In this study, we developed a two-day scaffolded digital skills training intervention for mobile literacy for people who are blind or partially sighted (BPS) and deaf or hard of hearing (DHH) across three research settings: Brazil, India, and Kenya. Using an adapted Mobile Device Proficiency Questionnaire (MDPQ) administered at pre- and post-intervention, we measured the impact of the digital skills training intervention on the perceived proficiency in smartphone use. We recruited 395 participants (BPS= 208, DHH=187), who undertook the two-day training and used the smartphone as assistive technology (AT) for six months. Through post-intervention interviews, we explored the participants’ experience of the training and of using the smartphone as an AT. Our findings reveal a significant impact of digital skill training on participants’ digital literacy and self-efficacy in using smartphones as AT in everyday settings. We also discuss the need for adaptive, ability-based design approaches to improve the learning experience and digital literacy of BPS or DHH individuals in low- and middle-income countries.

While school-aged children who are deaf or hard of hearing (DHH) spend much of the day in classrooms or playgrounds, little is known about how aspects of these environments, such as fast speech and background noise, affect their ability to process sentences in real time. The current study compared processing of sentences in 16-talker babble noise spoken at a fast (6.1 syll./s) vs normal (4.5 syll./s) speaking rates in twenty-seven 8-13-year-old children with hearing in the normal range (NH) and 31 DHH children. Children were instructed to detect a target word in a sentence, and response time (RT) was taken as an outcome measure. Relationships between working memory capacity, vocabulary knowledge, and RT were also assessed, but not observed. Both groups of children were slower to process fast speech than normal-rate speech, with no evidence that DHH children were differentially affected by speaking rate compared to peers with NH. DHH children processed sentences in noise slower than their peers with NH across speaking rates. These results suggest that children's sentence processing can be disrupted when they encounter fast speech in a noisy environment, and that DHH children may be most at risk for spoken sentence processing delays in real-world listening environments.

This study examined the effects of psychological resilience on career exploration and decision-making self-efficacy in deaf or hard-of-hearing (DHH) college students, and explored the mediating role of hope. A sample of 356 Chinese DHH college students aged 18-27years (mean age = 21.23; SD = 1.66) participated in this study and completed measurements about psychological resilience, hope and career exploration and decision self-efficacy. The results showed that psychological resilience positively associated with career exploration and decision-making self-efficacy. Agency thinking mediated the relationship between psychological resilience and career decisional self-efficacy, while pathway thinking mediated the relationship between psychological resilience and career decisional coping efficacy. These results indicated that the confidence of DHH college students in career exploration and decision-making can be built by developing their internal resources.

Early enrollment in Part C Early Intervention (EI) before age 6 months is linked to improved language and kindergarten readiness in children who are deaf or hard of hearing (DHH), but the effect on later academic outcomes is unclear. This study examines whether earlier (< 6 months) versus later (> 6 months) enrollment of children who are DHH in early intervention programs influences third-grade reading proficiency. This study used data linked from three Ohio state agencies for infants identified with permanent hearing loss born 2008-2014 who received EI. The sample consisted of 412 children who were DHH and had scores on third grade standardized reading tests. Reading levels were categorized from limited to advanced. Logistic regression assessed the association between enrollment timing and reading proficiency, adjusting for potentially confounding variables. Children enrolled in EI programs before 6 months of age (n = 231; 56.1%) were more likely to achieve advanced reading levels (19.9% vs. 12.2%) and less likely to score at limited levels (27.7% vs. 36.5%) than those enrolled later. Earlier enrolled children had reading performance comparable to all Ohio third graders. Earlier enrollment was statistically significantly associated with proficient or better reading levels compared to later enrollment (OR 1.64 95% CI [1.06, 2.57]). Benefits of earlier EI enrollment extend into elementary school, supporting healthy developmental trajectories and reducing risk for later academic challenges in children who are DHH.

