Deaf Children Research Articles

РАСПРОСТРАНЕННОСТЬ КАРИЕСА ЗУБОВ И ЗАБОЛЕВАНИЙ ПАРОДОНТА У ДЕТЕЙ С НАРУШЕНИЕМ СЛУХА (ОБЗОР ЛИТЕРАТУРЫ)

Subject. Deafness, hearing loss are one of the most common sensory pathologies in children. It negatively affects the formation of personality and quality of life. Children with hearing and speech impairments require special medical supervision. It is necessary to develop programs to prevent major dental diseases for deaf children. This requires a comprehensive assessment of the dental status, taking into account age, the severity of the main pathology, and socio-psychological factors that contribute to the development of the formation characteristics of the child’s body.
 Purpose. To analyze the prevalence and intensity of dental caries and periodontal diseases in children with hearing impairment according to various literature data.
 Methodology. An analysis of publications was carried out using scientific search library databases: PubMed Central, Google, Medline, eLibrary. The selection of materials was based on using keywords. The search included full-text articles. 36 sources were analyzed.
 Results. Analysis of the prevalence of dental diseases in children with hearing impairment has not been sufficiently published in Russian-language literary sources.
 According to various literature data, there is a high prevalence of caries and periodontal diseases in children with hearing impairment. Some authors compared these indicators with a group of healthy children. Children with hearing and speech impairments have higher rates of prevalence and intensity of caries and periodontal diseases.
 Conclusions. The high prevalence of dental diseases in children with hearing impairment is an additional medical and social problem. For this category of the population, it is of great importance for the development of prevention programs.

Importance of age at 2nd implantation and interimplant interval to the outcome of bilateral prelingually deafened pediatric cochlear implantation.

In Taiwan, the number of cases of sequential bilateral pediatric cochlear implantation (CI) is increasing but data regarding its effectiveness and impact of the reimbursement policy are lacking. We examined the speech perception and quality of life (QOL) of bilateral prelingually deaf children who underwent sequential CI, considering the effects of age at the time of second implantation and interimplant interval. We enrolled 124 Mandarin-speaking participants who underwent initial cochlear implant (CI1) in 2001-2019 and a second CI (CI2) in 2015-2020. Patients were followed up for ≥2 years and were categorized into groups based on age at the time of CI2 implantation (<3.5, 3.6-7, 7.1-10, 10.1-13, and 13.1-18 years) and interimplant interval (0.5-3, 3.1-5, 5.1-7, 7.1-10, and >10 years). We evaluated speech perception, device usage rates, and QOL using subjective questionnaires (Speech, Spatial, and Qualities of Hearing and Comprehension Cochlear Implant Questionnaire). Speech perception scores of CI2 were negatively correlated with ages at the time of CI1 and CI2 implantation and interimplant interval. Older age and a longer interimplant interval were associated with higher nonuse rates for CI2 and worse auditory performance and QOL. Among individuals aged >13 years with interimplant intervals >10 years, up to 44% did not use their second ear. Patients aged 7.1 to 10 years had better speech perception and higher questionnaire scores than those aged 10.1 to 13 and 13.1 to 18 years. Furthermore, patients aged 10.1 to 13 years had a lower rate of continuous CI2 usage compared to those aged 7.1 to 10 years. Timely implantation of CI2 is essential to achieve optimal outcomes, particularly among sequentially implanted patients with long-term deafness in the second ear and no improvement with hearing aids following CI1 implantation. For CI2 implantation, an upper limit of age of 10 years and interimplant interval of 7 years are essential to prevent suboptimal outcomes. These data can provide useful information to implant recipients, their families, and medical and audiological professionals, enabling a comprehensive understanding of the benefits and potential impacts of the timing of CI2 implantation.

