Sensory Disabilities and Disorders

Immanuel Kant’s theory of imagination is a surprisingly fruitful nexus of explanation for the prima facie disparate characteristics of autism spectrum disorder (ASD), especially the sub-spectrum best characterized by the Sensory Integration (SI) and Intense World (IW) theories of ASD. According to the psychological theories that underpin these approaches to autism, upstream effects of sensory processing atypicalities explain a cascade of downstream effects that have been characterized in the diagnostic triad, e.g., poor sensory integration contributes to weak central coherence, which (...) in turn contributes to difficulty participating in a back and forth conversation. To see why Kant’s theory of imagination might be useful, consider that ASD is neither a sensory disorder nor an intellectual disorder per se. Cognitive dysfunction is a common comorbidity of ASD, not a characteristic of it. If we exclude sense and intellect, what’s left? According to Kant, imagination is a synthesizing faculty that mediates between sense and understanding. It does so by transforming intuition from the canonic and vital senses. The uses of imagination include our spatially formative, temporally associative, and communicatively affinitive production, where affinitive production includes sympathy and fantasy. Imagination is thus the faculty of sensory integration, embodied subjectivity, empathy, mindreading, and social cooperation. The wide range of how autism presents and how it is experienced can thus be understood in terms of the atypical development of specific functions of imagination. Kant’s theory of imagination provides a new perspective on how to organize our understanding of autism at the psychological level, one that makes sense of how some of the disparate characteristic phenomena of autism are systematically related and which might lead to novel predictions, research targets, or intervention recommendations. (shrink)

New-born screening programs for congenital disorders and chronic disease are expanding worldwide and children “at risk” are identified by nationwide tracking systems at the earliest possible stage. These practices are never neutral and raise important social and ethical questions. An emergent concern is that a reflexive professionalism should interrogate the ever earlier interference in children’s lives. The Flemish community of Belgium was among the first to generalize the screening for hearing loss in young children and is an interesting case to (...) study the public justification of early interventions for families with deaf children. This article uses a critical lens to study the archive of the government child healthcare organization in Flanders in order to uncover underlying constructions of childhood, deafness, and preventive health. We focus on two interrelated themes. The first is the notion of exclusion of the human factor through the mediation of technology. The second is the idea of deafness as endangering a healthy development, an impairment that can nevertheless be treated if detected early enough. It is argued that, since deafness cannot be viewed as a life-threatening condition, the public interest which is implicitly defended is not the rescue of deaf children rather the exclusion of otherness. (shrink)

The development of visual attention in deaf children in relation to mother's hearing status Patterns of visual attention during free-play in deaf children with deaf and hearing mothers were compared at 9, 12 and 18 months. Dd children were more likely to look at their mother's face spontaneously than Dh children at all ages although spontaneous looking increased significantly at 18 months for both groups. The proportion of responsive looks declined at 12 months for the Dd group but not until (...) 18 months for the Dh group. Elicited looking was more common in the Dd group and, at 12 months, a greater proportion of these looks were to the mother's face. Overall the results suggest that Dd children show greater sensitivity to the communicative significance of their mother's face in the second year of life. (shrink)

This essay examines constructions of deafness in medieval culture, exploring how deaf experience disrupts authoritative discourses in three textual genres: medical treatise, literary fiction, and autobiographical writing. Medical manuals often present deafness as a physical defect, yet they also suggest how social conditions for deaf people can be transformed in lieu of treatment protocols. Fictional narratives tend to associate deafness with sin or social stigma, but they can also imagine deaf experience with a remarkable degree of sympathy and nuance. Autobiographical (...) writing by deaf authors most vividly challenges diagnostic models of disability, exploring generative forms of perception that deafness can foster. In tracing the disruptive force that deaf experience exerts on perceived notions of textual authority, this essay reveals how medieval culture critiqued the diagnostic power of medical practitioners. Deafness does not simply function as a symptom of an individual problem or a metaphor for a spiritual or social condition; rather, deafness is a transformative capacity affording new modes of knowing self and other. (shrink)

