Deaf And Hard-of-hearing Children Research Articles

Orthographic Learning in French-Speaking Deaf and Hard of Hearing Children.

Children are assumed to acquire orthographic representations during autonomous reading by decoding new written words. The present study investigates how deaf and hard of hearing (DHH) children build new orthographic representations compared to typically hearing (TH) children. Twenty-nine DHH children, from 7.8 to 13.5 years old, with moderate-to-profound hearing loss, matched for reading level and chronological age to TH controls, were exposed to 10 pseudowords (novel words) in written stories. Then, they performed a spelling task and an orthographic recognition task on these new words. In the spelling task, we found no difference in accuracy, but a difference in errors emerged between the two groups: Phonologically plausible errors were less common in DHH children than in TH children. In the recognition task, DHH children were better than TH children at recognizing target pseudowords. Phonological strategies seemed to be used less by DHH than by TH children who very often chose phonological distractors. Both groups created sufficiently detailed orthographic representations to complete the tasks, which support the self-teaching hypothesis. DHH children used phonological information in both tasks but could use more orthographic cues than TH children to build up orthographic representations. Using the combination of a spelling task and a recognition task, as well as analyzing the nature of errors, in this study, provides a methodological implication for further understanding of underlying cognitive processes.

The effect of retrieval practice on vocabulary learning for DHH children

Abstract On average, deaf and hard-of-hearing (DHH) children have difficulty developing expressive spoken vocabulary comparable to hearing peers. Yet, there are no evidence-based practices to guide classroom instruction for teachers of the deaf. Retrieval practice—a robust learning strategy—has been shown to improve children’s retention of vocabulary, but it has not been investigated with DHH children who use listening and spoken language. The present study examined whether DHH children benefit from using retrieval practice to learn new vocabulary. Sixteen DHH children (in the age range of 5.0–8.11 years) were taught a set of new vocabulary words using retrieval practice or repeated exposure. A recall test was administered two days later. Results showed that DHH children were twice as likely to recall a word taught through retrieval practice than exposure (OR = 2.01, p = .02). Presence of an additional diagnosis and number of practice trials were also significant predicting factors of vocabulary learning.

Implementing co-enrollment in preschool education in China: A case study

ABSTRACT This study aims to document the implementation of sign bilingualism and co-enrollment education in a kindergarten in Quzhou, Zhejiang Province, China, to identify the major characteristics of the programme, and to report findings of children’s language in terms of vocabulary and surveys on the views and attitudes of the stakeholders of the programme, including deaf and hard-of-hearing (DHH) as well as hearing children and teachers. The results indicate that (a) both deaf and hearing teachers enjoy working in the Sign Bilingualism and Co-enrollment (SLCO) class and believe it is beneficial for their professional development; (b) parents of both DHH children and hearing children are happy to send their children to the SLCO class; (c) the teachers and parents agree that the SLCO programme is helpful for the overall development of not only the DHH children but also the hearing children. They believe that such an environment benefits the children's language and communication skills and the development of self-confidence and social cognition; (d) both the teachers and parents believe that the DHH children and their hearing peers get along well with each other in the SLCO class and also enjoy learning sign language. Furthermore, they all agree that the SLCO programme is promising and should be continued in the current school and implemented in more schools.

Broadening understanding of executive function in children with different hearing histories: The roles of fathers and coparenting

Fathers and family-level characteristics are understudied but potentially impactful contributors to at-risk outcomes for deaf and hard-of-hearing (DHH) children who use spoken language. We investigated associations between paternal parenting stress, paternal self-efficacy for supporting language, and executive function (EF) development in DHH children and children with typical hearing (TH). Main and moderating effects of the coparenting relationship were also investigated. TH fathers of DHH children (n = 44) and TH children (n = 46) completed the Parenting Stress Index-4-Short Form, the Scale of Parental Involvement and Self-Efficacy, and the Coparenting Relationship Scale. Child EF was assessed via the Behavior Rating Index of Executive Function. Regression analyses revealed that paternal parenting stress was significantly associated with child EF difficulties regardless of child hearing status. Coparenting undermining moderated relations between paternal parenting stress and child difficulties with inhibition in the full sample. Coparenting undermining was associated with greater child difficulties with set-shifting for DHH children only. Paternal parenting stress represents a possible risk factor for child EF development, particularly in families with higher levels of coparenting undermining. DHH children might also be susceptible to adverse coparenting relations. Fathers of DHH children have previously been shown to be less involved and integrated during intervention, and a better understanding of the important contributions fathers have to child development could lead to novel, father-embedded intervention models.

