International Journal of Bilingual Education and

Bilingualism

ISSN: 1367-0050 (Print) 1747-7522 (Online) Journal homepage: http://www.tandfonline.com/loi/rbeb20

Bilingual education for deaf children in Sweden

Kristina Svartholm
To cite this article: Kristina Svartholm (2010) Bilingual education for deaf children in
Sweden, International Journal of Bilingual Education and Bilingualism, 13:2, 159-174, DOI:
10.1080/13670050903474077
To link to this article: http://dx.doi.org/10.1080/13670050903474077

Published online: 17 Feb 2010.

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International Journal of Bilingual Education and Bilingualism

Vol. 13, No. 2, March 2010, 159
174

Bilingual education for deaf children in Sweden

Kristina Svartholm*

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Department of Linguistics, Stockholm University, Stockholm, Sweden

(Received 9 November 2009; final version received 11 December 2009)
In 1981, Swedish Sign Language gained recognition by the Swedish Parliament as
the language of deaf people, a decision that made Sweden the first country in the
world to give a sign language the status of a language. Swedish was designated as a
second language for deaf people, and the need for bilingualism among them was
officially asserted. This was reflected in the first bilingual curriculum, introduced
in special schools for the deaf and hard of hearing in 1983, which stated that the
language of instruction in these schools should be Swedish sign language as well
as Swedish, the latter of which, for deaf children, was primarily intended to be in
its written form. These provisions were designed to ensure that pupils would be
able to develop their bilingualism. In 1994, this curriculum was replaced by a new
one that raised the bar even higher. In accordance with this curriculum, schools
became responsible for ensuring that all deaf and hard of hearing pupils would be
bilingual by the time they completed school.
In this paper, I will present details regarding the background of the Swedish
Parliaments decision and also compare and discuss the steering documents for the
schools in this regard. I will also describe some of the developmental work that
was implemented early in schools for the deaf, where teachers collaborated closely
with linguistic researchers. This work will be related to contemporary research on
sign language linguistics and Swedish as a second language for deaf people.
I will then present results from the bilingual approach, as reflected in the leaving
certificates of deaf school leavers over the years. Finally, I will briefly discuss the
current situation Swedish special schools face today, in which a quickly growing
number of deaf children with cochlear implants are applying for admission.
Although the need for bilingualism among these children is fully recognised, the
attainment of this goal may require schools to adopt different means of
instruction.
Keywords: deafness; bilingualism; sign language; Sweden

Background
In 1981, the Swedish Parliament passed a bill that stated the need for deaf people to
be bilingual, and more specifically, that deaf people in Sweden needed both sign
language and Swedish to function within their own group and in society at large
(Proposition 1980/1981). With this decision, an important step had been taken: a sign
language was officially recognised as a language in its own right for the first time
anywhere in the world.
By the 1980s, the need for changes in the education of deaf people was apparent.
Just as in any country in which deaf pupils are educated without sign language and
*Email: kristina.svartholm@ling.su.se
ISSN 1367-0050 print/ISSN 1747-7522 online
# 2010 Taylor & Francis
DOI: 10.1080/13670050903474077
http://www.informaworld.com

