Deaf And Hard-of-hearing Research Articles

Sign Language Detection Using Action Recognition LSTM Deep Learning Model

Sign language serves as a vital communication medium for the Deaf and Hard of Hearing (DHH) community, yet its recognition by computational systems remains a complex challenge. This research paper presents a novel approach to sign language detection utilizing action recognition principles through a Long Short-Term Memory (LSTM) deep learning model. Leveraging the temporal dynamics and sequential nature of sign language gestures, the LSTM model is trained to accurately identify and classify signs from video data. The proposed system processes video sequences to extract key frame features, which are then input into the LSTM network. The model's architecture is designed to capture the temporal dependencies and nuanced movements characteristic of sign language. We utilize a comprehensive dataset comprising diverse sign language gestures to train and evaluate the model. Our experimental results demonstrate that the LSTM-based approach achieves high accuracy in sign language detection, outperforming traditional static frame-based methods. The system's performance is evaluated through various metrics, including precision, recall, and F1-score, showcasing its robustness in real-world scenarios. Keywords: Gesture Recognition, Deep Learning(DL), Sign Language Recognition(SLR), TensorFlow, Matplotlib, Mediapipe, opencv-python, numpy.

Deaf/hard of hearing students' experiences with higher education's real-time captioning services.

Real-time captions appear to be an effective tool in assisting deaf and hard of hearing (DHH) college students' access information and communication in certain classroom settings. However, there is limited knowledge of DHH students' direct experiences with real-time captioning services. In this study, we gathered narratives from 15 DHH college students across the United States about their experiences with real-time captioning services in college. We analyzed the stories using thematic narrative analysis and uncovered 4 types that students told about their experiences. The story types were (a) stories of overcoming obstacles, (b) stories of resignation, (c) pragmatic stories, and (d) stories of personal connection. These story types reveal that although many students eventually experience effective communication access through real-time captioning services, they can initially struggle to overcome barriers to using the services successfully. Making time and space to listen to DHH students' narratives can teach educators and professionals how to support these students and resolve barriers before they arise.

UX Design for Deaf Children: How is it Done Now? Should it Change?

The process by which user experiences (UX) for children are created is uncertain, especially for deaf and hard of hearing (DHH) children. This paper seeks to (I) describe the origins of UX and child–computer interaction and to describe what is being taught to designers today; (II) use the example of digital assessment to extract insights from practitioners about UX design for DHH children; and (III) describe opportunities for amending today's UX design curricula to foster more equitably designed products for children. Interviewing 13 practitioners revealed the following findings. (1) Allowing non-designer participants to self-identify their profession makes them more likely to discuss design concepts. (2) The challenge of working with children is more about legal/risk assessment than any gaps in design education. (3) Practitioners who design products for children follow similar processes to designers who design for adults; age-specific language is the main difference child and adult UX.

Parental Linguistic Input to Children Who are Deaf and Hard-of-Hearing during Parent-Child Interaction: A Systematic Review and Meta-Analysis

Objectives: Parental linguistic input has long been shown to predict children’s later language ability. This study aimed to characterize the quantity and quality of parental linguistic input of children who are deaf and hard-of-hearing (DHH) through systematic literature and meta-analysis.Methods: One thousand seven hundred sixty-one articles from 2001 to February 2022 investigating parental linguistic input in children with DHH were identified via database searches. Nine articles were identified that met the PICOS (Participants, Intervention, Comparison, Outcomes, and Study design) criteria. A systematic review and metaanalysis of the literature were conducted. We used mixed effects models to estimate the overall mean effect size metric to address each research question.Results: As a result of the systematic literature review, the selected articles had a low risk of bias. In a considerable number of the presented meta-analytic articles, mothers and children aged 24-36 months participated. We did detect significant differences in the number of total words, the number of different words, and the proportion of the high-level facilitative language techniques from the parents’ utterances between the DHH and the typical hearing (TH) groups. On the other hand, there was not a significant difference in the number of total utterances between the two groups.Conclusion: This meta-analysis reports on different patterns of parental linguistic input between children with DHH and children with TH. We conclude with a discussion of the findings and consideration of the implications for research.