Early access to language supports number mapping skills in deaf children.

The ability to associate different types of number representations referring to the same quantity (symbolic Arabic numerals, signed/spoken number words, and nonsymbolic quantities), is an important predictor of overall mathematical success. This foundational skill-mapping-has not been examined in deaf and hard-of-hearing (DHH) children. To address this gap, we studied 188 4 1/2 to 9-year-old DHH and hearing children and systematically examined the relationship between their language experiences and mapping skills. We asked whether the timing of children's language exposure (early vs. later), the modality of their language (signed vs. spoken), and their rote counting abilities related to mapping performance. We found that language modality did not significantly relate to mapping performance, but timing of language exposure and counting skills did. These findings suggest that early access to language, whether spoken or signed, supports the development of age-typical mapping skills and that knowledge of number words is critical for this development.

Language experience matters for the emergence of early numerical concepts

Research has shown a link between the acquisition of numerical concepts and language, but exactly how linguistic input matters for numerical development remains unclear. Here, we examine both symbolic (number word knowledge) and non-symbolic (numerical discrimination) numerical abilities in a population in which access to language is limited early in development—oral deaf and hard of hearing (DHH) preschoolers born to hearing parents who do not know a sign language. The oral DHH children demonstrated lower numerical discrimination skills, verbal number knowledge, conceptual understanding of the word “more”, and vocabulary relative to their hearing peers. Importantly, however, analyses revealed that group differences in the numerical tasks, but not vocabulary, disappeared when differences in the amount of time children had had auditory access to spoken language input via hearing technology were taken into account. Results offer insights regarding the role language plays in emerging number concepts.

Applying the reference values of real-ear-to-coupler-difference for deaf and hard-of-hearing children in Taiwan: Cautions and considerations.

Measurement of real-ear-to-coupler differentials (RECDs) is a critical part of the hearing aid (HA) verification process. This study examines the validity of reference RECD values preset by the HA analyzer, Audioscan RM500, for deaf-and-hard-of-hearing (DHH) children in Taiwan. RECD measurements were performed on 658 ears of DHH children. A linear mixed model was used to analyze the reference and measured RECD values. The findings revealed slight disparities between normative RECD values from North America and those observed in Taiwanese DHH children. While generally small (less than 5 dB), these differences imply potential challenges in achieving optimal HA fitting in specific scenarios. Therefore, we recommend individualized RECD/REM measurements for cases of poor auditory performance, certain frequency ranges, or notable variations in ear canal volume. From a clinical perspective, while broadly applicable, the use of North American RECD normative data in Taiwan requires cautious consideration of potential minor variations. This study contributes to current knowledge by affirming the use of a Western RECD database for Taiwanese DHH children. However, we underscore the ongoing importance of individualized HA fitting strategies, particularly for cases with stagnant intervention progress. While built-in RECD reference values can offer preliminary fitting guidance, especially in busy clinical settings, our study sheds light on the circumstances where caution is essential. Audiologists can efficiently allocate their time and effort by focusing on personalized RECD measurements for cases exhibiting suboptimal intervention outcomes, thereby effectively optimizing HA gain settings.

Longitudinal relations between theory of mind and academic achievement among deaf and hard-of-hearing school-aged children

This 2-year longitudinal study investigated the bidirectional relations between the development of theory of mind (ToM) and academic competences in a sample of 270 deaf and hard-of-hearing (DHH) children (Mage at Wave 1 = 7.52 years, SD = 0.99; 58.5% boys and 41.5% girls). Across three waves (10 months apart), children were assessed for their ToM abilities, using the ToM scale and a second-order false belief task, as well as for their language and mathematics skills. Cross-lagged correlational analysis revealed significant bidirectional associations between ToM and academic achievement (language and mathematics). That is, ToM predicted academic achievement with similar strength as ToM development itself was predicted by academic achievement. Our results highlight the bidirectional nature of the association between ToM and academic achievement, and they show that ToM development plays a crucial role in DHH children’s school functioning.