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K. Svartholm

the primary medium of classroom teaching is speech, results from earlier efforts in
Sweden to educate deaf children were discouraging. Despite rapid and extensive
technical development from the 1950s, which had resulted in better hearing aids and
classroom equipment in schools for the deaf and hard of hearing, studies show that
the average deaf school leavers ability to read Swedish was far below an ageappropriate level, and their spoken language skills were also far below the norm
(Amcoff 1973; Norde n 1969; Svartholm 1983, 1984). The need for a change in
direction in how deaf people were educated was highlighted in the bill not only by its
recognition of sign language as a language, but also in the importance it placed on
bilingualism by requiring that deaf children also know Swedish.
Governing documents
The first bilingual version of the Swedish National Curriculum, valid for special
schools for the deaf and hard of hearing (henceforth: special school(s)), was written
as a supplement to the curriculum for Swedish schools in general and published in
1983 (LGr80 1983). (See below for a presentation of the Swedish school system.) The
aim of this supplement was to ensure that deaf children were provided the
opportunity to attain bilingualism in Swedish sign language (henceforth: sign
language) and Swedish, mainly in its written form. According to the supplement,
the languages of instruction were to be sign language and Swedish
the latter in its
written form for deaf pupils, and in both its written and spoken forms for hard of
hearing pupils. It also indicated that those pupils who could profit from instruction
through spoken language with the assistance of technical devices were to be taught in
groups of their own whenever possible. Furthermore, the curriculum stated that those
pupils who could develop intelligible speech should have individualised programmes
enabling them to do so.
The curriculum also included a definition of bilingualism for deaf children based
on a comparison with its definition for hearing people. One position that the
curriculum takes is that bilingualism in sign language and Swedish should be
considered monocultural in that, in the main, the two languages convey the same
culture. This reflects the position that Swedish deaf culture, i.e. the specific cultural
affiliation and affinity created by the need for and use of sign language among the
deaf, is a subset of the Swedish majority culture, not in opposition to it.1
Children generally acquire language naturally and spontaneously from linguistic
interaction with others in their immediate surroundings. However, the situation is
different for most deaf children, as they are usually born into hearing families with
no previous knowledge of sign language. Thus, deaf children gain access to sign
language through other means, often outside of the family context. Additionally,
among deaf children, the learning of spoken and/or written language is largely
dependent on teaching rather than on natural and spontaneous learning (LGr80
1983). What the deaf child perceives visually from speech, mainly lip patterns, does
not give enough linguistic information for the child to acquire knowledge of natural
spoken language; rather, explication is necessary. Teaching reading to a deaf child
then is more complex than teaching reading to a hearing child who has access to
spoken language as a basis for competence in reading. For a deaf child, learning to
read and learning the language can be seen as one and the same process.
As stated in the curriculum, Swedish sign language and Swedish fulfil different
functions for deaf pupils. Sign language is the primary tool for gaining knowledge

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International Journal of Bilingual Education and Bilingualism

161

and is the language used in direct communication with others. Swedish, on the other
hand, mainly fulfils the functions that are typical of written language. This division
of the two languages according to their functions can be described as a form of
diglossia (Svartholm 1993, cf. also Wallin 1988).
The 1983 curriculum also included syllabuses for the two language subjects
specific to special schools in which the main elements were listed for the different
stages of schooling. These elements are nearly identical to the elements included in
the syllabus for teaching both spoken and written Swedish as a first language, but
they are divided into two sections: those reflecting the development and use of
spoken language are assigned to the subject of sign language; and those connected to
written language are assigned to the subject of Swedish. Thus, the diglossic situation
is clearly mirrored in this section.
More than 10 years later, in 1994, the national curriculum was replaced by a new one
that was valid for the compulsory school system as a whole. Through this curriculum,
requirements for special schools were increased: the pupils were not only to be ensured a
development towards bilingualism; rather, schools were now responsible for ensuring
that upon completing their education all deaf pupils would be bilingual:
Schools for pupils with impaired hearing/vision and speech disabilities are responsible
for ensuring that all pupils, who are deaf or have impaired hearing, on completing
school:

. are bilingual i.e. can read (understand, my comment) sign language and
Swedish as well as express thoughts and ideas in both sign language and writing,

. can communicate in writing in English (LPO 94 1994, 19).

In this curriculum, it is explicitly stated that the general educational goals of deaf
students are the same as they are for hearing students. For English and Swedish,
however, the goals differ to some extent: neither spoken English nor spoken Swedish
is explicitly mentioned as a goal for students in special schools as they are for hearing
students. Basic knowledge of speech and of the workings of speech is included as a
goal for the teaching of Swedish, but the goals are tailored to individual pupils.
Furthermore, the curriculum considered English a third language for most deaf
students, and there was an emphasis on the use of sign language for discussions and
explanations in the syllabus (Skolverket 2001/2009).
The expectations for reading and writing were framed as mandatory goals in the
specific syllabus for Swedish in the terminating, 10th compulsory year of special
school:
Pupils should:
. be able to read and assimilate literature appropriate to their age and
understand factual texts of the kind needed for schoolwork;

. be able to write different kinds of texts so that the contents are clear, and in
doing this apply standards appropriate to the purpose, when writing by hand
and using computers;
. be able to communicate purposefully with different audiences and for different
purposes;
. be able to read and reflect over some literary works and authors
(Skolverket 2001/2009, 20).

In the syllabus for the subject of sign language, special attention was given to its
importance for developing and strengthening the pupils sense of personal identity.

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K. Svartholm

Among the goals that pupils should have attained by the end of the 10th year in
school were the following:
Pupils should:
. be able to actively take part in conversations and discussions, as well as be able

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to share the thoughts of others, and be able to present work to others so that the
contents are clear and understandable;
. be able to understand sign language texts appropriate to their age, as well as be
able to reproduce contents coherently and also reflect over this;

. ... ;
. have a knowledge of sign language which makes it possible to carry out
observations of their own and others use of language, as well as similarities
and differences between sign language and Swedish (Skolverket 2001/2009, 17).

