On the Coexistence of Captions and Sign Language as Accessibility Solutions in Educational Settings.

Different studies have shown that deaf and hard of hearing (DHH) students face many difficulties in learning applied disciplines in science, engineering, technology, and mathematics. The development of videos or avatars to aid in the teaching of programming for positively affects DHH students. The use of sign language increases the understanding of DHH, therefore, it will be utilized in the proposed virtual and Augmented reality environment which will hopefully improve students’ performance in learning about computer programming as well as enhance their engagement and facilitate the accessibility of learning for learners suffering from deafness in Saudi Arabia. This thesis aims to help deaf and hearing-impaired students in Saudi Arabia to tackle applied subjects like computer programming and equip them for careers in the technological field. Computer programming is an integral component in this field that can greatly assist in developing technological solutions. The study reveals important considerations in the creation of a virtual learning environment for DHH students to learn computer programming and showed that DHH students performed well, understood the topics, and could write a small program. The research methodology shows how to create an avatar for teaching computer programming using Arabic sign language. This gives DHH students opportunities to join the scientific world as they were previously unable to do so. Three expert signers evaluated the proposed Arabic Sign Language (ArSL) dictionary with 450 technological terms and added 114 new signs to the signer dictionary. Therefore, to make an overall evaluation, Augmented Reality (AR) as a knowledge technology will be applied through the 6 unit of the proposed “Java programming” course. Accordingly, 6 designed flashcards will be used, one flashcard for each course unit to retrieve summarized knowledge discovery of this unit. Also, many tools will be used to support augmented reality such as Vuforia and Unity library.

ObjectiveThe purpose of the study was to describe the collaborative process of a deaf-hearing research team developing diabetes education videos in American Sign Language (ASL) for deaf and hard of hearing (DHH) populations.MethodsDiabetes education videos were guided by a DHH community advisory board (CAB) who were living with diabetes (N = 10), DHH video production team (N = 9), DHH research team members (N = 3), hearing clinical experts and research team members (N = 3), and a hearing designer (N = 1). Over 10 meetings, the CAB provided ongoing feedback to enhance video content and design. Videos were then developed using a rigorous 5-step process that involved script development, design of visual supports, script translation into ASL by native signers, video recording, and video editing. Interviews with individual CAB members were obtained to understand future video needs.ResultsUsing a design thinking and collaborative approach between deaf-hearing team members, 20 diabetes education videos were designed to prioritize ASL and DHH culture while still being inclusive for hearing family members who may not know ASL. The videos met the WebAIM guidelines for accessibility. CAB members rated the videos positively.ConclusionsThe diabetes education videos in ASL fill an existing void in diabetes education for DHH populations and are still being evaluated in the Deaf Diabetes Can Together intervention and will be placed on a future diabetes education website in ASL. This article highlights key details of developing diabetes education videos using a deaf-hearing team that future studies could learn from.

Since the late nineties, several assessments to track and assess sign language acquisition in deaf and hard of hearing (DHH) children have been developed and standardised for some sign languages (Herman, Rowley, Mason, & Morgan, 2014; Rosenburg, Lieberman, Caselli, & Hoffmeister, 2020). These assessments have provided important insights into how DHH children acquire sign language and how acquisition can be impacted by developmental or acquired disorders (Mason et al., 2010; Quinto-Pozos, Forber-Pratt, & Singleton, 2011). Moreover, the development of sign language assessments has enabled research studies to show associations between language, cognitive skills and literacy (Botting et al., 2017). The availability of sign language assessments has confirmed that DHH children from DHH, signing families achieve similar milestones in sign language as their hearing counterparts in spoken language. Yet the measures developed to date are insufficient for tracking bimodal bilingual development in DHH children, particularly as children progress through the later school years. This article reviews hitherto mentioned and new issues in test development and standardization related to the status of sign language research, the size and nature of the population of DHH signers, and tester issues with a specific focus on assessments used by practitioners rather than those designed for research purposes. References are made to the reasons why DHH children are at risk for language delay. A selection of different types of sign language test is presented. In the UK and elsewhere, many of the tests developed to date have focused on the earlier stages of language development. We therefore include a description of a UK project that is adapting an assessment for adolescent signers.

