Deaf Hard Of Hearing Research Articles

An Integrative Review of Current Practice Models and/or Process of Family-Centered Early Intervention for Children Who Are Deaf or Hard of Hearing.

Over the past few decades, there has been an increasing shift toward emphasizing the importance of the child's family taking an active role in the habilitation process through family-centered early intervention (FCEI) programs. Accordingly, the Health Professions Council of South Africa recommends that early intervention services following confirmation of hearing loss must be family-centered within a community-based model of service delivery that is culturally congruent. The aim of this study was to explore and document current evidence reflecting trends in FCEI for children who are deaf or hard of hearing (DHH) by identifying and describing current practice models and/or processes of FCEI for these children. This study describes our first steps in formulating a framework for FCEI for children who are DHH in South Africa. An integrative literature review was conducted. Sage, Science Direct, PubMed, and Google Scholar databases were searched for studies published in English between January 2009 and January 2019 reporting on FCEI programs for children who are DHH. Studies that focused on the following were excluded from the study: speech and language outcomes of children, youth, and adults who are DHH; education for children who are DHH; universal newborn hearing screening; professionals' roles in early hearing detection and intervention; diagnosis of hearing loss; and sign language. Kappa statistics were performed to determine agreement between reviewers. Twenty-two studies were included in the review. Cohen's kappa revealed a substantial agreement (κ = 0.8) between reviewers for data extraction and synthesis in terms of the articles that met the criteria for inclusion in the review. Findings were discussed under 5 themes: caregiver involvement; caregiver coaching/information sharing; caregiver satisfaction; challenges with FCEI; and telehealth. Generally, there is sufficient evidence for FCEI, with caregivers indicating the need for full involvement in their children's care. Methods of caregiver involvement involving caregiver coaching/information sharing need to be culturally and linguistically appropriate, with sensitivities around time and manner. This increases caregiver satisfaction with intervention programs and improves outcomes for children who are DHH. Challenges identified by the studies raise implications for early hearing detection and intervention programs, as well as Departments of Health and Social Welfare. These included logistical challenges, professional-related challenges, and caregiver-related challenges. Various aspects of FCEI have been reported in the review. Findings of these studies have significant implications for the formulation of quality FCEI programs to ensure contextually relevant and contextually responsive care of children who are DHH.

Inclusion of Signing Deaf or Hard-of-Hearing Students: Factors That Facilitate Versus Challenge Access and Participation

PurposePast studies have consistently indicated a need for improvements in inclusive educational practices. Many have focused on a single actor (e.g., the student), not taking into account the interactive nature of communication.MethodA qualitative study, involving multiple participants in two subject area general education high school classrooms, was completed to examine factors that promote versus challenge deaf or hard-of-hearing (DHH) students' access to communication and participation in classroom activities. Participants included four classroom teachers, two sign language interpreters, and three DHH students who used sign language as their primary mode of communication. Data consisted of eight 60- to 75-min in-class observations, two interviews, and three questionnaires. Data were analyzed using a participation framework of interaction as coordinated linguistic and nonlinguistic actions between multiple actors.ResultsDespite the availability of technological tools and sign language interpretation, DHH students had inconsistent access to classroom communication and lower participation than their hearing peers.ConclusionsThe results correspond to those of past studies, which suggest a research-to-practice gap that needs to be addressed if we are to see improvements in inclusive practices, particularly for students who use signed communication. Several recommendations are proposed in consideration of teacher, interpreter, and student as integral participants. Speech-language pathologists can participate in assessing whether inclusive education is meeting desired results and contribute to the development and implementation of necessary adaptations. Future studies are needed to systematically examine the efficacy of specific education and training programs.

