Deaf And Hard-of-hearing Children Research Articles

Assistive Hearing Technology for Deaf and Hard-of-Hearing Spoken Language Learners.

Radical advancements in hearing technology in the last 30 years have offered some deaf and hard-of-hearing (DHH) children the adequate auditory access necessary to acquire spoken language with high-quality early intervention. However, meaningful achievement gaps in reading and spoken language persist despite the engineering marvel of modern hearing aids and cochlear implants. Moreover, there is enormous unexplained variability in spoken language and literacy outcomes. Aspects of signal processing in both hearing aids and cochlear implants are discussed as they relate to spoken language outcomes in preschool and school-age children. In suggesting areas for future research, a case is made for not only expanding the search for mechanisms of influence on outcomes outside of traditional device- and child-related factors, but also for framing the search within Biopsychosocial systems theories. This theoretical approach incorporates systems of risk factors across many levels, as well as the bidirectional and complex ways in which factors influence each other. The combination of sophisticated hearing technology and a fuller understanding of the complex environmental and biological factors that shape development will help maximize spoken language outcomes in DHH children and contribute to laying the groundwork for successful literacy and academic development.

Modality and Interrelations Among Language, Reading, Spoken Phonological Awareness, and Fingerspelling.

Better understanding of the mechanisms underlying early reading skills can lead to improved interventions. Hence, the purpose of this study was to examine multivariate associations among reading, language, spoken phonological awareness, and fingerspelling abilities for three groups of deaf and hard-of-hearing (DHH) beginning readers: those who were acquiring only spoken English (n = 101), those who were visual learners and acquiring sign (n = 131), and those who were acquiring both (n = 104). Children were enrolled in kindergarten, first, or second grade. Within-group and between-group confirmatory factor analysis showed that there were both similarities and differences in the abilities that underlie reading in these three groups. For all groups, reading abilities related to both language and the ability to manipulate the sublexical features of words. However, the groups differed on whether these constructs were based on visual or spoken language. Our results suggest that there are alternative means to learning to read. Whereas all DHH children learning to read rely on the same fundamental abilities of language and phonological processing, the modality, levels, and relations among these abilities differ.

Deaf children need language, not (just) speech

Deaf and Hard of Hearing (DHH) children need to master at least one language (spoken or signed) to reach their full potential. Providing access to a natural sign language supports this goal. Despite evidence that natural sign languages are beneficial to DHH children, many researchers and practitioners advise families to focus exclusively on spoken language. We critique the Pediatrics article ‘Early Sign Language Exposure and Cochlear Implants’ (Geers et al., 2017) as an example of research that makes unsupported claims against the inclusion of natural sign languages. We refute claims that (1) there are harmful effects of sign language and (2) that listening and spoken language are necessary for optimal development of deaf children. While practical challenges remain (and are discussed) for providing a sign language-rich environment, research evidence suggests that such challenges are worth tackling in light of natural sign languages providing a host of benefits for DHH children – especially in the prevention and reduction of language deprivation.

Factors Influencing Access to Cochlear Implantation in Deaf and Hard-of-Hearing Children in Southern California.

To determine the epidemiologic relationship of family demographics and educational resources with parental knowledge of and willingness for their children to receive cochlear implantation (CI) for deaf and hard-of-hearing (DHH) children. A total of 213 parents of DHH children were surveyed at local schools, specialized camps, and clinics in Southern California. Data on parents were solicited, including income, insurance status, education level, hearing status, primary language, and motivations towards CI. Sixty-six surveys were included in the analysis. Three of these patients had already undergone CI, thus of the 63 children without CI, 59% had been presented with the option of CI by a healthcare professional and 27% were willing to have their child undergo CI. Willingness for children to undergo CI was statistically higher in families with an annual income less than $15,000 or more than $75,000 (p = 0.02), and children enrolled in specialized schools for DHH (p = 0.02). The leading reasons for unwillingness to undergo CI were risks of surgery (17%) and discouragement from others (14%). A significant gap exists between the number of CI candidates and families and willingness to undergo CI. The difference could be related to socioeconomic status and the patient's school type. This underscores the importance of parental education through the use of a multi-disciplinary team to ensure all hearing rehabilitation options are explained.

Fathers of Deaf and Hard-of-Hearing Infants and Toddlers - Experiences, Needs, and Challenges.