Deaf and hard of hearing (DHH) individuals who use signed language and those who use spoken language face different challenges and stressors. Accordingly, the profile of their mental problems may also differ. However, studies of mental disorders in this population have seldom differentiated between linguistic groups. Our study compares demographics, mental disorders, and levels of distress and functioning in 40 patients using Norwegian Sign Language (NSL) and 36 patients using spoken language. Assessment instruments were translated into NSL. More signers were deaf than hard of hearing, did not share a common language with their childhood caregivers, and had attended schools for DHH children. More Norwegian-speaking than signing patients reported medical comorbidity, whereas the distribution of mental disorders, symptoms of anxiety and depression, and daily functioning did not differ significantly. Somatic complaints and greater perceived social isolation indicate higher stress levels in DHH patients using spoken language than in those using sign language. Therefore, preventive interventions are necessary, as well as larger epidemiological and clinical studies concerning the mental health of all language groups within the DHH population.

Deaf and hard of hearing (DHH) children are at particular risk of delays in the development of Theory of Mind (ToM) skills compared to hearing peers. One perspective links this to the development of social-cognitive abilities related to language acquisition (spoken language and/or sign language). Both ToM and language emerge from direct and indirect participation in communicative interactions. In this chapter we outline how ToM has several antecedent steps based in early interaction. The development of ToM leads on to many later important achievements during the school years. Research has also shown that intervention programmes can lead to improvements in ToM. In this context we describe the training programme The Mind Readers which aims to improve the development of ToM. The intervention targets ToM skills, emotion understanding, related sign and spoken language skills (on word/sign level, syntax, and conversation) in DHH children and young people.

The demand for employment in specific computing fields is high, during the last years. However, the deaf and hard of hearing (DHH) persons are significantly underrepresented. In this paper, we study methods for increasing the participation of DHH students in computing fields, in order to provide them equal opportunities with normal students. We focus on the following two key research questions: What is an appropriate inclusive curriculum in Higher Education for supporting DHH students studying information technology? What kind of assistive technology resources (e.g., vocabularies in Sign Language) should be embedded in the curriculum, and how DHH students can be enabled to access and use such resources? A systematic review of the literature is conducted, and the design of an introductory academic course on information technology literacy for DHH students is examined.

Care partners play an important role in diabetes management of people with diabetes. Although deaf and hard of hearing (DHH) adults experience diabetes at a higher rate than their hearing counterparts, there is a lack of information regarding the experience of care partners assisting those in the DHH community. There is a need to identify intentional support for this population. The purpose of this study was to explore how care partners of DHH people with diabetes provide helpful and unhelpful support, the care partner experience of providing support, and care partners' perceived diabetes self-management education, support needs, and recommendations. We engaged a community advisory board of care partners to DHH people with diabetes to explore how care partners provide support, their individual experiences in providing support, and their suggestions for diabetes self-management education. We used thematic analysis to analyze individual and collective responses. Three emergent themes were identified suggesting that care partners give support in a variety of ways, are often overwhelmed in meeting the demanding and ongoing needs of DHH people with diabetes, and have a multitude of suggestions for implementing a future diabetes care partner education program. We also identified some DHH population-specific challenges to diabetes care, including communication barriers with health care providers, inability to use hearing cues if a person with diabetes experiences a fall, and limited access to diabetes care education in sign language. These findings highlight a need to provide more support for care partners of DHH people with diabetes and to address the needs of DHH populations to ensure more equitable diabetes care. Further research is needed to adequately inform successful interventions for DHH people with diabetes and their care partners.

Sign Languages (SLs) are employed by deaf and hard-of-hearing (DHH) people to communicate on a daily basis. However, the communication with hearing people still faces some barriers, mainly because of the scarce knowledge about SLs among hearing people. Hence, tools to allow the communication between users of either sign or spoken languages must be encouraged. A stepping stone in this direction is the research of the sign language translation (SLT) task, which aims to produce a spoken language translation of a sign language video or vice versa. By implementing these types of translators in portable devices, we will make considerable progress towards a barrier-free communication between DHH and hearing people. That is why, in this work, we focus on reviewing the literature on SLT and provide the necessary background about SLs. Besides, we summarise the available datasets and the results found in the literature for one of the most used datasets, the RWTH-PHOENIX-2014T. Moreover, the survey lists the challenges that need to be tackled within the SLT research and also for the adoption of SLT technologies, and proposes future research lines.

