Analysing The God Of Small Things English Literature Essay

Analysing The God Of Small Things English Literature Essay May in Ayemenem is a hot, brooding month. The days are long and humid. This luscious and mysterious description of India sounds unmistakably like a tourist novel yet this example of post colonial exoticism is used to lure in readers to the novel The God of Small Things. Whilst being better known for its celebrity stakes of the Booker Prize, the author Arundhati Roy is ethnic, a strong activist and her cultural authenticity passively provides an authentic Indian voice through her idealised western way of talking and thinking about the east. Roy plays into a colonial style known for its dominating, restructuring and authoritative power over India using references from politics and history to keep the story real and dangerously intoxicating for her western readers. It serves the dual purpose of being able to write back to the empire whilst becoming a product of global capitalism, hybridity of the west and the east, using eastern examples of western ideals through examples of critiqued p ower relations and subverted ideas of the exotic. The society of Ayamenem strongly follows westerns ideas adopted from its colonial background by living with a caste system in which there are two classes, the inferior touchables who are of a higher class than the untouchables. This idea is borrowed from the class system of the British so the inequality between both is familiar to its readers but is also exotic in the way that it controls society and influences everyday life. The extremity of having the untouchables so grateful to the touchable class that a man is willing to kill his own son when he discovers that he has broken the most important caste rule, that there is no interclass relations. These rules of society are unknown to that of the reader; it provides them with the mystery and danger of the exotic. Also having no interclass relations means that there is a lot of tension in the relationships between characters in the novel. The untouchables have internalized class segregation and are aware of the limits of their place in society. Relationships with these people are strongly discouraged but the members of this family find reason to cross and defy these rules. This is unusual behaviour and the idea of resistance against the adopted colonial system is exciting to its western audience who believe that the underdog can win although Roys account provides enough twists and turns to keep the reader guessing the consequences of the characters defiance. The novel also exoticises Indias inequality, making it light hearted and approachable for its western audience. The style of writing suggests that Roy has written the story from an outsiders perspective, looking, observing and commenting on daily life, strange insects appeared like ideas in the evening, questioning her authenticity through her strategic use of words and in this example she tells the reader of strange insects in the afternoon yet these insects should be familiar to the teller of the story. This westernisation becomes more apparent through Indian society who seem like they are trying to appeal to the wider western audience. While choosing a name for the family pickle company the relevance of the name was an important factor, At first he wanted to call it Zeus Pickles and Preserves, but that idea was vetoed because everybody said that Zeus was too obscure and had no local relevance, whereas Paradise did. (Comrade Pillais suggestion -Parashuram Pickles was vetoed for the opposite reason: too much local relevance). Instead of marketing to their local community, the name Paradise seemed more suitable which shows how self aware their society has become knowing that the pickling company could be seen on a global scale promoting its exotic feeling to produce global product. Roy promotes this kind of thinking throughout her novel and in a sense she is able to sell her culture through her strategic storytelling. She tells of hotels that have truncated traditional kathakali performances from six hour classics to twenty minutes cameos for the small attention spans of the tourists. It shows how Indian society has given into its colonialisation, allowing their cultural values and actions to be altered so that it can be marketed on a global scale. The strategic use of how India will be seen from a tourist point of view appeals greatly to those who have never seen India and in these terms Roy provides the idealistic tourist guide that they have been seeking wi th bite sized portions of a culturally authentic experience such as her use of traditional Malayalam words throughout the text. Not only has Roy tried to westernise India in her novel, she has also borrowed ideas and put them into and Indian context. The notion of love is not widely or publicly spoken about in India (although glamorised through film), it is something that is private and varies with the type of belief system one has. The God of Small Things is unique in this way; it could almost be seen as a tragic Indian love story showing the different interpretations of the dimensions of love. The idea of romantic love barely exists in Indian society as it collective society who make decisions together while romantic love is independently chosen and a modern way of finding a partner. Roy explores this through the relationship between characters such Chacko and Margaret. Chacko is Indian and he falls in love with a European woman and their relationship is the least stable as they find that it does not work and although it is demanding to say the least, Chacko decides to devote himself to her even after they have split so he can always be there for her. This type of relationship can be identified with easily as it seems to be more common throughout the west and it shows how multicultural relationships work within society. Baby Kochamma also tries to find meaning in her life through unrequited love for a Irish priest. The idea of unrequited love is discouraged in Indian society as it is embarrassing for the family as it is publicly unsuccessful. Familial love is then the most important and scared of all types of relationships. The parents in the novel have a very strong and deep love for their children that readers can relate to, Chacko loves his daughter Sophie so much (even though he barely knew her) that when she dies he is distraught and has to move away. Ammu also has a very strong love for her children and she shares that with Velutha (her love interest) who also shows an unselfish love for her children as a reflection of his love for Ammu. The twins also love each other very much and their love is so strong that they can easily know what each other is thinking and feeling although this is where Roy introduces a twist to the plot by having these types of love become forbidden and incestuous. She crosses the line that most Indian authors would we unwilling to as such things are unspoken of and yet at the same time this excites the western readers who can handle reading about such a taboo experience. She shows that love is a powerful and uncontrollable force that cannot be contained by conventional social codes because a traditional Indian society (in the case of Ammu and Velutha) seeks to destroy romantic love as it believes that love should only be an emotion that is explained through two peoples cultural background and political identities. Roy speaks of love laws that have to be abided and such rules seem ridiculous and even intriguing to see how people live by them and the fascination of what happens if one might break these rules and how desperation and desire fight the overbearing force of being punished for loving the wrong person. The themes used by Roy are universal and provide a comfortable introduction to India. She is aware of how to sell her culture to the global market and is successful in promoting this novel as an authentic experience to the western world. It is not threatening but yet hybridity of cultures, strategically using exoticism to her advantage almost tricking her western audience into their curiosity to know more through her ability to be able to tell a great story which has no secrets and is exposed for all to take with them.