71 Profiles of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children with Autism Spectrum Disorder who are Deaf and Hard of Hearing

Objective:Standardized assessment measures can provide data to inform a diagnosis of Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, demonstrating listening response), and are often not appropriate for use with children who are Deaf and Hard of Hearing (DHH), especially with individuals who use signed languages. Few studies have reported on the Behavioral Assessment System for Children, Third Edition (BASC-3) for DHH children, and we aim to describe BASC-3 profiles in children with ASD who are DHH.Participants and Methods:Participants include eight DHH patients diagnosed with ASD through interdisciplinary team evaluations by developmental-behavioral pediatricians, speech-language pathologists, and neuropsychologists with expertise in DHH child development. Demographics include a mean age of 6.17 years, and 62.5% were Male. Self-reported racial distribution was 75% White, 12.5% Black and 12.5% declined to answer. Average Area Deprivation Index (marker of socioeconomic status) was 32.13%tile. As a part of the evaluation, parents rated their children using the BASC-3. Languages include spoken English (75%) and American Sign Language (25%). Relevant co-occurringneurodevelopmental/psychological diagnoses include Global Developmental Delay (n=1), Moderate Intellectual Disability (n=1), and Depression (n=1). Types of hearing loss include sensorineural (75%), conductive (12.5%), and mixed (12.5%). Three participants had different degrees of bilateral hearing loss in each ear: mild sloping-severe, moderate rising-mild (n=1), profound, moderate rising-normal level (n=1), and profound, moderate (n=1). Four participants had the same level of hearing loss in both ears: moderate-moderately severe (n=1), moderately severe-severe (n=1), severe-profound (n=1), and profound (n=1). One child had a unilateral moderate hearing loss. Technology utilized: unilateral hearing aid (n=2), bilateral hearing aids (n=2), unilateral cochlear implant (n=1), bilateral cochlear implants (n=2), and bimodal technology (n=1). BASC-3 scales of interest in this study were the developmental social disorders scale (DSD), Autism probability index (AUI), clinical scales, and adaptive scales. BASC-3 scores were standardized using General Combined norms and means were plotted.Results:BASC-3 mean scores on clinical scales were elevated (T>60) on Atypicality (M=71), Hyperactivity (M=63), Withdrawal (M=63), and Attention Problems (M=65) in children with ASD who are DHH in this sample. BASC-3 mean scores on adaptive scales were below threshold (T<40) on Social Skills (M=37), Functional Communication (M=39), and overall Adaptive Skills (M=39). DSD scores were in the at-risk (T>60<70) range for 2 out of 8 cases and clinically significant (T>70) for 5 out of 8 cases.The AUI was clinically significant for 2 out of the 3 cases within the age range for reporting AUI data.Conclusions:In this preliminary sample of DHH children with a confirmed diagnosis of ASD by comprehensive specialized interdisciplinary clinical evaluations, parent ratings on the BASC-3 were consistent with what is known about BASC-3 profiles in hearing children diagnosed with ASD. Our findings suggest it may be helpful to review the DSD, AUI, clinical scales, and adaptive skills scales profiles when assessing DHH children at risk for ASD. Further research, including a larger sample size and assessment of language differences among participants, is necessary.

Emotional behavioral outcomes of children with unilateral and mild hearing loss.

Deaf and hard-of hearing (DHH) children often experience emotional/behavioral difficulties. The impact of unilateral/mild hearing loss (HL) on children's emotion and behavior are unclear. We aimed to describe emotional/behavioral, health related quality-of-life (HRQoL) and parent psychological distress outcomes of school-age children with unilateral/mild HL, compared to children with moderate to profound HL, and in relation to population norms; and identify predictive factors of emotional/behavioral difficulties. Data of 339 DHH children, 5-12 years, enrolled in the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), which include demographics, early development, medical/audiological characteristics and parent rated questionnaires of emotion/behavior, HRQoL and parental psychological distress collected at various stages of child's life were analyzed. We used Cohen's d to investigate the outcomes by measuring the mean score differences of both groups with published norms and logistic regression to analyze the factors predictive of emotional/behavioral difficulties. The proportion of children with unilateral/mild HL and moderate to profound HL who experienced emotional/behavioral difficulties was similar (18.3% vs. 20.6%), with hyperactivity and poor prosocial behavior reported as the predominant symptoms in both groups. Mean emotional/behavioral scores of both groups were comparable and substantially higher than normative population scores. This was also the case for HRQoL and levels of parent distress. Among children with unilateral/mild HL, additional health needs were the strongest predictive factor, demonstrating an approximately 1.7-fold increase in odds of emotional/behavioral difficulties (OR = 1.67; 95% CI 1.29-2.17, p < 0.001) with every additional health need. Early developmental concerns, other than communication milestone and attending mainstream schoolshowed weaker evidence of association. Children with unilateral/mild HL were just as likely as those with moderate to profound HL to experience more emotional/behavioral difficulties, poorer HRQoL and higher parental distress scores compared to population norms. Our findings justify the provision of early intervention, support and medical services for all DHH children to identify those at risk of poorer outcomes.