A special section in the syllabi component of the regulations was devoted to an

explication of how the two languages interact and reinforce each other as tools for
communication and learning. The following is an excerpt from this section:
The development of bilingualism in sign language and Swedish is dependent on human
communication and that the language is brought to life and used in meaningful contexts.
. . . By means of actively using the language in discussions with others, through reflection
and processing information, pupils develop cognitively, emotionally, intellectually and
socially. The bilingual environment creates conditions to exchange experiences concerning the two languages, their structure and contents, and together with teachers and
comrades plan the working methods and contents of education, express views, search for
and impart knowledge, as well as develop new ideas. Learning takes place through both
languages. (Skolverket 2001/2009, 13)

To conclude, the Swedish documents reflect a view of deaf children as competent

learners and with the same capacity for learning language as any hearing child,
provided that specific requirements are fulfilled, namely, that the child experiences
natural and accessible language use in meaningful contexts as well as language
teaching adapted to its specific linguistic needs. It is also evident from the documents
that demands and expectations have increased over the years since sign language and
bilingualism was first introduced in special schools.
Developmental work and linguistic research
Sign language versus signs-and-speech
After the bilingual curriculum had been introduced in the 1980s, extensive
developmental work took place within special schools as a result of close cooperation
between teachers and linguistic researchers. The basis for this, going back to the mid1970s, was two different research projects, one that studied signs from a linguistic
point of view and another aimed at shedding light on the early linguistic and
cognitive development of deaf and severely hard of hearing children (Ahlgren 1978;
Bergman 1977).
Just as in many other countries, a signing system in which signs and spoken words
are combined had been constructed in Sweden in the 1970s. This system, called Signed
Swedish, was mainly designed for normative purposes, i.e. for standardisation of the
signs used among deaf people. The fundamental belief was that words from the spoken
language and signs should be used simultaneously, i.e. one was to speak and sign at the
same time. Every word in the spoken language was meant to correspond to a sign. Just

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International Journal of Bilingual Education and Bilingualism

163

as in other contexts in which signed systems like this have been created, the intention
was that this method of signing would not only ease communication between deaf
people and hearing people but would also make it easier for deaf children to acquire the
spoken language of society.
However, the expectations for Signed Swedish were not met. Hearing people
who had learned Signed Swedish encountered difficulties in making themselves
understood and in understanding deaf people, especially when they were communicating with each other (Bergman 1977). The improvements in classroom communication were small and unsatisfactory, as were the improvements of Swedish skills in
deaf children (Ahlgren 1984).
The explanation for why this simultaneous use of speech and signs did not
function as expected came later, with the knowledge gained through research on
genuine Swedish Sign Language, the sign language used within the deaf community.
Like any other natural sign language, Swedish Sign Language is not produced
manually with only the hands but also employs non-manual means, which include
such things as facial expressions, mouth movements, direction of gaze, etc. This
allows a significantly higher degree of simultaneously produced linguistic information than is possible in spoken language (Bergman 1979, 1982). Another significant
divergence from spoken language is that Swedish Sign Language, just as any natural
sign language, has a spatial organisation, i.e. the three-dimensional space in front of
the person signing is utilised in the language structure itself (Bergman 1990, cf. also
Engberg-Pedersen 1993; Liddell 2003).
The dominant organisation of spoken language is temporal, i.e. the words follow
one another in time. What happens when one simultaneously speaks and uses signs is
that this temporal, sequential type of organisation takes over. The signs become
subordinated to the spoken language, following one after another without the
linguistic characteristics found in the simultaneity and spatial utilisation of natural
sign language.
It follows that the linguistic information conveyed by signs is reduced and
fragmented, and expressions for the inherent relationships between the signs
disappear. There is also a great deal of significant information in speech that cannot
be fully expressed in a visually comprehensible way, such as the prosodic elements,
which include intonation and stress. This information must be supplemented by the
person who watches and relies on his or her ability to make the correct inferences
about what is missing in the visual representation, an ability that is dependent on
proficiency in Swedish.
Naturally, the task of understanding the message communicated via simultaneous
use of speech and of signs is easier if the message is short and simple and bound to
the immediate context, just as it is when adults communicate with small children. For
information that is more complex, this way of communicating is less appropriate
since it places great demands on the ability of the receiver to fill in the missing
information (Bergman 1977; Svartholm 2007).
It became clear early on that deaf children did not perceive Signed Swedish as
Swedish, but rather as signs with mouth movements. For every sign, they also had to
learn the corresponding Swedish word, both in speech and in writing (Bergman
1977). Thus, this was not an efficient shortcut to Swedish for them.
The decision about the use of sign language instead of Signed Swedish within the
special schools was, to a large extent, based on linguistic research on the language that
was in progress at the time. Pressure and information from involved organisations,