Understanding factors that affect the prior knowledge of deaf and hard of hearing students and their relation to reading comprehension

ABSTRACT The reading comprehension levels of students who are deaf or hard of hearing (DHH) are low compared to those of their hearing peers. One possible reason for this low reading levels is related to the students’ prior knowledge. This study investigated the potential factors that might affected DHH students’ prior knowledge, including their degree of hearing loss, the presence or absence of family members with a hearing loss, and educational stage (elementary–middle school). The study also examined the contribution of prior knowledge in predicting DHH students’ reading comprehension levels, and investigated the differences in the students’ scores based on the type of questions, including text-explicit (TE), text-implicit (TI), and script-implicit (SI) questions. Thirty-one elementary and middle-school students completed a demographic form and assessment, and descriptive statistics and multiple and simple linear regressions were used to answer the research questions. The findings indicated that the independent variables—degree of hearing loss, presence or absence of family members with hearing loss, and educational stage—explained little of the variance in DHH students’ prior knowledge. Further, the results showed that the DHH students’ prior knowledge affected their reading comprehension. Finally, the result demonstrated that the participants were able to answer more of the TI questions correctly than the TE and SI questions. The study concluded that prior knowledge is important in these students’ reading comprehension, and it is also important for teachers and parents of DHH children to use effective ways to increase their students and children’s prior knowledge.

Thinking Styles and Student Engagement among Deaf and Hard of Hearing Students

This study explores how students’ thinking styles are related to their engagement, by administering the Thinking Styles Inventory-Revised II and the Student Engagement Scale to 225 deaf or hard-of-hearing (DHH) school students in mainland China. Results show that, among all participants, those with Type I styles (i.e., more creativity-generating, less structured, and cognitively more complex) had higher levels of student engagement, while those with Type II styles (i.e., more norm-favoring, more structured, and cognitively more simplistic) had lower levels. The contributions, limitations, and implications of the present research are discussed.

Young Children With Hearing Impairment and Other Diagnoses: Effects of Sound-Field Amplification

This study examined the effects of sound-field amplification (SFA) use for children who are deaf or hard of hearing (DHH) with additional diagnosed conditions enrolled in preschool and first and second grades in a rural district. Four focus children who are DHH with additional diagnoses were matched with hearing peers and observed for attending behaviors and latency in compliance to following routine directions with introduction of SFA. The study used a single-case multiple probe across participants design. All participants demonstrated improved attending behaviors and compliance to directions with SFA, with the focus children who are DHH with additional diagnoses showing stronger results than their hearing peers. Teachers indicated SFA was beneficial to the children who are DHH and they would use it again. SFA is an effective strategy to improve access to educational opportunities by increasing attending behaviors and promoting participation for children who are DHH with other diagnoses in special and general education preschool and first and second grades.

Delayed Identification of Infants Who Are Deaf or Hard of Hearing - Minnesota, 2012-2016.

Few studies have examined factors associated with the timing of identification of hearing loss within a cohort of infants identified as deaf or hard of hearing (DHH) and what factors are associated with delayed identification. Minnesota Early Hearing Detection and Intervention (EHDI) personnel studied deidentified data from 729 infants with confirmed congenital hearing loss (i.e., hearing loss identification after not passing newborn hearing screening) born in Minnesota during 2012-2016. Differences in likelihood of delayed identification of congenital hearing loss (defined as not passing newborn hearing screening and age >3 months at the time of identification as DHH) based on multiple variables were analyzed. Overall, 222 (30.4%) infants identified as DHH had delayed identification. Multivariate regression showed that infants identified as DHH were significantly more likely to have delayed identification if they had 1) low birthweight, 2) public insurance, 3) a residence outside the metropolitan area, 4) a mother with a lower level of education, 5) a mother aged <25 years, or 6) a mother who was Hmong. Despite achievements of EHDI programs, disparities exist in timely identification of hearing loss. Using this information to develop public health initiatives that target certain populations could improve timely identification, reduce the risk for language delay, and enhance outcomes in children who are DHH.

Artificial intelligence fairness in the context of accessibility research on intelligent systems for people who are deaf or hard of hearing

We discuss issues of Artificial Intelligence (AI) fairness for people with disabilities, with examples drawn from our research on HCI for AI-based systems for people who are Deaf or Hard of Hearing (DHH). In particular, we discuss the need for inclusion of data from people with disabilities in training sets, the lack of interpretability of AI systems, ethical responsibilities of access technology researchers and companies, the need for appropriate evaluation metrics for AI-based access technologies (to determine if they are ready to be deployed and if they can be trusted by users), and the ways in which AI systems influence human behavior and influence the set of abilities needed by users to successfully interact with computing systems.