Preventing Blood Stream Infections Health And Social Care Essay

National Patient Safety Goals ( NPSG ) were introduced in 2002 in order to assist turn to some of the issues that were responsible for doing a bulk of the state of affairss that were responsible for making patient safety issues. These ends were implemented in order to set concentrate on what were deemed to be the most preventable of these issues. One of these ends is the bar of cardinal line-associated blood watercourse infections ( Lyles, Fanikos, & A ; Jewell, 2009 ) . Literature Review Central venous catheters ( CVC ) are indispensable in the attention of critically sick patients. However, their usage is non without hazard. Catheter-associated blood stream infections ( CA-BSI ) are common healthcare-associated infections in intensive attention unit ( ICU ) patients and have been estimated to happen in 3 % -7 % of all patients with CVC ( Warren, et al. , 2006 ) . It is good documented that intravascular catheter related complications are associated with widening hospital length of stay, increasing direct costs and increasing ICU mortality. Clinicians insert about 7 million cardinal venous entree devices ( CVAD ) yearly in the United States, and of these, 1 in 20 is associated with a CA-BSI, despite the usage of the best available sterile techniques during catheter interpolation and care. Overall, an estimated 250,000 CVAD-related CA-BSI occur yearly, with an attributed mortality of 12.5 % to 25 % per happening. The national cost of handling CA-BSI peers $ 25,000 per infection, severally, or $ 296 million to $ 2.3 billion in entire. While the figure of CA-BSI has remained comparatively steady, vascular entree device usage has drastically increased, particularly in nonhospital scenes ( Rosenthal, 2006 ) . A huge sum of research is directed toward cut downing these complications in an attempt to better patient outcomes. A reappraisal of the literature provides an overview of current recommendations refering intravascular catheter attention and research sing the usage of instruction plans to advance recommended pattern. The Centers for Disease Control and Prevention ( CDC ) published the Guidelines for the Prevention of Intravascular Catheter-Related Infections in 2002, which is the benchmark for all intravascular catheter attention recommendations. The guidelines for CVC suggest the replacing of dressings every 7 yearss or when soiled or loosened, endovenous tube alterations every 72 hours, and the replacing of tubing used to administrate blood merchandises and lipid emulsions within 24 hours of extract induction ( East & A ; Jacoby, 2005 ) . Harmonizing to the CDC, about 53 % of grownup patients in intensive attention units have a cardinal venous catheter on any given twenty-four hours ( Rupp, et al. , 2005 ) . Skin cleaning of the interpolation site is regarded as one of the most of import steps for forestalling catheter-related infection. Historically, povidone-iodine is an antiseptic that has been used during the interpolation and care of the intravascular devices. It works by perforating the cell wall of the micro-organism. More late, chlorhexidine has been studied and found to be more effectual as a skin antiseptic to forestall catheter-related infection. It works in less clip, retains its antibacterial consequence against vegetation thirster, is non inactivated by the presence of blood or human protein, and causes minimum skin annoyance. Chlorhexidine works by interrupting the microbial cell wall. It is active against many Gram-positive and to a somewhat lesser degree Gram-negative bacteria ( Astle & A ; Jensen, 2005 ) . A multistep procedure is recommended to forestall CA-BSI that includes: educating staff, utilizing maximum barrier safeguards ( e.g. a unfertile gown and baseball mitts, mask, cap, and big unfertile curtain ) , executing infection surveillance, and replacing occlusive dressing every 7 yearss or when needed ( Buttes, Lattus, Stout, & A ; Thomas, 2006 ) . Other strongly recommended patterns include proper manus hygiene, usage of chlorhexidine gluconate for interpolation site readying, and turning away of everyday catheter alterations. Catheters impregnated with antimicrobic agents are recommended when infection rates are high or when catheters will stay in topographic point for a considerable clip ( Krein, et al. , 2007 ) . Education of staff on the