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164

K. Svartholm

such as SDR, the Swedish National Association of the Deaf, working together with
the parents organisation DHB, The Swedish National Association for Deaf, HearingImpaired and Language-Impaired Children, were also important in this process.
Since 1980 Swedish Sign Language had been an academic subject in its own right,
manifested by research and teaching at Stockholm University. Courses in sign
language for teachers working in the special schools soon developed. Entrance
requirements for entering teacher-training programmes changed to include skills in
sign language. A general, intensive, in-service training programme also took place in
that Stockholm University received a five-year grant for setting up a sign language
course for all Swedish teachers for the deaf. Thus, every teacher from all five schools
for the deaf and hard of hearing, situated all over the country, studied sign language
for one semester during this period, beginning in 1990 (Mahshie 1995). All of this
was an important part of implementing the new, bilingual curriculum.
Written Swedish and bilingual education
A number of new research insights emerged from early studies of classroom
communication and language development in deaf children (Ahlgren 1982, 1984).
These studies also included observations about written Swedish as seen from the deaf
childs perspective. This was part of an extension of a project in which a group of deaf
children were given the opportunity to develop sign language as their first language
while still in pre-school. It was through this project that the fundamental importance
of sign language for the normal development of deaf children was recognised in
Sweden for the first time. The project also showed the importance of sign language
instruction for parents of deaf children, making them confident in their roles as
parents and in communicating with their children. The importance of encouraging
hearing parents to meet with deaf adults so that they could learn more about
deafness and the future prospects of their child was also highlighted in the project.
After these children entered primary school, they took part in a new project. A
deaf person was employed to work together with a hearing teacher in close
cooperation with linguistic researchers. In this way a model for bilingual education
was gradually developed (Ahlgren 1988; Svartholm 1993). Classroom work focused
on written Swedish and on translations of texts into sign language as well as on
contrastive work between the two languages. The questions that the deaf pupils
themselves put forth about the two languages and the different aspects of signing
versus use of written language that arose in the discussions were important for
further improvement of the model.
In many respects, the model was based on knowledge about the first and secondlanguage development of hearing children, and some assumptions were made about
how much of this knowledge was valid for deaf children. Very little of this early work
was based on previous research but gradually research developed alongside it.
Some important support for these ideas was given in the project: Swedish as a
Target Language for the Deaf, which was financially supported by the Bank of
Sweden Tercentenary Foundation. The project studied various syntactical elements in
deaf peoples written Swedish, including sentences with omitted subjects and/or
objects, as well as the use of relative clauses and expressions for locative states versus
expressions for moving from one place to another (Svartholm 1987a, 1987b, 1988). The
aim of this project was to learn more about similarities and differences between deaf
and hearing learners of Swedish as a second language. Earlier research had described a

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International Journal of Bilingual Education and Bilingualism