We argue for the existence of a state constitutional legal right to language. Our purpose here is to develop a legal framework for protecting the civil rights of the deaf child, with the ultimate goal of calling for legislation that requires all levels of government to fund programs for deaf children and their families to learn a fully accessible language: a sign language. While our discussion regards the United States, the argument we make is based on human rights and the (...) nature of law itself, and can likely be adapted to any country.We begin with an introduction to the biological facts surrounding language acquisition and how these facts impact the deaf child, where lack of language has devastating effects on individuals and negative effects on society in general. (shrink)

The relationship of language to cognition, especially in development, is an issue that has occupied philosophers, psychologists, and linguists for centuries. In recent years, the scientific study of sign languages and deaf individuals has greatly enhanced our understanding of deafness, language, and cognition. This Counterpoints volume considers the extent to which the use of sign language might affect the course and character of cognitive development, and presents a variety of viewpoints in this debate. This volume brings the language-thought discussion into (...) a clearer focus, both theoretically and practically, by placing it in the context of children growing up deaf and the influences of having sign language as their primary form of communication. The discussion is also sharpened by having internationally recognized contributors, such as Patricia Siple, Diane Lillo-Martin, and Ruth Campbell, with specialties in varied areas, all converging on a common interest in which each has conducted empirical research. These contributors clarify and challenge the theoretical assumptions that have driven arguments in the language-thought debate for centuries. An introduction by the editors provides a historical overview of the issues as well as a review of empirical findings that have been offered in response to questions about language-thought relations in deaf children. The final chapters are structured in the form of "live" debate, in which each contributor is given the opportunity to respond to the other perspectives presented in this volume. (shrink)

In this paper we wish to bring together two seemingly independent areas of research: synaesthesia and sensory substitution. Synaesthesia refers to a rare condition where a sensory stimulus elicits not only the sensation that stimulus evokes in its own modality, but an additional one; a synaesthete may thus hear the word “Monday”, and, in addition to hearing it, have a concurrent visual experience of a red color. Sensory substitution, in contrast, attempts to substitute a sensory modality that a person has (...) lost by transforming the information it provided so that it can be accessed through another, intact sensory modality. To make visual information accessible to a blind person, for example, data taken by a camera would be transformed into tactile or auditory information. What do synaesthesia and sensory substitution have in common? Research in both of these areas contributes to our understanding both of cross-modal cooperation and of sensory sensations or qualia, asking under what circumstances these can arise in a modality that is not stimulated. Synaesthesia reveals that this “sensory cross-activation” is possible, and sensory substitution research hopes to induce it. In this article, we will review briefly the literature on synaesthesia, and discuss the issue of qualia for this domain of research. We will then address the evidence for synaesthesia and visual qualia in the blind, and the research on sensory substitution, to finally ask whether sensory substitution may induce a ‘synthetic’ form of synaesthesia by taking advantage of the nervous system’s capacity for generating visual images in the absence of retinal input. (shrink)

Recent contributions to discussions on paediatric cochlear implantation in Norway indicate two mutually exclusive doctrines prescribing the best course of post-operative support for a child with cochlear implants; bilingually with sign language and spoken language simultaneously or primarily monolingually with speech only. This conflict constitutes an ethical problem for parents responsible for choosing between one of the two alternatives. This article puts forth the precautionary principle as a possible solution to this problem. Although scientific uncertainty exists in the case of (...) both doctrines, there exists a scenario of possible irreversible harm to some of the children habilitated monolingually. An application of the precautionary principle may hence suggest that it is rational to agree on the bilingual approach, at least for the time-being. (shrink)

After 50 years of being profoundly deaf, Patricia finds her world ‘transformed’—literally and metaphorically—when she receives a cochlear implant. Her sense of self and the taken-for-granted, comfortable world she knew before surgery disappear and she is thrown into an alien, surreal existence full of hyper-noise. Entry into this new world of sounds proves a mixed blessing as Pat struggles to come to terms with her changing relationships, not only with others but also with herself. On good days, she is exhilarated (...) by all her sensory gains and her feeling of being more connected with and to the world. On bad days she is distracted and overwhelmed by the intrusive noise and she is forcibly confronted with the painful reality of her own disability. The challenge she confronts is not simply the cognitive-perceptual one of learning to discriminate between sounds. Pat must also re-orientate herself and learn to cope with her transformed self and world. She must undertake a journey to come to terms with her past, present and future being. Pat shared her story with me and together we undertook collaborative existential phenomenological research, co-creating a narrative of her journey over the year and a half following her implant. This paper presents this narrative followed by an existential analysis of Pat’s disrupted, changing lifeworld. (shrink)

