explanation.

Using her studies concerning children's
conceptualizations of their bodies, Crider (1981) attempts
to further augment the simple Piagetian developmental
framework and describes eight levels of conceptualization
through which the ideal child would progress. The first
stage includes the absence of knowledge of certain body
parts. It also includes parts listed by their geography in
the body, rather than by their function. During the second
stage organs are assigned global functions. For example,
"The heart is for love". (Crider 1981, p.54). In the third
stage the child will assign perceptual attributes to organs,
such as shape or motion.

Further development leads to stage four when children
differentiate structure and function. In addition children
link structures together using another substance. For
example, at this stage a child might connect the mouth to
the stomach by the movement of food. At the fifth stage,
children begin to understand organs as active agents (i.e.
the heart pumps blood through blood vessels). During the
sixth stage there is further discrimination concerning the
movement of substances through the body. In this stage the
child may depict the heart as having two sides, or the
movement of food through the stomach continuuing beyond to

involve digestion and the excretion of waste material.

 

17

In the seventh stage, transformations of body
substances are recognized. For instance, breathing in good
air and breathing out bad air. Finally, transformations are
understood at the level of cells and chemical reactions.
This change allows for physiological explanations to emerge.

Crider admits that in her experience, all children are
transitional, manifesting aspects of more than one stage.
She also admits that there is a lack of data concerning
whether or not the highest developmental levels are
consonant among adults. She conjectures that they are not.
Despite these conflicts Crider asserts the construction of
stages is theoretically useful in understanding the
development of children's ideas about their bodies. The
application of developmental frameworks to various
children’s health issues has blossomed over the last two
decades and led to the investigation of a wide array of
issues: perception of internal body parts, causality of
illness, health beliefs, conceptions of medical procedures,
and understanding of medical instruments.

Examining the existing literature on the evolving
knowledge of internal body parts reveals that the number of
body parts named by children increases with age. (Gellert
1962, Porter 1985, Crider 1981, Glaun and Rosenthal 1988).
The brain, blood, bones and heart are the most commonly
named body parts at younger ages. The stomach and lungs are

later added, followed by parts such as the intestines, liver

18
and kidney. The average number of body parts named at
different ages varies by how body parts are defined by the
investigator (i.e. is "ribs" different from "bones").
Gellert’s data found the average number of parts named at
age five to be 3.3, while at the age of 10/11 years the
average named was 9.6. Porter found an average of 6.2 parts
named at 6/7 years and 15.6 parts named by 10/11 years.
Glenn and Rosenthal’s study reported an average of 3.4 parts
named at 5 years and 8.7 by 10/11 years.

Porter’s study, regarding the development of ideas
about internal body parts, included 144 children in the
first, third and fifth grades. She explains, "Children older
than 11 were not studied because, beyond the fifth grade,
health teaching increasingly becomes a part of the
curriculum so that the child's perceptions are influenced by
acquisition of knowledge." (Porter 1985, p.44) This
statement reflects an artificial separation between
development independent of any formal instruction, and
development in relation to the acquisition of knowledge in
school. In the educational system, adults teach children
culturally accepted information (albeit the dominant
culture). It is a formalized system to transfer culturally
accepted knowledge. Researchers in this field assume
cultural transmission of information concerning the body
will occur outside the school system and children’s

development will result in evolving interpretations of that

19
information. Information acquired within the school system
is treated as contaminating the results of "pure"
development.

Two studies completed later attempted to replicate
studies about the development of ideas about internal body
parts using deaf children as subjects. Gibbon’s study
(1985) compared the knowledge of ten deaf children to ten
hearing children. The ages of the children ranged from 8-10
years old. She used the same test as Porter, providing a
prepared outline drawing of a child's body with the facial
features drawn in. The children were instructed to draw and
label the internal body parts within the outline drawing.
She found a significant difference between the number of
responses of the two groups. The mean number of body parts
named for the non-deaf group was 9.3, compared to 3.0 for
the deaf group. (Gibbons 1985, p. 37)

A recent study completed by Badger and Jones (1990)
repeated Gibbon’s study with much larger numbers. Their
study included 80 deaf children and 190 hearing children.
They divided the children into three age groups: 5-7 year
olds, 8-11 year olds, and 12-15 year olds. The groupings
were intended to reflect the three Piagetian developmental
stages: preoperational, concrete operational, and formal
operational. Using ANOVA they found significant differences
in knowledge of the inside of the body based on age and

hearing status. They note that the average number of body

 

 

20
parts named by the 5-7 year old hearing children, 4.90, is
similar to the average number of parts named by the 12-15
year old deaf children, 4.17 (specific numbers were not
provided for the other age groups). (Badger and Jones 1990,
p. 203) Badger and Jones concluded that while the
developmental pattern was similar for the two groups, the
deaf children progressed at a much slower pace through
Piaget's cognitive stages.

The validity of the previously discussed assumptions
about the cultural transmission of information in relation
to these two studies is questionable. The likelihood of
cultural transmission of information outside the school
system for the deaf children is not addressed. It is not
clear if the deaf children in these two studies rely more on
the school system for the transmission of culturally based
ideas about the body. If this was true the artificial
division accepted in previous studies, which assumes the
cultural transmission of body stories outside of the school
system, may not be valid for all deaf children. Badger and
Jones conclude from their study that the deaf children
develop at a much slower pace than the hearing children.
The differences found may reflect delayed development, the
lack of cultural transmission, or an interaction between the
two.

Two studies in the third category of research

illustrate the difficulty in evaluating cognitive

 

21
development separate from linguistic skills. Best and
Roberts study (1975) included hearing and deaf children,
aged 23-38 months during the first testing, which included
sensorimotor tests. The second testing in their research
included children aged 36-54 months and incorporated a
classification test. They found that deaf children
proceeded through Piaget’s sensorimotor stage at a pace
similar to that of hearing children. In addition, they
found similarities among the two groups on cognitive tasks
requiring interaction with the environment.