Sign Language Detection Using Deep Learning

Abstract: Millions of citizens worldwide suffer from deaf and hard of hearing (DHH), a communication impairment that makes speaking difficult and necessitates the use of sign language. This communication gap frequently hampers access to education and opportunities for employment. Although AI-driven technologies have been studied to tackle this problem, no research has specifically looked into the intelligent and automatic translation of American sign gestures to text in low-resource languages (LRL), such as Nigerian languages. We suggest a unique end-to-end system for translating the American Sign Language, or ASL, Our framework uses the "no language left behind" translation model and the Transformer-based model for ASL-to-Text generation. converting the text generated from LRL to English. We assessed the ASL-to-Text system's performance. The people who participated were able to understand the translated text and expressed satisfaction with both the Text-to-LRL and ASL-toText models, according to a qualitative analysis of the framework. Our suggested framework shows how AI-driven technologies can promote inclusivity in sociocultural interactions and education, particularly for individuals with DHH living in low-resource environments. To bridge the gap between the non-sign language and hearing/speech impaired communities, sign language recognition is crucial. Sentence detection is more useful in real-world situations than isolated recognition of words, yet it is also more difficult since isolated signs need to be accurately identified and continuous, high-quality sign data with distinct features needs to be collected. Here, we suggest a wearable system for understanding sign language using a convolutional neural network (CNN) that combines inertial measurement units attached to the body with flexible strain sensors to detect hand postures and movement trajectories. A total of 48 frequently used ASL sign language terms were gathered and utilized to train the CNN model. This resulted in an isolated sign language word recognition accuracy of 95.85%.

Care Partner Experiences in Supporting Deaf and Hard of Hearing Adults With Diabetes

OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION 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.

The Crossover: Integrating Indian Sign Language with the Mudras in an Indian Classical Dance Performance Creation

Indian classical dance uses a variety of non-verbal communication devices, with gestures called hasta or mudra being one of the most ancient sign languages powerful to transmit the meaning of the lyrics through dance. The classical dance forms of Kerala have an elaborate scheme of gestures drawn from the ancient text on aesthetic sign language, called Hastalakṣanadīpika, inspired by the Vedic, Nāṭya and Tantric traditions. The following is an attempt to document a performance-oriented, socially inclusive effort that makes Indian traditional dance performance discernible to the Deaf and Hard of Hearing (DHH) community, a disparate group that is hardly considered as a spectator during performance creation by mainstream Indian classical dancers. The Indian Sign Language (ISL) of individuals with hearing impairments is elaborate, yet is rarely used as a gestural language along with other aesthetic gestural sign languages to disseminate a narrative in a work of art. In her role as both creator and performer, Methil Devika creates work in Mohiniyāṭṭam, a graceful dance form of Kerala, integrating the sign language of those with hearing impairments along with the gestural language prescribed in the ancient treatise Hastalakṣanadīpika. She applies it strategically in her work of art, as an interlinking tool between the art and the audience. In the first few moments, “all walls came crumbling down,” something the performer quotes in the visual documentation of the work. Any separation between the hearing impaired and the artiste, as well as the spectators, become inconsequential. The performance and the presentation have been video documented in a film called The Crossover, and the following is an attempt to describe the creative process.

Validity and reliability of Turkish version of the secondary screening instrument for targeting educational risk questionnaires