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number of grammatical errors in the written language of deaf people and had chosen to
explain them as indications of atypical language ability (Svartholm 1984).
The project did show that such written language demonstrated, to a great degree,
the same elements found at earlier levels in the interlanguage of hearing learners of a
second language. From a second language learning perspective the written language
of deaf people was far from unusual; rather, it could be described within the
theoretical framework of interlanguage, which takes into account the developmental
language of second-language learners (Svartholm 2008). Important conclusions
could be drawn from this about the teaching of Swedish in special schools.
Observations of how deaf pupils approached written language with respect to
reading also played an important role in the development of the bilingual educational
model. As already mentioned, work in the classroom focused to a large extent on
written Swedish and translations of texts into sign language, but there was no
research that could justify this as a method for teaching reading to deaf children.
However, none of the prevailing models and methods used for teaching reading to
hearing children seemed appropriate for this context. Instead, work had to rely on
what could be assumed from observations made in class and from assumptions based
on general knowledge about language learning (Svartholm 1993, 1994).
One important assumption pertaining to the role that sign language has as a first
language is that it functions well for the deaf child given that they have adequate access
to it. Knowledge about the world, gained from normal interaction with others, is thus
considered an important prerequisite for successful reading, i.e. reading is regarded as
a process in which the search for meaning and understanding content is important.
Another important assumption concerns the importance of maintaining a
separation between written Swedish and sign language during instruction. Since
their structures and the means they have for expressing content differ fundamentally
from each other, switching between them during teaching could presumably make the
challenge of learning Swedish difficult if not impossible. For example, adopting a
strategy for seeking meaning in texts by mapping single words to single signs would
most likely not help the apparent simplicity and transparency of this approach.
Instead, teachers were asked to work contrastively with Swedish and sign language by
using sign language as the medium for explaining meaning and to point out
similarities and differences between the two languages (Svartholm 1994, 2005).
In-service training of teachers took place alongside developmental work of
different kinds. This training included seminars and courses in bilingual education
in general, as well as in the new academic subject Swedish as a second language for the
deaf, which was introduced at Stockholm University in 1981. Much of this
developmental work was carried out through close cooperation between teachers
and researchers. Special schools requested seminars, courses and lectures that were
followed by specific projects aimed at providing teachers with materials and ideas for
the classroom.
One such project, which was designed to develop a primary reader for deaf
children, became popular because of its story and the language it was written in, as
well as its translation into sign language (Adams Book by Christersson 1990; see also
Mahshie 1995). Another project, which was aimed at describing Swedish and sign
language in a grammar for teachers of deaf students, involved a visual and functional
approach to written Swedish that was presented to teachers (Svartholm 1990). This
grammar was supplemented by a volume in which teachers themselves shared ideas
and methodological suggestions for working with reading, writing and speech within

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K. Svartholm

special schools (Metodbok 1991). A variety of pedagogical materials was developed

in which teachers were heavily engaged from the beginning, working in consultation
with researchers and organisations.

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Results
An early study of the outcome from the new bilingual approach was published in
1993 (Heiling 1993). In this study the social development and academic achievement
levels of orally educated deaf children (i.e. deaf children educated without sign
language) were compared to those of deaf children educated during the first years the
bilingual education was in place. Data used were from the 1960s and the middle/late
1980s, respectively. Most of the latter, bilingually educated children were late learners
of sign language and had had no access to signing before joining a special pre-school
group or until they began school. By the time they left school, all of them were fluent
in sign language (Heiling 1993).
Differences between the two groups were distinct. The signing children performed
significantly better in academic tasks, including in their understanding of written
Swedish. Qualitative differences were found between the two groups in writing;
however, the highest-achieving group still attained a much lower fluency in writing than
that achieved by hearing first-language learners in the same age group (Heiling 1993).
These results can be compared to those reported from the first group of deaf
children who had a consistent and well-controlled bilingual education, which included
access to sign language from very early on. Signing skills in these children were
described as appropriate for their age when they were due to begin school; however,
this was never actually verified by tests (Ahlgren 1994). These were the children who
took part in the aforementioned first bilingual project. When they were about to leave
school in the 10th grade in 1990/1991, their reading comprehension was examined,
and the results were comparable to those of their classmates with more heterogeneous
language backgrounds, quite similar to Heilings subjects (Svartholm 1994, 1998).
The results confirmed evaluations made by the groups teacher, namely that the
reading ability of the deaf students was fully comparable to that of hearing students in
their terminal school year. Results varied for other students in the same class. About
half of them failed to understand the texts used in the test, and only one of them
achieved a reading skill level similar to the students in the first project group
(Svartholm 1998). The results are consistent with more informal reports from teachers
during the 1990s on an increasing number of deaf students graduating from special
schools with progressively better skills in Swedish (e.g. Salander and Svedenfors 1993).
Official records of results from special schools have been sparse. It was not until
after the year 2000, when The National Agency for Special Schools for the Deaf and
Hard of Hearing was established, that results began to be published (Specialskolemyndigheten [SPM], from 2008: The National Agency for Special Need Education and
Schools, Specialpedagogiska skolmyndigheten [SPSM]). The following information is
collected from a sample of annual reports from the agency (SPM 2002, 2005, 2007,
2008), supplemented with information from SPSM (2009; E-mail correspondence
between a registrar at the Agency and author
February 26) and The Swedish
National Agency for Education (Skolverket 2009).2
Of special interest is the students passing or failing the so-called core subjects,
namely Swedish, Mathematics, English and (for students in special schools only) Sign
language. Passing in these subjects is a prerequisite for continuing education in the

