BILL ANALYSIS
AB 2072
Page 1
Date of Hearing: April 20, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 2072 (Mendoza) - As Amended: April 13, 2010
SUBJECT : Hearing Screening: resources and services.
SUMMARY : Requires parents of all newborns and infants diagnosed
with a hearing loss to be provided specified information on
communication options for children with hearing loss.
Specifically, this bill :
1)Requires parents of all newborns and infants diagnosed with a
hearing loss to be provided written or electronic information
on American Sign Language (ASL), Total Communication, Cued
Speech, and Listening and Spoken Language communication
options for children with hearing loss, including, but not
limited to, information about deaf and hard of hearing
organizations, agencies and early intervention centers, and
educational programs.
2)Requires that the information noted in 1) above be provided:
a) By an audiologist or other related professional at a
follow-up appointment after diagnosis with a hearing loss;
and,
b) By the Early Start Program, upon initial contact with
the parents of a newborn or infant newly diagnosed with a
hearing loss.
3)Requires that neither the state nor an Early Start Program
provider will incur costs for the implementation of the above
provisions.
EXISTING LAW :
1)Establishes the Newborn and Infant Hearing Screening,
Tracking, and Intervention Act which requires every general
acute care hospital with licensed perinatal services to offer
every newborn a hearing screening test for the identification
of hearing loss, as specified, and provide written information
on the availability of community resources and services for
children with hearing loss to the parents of those who are
diagnosed with a hearing loss.
AB 2072
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2)Establishes the California Early Start Intervention Services
Act, commonly known as the Early Start program, provides
various early intervention services for infants and toddlers
who have disabilities to enhance their development and to
minimize the potential for developmental delays.
FISCAL EFFECT : This bill has not yet been heard by a fiscal
Committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, with new
developments in Cochlear Implants, more profoundly deaf
children are able to hear and speak and can be completely
assimilated into society. The author maintains that the
maximum time for oral language development is in the first
five years of life. By the time children reach age five, the
author argues, the ability to learn oral language decreases
annually. The author asserts that oral language is one
hearing option for the profoundly deaf and hard of hearing,
but others include ASL, Cued Speech, and Total Communication.
According to the author, a major concern in California is that
many parents of infants who are diagnosed with hearing loss
are not provided with information on all communication options
and are most often unfamiliar with the resources and options
that are available to them. The author maintains that this
bill will help ensure that parents understand the rights and
resources that they have available for their children.
2)BACKGROUND . The California Newborn Hearing Screening program,
administered by the California Department of Health Care
Services (DHCS), is a comprehensive coordinated system of
early identification, intervention, and support services for
infants with hearing loss and their families. The goal of the
program is to identify infants with a hearing loss prior to
three months of age and to link infants with early
intervention services by six months. According to DHCS,
infants begin developing speech and language from the moment
they are born. Studies show that hearing loss occurs in
approximately two to four out of 1000 babies. DHCS states
that, prior to the Newborn Hearing Screening program,
unfortunately, hearing loss was often not identified until 18
months to three years. If an infant has hearing loss in one
or both ears, early identification is crucial to preventing
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delayed speech and language development.
In California, infants who do not pass the initial hearing
screening in the hospital are referred for a rescreening which
could be performed before one month of age. Infants who do
not pass the rescreening are referred for a diagnostic hearing
evaluation. Upon identification of hearing loss, infants and
their families are referred to the local Early Start Program,
a multi-agency effort by the Department of Developmental
Services and the California Department of Education for access
to early intervention and related services. Currently parents
are provided a packet of information which includes:
"Communicating with Your Child" which provides information
about local, state and national resources and the DHCS Web
site provides links to local, state, and national resources.
3)COMMUNICATION OPTIONS.
a) ASL . According to the National Association of the Deaf
(NAD), ASL is a visual language in which the brain
processes linguistic information through the eyes. The
shape, placement, and movement of the hands, as well as
facial expressions and body movements, all play important
parts in conveying information. Sign language is not a
universal language, each country has its own sign language,
and regions have dialects, much like the many languages
spoken all over the world. Like any spoken language, ASL
is a language with its own unique rules of grammar and
syntax and grows and changes over time. ASL is used
predominantly in the United States and in many parts of
Canada. ASL is accepted by many high schools, colleges, and
universities in fulfillment of modern and "foreign"
language academic degree requirements across the United
States.
