After early identification--what follows? A study of some aspects of deaf education from an otolaryngological viewpoint.

Otolaryngologists have accepted their role in the early diagnosis of the deaf and hard of hearing child: however, the social implications and habilitative programs embarked upon may often be regarded as unrelated to the practice of otolaryngology. The otolaryngologist is a key member of the team responsible for early detection and diagnosis, and he must become as involved with the available educational programs as are the other highly qualified competent individuals bringing expertise to the problem. The reason for emphasizing this area is that the otolaryngologist has witnessed a number of a major expansions in knowledge which have occurred in the past 15 years. These include: 1. Early identification of deafness through screening programs. 2. Early diagnosis through peripheral and brain stem evoked response audiometry. 3. Improvement in amplification in hearing aids. 4. Earlier placement in educational programs, many of which have been the center of controversy, particularly in the past 15 years. 5. Emphasis on continued research and development of programs such as the Cochlear Implant. A historical review of deaf education is presented together with an evaluation of the various claims made by the supporters of the auditory-oral vs. total communication techniques. No totally convincing argument for either system can be advanced. There is considerable doubt that the tri-stimulus, or total communication approach to teaching of the deaf, has any superiority over the auditory-oral approach. There are failures with both philosophies and the "deaf voice" is a stigma often associated with either system's graduates. A 13-year follow-up case study is presented in which the child was enrolled in an auditory-oral program. Comments are made as the child was followed through home training to preschool and on to complete integration in the regular school system. The implications of such a study for the Otolaryngologist, particularly with regard to early identification in order to avoid linguistic delay, are outlined.