The present action research study had two main aims. The first aim was to develop and implement a Teacher Training Program for teachers providing early intervention (EI) services for deaf/hard of hearing (DHH) children. The second aim was to investigate the contributions of the Teacher Training Program to the participating teachers, the principal, and the parents of DHH children. The research was conducted at a Special Education and Rehabilitation Center (SERC). The participants of the study included eight teachers, one school principal, eight DHH children, and their parents. Data were collected from reflective journals, documents, observations, semi-structured interviews, meetings, and artifacts, and analyzed using descriptive and inductive methods. The findings showed that teachers achieved significant professional development in the planning and evaluation of EI session, and in their interactions with children, utilizing play as a learning medium, supporting listening and spoken language development skills, and supporting active participation of the family. It was noted, however, that the high teacher turnover stemming from problems related to working conditions at the SERC limited the sustainability of the Teacher Training Program and its benefits to the center.

Early parent–child interactions are crucial for children’s social–emotional development. Mental state talk (MST)—language referring to thoughts, feelings, and intentions—is a key contributor. MST may be reduced in hearing parents of deaf or hard-of-hearing (DHH) children, who face unique communication challenges. Yet, existing research on MST in hearing parents of DHH children and on MST use by DHH children themselves is limited and fragmented, often focusing on MST quantity in a single context. Few studies have examined MST quality, variation across contexts, or its relationship with children’s social–emotional functioning. This study addresses these gaps by investigating MST quantity and quality across two activities and its associations with children’s MST and social–emotional development. Forty-eight hearing parent–DHH child dyads (ages 2–5) participated. MST was studied during storybook reading and free play. Children completed tasks on emotion understanding and theory of mind; parents reported on MS vocabulary and family characteristics. The results showed that parents adjusted MST complexity based on children’s age but not audiological characteristics. MST varied by activity, with different contexts eliciting distinct types of MST. Parental and child MST were associated, though not linked to children’s task performance. Findings highlight the importance of diverse interaction contexts and suggest a need for longitudinal research on MST’s developmental impact.

Retrieval practice involves actively recalling information from memory and has been found to be an effective strategy for word learning. This case study aimed to describe the effect of retrieval practice on word learning in four children who are deaf or hard of hearing (DHH). Children received eight language intervention sessions in 4 weeks. Target words were presented in the context of a narrative under three different conditions: no retrieval, immediate retrieval, or spaced retrieval. Under the no-retrieval condition, children received exposure to new words, but they were not asked to recall them. Under the immediate-retrieval condition, children were required to recall words immediately after exposure. Under the spaced-retrieval condition, children had to recall words some time after exposure. In addition, words were probed but not taught under a control condition. We measured word learning before, during, and after the intervention. We found that children learned target words under the intervention conditions but not under the control condition. Three out of four participants remembered more words under the spaced- and immediate-retrieval conditions than under the no-retrieval condition, suggesting that explicit and active practice contributes to learning more than passive exposure to words. The narrative intervention provided a natural context for teaching vocabulary, which can be implemented in both clinical and educational settings.

Abstract This scoping study integrates research on the experiences of deaf, Deaf or hard-of-hearing (DHH) people during extreme weather events and other emergencies in Organisation for Economic Co-operation and Development countries. The review identified 48 articles published between January 2005 and August 2024. Data charting and inductive analysis of these articles identified three factors that influence access to and participation in communication during emergencies: (1) emergency warnings, alerts, and announcements; (2) the emergency sector response; and (3) emergency preparedness. There are opportunities to leverage capabilities and facilitators to address common barriers and support increased accessibility and inclusion for DHH people before, during, and after emergencies. These include ensuring that warnings and alerts are provided in multiple formats and channels; providing training for first responders in communicating with DHH people; including the diverse needs of DHH people in emergency plans at all levels; and ensuring that training and educational materials are accessible and relevant to DHH people. There are roles for DHH community organizations and the hearing care sector to link DHH individuals with information, education, and training provided by the emergency sector. For many DHH people who do not have connections with support organizations or other DHH people, the hearing care sector may be the only linkage point between their deafness or hearing difficulties, their hearing devices, and their personal emergency awareness and preparedness.

Telehealth utilization and perceptions among deaf or hard of hearing adults: A cross-sectional analysis of the HINTS6 national dataset.

Teachers' obstacles and supports in distance learning education for students who are deaf and hard of hearing in the Kingdom of Saudi Arabia.