A difference was found between the two groups on a
classification task requiring the children to sort picture
cards into similar groups. Best and Roberts believe the
classification task represents an example of cognitive
development more dependent on verbal interaction with the
environment, Piaget’s "social transmission". (Best and
Roberts 1975, p. 25) According to this explanation deaf
children lag behind cognitively due to communication
difficulties interfering with the part of cognitive
development dependent on social interactions.

In 1976 Schlesinger and Meadow compared the performance
of deaf and hearing children on three major intelligence
tests. They found deaf children generally scored lower on
the intelligence tests. (Meadow 1980, p.57) Meadow offers
two possible interpretations of the differences observed

between the two groups. One interpretation of the

 

22
discrepancy reflects an understanding of the communicative
difficulties deaf children often encounter in testing
situations. (Meadow 1980, p.57) Intelligence tests, while
meant to test cognitive abilities rather than knowledge,
presuppose a command of the English language. There is also
the presupposition that the person administering the exam
will speak the same language as the examinees and therefore
will be able to clearly communicate directions.

The second interpretation focuses on the lack of
linguistic skills adversely affecting cognitive development.
(Meadow 1980, p.57) If this hypothesis is true then the
scores of deaf children accurately reflect cognitive
deficits. Meadow admits the difficulty in distinguishing
between the two interpretations and concludes, "It does not
appear possible to separate language from thought, and
therefore it is not possible to determine precisely whether
the difficulties in communication interfere with the
performance aspects or with the central processing
procedures of intellectual functioning." (Meadow 1980, p.57)

The second finding of Schlesinger and Meadow’s study
was that even though deaf children scored lower on
intelligence tests than hearing children, the pattern of the
performance was similar between the two groups. There
appeared to be no cognitive gaps among the deaf children.
Meadow explains,

there was no striking difference in the
pattern of performance demonstrated by the

23

two groups of children. The generalized

deficit was not distributed differently over

the range of skills tapped by the various

subtests. That is, for the performance

measures used, no cognitive "holes" were

observed among the deaf children, despite

their generally lowered IQ ratings. (Meadow

1980, p.57)

These studies, while not providing clear answers,
emphasize the importance in questioning the reasons behind
deaf children scoring lower on deveopmental exercises.

A factor meriting consideration in the evaluation of a
deaf child’s test results is the child's environment (i.e.
home, school, friends). For example, Gibbons mentions that
each of the ten deaf children included in her study have
hearing parents. No mention is made of the hearing status
of instructors, the parents signing skills, the instructors
signing skills, the availability of deaf adults as role
models, or what method of manual communication was used by
the interpreter. These kind of environmental factors can be

expected to affect both the testing setting and result

expectations.

Hypotheses
Originally I had four hypotheses. (1) The group of Deaf

children in this study would manifest knowledge about
internal body parts in a manner similar to that previously
reported for hearing children, but at a later age. (2) If
the children in this study were tested using the language

they were most likely to use amongst themselves and with

JIIII

 

24
other Deaf adults (ASL), a greater number of body parts
would be named as compared to test results dependent on
English language knowledge. (3) The explanations offered by
children in this study concerning the function of the heart
would become increasingly complex with increasing age. (4)
The explanations offered by children in this study
concerning the movement of food through the body would
become increasingly intricate with increasing age.

My first hypothesis was based on the previous research
concerning hearing children's knowledge of their internal
body parts, deaf children’s knowledge of their internal body
parts, and deaf children’s cognitive development. The two
studies previously completed which included deaf children
reveal differences between hearing and deaf children's
knowledge of body parts, with deaf children scoring lower.
From the viewpoint of cognitive research this could reflect
either communication difficulties or a lack of cognitive
development due to language deficits. Looking at the
environments of hearing and deaf children from an
anthropological perspective, hearing children benefit from
the cultural transmission of "body stories". This cultural
transmission is not necessarily assured for deaf children,
although the likelihood increases for those children more
assimilated into Deaf culture. As this is more likely as
children grow older, cultural transmission may occur at a

later age.

 

25

My second hypothesis was based on the idea of
linguistic skills and communication impacting the results of
test scores. Recognizing that the drawing test presupposes
a command of the English language through its requirement of
English labels for body parts, I believed changing the
testing parameters to exclude this presupposition would
result in different findings. Previous research completed
with deaf children concerning their knowledge of internal
body parts has not challenged this presupposition.

My third hypothesis was based on research completed by
Gellert, and later Crider with hearing children pertaining
to the function of the heart. They found increasingly
complicated explanations of function with increasing age,
and this is what I expected to find in the interviews with
the Deaf children in the study.

As far as I am aware, there has been no previous
research with hearing or Deaf children concerning
explanations of the movement of food, the topic of my fourth
hypothesis. Based on the previously mentioned studies I
expected to find increasingly intricate explanations with
increasing age in the section of the interview pertaining to

the movement of food also.

Methodology

My research was conducted at a residential school for

the deaf. I received permission and support to include

26
first through eighth graders in the project. Fifty-three
students met the grade level criteria. Of that group 41
parents (77%) responded to a letter and follow-up phone call
requesting permission for their child's participation in the
study. Thirty parents granted permission to have their child
included in both the interviewing and drawing exercises. I
eliminated one child from the study due to obvious mental
deficits and was left with a final sample size of 29.