Delayed auditory experience results in past tense production difficulties and working memory deficits in children with cochlear implants: A comparison with children with developmental language disorder

Extent evidence has shown that morphosyntax is one of the most challenging linguistic areas for children with atypical early language experiences. Over the last couple of years, comparisons between deaf children with CIs and children with DLD have gained interest – as cases of atypical early language experiences, including, but not restricted to, delayed onset of exposure to language input and language-processing difficulties. Evidence suggests that the morphosyntactic difficulties experienced by deaf children with CIs and children with DLD are very similar in nature. However, the few studies that have directly compared both groups are inconclusive, with deaf children with CIs either performing significantly better or on par with children with DLD. These differences in findings can be attributed, in part at least, to a failure to implement essential methodological controls – even more so given that deaf children with CIs comprise a very diverse population. The goal of the present study was to directly compare the performance of deaf children with CIs to that of children with DLD on a morphosyntactic ability known to be particularly difficult for both groups. Specifically, the present study conducted a detailed examination of the past tense marking abilities of deaf children with CIs and children with DLD while controlling for factors specific to deaf children with CIs, for children's basic cognitive abilities as well as for children's age, sex assigned at birth, and SES. Past tense verbs are particularly relevant as they are used as a marker of developmental language disorder (DLD) in children learning French.Moreover, extent evidence shows that deaf children with CIs and children with DLD have important WM difficulties, but also that there is an association between auditory perception, processing abilities, and working memory (WM) abilities as well as with the acquisition of morphological features, including tense marking. Unfortunately, no study has examined the relation between the accurate production of past tense verbs and WM abilities in children with CIs and children with DLD learning French.Fifteen deaf children with CIs between 5 and 7 years of age were compared to 15 children with DLD and to 15 typically-developing monolingual controls (MON), matched on important variables, using a past tense elicitation task as well as measures of phonological and nonverbal WM abilities.The results confirm that the deaf children with CIs and the children with DLD both performed significantly lower than the MON controls on the past tense elicitation task – suggesting that difficulties with past tense verbs in French might not only be a marker of DLD but, instead, a correlate of atypical language acquisition. Of importance, the present study is the first to show that deaf children with CIs perform significantly lower than children with DLD on a past tense elicitation task – highlighting the importance of using methodological controls. As well, significant correlations were found between the performance of the deaf children with CIs and of the children with DLD on the past tense elicitation task and their phonological and nonverbal WM abilities. Taken together with previous studies conducted in the same populations, this represents another evidence suggesting that early atypical language experiences result in language and WM deficits, including morphosyntactic difficulties.

Making Multiple Deaf Worlds Intelligible: A Posthumanist Arts-based Cartography of Apple Time

In this paper, I provide an arts-based posthumanist cartography of a theatre play, Apple Time performed by deaf youth in Regina, Saskatchewan. This play was co-constructed by deaf youth performers, two deaf adults, a hearing teacher, and a hearing director. Apple Time premiered in Regina, Saskatchewan on June 2, 2018, and was remounted again at the Globe Theatre (Regina) in February 2019 and again at the SoundOff Festival in Edmonton, Alberta. The arts-based cartography examines intelligibility as a methodological problem as posited by Graif (2018), in which the actions of deaf children and youth often remain invisible due to the ontological position that perception of the world is predicated upon the ability to hear. Intelligibility as a methodological problem poses a challenge to the deficit perspective commonly held by families and service providers working with deaf children and youth (Glickman &amp; Hall, 2019). The performers in this play were able to re-align audience perceptions through the presentation of their inner worlds and preoccupations, thereby making their multiple deaf worlds more intelligible.

Analysis of Social Interaction of Deaf Children in Special Schools

&#x0D; &#x0D; &#x0D; &#x0D; Deaf is a term used to describe the symptoms and symptoms of someone who is hearing impaired or deaf. Deaf children interact through a variety of methods, including sign language, facial expressions, and body, as well as the use of hearing aid technology. They can also utilize visual communication approaches, peer support, and participation in group activities to strengthen social skills. Social interaction is a dynamic in which individuals or groups communicate, act, or influence each other in a particular environment or situation. Social interaction involves the exchange of information, emotions, ideas, or behaviors between individuals or groups. This research makes a valuable contribution to improving our understanding of the benefits of social interaction for deaf children in Special Schools, opening up opportunities for the development of more inclusive educational strategies and supporting their holistic development. This study aimed to analyze social interactions between deaf children. An observational approach and interview, this study explores the dynamics of communication, information exchange, and emotional understanding in interactions between both groups of children. Qualitative analysis methods are used to identify unique communication patterns and understand the challenges faced by deaf children in communicating. The subjects in this study were interviewing homeroom teachers and counseling teachers at the school, the number of subjects to be studied were children with deafness. The results highlight adaptation efforts and communication strategies developed by deaf children to interact. The results of these findings can provide valuable insights for educators, parents, and health practitioners in supporting the development of social skills of deaf children so that they can engage more effectively in society.&#x0D; &#x0D; &#x0D; &#x0D;

