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B ILL G R A HAM AND MAR Y MAR GAR E T SHARP-PUCCI eaf or hearing-which?" This is a question often posed to the latedeafened individual. The answer is an enigmatic one. Physically, the deafened individual is deaf; the hearing mechanism is nonfunctional for the purposes of conversational speech, with or without hearing aids or other amplification. Culturally, this same individual is hearing; his or her language, thoughts, memories, and dreams are born of a distinctly hearing world. How one harmonizes the dissonance of these two identities is the challenge of the late-deafened adult. The Late-Deafened Population Definition A variety of definitions are used to refer to individuals who have experienced a loss of hearing at a time other than at birth. "Adventitious deafness" is a generic term; it simply means the hearing loss has taken place some time after birth. It makes no distinction between hearing loss occurring at the age of twenty-four months or the age of twenty-four years. The term "deafened" has a more specific meaning. A deafened individual is one "who at one time possessed enough hearing to learn language and oral communication through hearing, but who now suffers with a loss of hearing so severe that audition is useless for purposes of receiving oral communication" (Luey and Per-Lee, 1983). More recently, the term "late-onset deafness" has come into being. It describes a deafness that occurs in the adult years that causes fundamental changes in the way the person lives (Association of Late Deafened Adults, 1987a). The loss may have been sudden or may have happened gradually over a period of years. Prevalence Exactly how large is this late-deafened population? This question cannot be answered easily. The only comprehensive study of the deaf population in the United States took place in 1974 (Schein and Delk, 1974). The data that resulted, now fifteen years old, are The Special Challenge of Late-Deafened Adults no longer precisely accurate, but they do provide interesting insight into the make-up of the deaf population. If you question the general population about their image of a deaf person, they will typically describe a person who has been deaf since birth. The truth, however, is that congenitally deaf people account for only a small percentage of the overall deaf population . According to Schein and Delk (1974), 13.4 million people in the United States have a hearing loss ranging from mild to profound. Only 1.8 million of these individuals are deaf, and only 0.4 million became deaf before the age of nineteen years. This results in a staggering percentage of the deaf population falling under the category of late-deafened-approximately 78 percent, or 1.4 million people (Schein and Delk, 1974). What has caused this significant number of people to become deaf in their adult years? Perhaps most prevalent is neurofibromatosis, a condition of tumor growth. Traumatic injury to the head contributes to the numbers, as do infectious diseases such as meningitis. Adverse drug reactions have caused their share of deafness, and aging of the hearing mechanism (presbycusis) is an important factor as well. The causes of lateonset deafness and its complications are many and varied, contributing significantly to the diversity of this population. The Lale-Deafened Challenge The special challenges facing the late-deafened individual are many. Perhaps the most striking of these is the synthesis of two global identities: audiologically deaf and culturally hearing. The late-deafened individual has an established and distinct identification with the world. His marital, familial, societal, and vocational identities are by now securely rooted in spoken language and hearing mores, traditions, and opportunities. With the onset of deafness, spoken language no longer carries the power or place it once did, and opportunities connected with the ability to hear often cease to exist. Former identities begin to dissolve, and it is quickly realized that loss of hearing is a powerful loss of self. Developing a healthy new self is dependent in part on how well the deafened individual meets the new challenges before him. The Challenge of Communication The late-deafened individual has grown up in a world of free-flowing communication. In the past, communication just happened; it was not a goal for which one strived. Now, successful communication has become a system of carefully planned strategies. Communicative strategies are individual in the sense that anyone person may use a number of different techniques. A gathering of late-deafened individuals may reveal...

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