The age breakdown as shown in Table 2 includes thirteen
girls and sixteen boys. Thirteen of the children have
hearing parents, fourteen have hard of hearing or deaf
parents, and two of the children’s parental hearing status
is unknown (one child was adopted and one child did not have
the information included in their file). The lengths of
time the children had attended the school ranged from 1 year
to 7 years. The average length of attendance for the 27
students about which this information was available was 3.11

years (Standard deviation=2.04).

 

Table 2- Age of Children

Age f of Children g of
Children

6-8 (72-96 Mos.) 6 21%
8-10 (97-120 Mos.) 3 10%
10-12 (121-144 Mos) 11 38%
12-14 (145-168 Mos.) 7 24%

14+ (169+ Mos) 2 7%

 

 

27

A variety of elements impact the children's school
environment. Although a few important positions are filled
by Deaf adults, the majority of the staff at the school are
hearing. Many of the students are from out of town and stay
at the school during the week. These children stay in
dorms, and many of the dormitory staff are Deaf adults. All
children are required to go home on the weekend. The
children unable to go home go to foster parents for
weekends. Total communication is used in the classrooms;
the teachers speak and sign simultaneously during school.

This sample is not representative of deaf children in
two major ways. First, less than 10% of deaf children in
the general population have Deaf parents, whereas in this
sample half of the children do. Second, most deaf children
currently attend mainstream programs as a result of
legislation requiring children to attend school in the least
restrictive environment. Students in mainstreamed programs
are kept in a separate classroom in a school for the hearing
and/or mainstreamed into hearing classrooms using
interpreters. The children in this study attend a
residential school. Increasingly, Deaf parents of Deaf
children are petitioning state education departments to have
their Deaf children placed in schools for the Deaf, arguing
that these schools are the least restrictive environments
for their children. Sentiments such as these contribute to

the higher percentage of Deaf children with Deaf parents in

28
this sample.

The strength of this sample lies in the fact that the
residential school environment is conducive to developing
ASL skills through interactions with Deaf adults, and
interactions with peers that have learned ASL as a natural
language. The second half of this research project assumes
a knowledge of ASL equivalent to or better than the child's
knowledge of English. It presumably would make no
difference to give children an opportunity to express
themselves in ASL if they had never learned it. Another
important strength of this sample is the large number of
students located in one school. Most mainstreaming programs
include only a few deaf students, making it difficult
logistically to arrange this kind of study with a large
number of students.

All of the children included in the study were tested
using a projective drawing and labeling test. Half of these
children were randomly chosen for interviewing. Of the
children interviewed, some were given the drawing exercise
before the interview and some after the interview in
attempts to minimize any interactive effect. The projective
test consisted of an outline drawing of the body with the
eyes, nose, mouth and hair drawn in (see Appendix A). Each
child was asked to draw the inside of the body and label the
parts drawn.

The validity of the drawing exercise when testing Deaf

29
children is undoubtedly higher than a completely English
focused methodology, such as having them write out the body
parts they know in a list form. English is still a crucial
component in the exercise, as half of the test involves
labeling the parts drawn with English names. The purpose of
the exercise is to test the child’s knowledge of internal
body parts, not their knowledge of English. While this is
not an issue for most hearing, English speaking children,
differences in English skills make it an issue for the
children in this sample.

Using the drawing exercise could result in two possible
outcomes. First, the children could draw the parts they
know and not label the parts they didn't know English names
for. Second, the students could only draw parts they know
English labels for, leaving out parts they are unable to
label. I wanted to maximize the first scenario. During the
explanation of the directions, I told the children they
should draw all the parts they knew, label all the parts
they could and leave the rest unlabeled. Emphasizing the
acceptability of not knowing the English names for all the
parts, I encouraged children to draw all they knew.

A short-coming in the drawing component of the exercise
is even though children might be very willing to draw what
they know a scribble, line, or dot having no significance
for the researcher may be significant from the child’s

perspective. Whenever a child handed me a drawing with

 

30
scribbles I asked the child to name the scribble.
Occasionally a child would sign DON'T-KNOW, but more often
the answer was a body part including: BONE, BLOOD, SHIT, and
LUNG.

The interview consisted of five sections. (see Appendix
B) The first section of the interview tested the validity of
the projective drawing test. The second and third sections
provided depth to the picture of the children’s knowledge of
the inside of their bodies. The fourth section was to act
as an initial exploration of the children's ideas about
health and illness. Not all of the questions in this
section were consistently asked, and for that reason this
section will not be discussed in depth. The last section
provided an opportunity for the children to talk about the
body, health and illness on a more personal level.

Wanting to maximize communication I arranged for a Deaf
adult familiar with the children to conduct the interviews,
in addition to using ASL. This adult was a familiar face to
the children, making interviews possible with some of the

younger, shy students.

Results

Organizing the data involved recording the number of
parts named, the number of parts drawn, the labels used, and
additional notes on unusual aspects of the drawings. For

the first part of the interview I tabulated the number of

 

 

31

parts signed when describing the inside of the body. I then
reviewed each of the replies to questions concerning organ
functions. The heart was the only organ consistently
discussed, and therefore is the only organ included in the
results.

In examining the explanations of where food goes when
you swallow it, I recorded the children’s descriptions and
differences in the interview. After the first three

interviews it became apparent that the children were only

 

tracing half a path. The interview was changed to include a
prompt if the child stopped at the abdomen when describing
the path food takes. In these situations the child was
asked if the food stayed in the abdominal area.

The first part of my analysis concerns the drawings
completed by the children. After tabulating the number of
labels used by each child, I used age as a variable for
further evaluation. The mean number for each age group was
computed, and a linear regression calculated using age as a
predictor variable.