Research rarely focuses on how deaf and hard of hearing (DHH) students address mathematical ideas. Complexities involved in using sign language (SL) in mathematics classrooms include not just challenges, but opportunities that accompany mathematics learning in this gestural-somatic medium. The authors consider DHH students primarily as learners of mathematics, and their SL use as a special case of language in the mathematics classroom. More specifically, using SL in teaching and learning mathematics is explored within semiotic and embodiment perspectives to gain a better understanding of how using SL affects the development, conceptualization, and representation of mathematical meaning. The theoretical discussion employs examples from the authors' work and research on geometry, arithmetic, and fraction concepts with Deaf German and Austrian learners and experts. The examples inform the context of mathematics teaching and learning more generally by illuminating SL features that distinguish mathematics learning for DHH learners.

With approximately 40-50% of deaf and hard of hearing (DHH) individuals also having a disability, complex communication needs are particularly prevalent in this population. Augmentative and alternative communication (AAC) systems can address these complex communication needs, support language acquisition, and facilitate communicative engagement. This article examines (a) the role of AAC in supporting DHH individuals with disabilities (DHH+), (b) the integration of AAC with sign language, and (c) the relevant considerations when assigning and implementing AAC for this group. The literature reviewed within this article specifically highlighted that effective implementation of AAC for DHH+ individuals who have complex communication needs may be improved by (a) increased diagnostic accuracy, (b) access to a first language, and (c) the development of standardized methods for AAC selection and implementation tailored to the individual.

Vision is considered a privileged sensory channel for deaf and hard of hearing (DHH) students to learn, and, naturally, they recognize themselves as visual learners. This assumption also seems widespread among schoolteachers, which led us to analyse the intersection between teachers’ beliefs on deaf and hard of hearing students’ academic achievement, visual skills, attentional difficulties, and the perceived importance of image display in class. An online survey was designed to analyse the beliefs of the schoolteachers about the deaf and hard of hearing students learning in educational settings from Portugal and Sweden. Participated 133 teachers, 70 Portuguese and 63 Swedish, from the preschool to the end of mandatory education (ages 3–18) with several years of experience. The content analysis and the computed SPSS statistical significance tests reveal that surveyed teachers believe that deaf and hard of hearing students have better visual skills when compared with their hearing peers yet show divergent beliefs about visual attentional processes. Within the teachers’ perceptions on learning barriers to DHH students, the distractibility and cognitive effort factors were highlighted, among communicational difficulties in class. Conclusions about the prevalence of learning misconceptions in teachers from both countries analysed, corroborate previous studies on neuromyths in education, and bring novelty to Deaf Education field. The work of translation of scientific knowledge, teacher training updating, and partnership between researchers and educators are also urgently needed in special education.

Imitation and language processing are closely connected. According to the Ease of Language Understanding (ELU) model (Rönnberg et al., 2013) pre-existing mental representation of lexical items facilitates language understanding. Thus, imitation of manual gestures is likely to be enhanced by experience of sign language. We tested this by eliciting imitation of manual gestures from deaf and hard-of-hearing (DHH) signing and hearing non-signing children at a similar level of language and cognitive development. We predicted that the DHH signing children would be better at imitating gestures lexicalized in their own sign language (Swedish Sign Language, SSL) than unfamiliar British Sign Language (BSL) signs, and that both groups would be better at imitating lexical signs (SSL and BSL) than non-signs. We also predicted that the hearing non-signing children would perform worse than DHH signing children with all types of gestures the first time (T1) we elicited imitation, but that the performance gap between groups would be reduced when imitation was elicited a second time (T2). Finally, we predicted that imitation performance on both occasions would be associated with linguistic skills, especially in the manual modality. A split-plot repeated measures ANOVA demonstrated that DHH signers imitated manual gestures with greater precision than non-signing children when imitation was elicited the second but not the first time. Manual gestures were easier to imitate for both groups when they were lexicalized than when they were not; but there was no difference in performance between familiar and unfamiliar gestures. For both groups, language skills at T1 predicted imitation at T2. Specifically, for DHH children, word reading skills, comprehension and phonological awareness of sign language predicted imitation at T2. For the hearing participants, language comprehension predicted imitation at T2, even after the effects of working memory capacity and motor skills were taken into account. These results demonstrate that experience of sign language enhances the ability to imitate manual gestures once representations have been established, and suggest that the inherent motor patterns of lexical manual gestures are better suited for representation than those of non-signs. This set of findings prompts a developmental version of the ELU model, D-ELU.

