Abstract
Deaf and hard-of-hearing (DHH) children present several challenges to traditional methods of language assessment, and yet language assessment for this population is absolutely essential for optimizing their developmental potential. Whereas assessment often focuses on language outcomes, this Conceptual Analysis argues that assessing cumulative language input is critically important both in clinical work with DHH individuals and in research/public health contexts concerned with DHH populations. At the individual level, paying attention to the input (and the person’s access to it) is vital for discriminating disorder from delay, and for setting goals and strategies for reaching them. At the population level, understanding relationships between cumulative language input and resulting language outcomes is essential to the broader public health efforts aimed at identifying strategies to improve outcomes in DHH populations and to theoretical efforts to understand the role that language plays in child development. Unfortunately, several factors jointly result in DHH children’s input being under-described at both individual and population levels: for example, overly simplistic ways of classifying input, and the lack of tools for assessing input more thoroughly. To address these limitations, this Conceptual Analysis proposes a new way of characterizing a DHH child’s cumulative experience with input, and outlines the features that a tool would need to have in order to measure this alternative construct.
Highlights
Deaf and hard-of-hearing (DHH) children present several challenges to traditional methods of language assessment, and yet language assessment for this population is absolutely essential for optimizing their developmental potential
A second response to the complexity and diversity of DHH children’s cumulative experiences with input has been to rely on the construct of “communication mode” as a proxy for describing DHH children’s cumulative experience with language input. This construct is typically used in ways that are too simplistic to reflect children’s actual experiences, and too variable across studies to support meaningful generalization (Hall and Dills, 2020). This Conceptual Analysis argues that clinicians and researchers must reconsider the ways that we assess DHH children’s input, adopting methods that recognize its diverse and multidimensional nature throughout the crucial language-learning years of infancy and toddlerhood, and take dose-response functions into consideration
More attention is given to this notion of limited access at the population level; first, we consider the importance of assessing cumulative experience with input at the individual level
Summary
Deaf and hard-of-hearing (DHH) children present several challenges to traditional methods of language assessment, and yet language assessment for this population is absolutely essential for optimizing their developmental potential. The Joint Committee on Infant Hearing has been recommending routine and recurring language assessment for DHH children for at least the past 20 years (Joint Committee on Infant Hearing, 2000, 2019; Muse et al, 2013). In DHH populations, language assessment contributes to two important goals that can sometimes seem disconnected from one another: (1) optimizing the outcomes of an individual DHH child, and (2) optimizing the outcomes of the entire population from which the DHH child is sampled
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