Studies on fathers with deaf and hard-of-hearing (DHH) children are quite rare in deaf education; if they are conducted, they narrowly focus on preschool-age or school-age children. The study reported here presents data from a survey on 92 fathers of very young DHH children with a mean age of 26 months. Questionnaires were used to measure the impact of children's hearing loss on parenting, the frequency of fathers' participation in early intervention appointments, and the level of fathers' involvement in daily care as well as in early intervention activities. Furthermore, information on fathers' perceived support from early intervention agencies, general self-efficacy, parenting self-efficacy, and marital satisfaction was assessed. The results confirmed data from other studies addressing fathers with children who have a disability. In particular, a strong relationship between parenting self-efficacy, perceived support by early intervention agencies and activities, and impact of child's hearing loss on parenting became evident. This indicates the importance of participation and involvement of fathers in early intervention activities; therefore, early intervention services must enable fathers to participate as much as possible in sessions.

Assessment and Treatment of Behavioral Disorders in Children with Hearing Loss: A Systematic Review.

There is evidence that children who are deaf and hard of hearing (DHH) have a higher incidence of behavioral disorders. Assessment of behavioral health in this population is often complicated by language developmental delays, which may result in unrecognized and untreated behavioral problems. The purpose of this study is to assess the association of behavioral disorders among children who are DHH and to explore behavioral interventions for children in this population. PubMed, CINALH, PsychINFO, and Web of Science. Search terms included the following: problem behavior, child behavior disorders/diagnosis, child behavior disorders/psychology coupled with hearing loss, cochlear implants, hearing aids, or deafness. Studies from the last 30 years (1985-2016) were included. The articles were reviewed independently by 3 reviewers. Thirty-six articles met criteria. There was an association between internalizing behaviors and hearing loss among children, which may persist after cochlear implantation. These problems may be more pronounced for children with additional disabilities. Conduct and hyperactivity disorders as well as emotional and executive function problems among children who are DHH may be related to poor language development. There was limited evidence regarding interventions to address the behavioral disorders of DHH children. There is a significant body of evidence demonstrating behavioral problems among DHH children but a lack of clear understanding of the mechanisms involved. There is limited evidence on interventions to address the behavioral problems of DHH children. Future research is warranted to mitigate the long-term effects of disruptive behavior among these children.

Communicative Competence of Oral Deaf Children While Explaining Game Rules.

Classrooms are characterized by interactions in a range of genres. The concise language required by expository interactions can be challenging for children who have atypical language, including children who are deaf and hard of hearing (DHH). This study compared the way three groups of upper primary school students (aged 8-13 years) taught a peer to play a new unfamiliar board game: (a) DHH "experts" teaching a "novice" hearing peer; (b) hearing experts teaching a DHH novice; and (c) a hearing expert teaching a hearing novice. All DHH students were enrolled in mainstream schools and used spoken language as the main mode of communication. All three groups were able to convey game rules and purpose, and navigate clarifications. Differences emerged in the accuracy of the use of referents when instructing their peers how to play the game. The specific content vocabulary and the need to emphasize new concise information also challenged the DHH children. This study highlights the importance of including expository tasks in language support and intervention for children who are DHH.

Communication approaches for educating deaf and hard of hearing (DHH) children in Ghana: historical and contemporary issues

ABSTRACTThis paper discusses historical and contemporary issues regarding communication approaches for educating Deaf and hard of hearing (DHH) children in Ghana. Discussion of the communication approaches took into account a brief historical background to the development of formal education for DHH children in the country, academic achievement of DHH students at West African Senior Secondary Certificate Examination (WASSCE) over the past ten years, types of communication approaches for the DHH in Ghana, as well as legislation and relevant policy documents on educating DHH children in Ghana. The paper recommends the sign communication approach and other strategies which the authors believe will aid Ghana achieve the Sustainable Development Goal 4 for all DHH individuals.

Parent Couples' Coping Resources and Involvement in their Children's Intervention Program.

Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers' and fathers' coping resources and their involvement in their child's intervention program. In addition, the moderating roles of parent's gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child's intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor-partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers' child acceptance and social support were negatively associated with mothers' involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent's needs.

It Takes Two to Read: Interactive Reading with Young Deaf and Hard-of-Hearing Children

Interactive storybook reading is an important activity to enhance the emergent literacy skills of young deaf and hard-of-hearing (DHH) children. Parents have a crucial role to play in promoting their children's literacy development. However, parents often do not read in an interactive way; therefore guidance is recommended in applying these interactive reading strategies. In the present study we examined how parent reading behavior was affected by implementing an interactive reading training program for parents of young DHH children. Parents of 18 DHH toddlers in the Netherlands participated in a series of group training sessions and their interactive reading behavior was compared to that of 10 parents who did not participate. The results showed that parents' interactive reading behavior tended to increase after they participated in the interactive reading program. After the program, they applied the interactive reading strategies more often than parents who had not participated in the program. The findings suggest that interactive reading programs should be incorporated into early intervention programs for DHH children.