Communication Skills of Deaf Children

As social beings humans have a main need, namely communication, basically communication is a process, and the process must have an obstacle. Like the barriers experienced by deaf children, they experience barriers in their hearing as a result of which deaf people have difficulty speaking so that deaf children are not or less able to communicate verbally. Deaf children maximize their sense of sight as a way to complete the lack of hearing. The purpose and benefits of this study are to determine communication skills in deaf children, know how to socialize deaf children, and find out what are the obstacles in communicating deaf children. This study also aims to test whether there is an interaction between two independent variables that affect verbal and nonverbal communication skills in deaf children.deaf people often have communication problems as in students at SLB B-C Wijaya Kusumah, they still have difficulty in communicating even though generally deaf people use sign language alternatives. The results of our research found that the communication skills of deaf children in SLB B-C Wijaya Kusumah are still very low, this was obtained from the results of the researcher's interview with the class teacher concerned. There are only two children out of nine children who have comprehension in communicating using sign language, the rest still need special guidance in order to maximize their sense of sight as a way to perfect communication.

Analysis of Sign Language Skills in Improving Communication and Learning for Deaf Children

This study uses qualitative methods that aim to identify and describe how sign language skills improve communication and learning for deaf children. Data collection in this study is literature research, namely searching for research data and information through academic articles, books, references, and published materials contained in the library. The results of this study show that one form of communication used by deaf children is nonverbal sign language, and sign language is very important for deaf children who need special support because they cannot communicate like others. Deaf children usually encounter obstacles in the learning process such as when the interaction between the teacher and students is disrupted and students may not be able to understand the content delivered by the teacher. To achieve optimal learning, appropriate teaching methods and sign language are needed, namely SIBI (Indonesian Sign Language System) and Bisindo. Such methods help deaf students acquire language skills, improve communication skills, and facilitate the exchange of materials between teachers and deaf students. Therefore, in communicating with healthy people, it is necessary to communicate using sign language that can be understood by deaf people.

“I See What You Feel”: An Exploratory Study to Investigate the Understanding of Robot Emotions in Deaf Children

Research in the field of human–robot interactions (HRIs) has advanced significantly in recent years. Social humanoid robots have undergone severe testing and have been implemented in a variety of settings, for example, in educational institutions, healthcare facilities, and senior care centers. Humanoid robots have also been assessed across different population groups. However, research on various children groups is still scarce, especially among deaf children. This feasibility study explores the ability of both hearing and deaf children to interact with and recognize emotions expressed by NAO, the humanoid robot, without relying on sounds or speech. Initially, the children watched three video clips portraying emotions of happiness, sadness, and anger. Depending on the experimental condition, the children observed the humanoid robot respond to the emotions in the video clips in a congruent or incongruent manner before they were asked to recall which emotion the robot exhibited. The influence of empathy on the ability to recognize emotions was also investigated. The results revealed that there was no difference in the ability to recognize emotions between the two conditions (i.e., congruent and incongruent). Indeed, NAO responding with congruent emotions to video clips did not contribute to the children recognizing the emotion in NAO. Specifically, the ability to predict emotions in the video clips and gender (females) were identified as significant predictors to identify emotions in NAO. While no significant difference was identified between hearing and deaf children, this feasibility study aims to establish a foundation for future research on this important topic.

Exposure to sign language prior and after cochlear implantation increases language and cognitive skills in deaf children.