proper attention of CVC is paramount in cut downing the sum of CA-BSI. This is possibly one of the most cost-efficient methods of cut downing CA-BSI ( Ramritu, Halton, Cook, Whitby, & A ; Graves, 2007 ) . Execution A staff instruction plan was initiated for the nursing forces that chiefly deal with CVC. This instruction plan was aimed at developing the ICU and step-down unitaa‚Â ¬a„?s nursing staff proper attention and care of the CVC. Education focused on proper attention of the CVC, including when dressing alterations should be performed e.g. every 7 yearss or when the dressing is soiled. Nurses were besides trained in how to suitably help with CVC arrangement and the certification tool that infection control utilizes to measure attachment to interpolation guidelines. Posters were besides placed in the nurseaa‚Â ¬a„?s interruption and conference countries that had educational stuff related to proper attention of CVC. Documentation was besides placed in the physicianaa‚Â ¬a„?s lounges that bucked up use of maximum barrier safeguards during CVC interpolation. The installation that was observed presently utilizes a few different agencies of measuring with respects to CA-BSI. First, a checklist is utilised during CVC interpolation that evaluates attachment to interpolation guidelines by the staff. This checklist is sent to infection control and entered into a database which is correlated with patient informations sing CA-BSI. Second, in patients that are identified as holding a CA-BSI, after catheter remotion, laboratory microbiological surveies of the catheter, blood, and interpolation site swabs are performed to place causality of the infection. Execution Compared to Literature Suggestions Practices that cut down the hazard of CA-BSI include the undermentioned: ( 1 ) usage of maximum barrier safeguards during CVC interpolation ( i.e. , a surgical mask, unfertile gown, unfertile baseball mitts, and big unfertile curtains ) , ( 2 ) arrangement of the catheter in the subclavian vena instead than the internal jugular or femoral vena, ( 3 ) altering catheters merely when necessary, and ( 4 ) altering dressings on CVC issue sites when they become nonocclusive, soiled, or bloody. These patterns have been incorporated into national guidelines. Presently, the Healthcare Infection Control Practices Advisory Committee ( HICPAC ) of the Centers for Disease Control and Prevention ( CDC ) recommends that infirmaries implement comprehensive educational plans that teach proper CVC interpolation and care techniques ( Warren, et al. , 2006 ) . These patterns are largely in line with what is implemented at the ascertained installation. One difference, which is non in line with these reco mmendations, is that the ascertained installation has a high figure of internal jugular interpolations instead than using the subclavian vena. When asked about this, many of the doctors stated that entree was easier to place utilizing ultrasound during interpolation and they preferred this method over subclavian interpolation. Recommended Changes First, execution of an instruction plan for suppliers that is focused on infection control, particularly the recommendation of using the subclavian vena interpolation for CVC arrangement as a first pick in patients that have no contraindications to this arrangement. Second, securing the second-generation antiseptic catheter, coated with chlorhexidine and Ag sulfadiazine on the internal and external surfaces, to more efficaciously prevent microbic colonisation in patients that are identified as being at hazard. Decreased bacterial colonisation, a critical measure in the pathogenesis of catheter-associated infection, may correlate with bar of catheter-related bacteriemia ( Rupp, et al. , 2005 ) . Third, instruction and preparation demands to be expanded to any nurses that may be responsible for caring for a patient with a CVC. These countries include non-critical attention countries such as paediatric and medical floors. Larger Numberss of patients with CVC are now found in non-ICUs th an in ICUs and that CA-BSI rates in those scenes are higher. Catheter types and interpolation sites vary greatly among scenes. For illustration, jugular and femoral interpolation sites are common in ICUs ; subclavian and peripheral sites are more common elsewhere. So schemes for cut downing CA-BSI must be tailored to the scene ( Hadaway, 2006 ) .