It has been argued by some authors that our reaction to deaf parents who choose deafness for their children ought to be compassion, not condemnation. Although I agree with the reasoning proposed I suggest that this practice could be regarded as unethical. In this article, I shall use the term “dysgenic” as a culturally imposed genetic selection not to achieve any improvement of the human person but to select genetic traits that are commonly accepted as a disabling condition by the (...) majority of the social matrix; in short as a handicap. As in eugenics, dysgenics can be achieved in a positive and a negative way. Positive dysgenics intends to increase the overall number of people with a particular genetic trait. Marriage between deaf people or conceiving deaf children through reproductive technology are examples of positive dysgenics. Negative dysgenics can be obtained through careful prenatal or pre-implantation selection and abortion (or discarding) of normal embryos and foetuses. Only deaf children would be allowed to live. If dysgenics is seen as a programmed genetic intervention that undesirably shapes the human condition – like deliberately creating deaf or dwarf people – the professionals involved in reproductive technologies should answer the question if this should be an accepted ethical practice because the basic human right to an open future is violated. (shrink)

Focusing on the largest and, arguably, the least visible disability group, the hearing impaired, this paper explores present-day views and understandings of hearing impairment and rehabilitation in a Danish context, with particular focus on working-age adults with late onset of hearing impairment. The paper shows how recent changes in perception of the hearing impaired patient relate to the introduction of a new health care reform that turns audiological rehabilitation into a consumer issue. Ethnographic and interview data from hearing clinics provides (...) evidence that the hearing technologies that are on offer stabilise in specific forms through processes of negotiation among a variety of social actors representing the interests of science, industry, government, and hearing-impaired people. The discussion critically considers the emergence of an “informed consumer” in audiological practices. (shrink)

The use of cochlear implants, especially for prelingually deafened children, has aroused heated debate. Members and proponents of Deaf culture vigorously oppose implants both as a seriously invasive treatment of dubious efficacy and as a threat to Deaf culture. Some find these arguments persuasive; others do not. And in this context arise questions about the extent to which individuals with disabilities may decline treatments to ameliorate disabling conditions. When they do so, to what extent may they call upon society to (...) provide supportive services and accommodations? (shrink)

Around 96 percent of children with hearing loss are born to parents with intact hearing, who may initially know little about deafness or sign language. Therefore, such parents will need information and support in making decisions about the medical, linguistic, and educational management of their child. Some of these decisions are time-sensitive and irreversible and come at a moment of emotional turmoil and vulnerability (when some parents grieve the loss of a normally hearing child). Clinical research indicates that a deaf (...) child’s poor communication skills can be made worse by increased level of parental depression. Given this, the importance of reliable and up-to-date support for parents’ decisions is critical to the overall well-being of their child. In raising and educating a child, parents are often offered an exclusive choice between an oral environment (including assistive technology, speech reading, and voicing) and a signing environment. A heated controversy surrounds this choice, and has since at least the late 19th century, beginning with the International Congress on the Education of the Deaf in Milan, held in 1880. While families seek advice from many sources, including, increasingly, the internet, the primary care physician (PCP) is the professional medical figure the family interacts with repeatedly.The present article aims to help family advisors, particularly the PCP and other medical advisors in this regard. We argue that deaf children need to be exposed regularly and frequently to good language models in both visual and auditory modalities from the time hearing loss is detected and continued throughout their education to ensure proper cognitive, psychological, and educational development. Since there is, unfortunately, a dearth of empirical studies on many of the issues families must confront, professional opinions, backed by what studies do exist, are the only option. We here give our strongly held professional opinions and stress the need for improved research studies in these areas. (shrink)