Recent evidence suggests that deaf children with CIs exposed to nonnative sign language from hearing parents can attain age-appropriate vocabularies in both sign and spoken language. It remains to be explored whether deaf children with CIs who are exposed to early nonnative sign language, but only up to implantation, also benefit from this input and whether these benefits also extend to memory abilities, which are strongly linked to language development. The present study examined the impact of deaf children's early short-term exposure to nonnative sign input on their spoken language and their phonological memory abilities. Deaf children who had been exposed to nonnative sign input before and after cochlear implantation were compared to deaf children who never had any exposure to sign input as well as to children with typical hearing. The children were between 5;1 and 7;1 years of age at the time of testing and were matched on age, sex, and socioeconomic status. The results suggest that even short-term exposure to nonnative sign input has positive effects on general language and phonological memory abilities as well as on nonverbal working memory-with total length of exposure to sign input being the best predictor of deaf children's performance on these measures. The present data suggest that even access to early short-term nonnative visual language input is beneficial for the language and phonological memory abilities of deaf children with cochlear implants, suggesting also that parents should not be discouraged from learning and exposing their child to sign language. RESEARCH HIGHLIGHTS: This is the first study to examine the effects of early short-term exposure to nonnative sign input on French-speaking children with cochlear implants' spoken language and memory abilities. Early short-term nonnative exposure to sign input can have positive consequences for the language and phonological memory abilities of deaf children with CIs. Extended exposure to sign input has some additional and important benefits, allowing children to perform on par with children with typical hearing.

Prosody expression in prelingually- and postlingually- implanted deaf adults

Speech prosody - its melody, accent, and quantity - plays a significant role in language communication, including the expression of emotions. Limited prosodic skills in individuals with profound hearing disabilities affect their communicative functioning. Modern hearing prostheses, such as cochlear implants, enable deaf people to develop and utilize auditory and oral language abilities, although not always prosodic ones. The presented results of our own research indicate the importance of the period of hearing loss and the duration of implant use for prosodic effectiveness in cochlear implant users. They also emphasize the need for rehabilitation activities that focus on early prosodic stimulation in prelingually deaf children and prosodic training in prelingually deaf adults. / Keywords: speech prosody, prelingual and postlingual deafness, cochlear implant

Learning Methods Based on Deaf Children's Learning Styles

The problems taken from this research are how learning methods based on learning styles of deaf children at Sekolah Luar Biasa Wijayakusumah Bekasi, to what extent are learning style methods used by deaf students and what difficulties arise when deaf students have different learning styles. The purpose of this study is to describe learning methods that can develop the learning styles of deaf children. The method used in this article is a qualitative method. From the results of the learning process obtained by deaf students at school, students are able to achieve quite good academic learning outcomes. This makes deaf students able to equalize their abilities with other normal children.

A Long-Term Follow-Up Study on the Auditory Performance and Speech Intelligibility of Mandarin-Speaking Prelingually Deaf Children With Isolated Large Vestibular Aqueduct Syndrome After Cochlear Implantation.

The purpose of this study was to evaluate the auditory performance and speech perception of 104 children with isolated large vestibular aqueduct syndrome (LVAS) and 523 children with no inner ear malformation (IEM) for 5 years after cochlear implantation, in order to explore whether isolated LVAS can affect the long-term hearing and speech rehabilitation of deaf children after cochlear implantation. A cohort study was established consisting of 627 children who underwent cochlear implantation at Beijing Tongren Hospital from 1999 to 2016. The children were examined at 0, 6, 12, 24, 36, 48, and 60 months after cochlear implantation to assess their auditory performance and speech perception using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) questionnaires. The CAP scores of the isolated LVAS group increased significantly during the baseline to the 24th month, after which they gradually rose until reaching the plateau during the 24th to the 60th month. The CAP scores of the non-IEM group increased significantly during the baseline to the 36th month and then increased steadily. The SIR scores went up significantly during the baseline to the 48th month, and increased in a gradual manner in other stages of isolated LVAS evaluation. In comparison, The SIR scores of non-IEM group grew remarkably from the baseline to the 60th month. There were no significant differences in the CAP or SIR scores between isolated LVAS and non-IEM groups in each stage of evaluation, with the only exception being the CAP score at baseline month after cochlear implantation. The CAP and SIR questionnaires are helpful tools for quantifying the early hearing and speech skills of younger prelingually deafened cochlear implant recipients. This long-term follow-up study shows that the speech and hearing development of children in isolated LVAS and non-IEM groups follow similar patterns, and isolated LVAS does not affect the long-term rehabilitation of deaf children after cochlear implantation.