According to a January 2008 policy statement of NAD, deaf
infants and children should be given the opportunity to
acquire and develop proficiency in ASL as early as
possible. NAD takes the position that as a fully accessible
visual language, ASL should be made available to every deaf
infant, in addition to any assistive technologies that may
be used to take advantage of the deaf infant's access to
the language(s) used by their families and care providers.
b) Total Communication . According the Clearinghouse on
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Disabilities and Gifted Education, Total Communication is
an approach to deaf education that aims to make use of a
number of models of communication such as sign language,
oral, auditory, written and visual aids, depending on the
particular needs and abilities of the child. Total
Communication is a philosophy rather than a methodology.
As a result, the implementation of Total Communication
philosophy with one child could look entirely different
than its implementation with another child.
c) Cued Speech . According to the National Cued Speech
Association (NCSA), Cued Speech is s system of
communication used with and among deaf or hard of hearing
people. NCSA maintains that it is a phonetic-based system
which makes traditionally spoken languages accessible by
using a small number of handshapes (representing
consonants) in different locations near the mouth
(representing vowels), as a supplement to lipreading.
d) Listening and Spoken Language . According to the
Alexander Graham Bell Association for the Deaf and Hard of
Hearing (AG Bell), cochlear implants were developed in the
1970s to help profoundly deaf individuals who gained little
or no benefit from hearing aids. When hearing is
functioning normally, complicated parts of the inner ear
convert sound waves in the air into electrical impulses,
which are sent to the brain and recognized as sound. A
cochlear implant works in a similar manner. When
surgically implanted behind the ear, the electronic device
is able to bypass damaged hearing cells and stimulate the
auditory nerve to restore partial hearing. Cochlear
implants provide enhanced sound detection and the potential
for greater speech understanding.
According to AG Bell, hearing aids are electronic,
battery-operated devices that amplify sound to improve
listening comprehension. It collects sounds from the
environment via a microphone, amplifies those sounds and
then directs the amplified signal into the user's ear
through a tiny speaker. Hearing aids can be monaural (one
ear) or binaural (two ears). Using hearing aids in both
ears generally provides superior benefit compared to a
monaural hearing aid and is strongly recommended for
children who are learning to listen and talk.
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4)TECHNOLOGY . "Through Deaf Eyes" is a two hour Public
Broadcasting Service (PBS)-produced documentary that explores
200 years of Deaf life in the United States. As part of the
outreach campaign for the documentary, PBS provided
information about how technological changes over the years
have impacted the deaf community. For example, the invention
of the radio offered news, music, and weather warnings, but
not to deaf people. Telephones became a barrier to employment
and access. Technology also changed education and the
physical condition of deafness as hearing aids, FM systems,
and cochlear implants came to be used. Technological
"advancements" were often assessed differently by hearing and
deaf people.
The development of the telecommunications device for the deaf
(TTY/TDD) radically changed the quality of life for deaf and
hard of hearing people in the United States by allowing deaf
and hard of hearing people to communicate by phone. By the
mid 1980s, TTY/TTDs were in widespread use in the homes of
deaf people and in many businesses and government agencies. A
host of other technological advancements, many of which took
advantage of residual hearing, became available to deaf
people. Progressively smaller and lighter weight hearing aids
were developed. The early electronic hearing aids of the
1950s required large, heavy batteries and came with
instructions on how to discretely tuck batteries into
underclothing. Later versions could be stored in a pocket or
clipped to a belt, and eventually behind-the-ear hearing aids
were available.
However, not all technological developments have been
universally accepted by the deaf community. The cochlear
implant inspired both strong support and vehement opposition.
Among deaf people, the implants are generally hailed as a boon
for individuals who lost their hearing later in life, but
their use for deaf children became controversial. The
effectiveness and risks of the implants are a major part of
the debate, but there is an additional conflict between those
who view deafness as a physical impairment and those who see
it as a valued part of cultural identity. As cochlear implant
surgery has become more common in deaf children and have
become more widely used, the emphasis of the debate has
changed. The focus now is on the deaf child's exposure to
visual language and the type of support and educational
services the child receives.