Reviewing the drawings shows that 17 of the children
included unlabeled parts in their drawings. The breakdown of
labeled parts appears in Table 3. I did not include labels
such as "knee", "leg", "arm", "jaw", and "penis" in the
results, as they are labels for externally seen parts.
"Ribs" and "bones" were not counted as separate parts, as I

considered ribs a type of bone. Five of the children drew

32

 

Table 3- Labeled Body Parts

Aqe_§roun

6-8 8-10 10-12 12-14 14+
n=6 n=3 n=11 n=7 n=2

 

 

Bodv Part

0
N
.5
.5
N

Brain
Esophagus/
Throat
Heart
Lungs
Liver
Stomach
Bladder
Bones
Muscle
Vein
Intestines
Gall Bladder
Pancreas
Rectum
Anus
Kidney
Blood
Uterus
Vagina

 

OOOOOOOOOOOHOOOOOO
OOOOOOOOOOOI—‘OOOOI—‘O
HHbNMNHHwHUmHmbm¢b
I-‘I-‘OONNNNNOOI—‘ONNNU‘IN
OOI—‘I—‘OOOOOOI—‘I—‘ONONMH

 

the ribs in and labeled them separately, other bones were

not labeled separately. I included the label of "throat"

drawn as a tube in the neck region in the same category as

"esophagus". Interestingly, none of the children used the

label "food tube", a label reported in other studies. This

label was used in two of the textbooks I examined. The

mean number of parts named by the group overall was 3.76

(Standard deviation=4.19). The mean number of parts named l

by each age group appears in Table 4. Running a linear

33
regression using age as the predictor variable and the
number of parts drawn and labeled as the dependent variable
shows a slope significantly different from zero. (T=2.42,

p=.02) These findings support the hypothesis that as Deaf

Table 4- Number of Body Parts Named

 

 

 

 

Age Group Mean of arts named
6-8 0.17
8-10 1.33
10-12 5.45
12-14 4.43
14+ 6.50
Overall 3.76
Standard deviation 4.19

children grow older they know more English names for body
parts. They begin to learn the body story as told by their
textbooks and hearing adults.

The implementation of the study itself contributed to
some variation in the scores, due to changes in the
teacher’s behavior. Upon being informed of the study, two
of the teachers chose to teach academic material pertaining
to the human body. Most of the teachers told me directly
they had not taught the human body in science yet. Four
students were in the two classes that had recently taught
material about the human body, three in one class and one in
another.

The influence this had on the children’s replies is
represented by two children from the same class who drew and

labeled the uterus and vagina . This was not material

 

34
included in the textbook, but taught by their teacher in
class. Both children drew these parts in separate bodies on
the back of the sheet of paper provided them, the parts were
not integrated into the drawing of the body on the front.
One student was a male child and one student female. Both
drew two extra bodies on the back, one including a penis and
the other including a uterus and vagina.

In this same class the children were taught from a
textbook concentrating on the gastro-intestinal system. Two
of the three children in this class included lines drawn
into the limbs in their drawings, but did not label them.
Labels were largely restricted to the gastro-intestinal
system. One of the students in this class was interviewed,
but not taped due to technical difficulties. She is not
included in other calculations concerning differences
between the drawing and interview exercises. I noted her
incluSion of the signs BONE and BLOOD when describing the
contents of her arms and legs at the time of her interview.
She did not label these parts in her drawing, suggesting the
teacher’s focus in the class may have affected what she
chose to concentrate on in the drawing.

The unexpected jump in the mean number of parts named
in the 10-12 year old age group is best understood as
arising from an outlier, a student in the other class
teaching material about the human body. She named ten body

parts, well above the mean of her age group, 5.45. This

 

35
child was not in the group selected for interviewing. I
asked her about the functions of the body parts she drew
after she completed her drawing, because she drew many more
parts than the average child. She explained what each part
was and wrote down the following information for specific
parts: the lungs- "to breath", the heart- "pump the bleeds",
the muscles- "to move", the kidney- "water to pee", the
intestines- "to swallow the food to go in it", and the brain
that she drew as a circle in the head but could not label-
"to think right".

This child's parents are not deaf. I was told her
mother signed a little and her father even less. Her class
had made nearly life sized paper bodies and pasted different
parts on them just previous to the beginning of this study.
This child does not fit the expected pattern. She knew many
body parts, could label the parts with English names, and
could describe their functions. This is most likely the
result of her recent exposure to the topic in class, and the
manner in which it was taught. She also represents
individual variation, probably not all the children in her
class would have scored so high. When using a small sample
individual variation can greatly affect the results, as
demonstrated by the unexpected shift in the 10-12 year old
age group.

The next step in the analysis adds the first part of

the interview as a component. Data concerning the drawings

 

 

 

36
of the children interviewed is compared to the number of
parts named during the interview using a T-test. In
addition, a number of case examples are discussed. These
examples emphasize both how the use of ASL improves
communication with Deaf children and the significant impact
this improvement has on the portrayal of the human body.
While numbers help to illustrate this point, individual
qualitative descriptions play an important role in further
elucidating the effect of enhanced communication on the
children's depictions of their bodies.

The average number of parts drawn by the children
interviewed was 3.29. In the interview the average number
of parts mentioned was 5.14, a statistically significant
difference (T=2.290, p=.04). My results agree with Glaun
and Rosenthal's experience with the descriptive method used
with hearing children. They found scores to be increased in
71.4% of the children, the number of items added ranging
from 1-7. I found additional parts named in 92.8% of the
cases, the number of items added ranging from 1-9.

The children discussed as case examples have been
assigned the pseudonyms Justin, Caitlin, Mario, and Shawn.
Justin is approximately seven and a half years old, is male,
and has Deaf parents. In his drawing he labeled one part,
"bone". There were lines drawn in every part of the body
converging in the middle, a round configuration drawn in the

center of the body, and a scribble drawn in the head region.