ABSTRACT Objective The Secondary Screening Instrument for Targeting Educational Risk Questionnaires (Secondary S.I.F.T.E.R.) is a scanning tool for teachers to evaluate the challenges and educational risks faced by deaf and hard of hearing (DHH) students. In Turkey, there is a need for a screening tool to identify academic risks among DHH students. This study aimed to adapt the Turkish version of the Secondary S.I.F.T.E.R. (Secondary S.I.F.T.E.R.-T) and evaluate its validity and reliability. Materials and Methods The Secondary S.I.F.T.E.R.-T was translated and cross-culturally adapted. Subsequently, the Secondary S.I.F.T.E.R.-T was administered by teachers of 104 DHH students (group 1) and 69 normal-hearing students (group 2) in the 6th to 12th grades to evaluate. Results In the validity analysis of the Secondary S.I.F.T.E.R.-T, the item-total correlation coefficients, content validity ratio, and index were found to be compatible with the literature, and the subscale and total scale scores of the two groups were significantly different. High internal consistency reliability was determined using Cronbach's alpha, split-half Spearman-Brown correlation, and Guttman's coefficients. A scoring grid was developed to identify low-, middle-, and high-performing students. Conclusions The validity and reliability analyzes of the Secondary-S.I.F.T.E.R.-T were found to be acceptable, and scoring grids were determined. Secondary-S.I.F.T.E.R.-T can be used as a screening tool to identify academic risks among DHH students in Turkey.

Communication breakdown repair skills: Comparison between deaf and hard-of-hearing, and normal-hearing adolescents

Objectives Communication breakdowns and their repair by deaf and hard-of-hearing (DHH) and hearing adolescents were examined in conversation with an unfamiliar communication partner. Method This study compared the number and type of clarification requests and responses to those requests of 16 DHH and 16 normal-hearing adolescents aged 11–16 years, in a 10-minute conversation with an unfamiliar adult. It also analyzed the relationship between speech intelligibility, communication breakdowns, and clarification requests by an unfamiliar adult. the Children's Communication Checklist (CCC) was completed by parents. Results DHH adolescents demonstrated significantly higher usage of nonverbal clarification requests and verbal and nonverbal responses to clarification requests compared to normal-hearing adolescents in conversations with an unfamiliar adult. Furthermore, the subscale scores of the CCC and the speech intelligibility of DHH adolescents were significantly lower than those of normal-hearing adolescents. There were correlations between speech intelligibility and the speech subscale score of the CCC, as well as correlations between the pragmatic composite score of the CCC, the number of communication breakdowns, and the number of clarification requests by an unfamiliar adult. Discussion The adolescents with DHH experienced more communication breakdowns in conversation with an unfamiliar adult and the number of clarification requests made by adults was higher.

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.

Use of American Sign Language and Deaf Participants in Dance Theater: Considerations in Practice

ABSTRACT Productions can be made more accessible for Deaf and hard of hearing (DHoH) dancers, performers, and audiences. This article provides ideas and guidelines on how to include and accommodate them. Reflecting on our experiences developing the dance theatrical production of “Within Dreams,” we describe the need for making space for DHoH individuals in various areas of dance productions in higher education: in participation, patronage, and the use of American Sign Language (ASL) in dance pieces. Our hope is that elucidating what we learned makes it easier for other companies and universities to explore and incorporate thoughtful and successful relationships between sign languages, deaf, and dance.

The effect of retrieval practice on vocabulary learning for DHH children.

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 5.0-8.11years) 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.

The timeline of non-vocal and vocal communicative skills in infants with hearing loss.

The study investigates what is the link between early verbal and non-vocal abilities, when does predominantly verbal communicative style occur after the intervention with cochlear implants (CI) or hearing aids (HA), and how predictive it is of later linguistic development in deaf and hard of hearing (DHH) infants and children. Cohort: children with moderate-to-profound hearing impairment (N = 49, 20 girls, mean age at HA or CI intervention = 15 months, range: 4-35 months). Receptive and productive vocabulary at 24 and 36 months and video analysis at 12 months post-intervention. Analysis: Predictive values of total and verbal responses to communicative turns for later vocabulary development were assessed, as well as the relative time course of the development of vocal/verbal communication in DHH children. Vocabulary at 24 months is predicted by auditory responses at 12 months, as well as by overall responsiveness before intervention. Non-vocal responses decline and overall verbal responses increase significantly between 6 and 12 months after intervention. The trend is delayed in children with delayed (>12 months of age) treatment with CI or HA. Age of intervention affects the development of vocal/verbal communicative style. Language development, in particular, vocabulary growth, can be further stimulated by the enhancement of preverbal (both vocal and non-vocal) communicative skills.