This text presents an overview of the bioethical debate on pediatric cochlear implants and pays particular attention to the analysis of the Deaf critique of implantation. It dismisses the idea that Deaf concerns are primarily about the upholding of Deaf culture and sign language. Instead it is argued that Deaf skepticism about child rehabilitation after cochlear surgery is well founded. Many Deaf people have lived experiences as subjects undergoing rehabilitation. It is not the cochlear technology in itself they view as (...) problematic, but rather the subsequent rehabilitation process. Because they themselves have experienced what they describe as harmful effects which relate above all to the idea of normalization, they have articulated worries for the new generations of deaf children in need of rehabilitation following cochlear implant surgery. These insights have attracted little attention, but could represent relevant ethical questions of which both practitioners and researchers in the field of implantation might be aware. (shrink)

Almeder begins by distinguishing between two senses of "knows." What he calls "weak knowledge," although nominally defined in the classical way as justified true belief, does not require truth in the correspondence sense. This follows from the fact that weak knowledge of a proposition p does not require evidence that entails p, yet weak knowledge of p requires evidence that entails the truth of p. Further, Almeder argues that any interesting definition of knowledge or truth must allow us to determine (...) which things have these properties, and that a correspondence sense of truth would not allow such determination. (shrink)

Often hearing parents and adults belonging to the Deaf community have very different and opposite views regarding central themes in treatment and education of deaf children: cochlear implantation versus rejection of medicalization of deafness, oral communication versus Sign Language, and mainstreaming in regular schools versus education in deaf schools as the most natural learning environment for deaf children. The striking divergence of hearing and deaf people’s ethical judgments is a consequence of deafness and having normal hearing being “world-generating states,” conditions (...) that not only lead to a different understanding and perception of the world, but also to different courses of life that make the worlds of hearing and deaf people also really different.The views of hearing and deaf people stem from different worlds and different cosmologies, within which they have their own validity. The conflict between these two views is not resolved by arbitration or the choice for a middle course, but by negotiation. The basis for this negotiation may be an ethical analysis based on a Christian personalism that tries to combine full respect for the diversity of the negotiating partners with the effort of bringing their widely divergent worlds in communication with each other. (shrink)

The question is broadened from isomorphism to invertible transformation and optimal representation. Motivations are drawn from image compression but with an emphasis on object segmentation. Filling-in is considered as the phenomenal side of the binding process with back-surface filling-in being important. Finally, re-normalization of local filtering by globally integrated context is emphasized.

Based on neuropsychological evidence of nonverbal impairment accompanying aphasia, I propose that the neural prerequisites for language acquisition are shared with a range of nonverbal capacities. Their commonality concerns the ability to recognize a limited number of finite elements in manifold perceptual entities and to combine them for constructing manifold entities.

It’s 2019. Computers can drive cars, operate stores, and outperform humans in sophisticated games. However, computers cannot correctly read a PDF with footnotes. Alas, many people have to rely on their computers to read PDF papers. So, many people face significant obstacles while trying to consume written research. That seems bad. Insofar as we can prevent this bad outcome without making matters worse, we should.

Molyneux asked whether a newly sighted person could distinguish a sphere from a cube by sight alone, given that she was antecedently able to do so by touch. This, we contend, is a question about general ideas. To answer it, we must ask (a) whether spatial locations identified by touch can be identified also by sight, and (b) whether the integration of spatial locations into an idea of shape persists through changes of modality. Posed this way, Molyneux’s Question goes substantially (...) beyond question (a), about spatial locations, alone; for a positive answer to (a) leaves open whether a perceiver might cross-identify locations, but not be able to identify the shapes that collections of locations comprise. We further emphasize that MQ targets general ideas so as to distinguish it from corresponding questions about experiences of shape and about the property of tangible (vs. visual) shape. After proposing a generalized formulation of MQ, we extend earlier work (“Many Molyneux Questions,” Australasian Journal of Philosophy 2020) by showing that MQ does not admit a single answer across the board. Some integrative data-processes transfer across modalities; others do not. Seeing where and how such transfer succeeds and fails in individual cases has much to offer to our understanding of perception and its modalities. (shrink)