 

37
In his interview he named seven parts: stomach, heart,
lungs, muscle, blood, bone, and intestines. Clearly this
child knows more about his body than reflected in his
drawing or in his labeling.

The other three children I will discuss are Caitlin
(approximately eleven and a half years old), Mario (twelve
and a half years old), and Shawn (thirteen and a half years
old). None of these children were able to label anything in
their drawings. When I asked Shawn, a male child with
hearing parents, to label the parts he had drawn he
fingerspelled "food", and wrote it down in what appeared to
be the stomach. Many authors note the inclusion of objects
such as food in drawings as a sign of pre-operational
thinking. Shawn drew a highly integrated drawing, and named
nine parts in his interview. According to his English
labels the child is pre-operational.

All of the investigators discussed in the literature
review are hearing individuals from a shared culture.
Unspoken expectations underlie these studies, the children
will label concepts of internal body parts with labels from
the investigator’s realm of experience. Shawn does have
labels for internal body parts, but they are signed rather
than written. The acceptable English label he can produce
does not reflect his level of conceptual thinking.

Mario, another male child of hearing parents, named

four parts in the interview: bones, blood, heart, and lung.

 

 

38
When the interviewer asked Mario if there was anything else
besides blood and bones in his abdominal area he explained
that there was a "jelly-like substance". The interviewer
and I interpreted this to be a similar concept to the
English label "guts". In his drawing, Mario included some

kind of mass in the abdominal region. He could not label it

 

in the drawing, but he used a pantomimed sign conveying the
shape and the consistency of the mass.

This may reflect the communicative difficulties faced

 

by many deaf children in a testing situation. In an optimum
communication setting, one on one with another deaf
individual, Mario was able to convey through circumlocution
the conceptualization of an image he was unable to label.

In written testing situations he would have no way to
communicate the thought.

Caitlin, a female child of hearing parents, drew a
disjointed picture. What appears to be bones are drawn in
the left arm and leg. The right leg is colored in. A tube
in the throat area connects to what appears to be lungs. A
roundish object is drawn below the umbilicus, and a colored
in circle is drawn in the head. Caitlin named three objects
in the interview: heart, brain, and bone. She does not
mention in the interview objects in the drawing that appear
to be a trachea, lungs, and stomach. Caitlin had a
difficult time beginning her drawing, and only began after

encouragement was provided. I asked her at the time what

 

39
was the circle she had drawn in the abdominal area was, she
could not tell me. I asked her if she could fingerspell any
of the objects she had drawn, she told me no.

Caitlin appeared to lack linguistic skills more than
the other children. The interviewer repeated herself often,
and had to use a variety of explanations in the interview
with Caitlin. Despite these efforts Caitlin looked confused
through much of the interview. In the second part of the
interview Caitlin was the only child who answered DON’T-KNOW
to questions about both the function of the heart and the
brain. She also communicated a limited understanding of
where food goes. In the previously discussed situations the
children appeared to greatly benefit from the utilization of
an additional communication method. Caitlin produced no
English labels, few signed labels, and showed little
understanding of what she did sign. She did not appear to
benefit much from the addition of ASL to the testing
situation.

These children illustrate a range of experiences. On
the one end are children who greatly improve their scores in
a testing situation through the addition of communication in
ASL. At the other end of the spectrum are children for whom
this added channel makes little or no difference. However,
the statistics show overall there is a significant
difference between the use of a projective drawing test and

a descriptive test relying on ASL. These individual case

 

 

 

 

40
examples serve to illustrate the data from the first part of
the test can mask a tremendous amount of variability in deaf
children's performance in these two situations. They also
portray the difference the interview makes in accurately
depicting children’s knowledge of body parts.

The third part of the analysis focuses on the second
section of the interview dealing with the function of
internal organs. Specifically, I examined the children’s
responses describing the heart's function. After recording
the children's responses, I compared their responses to a
framework constructed from earlier research with hearing
children.

Crider, whose work was discussed in the review of
literature, constructs a range of explanations of the
function of the heart based on Gellert’s research with
hearing children. She lists them from those most often
named by younger children to those listed by older children.
They are as follows:

1. Don’t know.

2. Function related to emotional processes-for
example, to love.

3. Function related to health-for example, to keep you
well.

4. Function related to superego-for example, to
make you do the things you should.

5. Description of heart sounds-for example, ticks.

6. Description of heart actions-for example, thumps,
beats, pumps.

7. Heart is essential to life.

8. Function related to breathing.

9. Function related to being able to move the body or
supply energy.

10. Description of variation in heart rate or speed-for
example, goes fast when you run.

_||II

 

41

11. Function related to blood, without concept of
circulation-for example, blood comes from the
heart.

12. Function related to purification and/or renewal of
body parts or content.

13. Heart is essential to life explained in terms of
circulation, blood, or oxygen.

14. Heart pumps blood, makes it circulate.

(Crider 1981, p.52)

The thirteen replies to the question "HEART #00" in my

study were as follows, listed by age:

1. Breathing.

2. It pumps the blood.

3. Breathing. If you didn’t have a heart you would
die.

4. Makes you live.

5. For living. For blood. Moving around makes it beat
faster.

6. Don’t know.

7. It beats and controls what you do. If you didn’t
have one you would die. Playing and running makes
it go faster.

8. It controls your blood. Your heart beats as you
move.

9. If it stops you die.

10. For blood. If it stops you die. Helps you
breathe.

11. Pumps blood. Keeps you strong. Helps you move.

12. Pumps blood. Breathing. Makes you comfortable.
Supports veins.

13. It beats. It's for breathing air (so is the
lungs).

If these replies are then compared to Crider's

categories the relationship is as follows:

 

Child interviewed Crider’s category

(children listed by age)

1. 8
2. 14

3. 8, 7

4. 7

5. 7, 11, 10
6. 1

7. 6, 9, 7, 10
8. 11, 6

 

 

42

9. 7.
10. 11, 7, 8
11. 14, 9, 9
12. 14, 8, 3
13. 6, 8

If Deaf children follow the same developmental pattern
as hearing children, but in a delayed fashion I would expect
the younger replies listed by Crider to appear frequently in
older deaf children's responses. That was not the outcome
in this study. Possible explanations for this unexpected
pattern will be discussed in the conclusion.