Development of embodied listening studies with multimodal and wearable haptic interfaces for hearing accessibility in music

IntroductionThe intersection of hearing accessibility and music research offers limited representations of the Deaf and Hard of Hearing (DHH) individuals, specifically as artists. This article presents inclusive design practices for hearing accessibility through wearable and multimodal haptic interfaces with participants with diverse hearing backgrounds.MethodsWe develop a movement-based sound design practice and audio-tactile compositional vocabulary, co-created with a Deaf co-designer, to offer a more inclusive and embodied listening experience. This listening experience is evaluated with a focus group whose participants have background in music, dance, design, or accessibility in arts. By involving multiple stakeholders, we survey the participants' qualitative experiences in relation to Deaf co-designer's experience.ResultsResults show that multimodal haptic feedback enhanced the participants' listening experience while on-skin vibrations provided more nuanced understanding of the music for Deaf participants. Hearing participants reported interest in understanding the Deaf individuals' musical experience, preferences, and compositions.DiscussionWe conclude by presenting design practices when working with movement-based musical interaction and multimodal haptics. We lastly discuss the challenges and limitations of access barrier in hearing accessibility and music.

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.

Cancer Worry and Fatalism at the Intersection of Race and Hearing Status.

The deaf and hard of hearing (DHH) community experiences lower cancer screening rates than the general population. Cancer worry and fatalism can influence cancer screening, along with race, and the interaction of intrinsic factors with DHH health behavior needs to be investigated. The study examines the association of the intersection of race and hearing status with cancer worry and fatalism. This study analyzed cross-sectional survey data from NCI HINTS-ASL (for DHH adults) and NCI HINTS (for hearing adults). Multivariable logistic regression models were used to assess (i) the association of race-hearing status intersection with cancer worry and fatalism, as well as (ii) the relationship between hearing status and outcomes within each race. The study found that the overall interaction between race and hearing status was significantly associated with both high cancer worry and fatalism, with African American (AA)/Black and Asian/Other having higher odds of worry [1.17 (0.83, 1.64); 1.19 (0.85, 1.66), respectively] and other groups having lower worry than White hearing (P < 0.0001), and all deaf having less concern about cancer fatalism (P < 0.0001). Within each racial group, White DHH respondents had lower odds of cancer worry [aOR (95% CI): 0.72 (0.58, 0.91); P < 0.01] and fatalism [0.55 (0.46, 0.67); P < 0.0001] compared to White hearing respondents, while DHH AA/Black [1.89 (1.06, 3.37); P = 0.03], Asian/Other [2.39 (1.06, 3.37); P = 0.03], and Hispanic [1.95 (1.18, 3.22); P < 0.01] respondents had significantly higher odds of cancer worry and lower odds of cancer fatalism [Black: 0.50 (0.23, 1.09); P = 0.07; Asian/Other: [0.68 (0.42, 1.09); P = 0.10]; Hispanic: [0.69 (0.40, 1.17)]; P = 0.16] compared to their hearing counterparts. DHH individuals have different odds of experiencing cancer worry and fatalism compared to their hearing counterparts. Inclusion of individuals with sensory disabilities in a larger cancer study sample enriches the diversity of perspectives, ensuring that the findings reflect a broader range of experiences and needs. More research into contributory factors in the signing DHH population is needed.

Exploring the Interplay of Diabetes, Deaf Patient Reported Outcomes, and Cancer Screening in Deaf and Hard of Hearing Women.