Electrically evoked auditory brainstem responses in deaf children with cochlear nerve canal stenosis

Background Deaf children with cochlear nerve canal stenosis (CNCs) are always considered poor candidates for cochlear implantation. Objectives To investigate the function of the peripheral auditory pathway in deaf children with CNCs, as revealed by the electrically evoked auditory brainstem response (EABR), and postoperative cochlear implants (CIs) outcomes. Materials and Methods Thirteen children with CNCs and 13 children with no inner ear malformations (IEMs) who received CIs were recruited. The EABR evoked by electrical stimulation from the CI electrode was recorded. Postoperative CI outcomes were assessed using Categories of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR). Results Compared with children with no IEMs, children with CNCs showed lower EABR extraction rates, higher thresholds, a longer wave V (eV) latency and lower CAP and SIR scores. The auditory and speech performance was positively correlated with the diameter of the cochlear nerve canal and the number of channels showing wave III (eIII) and eV in children with CNCs. Conclusions and Significance The physiological function of the peripheral auditory pathway in children with CNCs is poorer than that in children with no IEMs. Postoperative auditory and speech abilities may depend on the severity of cochlear nerve malformation and auditory conduction function.

Penerapan Convolutional Neural Network dengan Arsitektur Mobilenetv2 Pada Aplikasi Penerjemah dan Pembelajaran Bahasa Isyarat

Sign Language is the main communication medium for deaf people, in Indonesia itself there are several types of sign language, one of which is SIBI or Indonesian Sign Language System. This type of SIBI sign language is one type of sign language used in special school (SLB) environments. Deaf children are not yet able to use sign language and others have difficulty communicating with people around them. This research aims to help deaf children learn sign language, as well as help them communicate through sign language interpreters. The methodology applied to the application is by using a Convolutional Neural Network with the MobileNetV2 architecture. CNN is an algorithm that is included in the artificial neural network category which has the advantage of having a very high level of accuracy in classification, and MobileNetV2 is a form of Convolutional Neural Network (CNN) architecture that is able to overcome the need for excess computing resources created by Google researchers. so that it can be used on mobile devices or cell phones. The model training stage obtained an accuracy value of 98.99% with a total of 100 epochs. The model trained did not experience overfitting or underfitting so the model can be used. The testing stage uses black box testing to ensure the application is running correctly. The final stage is conducting research using TAM (Technology Acceptance Model) to measure the level of approval of the application using a Likert scale. Testing using black box testing was successful and met expectations, and the implementation of the application received an approval rate of 78.4% on average.

False belief understanding in deaf children: what are the difficulties?

Children with cochlear implants (CIs) demonstrate proficiency in verbal-story elicited-response (VS-ER) false-belief tasks, such as the Sally & Ann task, at a similar age as typically developing hearing children. However, they face challenges in non-verbal spontaneous-response (NV-SR) false-belief tasks, measured via looking times, which hearing infants typically pass by around 2 years of age, or earlier. The purpose of the present study was to examine whether these difficulties remain in a non-verbal-story elicited-response (NVS-ER) false-belief task, in which children are offered the opportunity to provide an elicited response to a non-verbal-story task. A total of thirty 4- to 8-year-old children with CI-s and hearing children completed three different kinds of false-belief tasks. The results showed that children with CI-s performed above chance level on the verbal task (i.e., VS-ER task), but not on the two non-verbal tasks, (i.e., NVS-ER and NV-SR tasks). The control group of typically developing hearing children performed above chance on all three kinds of tasks (one-tailed significance level). Our findings highlight the importance of external narrative support for children with CIs in tasks that involve mental perspective-taking, and specifically predicting actions based on false beliefs.