Factorial Validity and Measurement Invariance of the Test of Preschool Early Literacy-Phonological Awareness Test Among Deaf and Hard-of-Hearing Children and Hearing Children.

Emerging evidence suggests that early phonological awareness in deaf and hard-of-hearing (DHH) children with functional hearing is significantly related to their reading acquisition, and the assessment of phonological awareness can play a critical role in preventing reading difficulties. Validation of the scores obtained from standardized assessments when used with DHH students is crucial to support the assessments' intended interpretations and implications of test scores. Using archival data sets, the aim of this study was twofold: (a) to establish the factorial validity of the item scores on the Test of Preschool Early Literacy-Phonological Awareness (TOPEL-PA) for DHH children with functional hearing and hearing children and (b) to test measurement invariance across these groups. Our archival data sets included assessments of DHH children, hearing children from low socioeconomic status (SES) backgrounds, and hearing children from a range of SES backgrounds. We hypothesized that a second-order unifying ability, Phonological Awareness, along with four first-order subtest factors would explain inter-item associations among the 27 items on the TOPEL-PA. We further hypothesized that patterns of associations among the item scores would be similar across groups and that the individual items would function similarly across groups. Seven hundred and thirty-three children from three samples participated in the study; 171 were DHH children (Mage = 58.7 months old, SDage = 12.5 months old), 195 were low-SES hearing children (Mage = 55.5 months old, SDage = 3.5 months old), and 367 were diverse-SES hearing children (Mage = 53.4 months old, SDage = 8.9 months old). All DHH children were able to identify the referent of monosyllabic spoken words on the Early Speech Perception Test. Test of confirmatory item factor analyses of the hypothesized second-order factor structure revealed that a second-order unifying ability along with four first-order subtest factors well explained associations among the item scores for all groups. This aligned with the scoring structure of the TOPEL-PA, providing strong evidence for factorial validity of the item scores for DHH children as well as for hearing children groups. The measurement invariance test results provided evidence that the vast majority of TOPEL-PA items functioned similarly for hearing children and DHH children with speech perception abilities, suggesting that the utility of the assessment scores obtained from DHH children is consistent with the scores obtained from hearing children. Results of our study suggest that researchers and practitioners can use the TOPEL-PA to assess DHH children with functional hearing. It also suggests that the two skills measured on the TOPEL-PA (blending and elision) are qualitatively similar for DHH and hearing children, but the latent mean score obtained from the DHH children significantly differed from those of the hearing groups, suggesting a quantitative difference.

The Impact of Language Input on Deaf and Hard of Hearing Preschool Children Who Use Listening and Spoken Language.

The researchers investigated the effects of adult language input on the quantity of language, vocabulary development, and understanding of basic concepts of deaf and hard of hearing (DHH) children who used listening and spoken language. Using audio recording and Language ENvironment Analysis (LENA) software, the study involved 30 preschool DHH children who used spoken language as their communication modality and 11 typically hearing same-age peers. The children's language and the language spoken to them during all waking hours over a 2-day period (16 hours per day) were recorded and analyzed quantitatively and were compared to the children's performance on the Boehm Test of Basic Concepts and the Peabody Picture Vocabulary Test. The results highlight the relationship between the quantity of adult language and the language, vocabulary, and basic concept knowledge of DHH preschool children who use listening and spoken language.

Computerized Sign Language-Based Literacy Training for Deaf and Hard-of-Hearing Children.

Strengthening the connections between sign language and written language may improve reading skills in deaf and hard-of-hearing (DHH) signing children. The main aim of the present study was to investigate whether computerized sign language-based literacy training improves reading skills in DHH signing children who are learning to read. Further, longitudinal associations between sign language skills and developing reading skills were investigated. Participants were recruited from Swedish state special schools for DHH children, where pupils are taught in both sign language and spoken language. Reading skills were assessed at five occasions and the intervention was implemented in a cross-over design. Results indicated that reading skills improved over time and that development of word reading was predicted by the ability to imitate unfamiliar lexical signs, but there was only weak evidence that it was supported by the intervention. These results demonstrate for the first time a longitudinal link between sign-based abilities and word reading in DHH signing children who are learning to read. We suggest that the active construction of novel lexical forms may be a supramodal mechanism underlying word reading development.