Identifying Developmental Language Disorder in Deaf Children with Cochlear Implants: A Case Study of Three Children.

(1) Background: While spoken language learning delays are assumed for deaf and hard of hearing (DHH) children after cochlear implant (CI), many catch up with their hearing peers. Some DHH children with CIs, however, show persistent delays in language, despite protective factors being in place. This suggests a developmental language disorder (DLD). However, at present there is little consensus on how to diagnose DLD in DHH children. (2) Methods: Given the lack of consensus in this area, a set of case studies provides an appropriate first step. The goal of this paper is to show the plausibility of a DLD diagnosis, following careful analysis of protective and risk factors. A retrospective case study review was conducted for three children. Their long-term language outcomes up to four years after CI were considered in the context of access to sound, speech sound discrimination, social skills and non-verbal cognition. (3) Results: It was possible to posit DLD in one child who had experienced good access to sound, alongside good speech discrimination abilities and social development, and normal non-verbal cognition, but who presented with severe language learning difficulties. (4) Conclusions: Finding markers for DLD in DHH children is important for diagnosis and intervention. The implications for clinical practice are discussed.

Deaf and Hearing American Sign Language-English Bilinguals: Typical Bilingual Language Development.

Some studies have concluded that sign language hinders spoken language development for deaf and hard-of-hearing (DHH) children even though sign language exposure could protect DHH children from experiencing language deprivation. Furthermore, this research has rarely considered the bilingualism of children learning a signed and a spoken language. Here we compare spoken English development in 2-6-year-old deaf and hearing American Sign Language-English bilingual children to each other and to monolingual English speakers in a comparison database. Age predicted bilinguals' language scores on all measures, whereas hearing status was only significant for one measure. Both bilingual groups tended to score below monolinguals. Deaf bilinguals' scores differed more from monolinguals, potentially because of later age of and less total exposure to English, and/or to hearing through a cochlear implant. Overall, these results are consistent with typical early bilingual language development. Research and practice must treat signing-speaking children as bilinguals and consider the bilingual language development literature.

Evaluation devices in the narratives of deaf/hard of hearing and hearing Arabic-speaking adolescents.

Pragmatic language use in general and the use of evaluation devices (EDs) are very important components in everyday communication and expressing thoughts and feelings in narrative production. However, very little is known about the use of evaluative devices in the narratives of Arabic-speaking adolescents, especially those who are deaf and hard of hearing (DHH). The present study investigated the use of EDs in personal oral narratives elicited from 124 hearing and DHH Arabic-speaking adolescents. Each participant was asked to tell a personal story about a time he or she was in a dangerous situation. Narratives were transcribed and coded for nine different types of evaluation. A three-way interaction of group (hearing/DHH) by gender (Female/Male) by evaluation type emerged such that female hearing adolescents' narratives contained significantly more frames of mind than the narratives of DHH females and hearing males and more hedges than DHH females. In addition, hearing males' narratives contained more hedges than those of DHH males and more negative comments than the narratives of both hearing females and DHH males. The present research identifies factors that facilitate narrative abilities by DHH. Discussion centres on explanations for group and gender differences in terms of exposure and language socialization. What is already known on this subject Although narratives have been researched extensively in comparisons of hearing and deaf and hard of hearing (DHH) children, only a few studies have examined pragmatic language use in general and evaluation devices in particular. These studies show that the narratives of DHH children and adolescents contain fewer figurative expressions, frames of mind and hedges and that children who are DHH have difficulty comprehending and producing metaphors. Very little is known about the use of evaluative devices in the narratives of Arabic-speaking adolescents, especially those who are DHH. What this study adds The present study found that hearing participants produced significantly more evaluation devices (Eds) than their DHH peers, and female participants produced significantly more EDs than their male peers. Moreover, hearing females' narratives contained more frames of mind and more hedges than did the narratives of DHH females; also, hearing females' narratives contained more frames of mind than those of hearing males. In addition, hearing males' narratives contained more hedges than those of DHH males. Finally, hearing males' narratives had more negative comments than both the narratives of hearing females and those of DHH males. Clinical implications The one evaluation device produced in large numbers (hedges) by adolescents who are DHH was expressed in only one of two ways. One important clinical implication of this finding is that pragmatic language in general and use of EDs in particular should be part of any speech and language evaluation. Another takeaway is that intervention should attempt to provide rich exposure to social communicative language, providing many ways to convey each function, enabling adolescents to communicate in different contexts.