The Savage Beast†Man’s Inherent Primitivism as Shown in Lord of the Flies

Ray Penman Oct 3, 2010 The Savage Beast— Man’s Inherent Primitivism as Shown in Lord of the Flies A running theme in Lord of the Flies is that man is savage at heart, always ultimately reverting back to an evil and primitive nature. The cycle of man's rise to power, or righteousness, and his inevitable fall from grace is an important point that book proves again and again, often comparing man with characters from the Bible to give a more vivid picture of his descent.Lord of the Flies symbolizes this fall in different manners, ranging from the illustration of the mentality of actual primitive man to the reflections of a corrupt seaman in purgatory. The novel is the story of a group of boys of different backgrounds who are marooned on an unknown island when their plane crashes. As the boys try to organize and formulate a plan to get rescued, they begin to separate and as a result of the dissension a band of savage tribal hunters is formed. Eventually the boys lose all sen se of home and civilization. â€Å"The world, that understandable and lawful world, was slipping away. (Golding, Ch 5) When the confusion finally leads to a manhunt, the reader realizes that despite the strong sense of British character and civility that has been instilled in the youth throughout their lives, the boys have backpedalled and shown the underlying savage side existent in all humans The novel shows the reader how easy it is to revert back to the evil nature inherent in man: if a group of well-conditioned school boys can ultimately wind up committing various extreme travesties, one can imagine what adults, leaders of society, are capable of doing under the pressures of trying to maintain world relations.Lord of the Flies’ apprehension of evil is such that it touches the nerve of contemporary horror as no English novel of its time has done; it takes us, through symbolism, into a world of active, proliferating evil which is seen, one feels, as the natural condition of man and which is bound to remind the reader of the vilest manifestations of Nazi regression. In the novel, Simon is a peaceful lad who tries to show the boys that there is no monster on the island except the fears that the boys have. Simon tries to state the truth: â€Å"Maybe there is a beast†¦What I mean is†¦ maybe it's only us. † (Golding, Ch 5) When he makes this revelation, he is ridiculed. This is an uncanny parallel to the misunderstanding that Christ had to deal with throughout his life. Later in the story, the savage hunters are chasing a pig. Once they kill the pig, they put its head on a stick and Simon experiences an epiphany. As Simon rushes to the campfire to tell the boys of his discovery, he is hit in the side with a spear, his prophecy rejected and the word he wished to spread ignored.Simon falls to the ground dead and is described as beautiful and pure. The description of his death, the manner in which he died, and the cause for which he died ar e remarkably similar to the circumstances of Christ's life and ultimate demise. The major difference is that Christ died on the cross, while Simon was speared. However, a reader familiar with the Bible recalls that Christ was stabbed in the side with a spear before his crucifixion. When Piggy, the largest advocate of the law, is killed near the end of the book, the conch is broken.Until that point, the conch had been a way to control and pacify the crowd— only someone holding the conch may speak. When Jack and the boys have had enough of Ralph’s laws, the boys kill Piggy and shatter the conch. The law ceases to exist, though when the boys are rescued, the â€Å"game† ends and they are once again just bedraggled boys smeared in mud and blood on the shore. William Golding discusses man's capacity for fear and cowardice. In the novel, the boys on the island first encounter a natural fear of being stranded on an uncharted island without the counsel of adults.Once th e boys begin to organize and begin to feel more adult-like themselves, the fear of monsters takes over. It is understandable that boys ranging in ages from toddlers to young teenagers would have fears of monsters, especially when it is taken into consideration that the children are stranded on the island. The author wishes to show, however, that fear is an emotion that is instinctive and active in humans from the very beginnings of their lives.This revelation uncovers another weakness in man, supporting the idea or belief that man is pathetic and savage at the very core of his existence. Throughout the novel, there is a struggle for power between two groups. This struggle illustrates man's fear of losing control, which is another example of his selfishness and weakness. The fear of monsters is natural; the fear of losing power is inherited. The author uses these vices to prove the point that any type of uncontrolled fear contributes to man's instability and will ultimately lead to h is demise spiritually and perhaps even physically.The author chooses to use an island as the setting for the majority of the story. The island is an important symbol in Lord of the Flies. It suggests the isolation of man in a frightening and mysterious cosmos. The island in the novel is an actual island, but it’s more than just that. It is a microcosm of life itself, the adult world, and the human struggle with his own loneliness. Man grows more savage at heart as he evolves because of his cowardice and his quest for power.The novel proves this by throwing together opposing forces into a situation that dowses them with power struggles and frightening situations. By comparing mankind in general to Biblical characters in similar scenarios, the novel provides images of the darker side of man. This darker side of man's nature inevitably wins and man is proven to be a pathetic race that refuses to accept responsibility for its shortcomings.Bibliography: Golding, William. Lord of t he Flies. 1952. 13. 3 (1952): 1-248. Print.