The Effects of Interactive Storybook Reading With Preschoolers Who Are Deaf and Hard-of-Hearing

Vocabulary is a consistent predictor of reading achievement for deaf and hard-of-hearing (DHH) children. DHH children tend to have a smaller vocabulary knowledge base than their hearing peers and r...

Interactive Reading with Young Deaf and Hard-of-Hearing Children in eBooks Versus Print Books.

Interactive storybook reading is effective in enhancing deaf and hard-of-hearing (DHH) children's emergent literacy skills. The current digital era gives parents more opportunities to read books with their child. From an early age on, interaction between parent and child during literacy activities is very important for the development of emergent literacy skills. The purpose of the present study was to explore the opportunities of eBooks on a tablet for interactive reading with young DHH children. Parent and child interactive behavior in reading print books was compared to eBooks in 18 parents and their 1- to 3-year-old DHH child. All parents followed an interactive reading program after which their interactive reading behaviors were observed while reading print books and eBooks with their child. Results mainly showed similar interactive reading behaviors in parents and children when reading print books or eBooks, except for a lower occurrence of pointing to pictures/objects in the parent behavior when reading the eBooks. These results give parents and professionals even more opportunities for interactive storybook reading with DHH children, and thus more opportunities to enhance their language and literacy skills. Tablets can be easily taken with you making eBooks accessible for interactive reading wherever you are.

The Effect of Handwriting Training on Language Learning Among Deaf Children and Their Matched Hearing Peers in China.

Comparing deaf and hard of hearing (DHH) children with their hearing peers in learning Chinese, the study tested the lexical quality hypothesis (Perfetti, 1992, 2007), which asserts the importance of building orthographic, phonological, and semantic connections in high-quality lexical representations. DHH children and hearing peers matched on reading age were randomly assigned to one of two groups: One received writing training on both Day 1 and Day 2; the other received pinyin typing training on Day 1 and writing training on Day 2. Compared with younger hearing controls, DHH children showed equivalent vocabulary acquisition and appeared to benefit from orthography training. The study demonstrated, for the first time, the writing effect in DHH children's acquisition of Chinese. It suggests that a combination of character handwriting and phonology training can promote the ability of children to read Chinese, including children who are DHH.

Preliminary Evidence Assessing Social-Emotional Competences in Deaf and Hard of Hearing Infants and Toddlers Using a New Parent Questionnaire.

Social-emotional competences are an important developmental domain for deaf and hard of hearing (DHH) children and early diagnosis of problems is needed to ensure that DHH children receive appropriate support in this domain. In order to explore the usefulness of an instrument, which was recently developed for very young children, two studies in DHH infants and toddlers were conducted from Germany using the Social-Emotional Assessment/Evaluation Measure (Squires et al. (2013). Social-Emotional Assessment/Evaluation Measure (SEAM). Baltimore, ML: Brooks). Preliminary analysis of data obtained from a sample of 182 DHH children aged between 2 and 36 months (Study 1) suggests that it provides valid, reliable data and is suitable for use in practice. The data also corroborate well-known findings from other research in deaf education, in particular the role of parental responsivity for the development of social-emotional competences. Study 2 documents the consistency of evaluations of 44 DHH children by their mothers and by early intervention providers using the scales. Overall, the results suggest that this new evaluation instrument has potential applications in deaf educational practice but further research is needed to demonstrate its full value.

Mental Disorders in Deaf and Hard of Hearing Adult Outpatients: A Comparison of Linguistic Subgroups

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.

Vocabulary and Grammar Differences Between Deaf and Hearing Students.

The present study investigated the development of literacy skills of deaf and hard-of-hearing (DHH) children in Japan. The three components of literacy, vocabulary, orthographic knowledge, and grammatical knowledge were assessed by using the subtests of the Adaptive Tests for Language Abilities (ATLAN), based on the item response theory developed by the authors). The participants consisted of 207 DHH children (first through twelfth grades) in Study 1, and 425 hearing children (first through sixth grades) in Study 2. The findings show that more than 80% of DHH children's vocabulary variance was explained by the other two componential skills, while the three tasks' difficulty was different. More specifically, their vocabulary and especially, their grammar lagged behind those of hearing children, whereas the difference between the two groups on kanji (one of the three orthographic systems in Japanese taught during the school years) was less. Although considerably delayed, their pattern of responses in grammar was similar to that predicted from normative data. Effective instruction for DHH children's literacy skills was generally discussed.

Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability.

Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CI also had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between-category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.