Knowledge is an infinite world. In this endless world, everyone strives to get what they need. Everyone believes that knowledge is the basis for improving their lives. Such people are children with special educational needs. Now the opportunities have expanded, as a result of which the concept of inclusive education and inclusive learning has been formed. Inclusive education represents a critical strategy for enhancing educational systems globally. A systematic literature review has been conducted to assess the current state of inclusive education and identify existing gaps. The primary objective of this research is to explore the application and effectiveness of sign language recognition systems within inclusive education frameworks. To achieve this goal, two specific tasks were addressed: first, to examine the practice of inclusive education, including the identification of unique learning characteristics and needs of Deaf or Hard-of-Hearing (DHH) students; and second, to evaluate the experience and impact of integrating sign language recognition technologies into the educational experiences of individuals with hearing impairments. This includes a detailed consideration of contemporary technological advancements. Through this exploration, the research aims to provide a comprehensive understanding of how modern technologies can be leveraged to enhance inclusive education and improve outcomes for students with diverse needs. Further studies could build on these findings to advance the development and implementation of such technologies in educational settings.

The understanding of hidden emotions—situations in which individuals deliberately express an emotion different from what they genuinely feel—is a key skill in theory of mind (ToM) development. This ability allows children to reason about discrepancies between internal emotional states and external expressions and is closely tied to linguistic development, particularly vocabulary related to mental states, which supports complex emotional reasoning. Children who are deaf or hard of hearing (DHH), especially those born to hearing non-signing families and raised in oral language environments, may face challenges in early language exposure. This can impact the development of social and emotional skills, including the ability to understand hidden emotions. This study compares the understanding of hidden emotions in hearing children (n = 59) and DHH children (n = 44) aged 7–12 years. All children were educated in spoken language environments; none of the DHH participants had native exposure to sign language. Participants completed a hidden emotions task involving illustrated stories where a character showed a certain emotion in front of two observers, only one of whom was aware of the character’s true emotional state. The task assessed children’s understanding of the character’s emotional state as well as their ability to reason about the impact of hiding emotions on the beliefs of the observers. The results showed that the hearing children outperformed their DHH peers in understanding hidden emotions. This difference was not attributed to hearing status per se but to language use. Specifically, children’s spontaneous use of cognitive verbs (e.g., think or know) in their explanations predicted task performance across the groups, emphasizing the role of mental state language in emotional reasoning. These findings underscore the importance of early and accessible language exposure in supporting the emotional and social cognitive development of DHH children.

The aim of this study was to analyze with the help of claims data which additional diagnoses are common for children who are deaf or hard-of-hearing (DHH) and at what frequency. Claims data sets from statutory health insurance providers contain different pieces of information, including medical diagnoses. The analysis of claims data was conducted for the 2010 birth cohort of 38,705 children who were insured by the BARMER health insurance company. This birth cohort was then narrowed down to all children who received a prescription for a hearing device within the first 10years of their life (n = 474). For these 474 children, we assessed the most common additional diagnoses coded according to the International Classification of Diseases (ICD)-10-GM and analyzed their frequency. Apart from the high frequency of ear diseases such as "Diseases of middle ear and mastoid" (ICD category H65-H75, 95.4%), we also found a high frequency for "Developmental disorders" (ICD category F80-F89, 81.9%) and various other additional diagnoses. Our results show that DHH children are a heterogenous group with a high frequency of additional diagnoses.

ABSTRACT Many deaf or hard-of-hearing (DHH) preadolescents in mainstream classes face social exclusion, yet little is known about how they cope with communication barriers. We interviewed 15 DHH preadolescents on their coping strategies and assessed their social participation through self-reports, peer-nominations, and wearable sensors used by them and 197 classmates during multiple recess periods. Thematic analysis revealed six strategies: actively expressing hearing-related needs, receiving assistance from friends, acceptance of missing out, experiencing negative emotions, withdrawing socially, and denying mishearing. Findings indicated that, despite employing various strategies, most participants were poorly integrated socially. However, some emerging coping patterns were discerned between participants with varying levels of social participation. These findings, framed within coping models and disability studies perspectives, suggest that DHH students’ sense of limited control over their classmates’ behaviours should be acknowledged, highlighting the need to conceptualise children’s coping with disability within dyadic or group frameworks, rather than individual ones.

