The Silent Ones: Indians and Hearing Loss
From the earliest documented times in American history, there were reports of deafness among indigenous people. In 1618, the Jesuits in America wrote to church officials inquiring whether a “deaf-mute Indian” could be admitted to the church. In seeking clarification of the church’s stance on the ability of a deaf person to learn and to demonstrate acceptance of the word of God, the pioneer Jesuits must have believed there was such potential. Two decades later, Roger Williams, a church leader and founder of the colony of Rhode Island, noted that among the Wampanoag Native children, “some are born deaf and so dumb;” and deaf Native American, Black Coyote, was one of the first, if not the first, victims at Wounded Knee.
Otitis media (inflammation of the middle ear) is the leading cause of middle-ear disease in American Indian populations; with the majority of cases occurring in young children. Episodes of middle-ear disease are often accompanied by periods of mild-to-moderate conductive hearing loss. Recent studies indicate that the auditory and educational consequences of episodes of otitis media extend far beyond its diagnosis. Numerous perceptual, speech, language, spelling, grammar, cognitive, behavioral, emotional and poor educational performance has been identified. At the age of 6, I had suffered the consequences of otitis media leaving me with unilateral hearing loss that caused me to withdraw from many school social activities.
Otitis media, is characterized by an accumulation of fluids in place of the air which normally occupies the middle ear (behind the ear drum), and/or negative pressure in the middle ear resulting from poor middle ear ventilation. Yet, its actual cause, and thus prevention, is not known. However, viral infections, upper respiratory diseases, allergy, lack of health care and eustachian tube dysfunction may play a part in the problem. Methods of treatment, including decongestants, antihistamines, antibiotics, allergy treatment and surgery focus on the relief of secondary symptoms, but by no means a cure.
While many children experience occasional episodes of acute otitis media, studies have identified certain groups of children that are at high risk for chronic middle ear disease. The estimated incidence of middle ear disease in the general childhood population is around five percent, but for poor children, the incidence rate has been found to be closer to 20 or 25 percent.
American Indian children have even more middle ear disease than can be explained by their relatively low socioeconomic status. In a paper, Survey of Disorders of Speech and Hearing and Ear, Nose and Throat Pathology among Children of the South Dakota Indian Population (1996), revealed a failure rate of 27 percent. In studying a cohort of 378 Alaskan Eskimo children, The American Journal of Public Health, Otitis Media and Hearing Deficiency among Eskimo Children: A Cohort Study, found two-thirds of the children had otorrhea (draining ears) one or more times. By four years of age, thirty-one percent had a unilateral hearing loss of at least 25dB. Sixty-five percent of the children with otorrhea had the first episode by their first birthday; 89 by their second. In a 1973 study, Long Term Effects of Otitis Media: A Ten-Year Cohort Study of Alaska Eskimo, of 489 Alaskan Eskimo children, found that seventy-six percent had an ear infection during their first two years.
The Indian Health Service reported that: “For the calendar year 1975, there were more than 56,000 reported new cases of otitis media among American Indians . . . 65% occurred in children under five years of age.”
In a 1978 pilot study at an inner city public school complex in Minneapolis, children from kindergarten through third grade were randomly selected for screening by a certified audiologist with an impedance audiometer. Results indicated that about twenty percent of the non-Indian children and nearly 50 percent of the American Indian children had evidence of otitis media.
The Journal of American Indian Education (1990) Effects of Recurrent Otitis Media on Language, Speech, and Educational Achievement in Menominee Indian Children, states Head Start programs continue to report that language and speech impairment is the leading category of disability, with otitis media suspected as a contributing factor (Harris, 1986). Moreover, within school-age children, the Bureau of Indian Affairs estimates that of the children who received special educational services within BIA schools during 1983-84, twenty-four percent were classified as language-speech impaired and fifty-three percent as learning disabled. Head Start programs, schools and most importantly, educators of Indian children need to be made aware that although social-economic and cultural factors may influence educational progress, early recurrent otitis media may place a child at additional risk for normal acquisition of communicative competence, and possibly leaving them to live in a world gone silent.
Julianne Jennings, E. Pequot-Nottoway, is a Ph.D. student at Arizona State University.