Elvis by Albert Goldman essays

Elvis by Albert Goldman essays Elvis by Albert Goldman is a book about the life and times of the king of rock and roll. It shows how a country boy rose up and ruled the world of music, and also showed his downfall. It starts by telling about Elvis' childhood, and moving to his teenage years. Elvis was always a wholesome country boy no matter if people considered him leud, or outrageous. In fact, Elvis was discovered when he made a record for his mothers birthday, Elvis always respected his parents. Next it moves on to the first few records that Elvis cut at Sun Records with his first producer Sam Phillips. What made Elvis different from other singers was that he was "a white boy who could sing like a nigger." as Sam Phillips described his style. It then moves on to detail his breakthrough year of 1956 in which he had such hits as Heartbreak Hotel, and Hound Dog. 1956 was the year that Elvis took America by storm, and earned him the title "The King of Rock and Roll". After that, it states the hardships that Elvis faced over the next few years in the military. These few years were not very good for Elvis, for the first time he had to leave the US, and his beloved mother passed away before he left for his assignment in Germany. Moving on it tells us about his glorious return to the United States, reclaiming his title as "King", and moving on to something bigger and better the movies. Over the course of the next few years Elvis made a lot of movies, but none were liked by the critics, but they did make money. After his less than stellar movie career Elvis came back to music with a blast the 68' Comeback Special. Once again Elvis was on top of the music industry. After the 68' Comeback Special Elvis moved on to very successful shows at Las Vegas. Elvis played in Las Vegas until his death. He also started to tour again. It was during this time that he and his wife of only a few years, Pri...

How to Provide Social Media Customer Service [PODCAST]

How to Provide Social Media Customer Service [PODCAST] Social media: If you have it, you need to be involved. Sometimes, your customers will use the power of social media to bring concerns and tough questions to your attention. Do you know how to handle these often very public situations? Today, we are talking to Agnieszka JaÅ›kiewicz, the social media manager at LiveChat. She’s going to talk about her process when it comes to handling tough customer interactions via social media, and you’ll learn how to provide the best customer service possible with your chosen networks and platforms. Information about LiveChat and what Agnieszka does there. Agnieszka’s favorite story about providing excellent customer service via social media. A good process for providing great customer support, including how to know when to switch to private messages and how to keep track of the questions and concerns that come in. Tips on how to decide which platforms to use as a business. Agnieszka’s best tricks for responding quickly to customer concerns via social media. How to diffuse the situation when a customer is angry and attacking on your social media page. Why it’s important for every business to have some type of social media presence. Links: Agnieszka JaÅ›kiewicz on LinkedIn LiveChat If you liked today’s show, please subscribe on iTunes to The Actionable Content Marketing Podcast! The podcast is also available on SoundCloud, Stitcher, and Google Play. Quotes by Agnieszka: â€Å"I would use the customer service mantra, be where your customers are.† â€Å"People don’t like to wait on social media. They came to social media because they want their query to be answered quickly.† â€Å"If I were to choose one piece of general advice, I would say make one person responsible for answering this queries on social media.†

African-American family sitcoms Assignment Example | Topics and Well Written Essays - 2000 words