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International Journal of Bilingual Education and Bilingualism

167

Swedish gymnasium (corresponding to sixth form or Senior High School),

whether the students are deaf or hearing. The percentages of students passing these
kernel subjects are reported in Table 1.
For assessing students in Swedish, Mathematics and English, national tests
developed for compulsory schools in general are used in special schools when
applicable (e.g. SPM 2008). For Sign language, standardised assessments are still in
development.
Table 1 shows that the percentage of students passing these subjects in special
schools is lower than for students in mainstream schools. This has caused serious
concern among the Swedish school authorities about the quality of deaf education,
and a special study of attainment was initiated by the Government in 2006 (Hendar
2008).
The poor levels of attainment in special schools, as shown in Table 1, have been
accounted for by the National Agency for Special Schools for the Deaf and Hard of
Hearing by making comparisons between the populations found within the different
types of schools. Besides being deaf or hard of hearing, pupils within special schools
are as a group characterised as follows:
. Approximately 40% of the pupils in special schools have additional difficulties.
This includes, pupils with an extraordinary learning situation, often with great
learning problems, some of whom also have some form of learning disability.
(SPM 2007, 10; my translation)
. The ratio of pupils with an immigrant background in special schools is
relatively high (25%). Many of them may be in a problematic linguistic situation
with parents who do not know Swedish or any sign language and use another
language in the home. (SPM 2007, 16)
. The number of pupils enrolled late in special schools has increased during the
last few years. In 2007, 32% of all new pupils were enrolled as late as forms 7

10. This may cause problems: . . . to change the type of school after several
years may of course have an influence on possibilities for reaching goals. This is
especially so when the pupil has an insufficient language when he or she begins
in the special school, which is often the case both for Swedish and for sign
language. (SPM 2007, 16; my translation)
It is important to consider how these results can be used to make international
comparisons and to evaluate the bilingual approach. The percentage of deaf and
hard of hearing students passing in, e.g. Swedish, thus showing that they can read at
an age-appropriate level, may seem unacceptably low to many, but from an
international perspective it is not:
Table 1. Students passing in kernel subjects in special school 10th grade, 2002, 2005, 2008
and in ordinary compulsory school, ninth grade, 2008.

Swedish (%)
Sign language (%)
Mathematics (%)
English (%)
a

2002

2005

2008

Ordinary school 2008

62
78
56
52

55
77
48
42

69
77
55
59

96.5 (77.7)a


92.6
94.3

The figure 77.7% concerns the subject Swedish as a second language, i.e. Swedish for immigrants.

168

K. Svartholm

Despite decades of concerted effort, most deaf children progress at only a fraction of the
rate of hearing peers in learning to read. Current data indicate that, on average, 18-yearold deaf students leaving high school have reached only a fourth to sixth grade level in
reading skills. (Marschark, Lang, and Albertini 2002, 157)

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Comparisons between results from different school systems in different countries are,
however, difficult to make. The expectations and demands placed on deaf and hard of
hearing pupils are different:
. . . it is still relatively unusual for deaf and hard of hearing pupils in special schools to
follow their respective countrys general governing documents [for the schools]. In this
respect, we in Sweden place high demands on our deaf and hard of hearing pupils. (SPM
2005, 9; my translation)

The situation in Sweden today and tomorrow

Counselling and choice of school placement
By the time that bilingualism was introduced in Sweden, it was considered more or
less a matter of course that deaf and hard of hearing children should be enrolled in
one of the five regional special schools. Other options, such as specially adapted
hearing classes (see below), were restricted. In the following section the current
counselling and school system is presented.
First, it should be noted that Sweden is a small country, with a total population of
only about nine million people. This means that the number of deaf and hard of
hearing children born annually is relatively low: only around 200 children are born
every year with a hearing impairment such that they need a hearing aid and/or to use
sign language for their communicative development (HRF 2007). The number of
children in different regions belonging to different age groups may thus vary
considerably from year to year.
There are in total 18 County Councils (landsting) responsible for health care
and habilitation, which includes home counselling and support for parents with deaf
and hard of hearing children. The organisation looks somewhat different in different
parts of Sweden, but in general there are different centres for pedagogical counselling
on one hand and medical and/or technical counselling on the other. Since 2007, all
County Councils have offered early screening of newborn babies in order to detect
deafness/hearing impairment as early as possible (HRF 2007).
The County Councils are responsible for disseminating information about
Swedish sign language to parents of deaf and hard of hearing children and for
organising introductory courses on the subject. Since 1998 all parents have had the
right to attend up to 240 hours of free courses on the subject, commonly spread over
the childs first four to five years. These courses are subsidised by the state. The
number of parents who have attended these courses has gradually decreased over the
years (SOU 2006); one probable reason for this is that parents whose child gets a
cochlear implant may adopt a wait-and-see policy concerning their childs need for
sign language (cf. below). Other reasons may be practical problems connected to
work and/or need for travelling to attend the courses, etc.
By law, the local authorities (kommuner) are responsible for schooling in
general, including pre-school. The total number of these authorities, 290, suggests
that the school situation for deaf and hard of hearing children may look different in
different parts of Sweden since the local authorities are autonomous. According to