Socio-Emotional Experiences and Wellbeing of Deaf and Hard of Hearing Children and Their Parents before and during the COVID-19 Pandemic.

Deaf and hard of hearing (DHH) children in Victoria, Australia, were exposed to strict public health restrictions, including sustained lockdowns, during the COVID-19 pandemic. DHH children have higher health and socio-emotional needs than their hearing peers. We aimed to (1) describe the socio-emotional experiences of DHH children and their parents and (2) compare child and parent socio-emotional wellbeing, before and during the COVID-19 pandemic. Between May and September 2020, 497 (62%) parents of DHH children from the Victorian Childhood Hearing Longitudinal Databank completed an online survey. Measures were drawn from the CoRonavIruS Health Impact Survey (CRISIS) v3.0. Data were summarized using descriptive statistics to compare outcomes before and during the pandemic. Parents reported their children to have more negative socio-emotional wellbeing (mean emotions/worries score, EWS, changed from 0.76 pre-pandemic to 1.10 during the pandemic, mean difference 0.34, 95% CI: 0.28 to 0.39), regardless of the type or severity of hearing loss. Parents also had more negative socio-emotional wellbeing (mean EWS changed from 1.05 pre-pandemic to 1.43 during the pandemic, mean difference 0.38, 95% CI: 0.31 to 0.44). Negative socio-emotional experiences co-occurred with large social changes during the pandemic. Additional services should support the socio-emotional wellbeing of DHH children during significant adverse childhood experiences.

Validating the ORACollect for the detection of cytomegalovirus

Targeted screening for Cytomegalovirus (CMV) in Deaf and Hard of Hearing (DHH) children is now internationally recommended. With newborn genomic screening for DHH children a future possibility, the commercially-available human genomic DNA collection kit (ORACollect, Oragene OCR-100) could enable one single sample to screen for CMV and genetic causes of deafness at scale with minimal additional costs. Our pilot study validated ORACollect against Copan FLOQswabs® (gold standard clinical procedure) for detecting CMV using 15 sets of saliva samples from 14 infants/children, comparing CMV PCR results using different testing protocols. ORACollect stored at room temperature had high sensitivity (up to 89%), specificity (up to 80%) and percent agreement (up to 86%) in detecting CMV DNA compared to FLOQswabs®. This suggests that ORACollect is an appropriate alternative to FLOQswabs® for collecting viral CMV DNA for PCR testing, independent of the DNA extraction approach. This could be revolutionary in facilitating dual genomic and viral screening in newborns and would enable CMV screening in non-tertiary hospital settings where laboratory facilities are not available.

Virtual Assessment of Deaf and Hard of Hearing Students in the Schools.

The COVID-19 pandemic placed stress on all aspects of the educational system. Many state departments of education acknowledged the disruption to individualized education program evaluation and implementation but insisted that evaluation timelines and services continue undisrupted. School psychologists were therefore forced to navigate the viability of virtual assessment without established research supporting this type of student evaluation. Formal assessments used in the identification of learning disabilities and other areas of disability were not standardized with virtual administration procedures; however, many test publishers have offered guidelines for online administration. These guidelines may not be suitable for test administration with deaf and hard of hearing (DHH) children. Through the presentation of two case studies, this article explores some of the available administration guidelines and evaluates their appropriateness for use with DHH children. Information in this article informs current practice of school psychology in a virtual environment.