African-American family sitcoms - Assignment Example The Jeffersons showed that poor, uneducated blacks could make a great success of themselves with some hard work and pluck, and this show, too, showed good family values. The Cosby Show was a show that did not really reference the black experience, but their family values were also excellent. Their message was that blacks can be well-educated and wealthy. This essay will examine each of these shows. The first black sitcom that will be analyzed will be Good Times. The particular episode is titled Black Jesus.The basic premise of Good Times is that it follows a struggling black family who are living in the ghetto – Michael, who is the youngest child and eventually is a militant black man, but,in the early days, he was a young boy who was very much into black power and black rights; JJ, the oldest child who was a gifted artist and a wisecracker;Thelma, the middle child, who's identity was somewhat nebulous, although she did seem to be into black rights as well, but not as much as Michael; Florida,the mother, who is very religious and had an iron will and was intelligent and kept her family in line;and James, the father, who was struggling for work and could sometimes be temperamental and dominant,but was also very loving.This episode was a typical episode – the jokes came from various aspects of what it meant to be poor and black. This was a sitcom in the 1970s, but its jokes still seem fresh and relevant and timeless today. In this episode, JJ was working to enter an art contest, and his topic was a pimp who lived in the neighborhood. Thelma didn't think that this was an appropriate thing to paint, but JJ pointed out that this pimp made a lot of money not doing much of anything, and that he was the â€Å"same dude who got shot and ran seven miles to the hospital† (Good Times). This line was good for a laugh. JJ also showed that he painted a portrait of Jesus who was black, and this Jesus was based upon â€Å"Ned the wino,† a local alcoh olic who everybody knew. Michael loved the idea of a black Jesus, so he put the picture on the wall in place of the real Jesus. Florida, the Christian woman, didn't like the idea of the black Jesus, until Michael pointed out that The Bible indicated that Jesus had â€Å"hair like wool, and eyes like fire,† which means that Jesus might have really been black. At that point, Florida changed her mind about having the painting on the wall. Then, everybody in the family started to experience luck. James' bet on the horses paid off, and he went to the IRS for an audit and found that they owed him money. Thelma was asked out by somebody she liked. Winona, the neighbor, who had a disastrous date, but it turned out that the guy was rich. James decided that it was black Jesus who was bringing the family luck, so he wanted to keep it on the wall. In the end, JJ entered the black Jesus in the art contest, but lost, but the black Jesus was hung on the wall alongside the traditional Jesus. This was a typical episode of Good Times. JJ had most of the cracks, and these cracks were jokes that reflected the ghetto black experience. The crack about the pimp being the same guy who got shot and had to run 7 miles to the hospital got many laughs. Another crack came when the family debated on whether Jesus really was black, and Michael pointed out that Jesus was lost in the desert, and JJ said â€Å"that makes sense. If ever people were lost, we are it.† This shows the type of gallows humor, where people who are oppressed make light of their situation, which is often seen in black sitcoms that focus around poor blacks. Other jokes make light of the

Hearing Imapried Essay Example | Topics and Well Written Essays - 1000 words

Hearing Imapried - Essay Example ‘Hard of hearing’ is a term referring to a person who has some degree of hearing loss but is able to function in the hearing and speech modalities either with or without the use of assistive listening devices such as hearing aids. ‘Deaf’, on the other hand, is a term used to refer to people who have a greater degree of hearing loss, use sign language as their primary means of communication, and are in some manner affiliated with the Deaf community. Thus, deafness may be viewed as a condition that prevents an individual from receiving sound in all forms. In contrast, a child with hearing loss can generally respond to auditory stimuli, including speech (â€Å"Deafness†, 2004). Section 504 of IDEA states, â€Å"No otherwise qualified individual with disability in the United States †¦ shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance† (â€Å"Exceptional†, 2007). The problem undertaken in ensuring this law is complied with enters when one begins to look at the various characteristics of hearing loss and deafness and attempts to incorporate alternative learning strategies into the classroom are made. People who are deaf or hard of hearing use one of three main approaches to communicate. These include the oral approach, the manual approach and the total approach. The oral approach makes heavy use of speech and reading skills to communicate with others and generally has a tendency to remain close to the familiar. The manual approach uses sign language only as a means of communicating and is generally used by people who are completely deaf or well integrated into the Deaf community. Total communication refers to the use of a combination of the oral and manual approach to communication, including the use of informal gestures and written or spoken words. Certain