The effectiveness of the adapted Box Clever language intervention programme in the development of vocabulary and narrative skills of deaf and hard of hearing children

ABSTRACT Children who are deaf or hard of hearing (DHH) in Sri Lanka have inadequate access to early amplification and language stimulation. As a result, they are at risk of impoverished language development: spoken language and sign language. Thirty DHH children who use Sri Lankan sign language between the ages of 4;4-7;2 years from three classrooms of a School for the Deaf were included in this study. The culturally-modified Box Clever language-enrichment programme was offered as a whole-class approach twice a week during a 12-week school term through the class teacher. Pre- and post-intervention language measures and statistical analyses of language scores were undertaken of receptive and expressive vocabulary on picture-naming tasks of target vocabulary. In addition, content and syntactic analyses of narrative skills were undertaken using the Elephant Tales Narrative Assessment, an informal assessment created by the researchers, as no local formal standardised assessments exist currently. There were promising results with statistically significant positive gains in receptive and expressive vocabulary skills on target vocabulary items post-intervention by all the participants. Positive qualitative differences were observed in the content within the target narrative assessment post-intervention by all participants with evidence of the emergence of two to three sign combinations by many of the children.

The design and evaluation of an interactive multimedia program for promoting deaf learners' reading skills

Deaf children have difficulties to remember things through vision. The study aimed to design and evaluate learning through reading conceptual framework by multimedia stories. The subjects are 16 deaf or hard-of-hearing (DHH) children, aged 10 to14, from two elementary schools for the deaf in Thailand. The reading experienced with experimental multimedia and the control (teachers without multimedia) groups were designed and conducted over a 20-week period in each school. The evaluation was conducted including the observation, interviews with instructors, DHH and DHH' parents. There was a significant increase in vocabulary learning skills of the DHH children in the experimental group (Z = 2.53*, Z = 2.53*) and a non-significant effect in the control group (Z = 1.58*, Z = −2.38*). The result shows that DHH in the experimental perception with words and sentences, while in the class DHH ability for learning and concentrating on multimedia will be till the end.

Being the Father of a Child Who Is Deaf or Hard of Hearing: A Phenomenological Study of Fatherhood Perceptions and Lived Experiences in the Turkish Context

The present study investigated the phenomenon of being a father of a child who is deaf or hard of hearing (DHH) and attending an early intervention service in the Turkish context. The research was designed as a transcendental phenomenological study. The participants were seven fathers of children who were DHH. Data were collected through interviews, document analysis, and a reflective journal. The findings indicated that the fathers experienced fatherhood as a responsibility toward their DHH children and families. Although they experienced much sadness when they learned that their children were deaf, they interpreted the deafness as both the will of God and a challenge. To deal with deafness, the fathers attended an early intervention service and completed educational assignments. The fathers expressed concerned about the future of their children; thus, they said, they intended to support them as long as they, the fathers, lived.

Building strong foundations for educational achievement: Language assessments in early childhood education for deaf and hard of hearing children

AbstractIt is widely accepted that assessment plays a role in monitoring the development of young children with special needs in early intervention/early childhood settings. The process of assessing young children's language skills often looks for delays within a solid language foundation. However, many children who are deaf or hard of hearing (DHH) may not have a solid language foundation to assess, leading to inaccurate assessment. When we reframe how we assess language skills in children who are DHH, we ensure the assessment provides a comprehensive picture of the child's language development. It is important to modify language assessment tools where necessary while ensuring the assessment stays reliable and valid. It is critical to use multiple assessment tools to monitor the child's progress, including standardized assessments and assessment tools normed for DHH populations. Finally, it is crucial to monitor the child's skills in each language that they are using, regardless of which language is used most often. We explain why each of these factors needs to be considered in the assessment of young children who are DHH, will discuss the challenges of assessing this population, and will provide solutions to some of the challenges of assessing language skills in of young children who are DHH.

Relationships Among Deaf/Hard-of-Hearing Siblings: Developing a Sense of Self.

While sibling relationships are known to be important for children’s social and emotional well-being, little is known about sibling relationships when both siblings are deaf or hard-of-hearing (DHH). In-depth interviews were conducted with 10 young DHH adults (20–30 years old) who had studied in mainstream schools to explore their retrospective experiences of growing up with a DHH sibling. Interviews were analyzed using interpretive phenomenological analysis. Findings revealed two superordinate themes: (1) sibling relationship and sense of self and (2) family coping and relationships, with each superordinate theme containing several subthemes. Findings highlighted the various ways sibling relationships contribute to siblings’ psychological development, identity formation, and coping with deafness. Potential challenges were identifed, as well as the role of parents’ attitudes and coping with hearing loss in promoting supportive sibling relationships. Parents and professionals should be aware of the valuable and unique aspects of DHH siblingship and attend to imporatnt relationship asepcts such as sibling communication, sibling comparisons, and parental differential treatment.