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5)SUPPORT . Supporters of this bill state that more children are
born with permanent hearing loss than any other birth defect.
Supporters maintain that recent advances in technology and
educational practice make it possible for most deaf or hard-of
hearing children to make similar progress to their
typically-hearing peers if diagnosis and treatment happen
early, preferably during the first few months of life.
According to supporters, one of the most important things for
parents of a newly-identified child who is deaf or hard of
hearing is knowing that they will be able to communicate with
their child. Supporters assert that the method of
communication chosen by parents is a very personal decision,
and parents need to know what alternatives are available.
Supporters argue that programs and resources are available in
California to support various options, but many parents of
newly-identified deaf or hard of hearing children do not even
know what options exist. Supporters maintain that this bill
will ensure that all parents of children diagnosed with
hearing loss will be provided information about communication
options and resources which will result in less confusion
about the availability of resources.
6)OPPOSITION . The opposition of this bill states that they
believe that each infant and toddler, including those
identified deaf and hard of hearing, should have every
opportunity to learn language. The opposition argues that the
focus of this bill about "communication options" is misleading
and picking one option over another would only rob the child
of the ability and opportunity for full language acquisition.
According the opposition, Californians who are deaf request
the need for sign language to be respected and support early
intervention services acquiring sign language as well as
English. The opposition also argues that audiologists are not
the appropriate experts to advise parents and families about
language acquisition because audiologists are trained to
measure and "treat" hearing loss by recommending hearing aids
or cochlear implants. The opposition maintains that it is the
right of a deaf infant and toddler to acquire full language
acquisition through visual language so that by the time the
child starts Kindergarten and first grade, the child is ready
to learn, receive an education, ultimately graduate, enter
postsecondary education and enter the world of work as
productive tax-paying citizens.
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7)PREVIOUS LEGISLTION :
a) AB 2555 (Torrico), Chapter 245, Statutes of 2008,
requires the existing notice of parent rights and
procedural safeguards provided to parents or guardians of
pupils with disabilities to include information regarding
the state special schools for pupils who are deaf, hard of
hearing, blind, visually impaired, or deaf-blind.
b) AB 2780 (Gallegos), Chapter 310, Statutes of 1998, the
Health Services Budget Act establishes the Infant Hearing
Screening Program to provide hearing screening tests for
children at risk for deafness and a system to provide
follow-up and assessment services.
c) AB 1836 (Eastin), Chapter 1126, Statutes of 1994,
expands legislative intent and makes other changes related
to special education for hard-of-hearing and deaf pupils.
Specifically, states intent that individuals with
exceptional needs be offered special assistance programs
which take into consideration, for hard-of-hearing or deaf
children, the individual's need for a sufficient number of
age and language mode peers and for special education
teachers who are proficient in the individual pupil's
primary language mode.
8)POLICY CONCERNS .
a) On page two, line 11 the bill indicates that information
will be provided to parents by audiologists and "other
related professionals." The author may wish to clarify who
is being referred to as "other related professionals."
b) The bill indicates that neither the state nor the Early
Start Program provider shall incur any cost for the
implementation of this bill but does not indicate who will
pay for the development and distribution of the proposed
materials to be provided to parents.
c) Without the involvement of a state agency in the
development and distribution of the proposed materials, how
can the state be assured that the information being
provided to parents is comprehensive, evidenced-based,
unbiased, and accurate?
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REGISTERED SUPPORT / OPPOSITION :
Support
California Coalition (sponsors)
American Federation of State, County and Municipal Employees
California Academy of Audiology
California Association of Private Special Education Schools
California Coalition
California Hospital Association
California Speech-Language Hearing Association
Numerous individuals
Opposition
ASL Presents LLC
California Association of the Deaf
California Association of the Deaf, Sacramento Chapter
Center on Deaf Inland Empire Community
Deaf and Hard of Hearing Service Center, Inc.
Deaf Counseling, Advocacy, and Referral Agency
IMPACT
NorCal Services for Deaf and Hard of Hearing
Numerous individuals
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097