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169

HRF (2007) 35% of all pre-school children who were deaf and/or had a cochlear
implant and/or a hearing aid attended a specially adapted pre-school that year.
Almost all profoundly deaf children attended a special pre-school; the figure for
children with cochlear implants was 50
55% and for children with traditional hearing
aids 25
30%.
Local authorities are not obliged to offer specially adapted pre-schools of this
kind. Further, they can refuse to reimburse parents for their costs if the parents
choose a pre-school in a region outside their own. One of the conclusions drawn by
HRF (2007) is that many hard of hearing children with a need for specially adapted
pre-schools
for instance, those which use sign language, have good acoustics, limit
group sizes, etc.
do not have access to these schools today.
Just as with the pre-schools, the local authorities are not obligated to organise
special classes and/or schools for deaf and/or hard of hearing children. However, they
are responsible for providing for any childs needs in general terms. Mainstreamed
schooling is offered in general education classes, with or without extra, individual
support from assistant teachers. Of all children with hearing aids, 79% attended such
classes in 2007, as did 27% of all children with cochlear implants. No deaf children
without a cochlear implant were reported to be mainstreamed; they were all enrolled
in a special school (HRF 2007).
These mainstreamed pupils constitute the vast majority, 84%, of all children
with hearing impairment, which leaves 16%, i.e. 948 individuals, to other, specially
adapted school forms. The figures below are all from the school year 2006/2007, as
reported by HRF (2007):
. so-called hearing classes, i.e. small classes/groups mainstreamed in regular
schools, financed and organised by local and regional authorities (93 pupils
altogether);
. regional schools for hearing classes, financed and organised by the state and
local authorities (362 pupils total in seven different schools);
. regional special schools for deaf and hard of hearing children, financed and
organised by the state (493 pupils total in five different schools).
In addition to this, there is one special school for deaf and hard of hearing
children with learning disabilities and one school for visually impaired children with
additional disabilities.
Parents get information about the different schooling options from the habilitation centres. They are supposed to make their own choices as to which school is best
for their child, based on the degree of hearing loss in the child, the need for adapted
communication (including the need for sign language), for special technical
equipment, for acoustically adapted classrooms, and the distance to school, as well
as what the child wants (Hendar 2008). If they choose any of the five regional special
schools, the cost for doing so, including travelling costs and costs for lodging in a
family home during the weeks, if distance makes this necessary, is free.
Children with cochlear implants
Cochlear implants for children were introduced in Sweden around 1990. The number
of children who have received this surgically inserted electronic hearing aid has since
grown rapidly. Today, approximately 90% of all children born deaf receive an

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170

K. Svartholm

implant; it is also common that the child receives two implants, one in each ear (HRF
2007).3 There are very few deaf pre-school children in Sweden today who do not have
a cochlear implant. According to the official statistics, around 24% of the pupils in
special schools had cochlear implants in 2007 (SPM 2007), a figure that will certainly
increase dramatically within the next few years.
Very little is still known about the effects of these implants on language
development in the children, their academic achievement and their psycho-social
well-being from a long-term perspective. However, research on the very first
generation of deaf children with cochlear implants in Sweden has produced some
important insights that could be of importance to later generations.
In a longitudinal study conducted by Preisler et al., 22 children born between
1990 and 1994 were followed from pre-school age until the first years of school (e.g.
Preisler, Tvingstedt, and Ahlstrom 2002; for an overview, see Preisler 2007). As part
of the study, the children, their parents and their teachers were interviewed in order
to get their perspectives on the school situation for the children, their language use
and interaction with others.
For most of the parents in the study, the cochlear implant was regarded as a
means for the child to become bilingual in spoken Swedish and sign language. Sign
language was considered a necessity for the children to understand more complex
messages and grasp more abstract reasoning (Preisler 2007). Thus, it was agreed upon
that sign language worked as a complement to spoken language for these children.
This is fully in line with what is claimed by the Swedish Association of Hard of
Hearing People (HRF) when they call for sign language and bilingualism for their
target group as well, e.g. children with traditional hearing aids (e.g. Ahlstro m and
Svartholm 1998; HRF 2007; Svartholm 2007).
New generations may get even better prerequisites for developing speech and
hearing, due to better working implants and implantation at an earlier age than those
in Preislers study. Nevertheless, the need for sign language as a complement to
speech is apparent for these younger children as well. This is articulated as follows by
the Swedish Council on Technology Assessment in Health Care:
Cochlear implants enable children to develop speech communication skills, depending
on individual abilities. Maintaining sign language in these children, and in their
environment, is important since the outcome of implantation varies by individual and
because implants cannot be used in some situations . . . (SBU 2006, 1)