In the third part of the interview the children were
asked "where does food go when you eat", signed FOOD
SWALLOW, WHERE GO. Each child’s response is described in
this analysis, as well as differences in the interview.
During the first three interviews the children showed food
following a path leading to the abdomen. Wondering if this
accurately represented their knowledge, we began asking the
children that ended the path of food on the abdomen if food
stayed there. The answer was no in every case but one.

When pressed further, most of the children explained the
food came out eventually as a bowel movement. This
reluctance to explain the entire pathway of food, especially
the bowel movement, suggests the possibility of cultural
influences affecting the children’s descriptions.

The replies listed in order by age are as follows:

1. Traces a path down to the abdomen and around (did
not ask if it stays there).

2. Traces path down the throat to abdomen (did not ask

 

 

10.

11.

12.

13.

14.

43
if it stays there).
Traces path down to the abdomen, then signs TOILET.

Traces path down throat to the abdomen (asked if
food stays in the abdomen and the reply is yes).

Traces path down abdomen and around (asked if it
stays there the reply is no, you go to the
bathroom).

Traces path to the abdomen (asked if it stays
there, reply is no, TOILET).

Traces path to abdomen (asked if it stays there,
the reply is no but no alternative explanation is
given).

Traces path down to abdomen. What is good is
saved, what is bad is discarded. The food is
digested, then you go to the bathroom.

Traces path down to abdomen, says DON’T-KNOW NAME
"i", traces path around abdomen (asked if it stays
there, the reply is no, TOILET).

Traces path down to the abdomen (asked if it stays
there, the reply is no, TOILET).

Traces path down to the abdomen, shows it spreading
out from there (asked if it stays in the abdomen,
the reply is no, it spreads out to the body from
there).

Traces path down to the abdomen, it’s digested and
sent to different parts of the body.

You swallow, it goes down your throat, through your
chest, past your heart, into the stomach. It’s
digested and spreads through the body. It goes
through the intestines and then stops in two areas,
one on each side of the body. When you’re

ready you have a bowel movement.

Traces path to the abdomen, mixes up so you can
grow (did not ask if it stays there).

In this section of the interview different levels of

conceptualization appear related to age. At younger ages

 

44
the food is shown taking a direct path through the body. At
later ages an integration of the digestive system with the
rest of the body emerges.

After reviewing the children’s replies, I was impressed
by the difference between the explanations provided in the
interview and the depiction of the gastro-intestinal system
in their drawings. To further explore these differences I
reviewed both sets of data using Glaun and Rosenthal’s
concept of integration. They describe integration as, "the
extent which organs and parts are inter-connected to form
bodily systems." (Glaun and Rosenthal 1988, p.66) I was
interested in two aspects of integration. First, how much
integration appeared in the children’s drawings and how did
it relate to age. Second, how was the integration in the
drawings, or lack thereof, reflected in the explanations of
the gastro-intestinal system during the interview.

Glaun and Rosenthal scored each child’s drawing in
their study on level of integration by dividing drawings
into two categories. The first level included drawings
depicting organs and parts as floating unconnected within
the body. The second level included drawings showing some
attempt to connect parts into systems. For example, a tube
connecting the mouth to the stomach or the heart connected
in some way to vessels in the extremities. They found an
increasing amount of integration with age, but overall a low

level. None of the five year olds and only 38% of the 10/11

 

 

 

45
year olds demonstrated integration. (Glaun and Rosenthal
1988, p.66)

Of the 29 drawings in my study, only six drawings
showed some degree of integration. Of these six drawings,
five showed integration of the GI system and two showed
integration of the cardiovascular system. The ages of
children producing these integrated drawings were
surprisingly distributed: 80 months, 89 months, 131 months,
147 months, 160 months and 161 months. Based on Glaun and
Rosenthal's results I expected to see integration in the
drawings exclusively in the older age group.

Transcripts of the third section of the interview,
containing descriptions of the gastrointestinal tract
revealed a much greater level of integration than is
expressed in the children's drawings. Only one of the
children displaying integration in their picture was also
interviewed, and the high degree of integration in the
child’s drawing was reflected in the explanation of food's
pathway provided during the interview. The rest of the
children interviewed showed no integration in their
drawings. Every interviewed child was able to depict a
pathway for food proceeding from the mouth to the abdomen.
Several of the children were able to proceed beyond that
point providing integrated explanations of food's migration
through the body including digestion and bowel movements.

This understanding was not reflected in their drawings. The

 

46
use of ASL allowed them to spatially express knowledge in a

way that drawings did not.

Discussion of Results

The first of my original hypotheses involved the idea
that Deaf children’s concepts concerning the internal body
would develop in a similar manner, but at a later age than
hearing children. The average number of parts labeled by
the Deaf children in this study was less than that reported
in other studies with hearing children. In this respect,
the results concur with similar studies completed previously
on this topic. Using a linear regression to relate the
number of parts labeled to the age of the child showed the
number of English labels provided by the children increased
with increasing age.

Neither of these findings is surprising, but
speculations as to why Deaf children appear to know less
than hearing children at equivalent ages should be pursued.
A superficial explanation is that children without hearing
are handicapped, deficient in a way that hearing children
are not. Due to this deficiency they lag behind their
hearing peers developmentally.