Most children exhibit preliteracy skills by preschool. Children who are deaf/hard of hearing (DHH) with a language gap are at risk for delayed preliteracy skills. Our study aimed to describe preliteracy skill development in preschool-aged DHH children and investigate associated factors. Children, aged 3 to 5 years, were included in the analysis if enrolled in randomized trials of a language intervention using augmentative and alternative communication, shown to boost language skills. Evaluations using the Clinical Evaluations of Fundamentals-Preschool Preliteracy Rating Scale (PRS) were conducted at baseline, 24 weeks, and 48 weeks. Repeated-measures models assessed changes in total PRS scores and Early Reading and Early Writing subdomains. Results were presented as least square mean values with 95% confidence intervals. Forty-five children had completed pre-data and post-data. The mean nonverbal IQ was 99.3 (SD 14.3), and receptive and expressive language were 82.3 (14.9) and 76.8 (17.0), respectively. Significant ( p < 0.0001) skill growth was observed with all preliteracy outcomes, ranging from 11 to 15 points in the first 24 weeks. Increasing receptive and expressive language over time was significantly associated with increasing scores. Factors such as aided hearing thresholds, caregiver education level, and hearing device use were not significant in models. Language is essential for literacy development. Language-enhancing interventions could facilitate literacy skills. Monitoring preliteracy skills in DHH children is crucial, given their increased risk for language delays. Further research is needed to support early literacy development in this population, ensuring they have the tools they need for future success.

ABSTRACT Student engagement mattered a lot in student development across different domains. Researchers have attempted to facilitate it through either implementing interventions or examining influencing factors. This study explores how students’ self-determination is related to their engagement, by administering the AIR and the Student Engagement Scale to 214 deaf or hard-of-hearing (DHH) school students in mainland China. Results showed that participants with higher levels of self-determination scored higher on student engagement, while those with lower levels scored lower. This research pioneers in exploring the relationships between self-determination and student engagement among DHH school students in mainland China. However, all the DHH participants are educated in secondary schools for the deaf. This research employed senior students majoring in sign language instead of professional interpreters to administer the inventories, which may have influenced the results. This research indicated that university/school administrators, counsellors and teachers may provide more opportunities in or after class for students to handle tasks that require freedom and independence, or by encourage students to deal with more complex and less structured activities. DHH students may actively learn new things or assimilating surrounding information, which may help them to deal successfully with engagement tasks, and consequently increase their engagement.

Many students in STEM experience decreased performance due to anxiety, namely math and science anxiety. However, spatial skills are correlated with better STEM outcomes. Our research addressed a previous gap in the literature, investigating if STEM anxiety or spatial experiences have a stronger relationship with STEM outcomes. In this online study, we explored which factors were related to STEM outcomes in a sample of deaf, hard of hearing (DHH), and hearing adults (N = 115) who had experience with American Sign Language, which has been associated with improved spatial skills. Participants completed a mental rotation task, and self-reported interest in STEM, and anxiety. Results showed math and science anxiety were significant predictors of mental rotation performance and interest in studying STEM, even when accounting for other spatial factors. For DHH and hearing people alike, math and science anxiety are important factors that must be addressed to encourage STEM success.

Group work is commonly adopted in university science laboratories. However, student small-group discourse in university science labs is rarely investigated. We aim to bridge the gap in the literature by characterizing student discourse group roles in inquiry-based science labs. The instructional context for this study was a summer program hosted at a private research university in the eastern United States. The program was designed as a bridge program for matriculating students who were first generation and/or deaf or hard of hearing (DHH). Accommodations such as interpreters and technological tools were provided for DHH students. We analyzed 19 students’ discourse moves in five lab activities from the video recordings, resulting in a total of 48 student-lab units. We developed codes to describe student discourse moves: , and . Through a cluster analysis using the 48 student-lab units on quantified discourse moves, we identified four discourse styles, . The results show that individual students tended to demonstrate varying discourse styles in different lab activities; students’ discourse styles within the same groups tended to be aligned with their group members. By examining group members’ discourse styles in mixed-gender groups, we did not observe a difference in engagement levels between female and male students. DHH students in mixed hearing ability groups, however, were observed to have a lower level of engagement compared to their non-DHH group members. We discuss possible factors that may have contributed to the observations for genders and students with different hearing abilities. We also provide suggestions for promoting equitable small-group discourse in university science labs.