The importance of sign language and bilingualism for children with cochlear
implants has also received recognition in an inquiry preceding a law proposal (The
Swedish Language Act), a law that came into force from July 2009:
Children with ci [cochlear implant(s)] should [ . . .] not be regarded as hearing. They need
sign language for all life situations in which, despite ci, they cannot cope by using their
hearing alone. (SOU 2008, 122; non-official translation)

The inquiry continues:

It is particularly important that attention is drawn to the situation of children with ci
implants and their need for sign language. [ . . .] [The] general faith in the effect of the
implant on hearing capacity does not always match with the childs reality. It is also
difficult for the child to understand and express a need to have access to sign language in
particular situations. The child may itself gradually come to realize and express such a

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171

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need, but may meanwhile have missed out on a great deal both socially and in terms of
skills acquisition. (SOU 2008, 122; non-official translation)

Thus, the need for bilingual education for children with cochlear implants is officially
recognised in Sweden. Special schools, as well as the other school forms mentioned
above, are now exploring new ways of working bilingually that take into account the
changing context. For example, in one of the special schools, some classes are taught by
teachers who switch between sign language and Swedish during the lessons to try to
achieve a balance between the two languages. In another special school, deaf and
hearing teachers alternate between teaching different school subjects. The hearing
teacher may use sign language or Swedish or both, and in some classes, sign supported
speech is used as well. In this case, it is emphasised that using signs together with speech
is a support for lip-reading spoken language, not a representation of it. The common
assumption, irrespective of the choice of language use, is that sign language is the
language accessible to everyone and that both languages are important not only for
communication but also for learning and acquiring knowledge.
In other types of schools, work is ongoing as well. One of the regional schools in
Stockholm for hearing classes, i.e. classes/groups with hard of hearing children
mainstreamed in regular schools, is cooperating closely with a special school to
develop a bilingual approach that has been introduced recently for hard of hearing
children. Other schools of the same kind have also included sign language and
bilingualism as part of their local plans and guidelines.
What is needed today is overall planning and coordination of the work going on
within the schools. Much new developmental work is necessary in order to find the
best methods for teaching sign language, written language and spoken language in
the changing context. The authorities are aware of the importance of this for deaf
education in and beyond Sweden:
Internationally, Sweden can now, in the twenty-first century, just as we proved the right
to sign language for the deaf during the 1980s and 1990s, prove the importance and the
value of both sign language and technology and that an early developed bilingualism, in
sign language and Swedish, can be an asset in a life perspective. (SPM 2008, 5; my
translation)

The strength and value of the bilingual approach in deaf education is definitely
proven by the fact that todays parents in Sweden still choose special schools for their
deaf and hard of hearing children, whether their child has a cochlear implant or not.
They do so because they realise the linguistic needs of their children and want them
to become bilingual.

Notes
1.
2.
3.

This does not contradict the position that deaf people should be considered a linguistic
minority, as stated in several policy documents from The Swedish National Association for
the Deaf.
The reports all emphasise that the statistics are to be treated with caution because of the
small groups: only around 70 students leave special school every year, with or without
having attained the goals for getting their school-leaving certificates (e.g. SPM 2005).
The benefits from this were questioned in 2006 by SBU, The Swedish Council on
Technology Assessment in Health Care, established by the Swedish Government, which
came to the conclusion that scientific documentation on the effects of bilateral
implantation was insufficient (SBU 2006). Nevertheless, of all children in Sweden with

172

K. Svartholm
cochlear implants
483 children altogether
42% had bilateral implants in 2007 (HRF
2007).

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