Alternatively, multiple factors can be elucidated as
possibly contributing to the above results. First,
communication difficulties may contribute to the differences

seen. The drawing exercise is assumed to be an equivalent

 

 

47
evaluation of hearing and Deaf children's knowledge. The
drawing exercise uses pencil and paper. Deaf children have
conceivably faced repeated frustrations with such
evaluations that hearing children have not at the same
level. In addition, the drawing exercise utilizes English
labels. Hearing children have these labels reinforced on a
day to day basis through speech and hearing. Deaf children
are more likely to associate a body part to a sign,
something that has meaning for them.- English labels can be
understood as meaningful symbols for hearing children. They
are much more likely to be nothing more than a memorized
string of letters, possibly then associated with a sign in
the mind of a Deaf child.

Communication difficulties also intervene at the level
of instructions. Gibbons notes,

The deaf children had some difficulty

understanding the concept of ’inside’ as

indicated by their facial expressions, verbal

questions, and frequency of external body

parts drawn...A few subjects apparently had

problems understanding the words ’body parts’

as their test revealed merely scribblings,

lines, or dots within the body boundaries.

(Gibbons 1985, p.44)

This description emphasizes the difficulties involved
in communicating with the deaf children. These difficulties
are not present during the testing of the non-deaf group.
While Gibbons attributes the difficulties to the children's

lack of understanding of the concepts, details are not

provided about the context of the misunderstanding. This

 

 

48
situation could arise either through the suggested
misapprehension of ideas or as the result of poor
communication skills on the part of investigators. There is
no way to further evaluate this based on the provided
information.

In my study after explaining who I was ( my name, that
I was a medical student, and that some day I would be a
doctor) and what I was trying to find out ( what they knew
about the inside of their bodies) I would pass out the
outline drawings. I would then set the following scenario:
suppose you opened up your body and looked inside, what
would you find? I want you to draw what you would find
inside the body. I signed this SUPPOSE YOU BODY OPEN
LOOK=inside body, WHAT FIND. I WANT YOU DRAW INSIDE=bOdy.

To further clarify this I would elaborate on opening the
head, neck, chest, abdomen, arm and leg.

Once, when I encountered further confusion, I decided I
could clarify this concept further by depicting an
operation, and asked what a person would see if they
operated on the body. Rewarded with a look of comprehension
and the onset of drawing I sat back satisfied. The child
brought me a drawing of the outline covered with several
scars, apparently a depiction of the scars on her body.
While this is an obvious example of miscommunication, it
raises the possibility of numerous subtle misunderstandings.

Linguistic skills, or the lack thereof, on my part and

 

49
on the part of the children will contribute to communication
difficulties. The children in this study have varying
levels of competency in English and ASL. Currently the
question of how cognitive development and linguistic skills
interplay remains unanswered. If a lack of linguistic
skills does augment a developmental lag cognitively, this
could contribute to the findings of this study. I met/
several children who came to the school with very little
English comprehension, and whose parents signed very little.
Once in the school the children have the opportunity to pick
up ASL from other Deaf adults and children. These are
children lacking a natural language from birth. The
developmental effects of this situation could contribute to
the findings of this study.

Variations in communication can also impact the
cultural transmission of ideas. If communication is
hampered between adults and children the story of the body
cannot be passed on. This may especially be true of the
inside of the body and how it works, as these parts cannot
be seen. Knowledge about the body is partially experiential
(i.e., the pounding of the heart, the swallowing of food,
the act of a bowel movement), but how these experiences are
linked together is a cultural story requiring a language for
transmission. While some of these children have Deaf
parents, allowing this kind of story telling, many do not.

My second hypothesis compared the projective drawing

 

 

 

50
exercise to a descriptive exercise maximizing communication
through the use of ASL by a Deaf adult. Improving
communication resulted in a much more comprehensive picture
of the children’s knowledge. Argueably, the use of a
descriptive method may result in an increase in displayed
knowledge whether or not the child is Deaf. While this may
be true in part, I would argue that for the Deaf child the
switch to a descriptive methodology involves a switch in the
cultural milieu. The addition of ASL to the testing
situation will increase comfort in a way that adding English
to the testing situation for hearing children does not.

The addition of a descriptive portion to the research
project allowed further exploration into the children's
ideas about body function and the movement of food through
the body. In the section of the interview concerning the
function of the heart, the answers the children provided do
not fall in any expected order when compared to the
framework proposed by Crider. There are several possible
explanations for this result. One explanation is that the
absence of a pattern is due to the small sample size and
given a much larger sample a pattern would emerge. Another
possible explanation involves examining the origins of the
explanation’s on Crider’s list. The last six explanations
are clearly more "scientific" explanations of the function
of the heart. Knowing I was a medical student and the

interviewer was in a health related position, it is possible

 

 

51
the children geared their answers more scientifically in
response to what they thought we wanted to hear.

Examining some of the less scientific descriptions on
Crider’s list provides another possible explanation. The
idea of the heart as being the center of love is readily
apparent throughout our culture. Phrases such as "she stole
my heart", "she broke my heart", and "I love you with all my
heart" are common and found in writings, songs, and the
multiple forms of the media. Ideas of the heart in relation
to the superego are expressed in terms such as "she has a
good heart" and "she has evil in her heart". These ideas
compose part of the culture the majority of U.S. hearing
children grow up within. It is possible that Deaf children
are exposed to a different cultural environment than hearing
children, and so these ideas are not as prevalent among Deaf
children.