In remote collaboration using Augmented Reality (AR), speech and gesture are major communication methods for the general public. However, the Deaf and Hard-of-Hearing (DHH) population cannot join in the communication due to the absence of a sign language interface which is their primary language. Recent works have tried to augment spoken language with sign language animations or captions, but the research to convey sign language with spoken language is still very limited. In this paper, we propose a novel multi-modal communication system that integrates sign language translation, speech recognition, and shared object manipulation in the mobile AR environment. Though the system is currently under development, we demonstrated a rapid prototype of the telemedicine app leveraging the video prototyping method to integrate the system modules. We performed preliminary interviews about our approach with DHH users, a sign language interpreter, and a physician. We discuss the insights into the future design of the DHH communication support in the AR collaboration system. This study has a socio-cultural, economic impact on the DHH population as a barrier-free design of a remote collaboration system in a practical scenario. Another contribution of this work is that we suggested a novel user-centered system for DHH users in AR by integrating the existing technologies.

IntroductionDespite the significant number of deaf and hard of hearing (DHH) people living in the U.S., oral health research on DHH people who use American Sign Language (ASL) is virtually nonexistent. This study aims to investigate dental needs among mid-to-older DHH women and identify social determinants of health that may place them at higher risk for unmet dental health needs as the primary outcome.MethodsThis cross-sectional study uses data drawn from Communication Health domain in the PROMIS-DHH Profile and oral health data from the National Health and Nutrition Examination Survey. Both measures were administered in ASL and English between November 2019 and March 2020. Univariate and bivariate analysis included only complete data, and multivariable logistic regression analyses were conducted on multiply imputed data.ResultsOut of 197 DHH women (41 to 71+ years old) who answered the dental visit question, 48 had unmet dental needs and 149 had met dental needs. Adjusting for sociodemographic variables, disparity in dental needs was observed across education [OR (95% CI): 0.45(0.15, 1.370)] and communication health [0.95 (0.90, 1.01)].DiscussionOur study is the first to describe DHH mid-to-older women's access to oral health care. DHH women who do not have a college degree may be impacted. Further research is needed to elucidate the particular risk factors, including cultural, to which DHH individuals from marginalized racial groups are susceptible to unmet oral health needs.ConclusionsEvidence shows that DHH ASL users who have less years of education or are single experience barriers in accessing dental care.

When considering deaf and hard of hearing (DHH) population, research recognizes that fatigue due to communication challenges and multi-focal attention allocation is a significant concern. Given the putative heightened demands of distance learning on deaf and hard of hearing students, we investigate how an online environment might differently affect deaf and hard of hearing participants, compared to hearing participants, Portuguese Sign Language (PSL) users and non-users. Our findings show that the deaf and hard of hearing group present higher values in the post-task fatigue rates with significant differences from the hearing group (non-PSL users). Furthermore, our results revealed an association between post-task fatigue rates and lower performance scores for the deaf and hard of hearing group, and the gap is significantly bigger when compared with the hearing group (non-PSL users). We also found evidence for high levels of post-task fatigue and lower performance scores in the hearing group PSL users. These novel data contribute to the discussion concerning of the pros and cons of digital migration and help redesign more accessible and equitable methodologies and approaches, especially in the DHH educational field, ultimately supporting policymakers in redefining optimal learning strategies.