Predicting variation in word decoding development in deaf and hard-of-hearing children

Background: Deaf and hard-of-hearing (DHH) children may experience difficulties in word decoding development. Aims: We aimed to compare and predict the incremental word decoding development in first grade in Dutch DHH and hearing children, as a function of kindergarten reading precursors. Methods and procedures: In this study, 25 DHH, and 41 hearing children participated. Kindergarten measures were phonological awareness (PA), letter knowledge (LK), rapid naming (RAN), and verbal short-term memory (VSTM). Word decoding (WD) was assessed at three consecutive time points (WD1, 2, 3) during reading instruction in first grade. Outcomes and results: The hearing children scored higher than the DHH children on PA and VSTM only, although the distribution of WD scores differed between the groups. At WD1, PA and RAN predicted WD efficiency in both groups; but PA was a stronger predictor for hearing children. At WD2, LK, RAN, and the autoregressor were predictors for both groups. While at WD3, only the autoregressor was a significant predictor. Conclusions and implications: WD development in DHH children on average shows similar levels as in hearing children, though within the DHH group more variation was observed. WD development in DHH children is not as much driven by PA; they may use other skills to compensate.

Written products and writing processes in Swedish deaf and hard of hearing children: an explorative study on the impact of linguistic background.

The small body of research on writing and writing processes in the group of deaf and hard of hearing (DHH) children has shown that this group struggles more with writing than their hearing peers. This article aims to explore in what ways the DHH group differs from their peers regarding the written product and the writing processes. Participants are all in the age span 10-12 years old and include: (a) 12 DHH children with knowledge of Swedish sign language (Svenskt teckenspråk, STS) as well as spoken Swedish, (b) 10 age-matched hearing children of deaf adults (CODA) who know STS, (c) 14 age-matched hearing peers with no STS knowledge. More specifically we investigate how text length and lexical properties relate to writing processes such as planning (measured through pauses) and revision, and how the background factors of age, gender, hearing and knowledge of STS predict the outcome in product and process. The data consists of picture-elicited narratives collected with keystroke logging. The overall results show that age is a strong predictor for writing fluency, longer texts and more sophisticated lexicon for all the children. This confirms theories on writing development which stress that when children have automatized basic low-level processes such as transcription and spelling, this will free up cognitive space for engaging in high-level processes, such as planning and revision-which in turn will result in more mature texts. What characterizes the DHH group is slower writing fluency, higher lexical density, due to omitted function words, and extensive revisions (both deletions and insertions) on word level and below. One explanation for the last finding is that limitations in the auditory input lead to more uncertainty regarding correct and appropriate lexical choices, as well as spelling. The article contributes with more specific knowledge on what is challenging during writing for DHH children with knowledge of STS and spoken Swedish in middle school, in the developmental stage when basic writing skills are established.

Learning a Sign Language Does Not Hinder Acquisition of a Spoken Language.

The purpose of this study is to determine whether and how learning American Sign Language (ASL) is associated with spoken English skills in a sample of ASL-English bilingual deaf and hard of hearing (DHH) children. This cross-sectional study of vocabulary size included 56 DHH children between 8 and 60 months of age who were learning both ASL and spoken English and had hearing parents. English and ASL vocabulary were independently assessed via parent report checklists. ASL vocabulary size positively correlated with spoken English vocabulary size. Spoken English vocabulary sizes in the ASL-English bilingual DHH children in the present sample were comparable to those in previous reports of monolingual DHH children who were learning only English. ASL-English bilingual DHH children had total vocabularies (combining ASL and English) that were equivalent to same-age hearing monolingual children. Children with large ASL vocabularies were more likely to have spoken English vocabularies in the average range based on norms for hearing monolingual children. Contrary to predictions often cited in the literature, acquisition of sign language does not harm spoken vocabulary acquisition. This retrospective, correlational study cannot determine whether there is a causal relationship between sign language and spoken language vocabulary acquisition, but if a causal relationship exists, the evidence here suggests that the effect would be positive. Bilingual DHH children have age-expected vocabularies when considering the entirety of their language skills. We found no evidence to support recommendations that families with DHH children avoid learning sign language. Rather, our findings show that children with early ASL exposure can develop age-appropriate vocabulary skills in both ASL and spoken English.

Development of literacy skills for Japanese deaf and hard-of-hearing children.

We compared the reading development of 77 deaf and hard-of-hearing (DHH) Japanese children, aged 5-7 (40 females), with 139 of their hearing peers (74 females) in 2018. We assessed each group's phonological awareness (PA), grammar, vocabulary, and reading of hiragana (Japanese orthography children learn first). DHH children showed significant delays in grammar and vocabulary but only a slight delay in PA. Younger DHH children scored better than their hearing peers in reading. Although PA predicted reading for hearing children, reading predicted PA for DHH children. PA partially explained grammar skills for both groups. The results suggest educational intervention for reading acquisition should be based on not only general linguistic features but also each language's unique characteristics.