It is particularly striking that none of the children
associated the heart with functions related to emotional
processes. There are a number of ASL signs describing
emotions that occur in the same area as the heart (i.e.
CARE, SWEETHEARTS, GRIEF), so the idea of the heart as being
related to emotions should not be completely foreign. Not
knowing how strong the association is used around and
amongst the children in this study makes it impossible to
assess for certain the cultural explanation for the absence

of this response. This section does challenge the simple

 

52
idea that Deaf children proceed through concepts in an
identical manner, but at a slower pace than hearing
children. That idea does not take into account possible
cultural differences contributing to different outcomes.

There is no previous research with hearing children
concerning the movement of food with which to compare the
children's explanations in the third section of the
interview. In this study increasingly complex explanations
of the movement of food occurred with increasing age.
Possible explanations for this change with age include:
cognitive development, linguistic development, and increased
exposure to cultural stories. These three factors are
interlinked. Increased cognitive development may allow for
increased linguistic development and visa-versa. Increased
linguistic development may also allow for increased cultural
transmission of information. In addition, cultural exposure
to new ideas may further stimulate cognitive and linguistic
development.

Comparing the interviews concerning the movement of
food to the drawings the children had completed of the GI
system led to the further exploration of the concept of
integration. Only one of the children interviewed showed
some integration in their drawing. All of the children
showed some level of integration of the gastrointestinal
system during the interview, at least drawing a path from

the mouth to the abdomen. Analyses of the drawings and the

 

 

53
interviews would result in markedly different estimations of
the children's levels of conceptualization of the
gastrointestinal system, reinforcing the importance of the
descriptive method.

The discrepancy between the drawings and the interviews
may represent an inability to convey the concept of GI
integration due to the lack of artistic ability. Language
may provide a better conduit for intricate explanations,
whether or not the child is hearing or Deaf. My expectation
that the children would express the same level of
integration on paper as they expressed in the interviews may
in part be influenced by my biases as a hearing person
viewing ASL. As a hearing person I believe there is a
tendency to see the depiction of concepts in ASL as drawings
in the air, or in the case of these descriptions, drawings
on the body. I view the visual language as equivalent to a
visual linear picture. This may not be the experience of a

Deaf child using ASL to communicate difficult concepts.

Conclusions

Whenever research is undertaken with Deaf children the
usual problems with research involving human subjects can be
expected. Differences among samples can be expected based
on socioeconomic status, gender, age, level of parental
education, and a multitude of other factors. In addition,

differences in cultural and linguistic backgrounds will have

 

 

54
a profound impact on results. In this research I tried to
utilize information concerning the cultural and linguistic
background in constructing the methodology, conducting the
research, and analyzing the results. In actuality, I failed
to incorporate much of this information into the analysis of
my results. To construct the cultural and linguistic
background of each child was beyond the scope of the
project. If this information was obtained, analyzing on the
basis of it would have resulted in very small sample sizes.
This is a difficulty faced repeatedly in research concerning
individuals with a hearing loss. Can a homogenous sample be
gathered, and if it can will it be large enough to draw
conclusions from?

The passing on of information from one generation to
the next involves a sort of cultural story telling. This
cultural story telling occurs in homes and in schools. It
happens throughout every day in every child’s life. Passing
on difficult parts of a cultural story requires a complex,
comprehensive communication system.

Total communication, the system used in most
curriculums for deaf children, is in reality much less
comprehensive than its name implies. The possibility of
children with a hearing loss learning English as a
comprehensive, complex, first language is greatly reduced by
the fact that they will not auditorially absorb what the

hearing child does. Currently, the chances are slight that

 

 

55
ASL will be available as a first language for the majority
of deaf children.

Making ASL available as a first language would
involve training both hearing parents and those educators
who are hearing in bilingualism. This task is formidable in
and of itself. Before approaching this task hearing parents
and teachers would need to accept the idea of communicating
with their children by foregoing a central and integral
tenant of their own culture, their language. As ASL
continues to gain acceptance as a language, and advocates
for its use continue to grow, the task is approached. Until
cultural and linguistic factors are taken into fuller
account we can expect cultural story telling to be difficult

between hearing adults and deaf children.

APPENDICES

56

APPENDIX A

FIGURE PROVIDED FOR DRAWING TEST

 

 

 

 

 

 

57

APPENDIX B

INTERVIEW FORMAT

Part I

Suppose you opened up your body, what would you find
inside?

After initial response proceed to question about
specific areas.

Suppose you opened your head (your neck, your chest,
your belly, your leg, your arm), what would you find inside?

Part II
Go over the parts the child names and ask functions.
Example: What does your heart do?

Part III
What happens to the food we eat?
What happens to the air we breathe?

Part IV

All kids get sick once in a while. How do kids know
when they are sick?

How do kids get sick?

How can children keep from getting sick?

Sometimes children get stomachaches when they are sick.
How do kids get stomachaches?

Sometimes when children get sick they get little bumps
or spots on their skin that itch. How do kids get those
bumps or spots?

Sometimes when children sick they have to stay in a
hospital. What would be wrong with them that would make
them have to stay in a hospital?

When children are sick, how can they get better again?

Sometimes when children get sick they have to take
medicine. How does medicine work?

Part V

Attempt to elicit a conversation about the body based
on a more personal experience.

Have you ever been sick?

Have you ever had an operation?

Has anyone in your family ben sick or had an operation?
If the child answers yes, ask the child to describe what
happened.

 

BIBLIOGRAPHY

 

Biblio ra h

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Benderly, Beryl Lieff. 1980. Dancing Without Music.
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Best, Barbara and Gail Roberts. 1975. "Cognitive
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Cokely, Dennis. 1983. "When is a Pidgin Not a Pidgin?
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Johnson, Lidell and Carol Erting. 1989. "Unlocking the
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Meadow, Kathryn. 1980. Deafness and Child Development.
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Nash Jeffrey and Anedith Nash. 1981. Deafness in
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