Evaluating Data Quality of Newborn Hearing Screening.

Jurisdictional-based Early Hearing Detection and Intervention Information Systems (EHDI-IS) collect data on the hearing screening and follow-up status of infants across the United States. These systems serve as tools that assist EHDI programs' staff and partners in their tracking activities and provide a variety of data reports to help ensure that all children who are deaf/hard of hearing (DHH) are identified early and receive recommended intervention services. The quality and timeliness of the data collected with these systems are crucial to effectively meeting these goals. Forty-eight EHDI programs, funded by the Centers for Disease Control and Prevention (CDC), successfully evaluated the accuracy, completeness, uniqueness, and timeliness of the hearing screening data as well as the acceptability (i.e., willingness to report) of the EHDI-IS among data reporters (2013-2016). This article describes the evaluations conducted and presents the findings from these evaluation activities. Most state EHDI programs are receiving newborn hearing screening results from hospitals and birthing facilities in a consistent way and data reporters are willing to report according to established protocols. However, additional efforts are needed to improve the accuracy and completeness of reported demographic data, results from infants transferred from other hospitals, and results from infants admitted to the Neonatal Intensive Care Unit.

Healthcare providers’ and deaf patients’ interpreting preferences for critical care and non-critical care: Video remote interpreting

BackgroundWhile Video Remote Interpreting services provides prompt services for emergency care and is cheaper than in-person interpreting services, there have been several issues, such as poor connection and limited flexibility to maneuver. ObjectivesThis study proposes three research questions and four hypotheses to identify healthcare providers and deaf/hard of hearing (DHH) patients’ preferences for VRI and in-person interpreting on critical care and non-critical care. MethodsThe study utilizes a mixed methods design incorporating both an online survey and qualitative interviews. A total of 103 participants responded to the online survey. This included 36 healthcare providers who worked with limited English proficiency (LEP) patients, 26 healthcare providers who worked with DHH patients, and 41 DHH patients. Qualitative interviews were also conducted with eight healthcare providers and eight DHH patients to explore the online survey findings. ResultsIn the Part I study, healthcare providers (n = 62) included 16 males and 45 females; most professions were dentists, nurse practitioners, and students. DHH patients (n = 41) included 17 males and 22 females; most education was graduate or professional degrees. There was no statistical difference in their preference uses for critical care (p = 1.000), but there was a statistical difference for non-critical care (p = .035). In the Part II study, both healthcare providers and DHH patients preferred in-person interpreting for critical care to obtain effective communication, translation accuracy, and better treatment. ConclusionsRecommendation to improve VRI equipment and training with healthcare providers, hospital administrators, VRI companies, VRI interpreters, and DHH patients to improve healthcare communication.

Educational inclusion of children who are deaf or hard of hearing and from migrant Roma families: Implications for multi-professional working

ABSTRACT This research examined the educational inclusion of children who are deaf or hard of hearing (DHH) and from Roma families who have migrated to England. The study was co-developed with practitioners in the field and involved: a demographic survey of deaf education services; five institutional case studies of local authority services and four individual case studies of children who are DHH and from Roma families. An intersectional approach to the analysis of the data revealed the different vulnerabilities associated with being a child who is DHH and being from a migrant Roma family in England. The study provides the first estimate of the numbers of children who are DHH and from Roma families in England. It also documents an overview of the support offered to Roma children by local authority services and offers insights into the experiences of families and children. In conclusion, it considers the implications for multi-professional practice.

Parents' Perceptions and Needs for their Children who are Deaf or Hard of Hearing in the Kingdom of Saudi Arabia

Abstract This study was conducted to investigate the perceptions of parents of children who are deaf or hard of hearing (DHH) in the Kingdom of Saudi Arabia (KSA) regarding the support and services provided to them and their children. One hundred fifty-eight parents of children who are DHH were surveyed. The survey questions focused on five areas: early identification, hearing technology, communication, education, and social support. The results indicated that (a) a variety of services are available and have been received by some parents, (b) parents reported an average level of satisfaction towards the services and supports received, and (c) all services listed are needed. Additionally, parents identified problems and offered solutions to improve the services and support for their children. The need for more research in the KSA is noted in order to obtain a more in-depth understanding of parents' perceptions and needs.