The process of acceptance and resilience of a mother with deaf child: Life history

Every mother hopes to give birth to a perfect, normal, and healthy child, hope arises from the moment the child is still in the womb. Things turned around when the mother heard the diagnosis of her child with special needs. Various psychological problems experienced by mothers before finally reaching the stage of self-acceptance to be able to accept the state of themselves as mothers of children with special needs is a difficult process. Every mother has her own process and way to reach this stage. The purpose of this study was to see the picture, process, and factors of self-acceptance of mothers with children with special needs. This type of research uses qualitative with Life History. Data collection techniques use observation of family activities and interactions, in-depth interviews and document studies. Data collection was conducted from November 2022 to January 2023. The data obtained are analysed using thematic analysis techniques inductively. Based on the results of the study, the process towards maternal acceptance of deaf children begins with grief, anxiety. Self-acceptance is evidenced by the mother's adaptation process to master the situation, seek information, be sincere, think positively, and endeavour treatment. The process of self-acceptance is influenced by good family reciprocity, warm family support, good religious knowledge, and a supportive environment.

Technology Support for the Inclusion of Deaf Students in Special School Sukabumi City

The COVID-19 pandemic brought rapid changes in various areas of life, including education and technology. One of the learning media that the deaf can use to improve their ability to compose sentence structures is I-CHAT (I Can Hear and Talk). I-CHAT is a portal that contains applications that function as tools for the deaf in language acquisition. In communicating, mastery of sentence structure is crucial. It is because with the correct sentence structure, other people will better understand what we are talking about, and besides that, communication becomes more effective and efficient. Communication barriers that occur in deaf children are caused by hearing impairment, which ultimately requires deaf children only to use sight to acquire their receptive language. This has an impact on the acquisition of imperfect or partial deaf children's receptive language because not everything they see can be understood. Therefore, if a deaf child makes a sentence, the sentence structure is sometimes wrong. This research aims to determine the use of I-CHAT in the preparation of sentence structures for deaf students at Inclusive School Sukabumi City. This research is experimental with a quantitative approach. The results of the research show that the use of I-CHAT can improve the ability to compose sentence structures for deaf children in Special School Sukabumi City.

Variability in Receptive Language Development Following Bilateral Cochlear Implantation.

The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.

Penggolongan Anak Berkebutuhan Khusus Berdasarkan Mental Emosional Dan Akademik

Children with special needs are children who require special treatment because of developmental disorders and abnormalities experienced by children. Children with special needs have differences that occur in several ways, such as the process of growth and development that experiences abnormalities or deviations both physically, mentally, intellectually, socially and emotionally. In the context of special education in Indonesia, children with special needs are categorized in terms of blind children, deaf children, children with intellectual disabilities, children with motor disabilities, children with social emotional disorders, and children with intelligent and special talents. Every child with special needs has different characteristics from one to another. In addition, every child with special needs also needs special services that are tailored to their abilities and characteristics. It is important to carry out identification and assessment activities to identify their characteristics and needs. It is considered important to get the right service according to the characteristics, needs and capabilities.

Imperial optics and colonial disability: missions to blind and deaf children in ‘the East’, c. 1880-1939

ABSTRACT This article explores missions to blind and deaf children in late nineteenth and early twentieth-century India, Sri Lanka, and China which were established by the Church of England Zenana Missionary Society. Manly staffed by women, these missions can be seen as innovative in the colonial treatment of disability in South and East Asia, pioneering the use of sign languages, tactile alphabets, and oralism as methods of special education in what they referred to as ‘the East’. In making appeals to British readers, missionaries emphasized the humanity of those with whom they worked. At the same time, their representation of disability, ethnicity, and gender were firmly rooted in longstanding colonial and Orientalist discourses which emphasized difference as much as they did universality. I argue that these representations were ambivalent, encouraging both affective connections between missionaries, their subjects, and their supporters back in Britain and defined by racialized and ableist othering. As such, the article aims to track their development and analyse missionary praxis and discourse in relation to disability and colonialism.