This systematic review aimed to assess the mental health of children and adolescents who are Deaf or Hard of Hearing (DHH), including those with moderate to profound levels of hearing loss, exploring factors influencing their psychological well-being and social functioning. Following PRISMA guidelines, a comprehensive search was conducted in nine databases (Medline, PubMed, PsycINFO, etc.) up to January 2025. Empirical qualitative, quantitative, and mixed-methods studies published in English were included, with 46 studies selected after screening. Study quality was assessed using a 14-criteria scoring system. Data extraction was performed by the first author and validated by co-authors. A total of 46 studies with 22,859 participants (ages 6-21) were included. Findings revealed that individuals who are DHH or moderate to profound hearing loss experience higher rates of internalizing disorders, such as anxiety and depression, compared to hearing peers. Social exclusion, communication barriers, and stigma were significant risk factors. Mainstream schools exacerbated mental health challenges, whereas specialized schools provided a supportive environment. Early diagnosis and intervention, especially cochlear implants, improved psychosocial development. Communication proficiency, especially sign language, positively impacted quality of life and mental health. Parental involvement and targeted interventions helped mitigate behavioral challenges and executive functioning deficits. This review highlights the key factors affecting the mental health of DHH youth, including communication methods, educational setting, early intervention, and social relationships. Tailored interventions addressing these factors are essential for improving psychosocial development. Future research should focus on developing and testing interventions to enhance the mental health and well-being of individuals who are DHH or have moderate to profound hearing loss.

BackgroundVulnerable populations at risk of injury include persons with intellectual and developmental disabilities (IDD), and persons who are deaf or hard of hearing (DHH). The purpose of this study was to describe and compare emergency department and inpatient hospitalization (ED + IP) injury rates and rate ratios by injury type among persons under age 65 with IDD or with DHH to those without IDD or DHH.MethodsThis is a descriptive population-based retrospective cross-sectional study of injuries among patients under the age of 65 with an IDD disability or a DHH disability using Kentucky ED + IP discharge datasets from 2019 to 2023. Injury rates and injury rate ratios were calculated for those under the age of 65 with an IDD or a DHH disability and without an IDD or a DHH disability, using number of persons under age 65 with or without the related disability as the denominator.ResultsThe overall injury rate was lower for persons under age 65 with an IDD or DHH compared to those without those disabilities in 2023 (1 and 3 per 100,000 population, respectively). IDD or DHH disability types had significantly lower overall ED + IP injury rate ratios compared to those without those disabilities (IDD: 0.667 [95% CI: 0.640–0.694], DHH: 0.658 [95% CI: 0.633–0.683]). When ED + IP injury type rate ratios were compared, IDD or DHH persons had higher injury rate ratios for self-harm (IDD: 8.740 [95% CI: 7.783–9.815], DHH: 1.7846 [95% CI: 1.402–2.272]), assault (IDD: 1.386 [95% CI: 1.173–1.637], DHH: 1.310 [95% CI: 1.115–1.540]), unintentional falls (IDD: 1.540 [95% CI: 1.436–1.633], DHH: 1.283 [95% CI: 1.201–1.372]), and drug poisonings (IDD: 2.401 [95% CI: 2.103–2.740], DHH:1.620 [95% CI: 1.391–1.886]) compared to those without such disabilities. Those with IHH or DHH who were treated for injuries incurred triple the charges of patients without these conditions (~$17,086 IDD; $19,550 DHH; and $5,216 no IDD or DHH disabilities).ConclusionsThese findings have implications for health policy at the state and federal level. Clinical care interventions to reduce assault, self-harm, drug poisonings and unintentional injuries and healthcare utilization in persons with IDD or DHH should be publicly funded or covered by health insurance.