Diversity in deafness: Assessing students who are deaf or hard of hearing

AbstractThe purpose of this article is to support members of a student's multidisciplinary team to identify complex factors involved in providing valid classroom‐based assessment data, including issues surrounding technology‐based assessment for students who are deaf or hard of hearing (DHH). The diversity of this population creates unique challenges in creating guidelines for assessment. An overview of the diversity of DHH students is used to provide a framework for examining current assessment practices, including both effective and ineffective practices. Cognitive and linguistic learning differences and diverse language learning experiences in the population are discussed as they relate to assessment protocols. Paralleling technology‐based learning experiences with comparable technology‐based assessment experiences is also presented. Recommendations for planning for accessible and meaningful assessment include the use of innovative technologies to align instruction and assessment.

Vocal and Tactile Input to Children Who Are Deaf or Hard of Hearing.

Purpose Caregivers may show greater use of nonauditory signals in interactions with children who are deaf or hard of hearing (DHH). This study explored the frequency of maternal touch and the temporal alignment of touch with speech in the input to children who are DHH and age-matched peers with normal hearing. Method We gathered audio and video recordings of mother-child free-play interactions. Maternal speech units were annotated from audio recordings, and touch events were annotated from video recordings. Analyses explored the frequency and duration of touch events and the temporal alignment of touch with speech. Results Greater variance was observed in the frequency of touch and its total duration in the input to children who are DHH. Furthermore, touches produced by mothers of children who are DHH were significantly more likely to be aligned with speech than touches produced by mothers of children with normal hearing. Conclusion Caregivers' modifications in the input to children who are DHH are observed in the combination of speech with touch. The implications for such patterns and how they may impact children's attention and access to the speech signal are discussed.

Comprehension of networked hypertexts in students with hearing or language problems

The compensatory effects of a graphic overview and the effects of students' cognitive-linguistic skills on the comprehension of networked hypertexts were investigated in students with hearing or language problems. Networked hypertext comprehension of 28 deaf/hard-of-hearing (DHH) students and 33 students with Developmental Language Disorder (DLD) was compared to that of 77 hearing students with a comparable reading level and 60 hearing students of a comparable age. The results showed lower networked hypertext comprehension of DHH students and students with DLD compared to hearing students of the same age, but not to those of the same reading level. Hypertext comprehension was mainly predicted by vocabulary level. Across groups, students with lower vocabulary benefitted from a graphic overview in comprehending networked hypertexts. It was concluded that although DHH students and students with DLD have more problems with comprehension of networked hypertexts than hearing students without language problems, the difficulties are predominantly caused by their generally lower vocabulary size.

Using focused recasting and auditory bombardment to teach child-specific morphosyntactical skills to preschoolers who are deaf or hard of hearing

ABSTRACT Preschoolers who are deaf or hard of hearing (DHH) generally do not acquire grammatical forms at the same ages or rates of children who are not DHH. The purpose of this study was to investigate treatment intensity using a variation of enhanced conversational recast (Encinas & Plante [2016]. Feasibility of a recasting and auditory bombardment treatment with young cochlear implant users. Language, Speech, and Hearing Services in Schools, 47, 157–170 ), auditory bombardment, and attentional focus to improve the use of grammatical verb forms in preschoolers who are DHH. Three preschoolers (2 male and 1 female) between the ages of 3 and 4 years and enrolled in a public preschool which used an oral communication approach participated in this study. Results indicate that combined focused conversational recasting, auditory bombardment, and attentional focus during a 5-minute intervention session produced an effect size (Tau-U) of .70 for Child 1; .91 for Child 2; and .67 for Child 3, representing moderate to strong effects of the treatment for Child 1 and 2 and strong effects of the treatment for Child 3. The results suggest that the combination of focused conversational recasting, auditory bombardment, and attentional focus can be implemented by classroom teachers in a 1:1 setting and can yield improved grammatical skills in young children.