Some deaf and hard-of-hearing (DHH) individuals face health information barriers, increasing their risk of diabetes mellitus (DM) and subsequent cancer development. This study examines if health-related quality of life (HRQoL) and deaf patient-reported outcomes (DHH-QoL) mediate the relationship between DM diagnosis and cancer screening adherence among DHH individuals. In a cross-sectional study, US DHH adults assigned female at birth answered questions on cervical and breast cancer screenings from the ASL-English bilingual Health Information National Trends Survey (HINTS-ASL) and the PROMIS (Patient Reported Outcome Measurement Information System) Deaf Profile measure's Communication Health and Global Health domains. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from multivariable logistic and linear regression models, examining the association between DM, DHH-QoL, and cancer screening adherence, adjusting for other covariates and HRQoL. A Baron and Kenny causal mediation analysis was used. A two-sided p < 0.05 indicated significance. Most respondents were White (66.4%), heterosexual (66.2%), did not have DM (83.9%), had health insurance (95.5%), and adhered to pap smears (75.7%) and mammograms (76.9%). The average (standard deviation) DHH-QoL score was 50.9 (8.6). Those with DM had lower HRQoL scores (46.2 (9.5) vs 50.2 (8.8); p < 0.0001) than those without. Non-significant multivariable models indicate that those with DM were more adherent to pap testing (OR: 1.48; 95% CI: 0.72, 3.03; p = 0.285) and mammograms (2.18; 95% CI: 0.81, 5.88; p = 0.122), with DHH-QoL scores slightly increasing them to 1.53 (0.74, 3.16; p = 0.250) for pap testing and 2.55 (0.91, 7.13; p = 0.076) for mammograms. DHH-QoL was significantly associated with mammograms (p = 0.027), with 6% increased adherence per unit increase in the score. Overall, HRQoL and DHH-QoL were not significant mediators. While HRQoL/DHH-QoL in DHH individuals with DM does not mediate cancer screening adherence, higher DHH-QoL scores are associated with it. DHH-focused health literacy and communication training can improve cancer-related outcomes.

Instruments for evaluating the parental emotional status and ecological support systems among parents who considered cochlear implantation for their children with hearing loss: A scoping review.

Parents of children diagnosed with severe-to-profound sensorineural hearing loss may experience a range of emotions owing to a lack of knowledge and experience in dealing with such children. However, most audiology clinics only attend to children with deaf and hard of hearing (DHH) and not their parents. Thus, parents' emotional and support needs are frequently excluded from the intervention sessions, making their own needs invisible. This study aimed to identify academic and clinical instruments used for assessing parental emotional status (PES) and ecological support systems (ESS) in early intervention and determine the factors affecting PES and ESS among parents of DHH children undergoing cochlear implantation. This scoping review followed the rigorous methodological framework; searched Medline (via OVID and EMBSCO), Scopus, and Web of Science; and selected studies relevant to validated instruments used to evaluate the PES and ESS among parents of DHH children below 6 years old. Before selecting and reviewing relevant articles, two reviewers independently assessed article titles and abstracts from the data sources. Two reviewers verified half of the first reviewer's extracted data. Overall, 3060 articles were retrieved from the database search, and 139 were selected for full-text review following title and abstract reviews. Ultimately, this study included 22 articles. Among them, 23 and 12 validated instruments, most of which are generic measures, were used for assessing PES and ESS, respectively. Three condition-specific instruments were identified and designed to be administered following cochlear implantation surgery. This study revealed that healthcare professionals who interact with parents of DHH children lack the necessary instruments, particularly for parents of children undergoing cochlear implantation surgery. Therefore, it is necessary to develop condition-specific instruments for parents who consider cochlear implantation for their children.

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.

Comparison of Children’s Communication Checklist Between Deaf and Hard of Hearing, and Hearing Adolescents

Background and Objectives: The present research compared pragmatic abilities between deaf and hard-of-hearing (DHH), and hearing adolescents using the children’s communication checklist (CCC). Methods: In this study, 16 hearing adolescents aged 11–16 and 16 deaf and DHH adolescents with similar chronological ages participated. The CCC was completed with parents of DHH and hearing adolescents. Results: The study’s results revealed that DHH and hearing adolescents had a significant difference in pragmatic composite scores (PCS) and the score of all CCC subscales. The results showed that in all subscales of the CCC, DHH adolescents received lower scores from their parents than hearing adolescents. The inappropriate initiation and stereotyped language subscales of the CCC had the highest correlation rates. Also, the pragmatic composite score showed the highest correlation with the stereotyped language subscale. Conclusion: DHH adolescents showed weaker performance in pragmatic skills than hearing adolescents.