Abstract
The development of pragmatic skills does not often receive attention by professionals who are recommending or undertaking assessment of deaf and hard of hearing (DHH) children, yet social communication is vital for linguistic, social, emotional, and academic development. We acknowledge the challenges that DHH children have with pragmatic skills, advocate for monitoring of pragmatic development for all DHH children by medical professionals, and provide direction for assessment of pragmatic skills in young DHH children, particularly for clinicians and teachers who are tasked with that work. Pragmatic assessment is challenging because it must involve observations of the child in interaction with a communication partner, either directly during a specific interaction or through the reflections of a familiar adult. In this article, we recommend two complementary assessment procedures for young DHH children who use spoken language. Assessment 1 recommends that a parent or caregiver completes The Pragmatic Checklist to provide a picture of the child's functional communication. In assessment 2, the information gained through the checklist is complemented by using direct observations of a child in interaction with an adult or a peer. The Pragmatic Protocol uses a video-recorded conversation sample between the child and familiar person that is analyzed by a DHH professional for 30 different pragmatic behaviors. We conclude this article with a recommendation for pediatricians and health care professionals to monitor pragmatic developmental milestones in DHH children, to refer them for pragmatic assessments, and to collaborate with researchers to develop valid, reliable tools that adequately capture the pragmatic skill strengths and needs of DHH children.
Highlights
The development of pragmatic skills does not often receive attention by professionals who are recommending or undertaking assessment of deaf and hard of hearing (DHH) children, yet social communication is vital for linguistic, social, emotional, and academic development
Some of the tools may not be well suited to the assessment of DHH children because (1) the underlying cause of pragmatic delay relates to the way deafness affects opportunities for interactions with a range of communication partners, (2) DHH children may acquire certain pragmatic skills at a different age than their hearing counterparts, and (3) the pragmatic skills necessary for living in the world as a DHH child may not be captured in these instruments
Simon[21] and reported by Goberis et al[10] on the basis of the following features: (1) it has been researched with DHH children, (2) it is completed by parents who reflect on their child’s current pragmatic skills, (3) it has a solid theoretical basis that was used to develop checklist items, and (4) it provides both validity data and norms based on a sample of 109 typically developing children
Summary
Pragmatics is the ability to deploy language resources to support effective social interaction, taking the demands of the physical context and the needs of your conversational partner into account.[1]. When compared with hearing children, many DHH children who use spoken language experience a range of challenges with the development of pragmatic skills.[2,3,4] Pragmatic skills are strongly associated with social functioning and academic achievement in DHH children.[5,6,7,8,9] Some DHH children who have average language skills on standardized language tests may still have delayed pragmatic skills.[8,10] Assessment of pragmatic skills is vital to identify DHH children who need additional intervention in the area of social communication. Not explicitly stated in the Joint Committee on Infant Hearing guidelines, the recommendation to assess pragmatic skills is aligned with the goal to “maximize linguistic competence and literacy development for all children who are deaf or hard of hearing.”[11].
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