Deaf Toddlers Research Articles

Parent-child sensorimotor coordination in toddlers with and without hearing loss.

Infants experience the world through their actions with objects and their interactions with other people, especially their parents. Prior research has shown that school-age children with hearing loss experience poorer quality interactions with typically hearing parents, yet little is known about parent-child interactions between toddlers with hearing loss and their parents early in life. In the current study, we used mobile eye-tracking to investigate parent-child interactions in toddlers with and without hearing loss (mean ages: 19.42 months, SD = 3.41 months). Parents and toddlers engaged in a goal-directed, interactive task that involved inserting coins into a slot and required joint coordination between the parent and the child. Overall, findings revealed that deaf toddlers demonstrate typical action skills in line with their hearing peers and engage in similar interactions with their parents during social interactions. Findings also revealed that deaf toddlers explored objects more and showed more temporal stability in their motor movements (i.e. less variation in their timing across trials) than hearing peers, suggesting further adaptability of the deaf group to their atypical sensory environment rather than poorer coordination. In contrast to previous research, findings suggest an intact ability of deaf toddlers to coordinate their actions with their parents and highlight the adaptability within dyads who have atypical sensory experiences.

A helping hand

In this article, I examine responses to the taking of food items during snack time in an early childhood education classroom with deaf toddlers (18 months to three years old) who are native signers of American Sign Language (ASL). These children have grown up with exposure to ASL from deaf family members and are attending a classroom where all individuals use ASL. Through the combined analysis of ethnographic and interactional data, I argue that the teachers’ corporeal socialization of the deaf toddlers into a visual orientation leads to their development of a social and moral understanding of ownership rights within the classroom which is displayed in the children’s social awareness, social responsiveness and self-reliance in responding to food takings.

Visual statistical learning in deaf and hearing infants and toddlers.

Congenital hearing loss offers a unique opportunity to examine the role of sound in cognitive, social, and linguistic development. Children with hearing loss demonstrate atypical performance across a range of general cognitive skills. For instance, research has shown that deaf school‐age children underperform on visual statistical learning (VSL) tasks. However, the evidence for these deficits has been challenged, with mixed findings emerging in recent years. Here, we used a novel approach to examine VSL in the action domain early in development. We compared learning between deaf and hearing infants, prior to cochlear implantation (pre‐CI), and a group of toddlers post implantation (post‐CI). Findings revealed a significant difference between deaf and hearing infants pre‐CI, with evidence for learning only in the hearing infants. However, there were no significant group differences between deaf and hearing toddlers post‐CI, with both groups demonstrating learning. Further, VSL performance was positively correlated with language scores for the deaf toddlers, adding to the body of evidence suggesting that statistical learning is associated with language abilities. We discuss these findings in the context of previous evidence for group differences in VSL skills, and the role that auditory experiences play in infant cognitive development.

Differences in Established Joint Attention in Hearing-Hearing and Hearing-Deaf Mother-Child Dyads: Associations With Social Competence, Settings, and Tasks.

The authors examined relations among observed joint attention, maternal report of child's social competence, setting (home vs. laboratory), task (unstructured vs. semi-structured), and dyad type [hearing mother-hearing child (n=55, Mage =25.8months) vs. hearing mother-deaf child (n=27, Mage =26.9months)]. Hearing child dyads scored higher on joint attention during unstructured tasks, especially in their home environment. Hearing child dyads displayed similar joint attention to deaf toddler dyads when they engaged in a semi-structured task, but higher on these measures during unstructured free play. Unlike hearing children, joint attention was differentially related to social competence in deaf children, with relatively higher versus lower social competence depending on relatively high versus low observed joint attention, respectively.

Sign Vocabulary in Deaf Toddlers Exposed to Sign Language Since Birth

Lexical comprehension and production is directly evaluated for the first time in deaf signing children below the age of 3 years. A Picture Naming Task was administered to 8 deaf signing toddlers (aged 2-3 years) who were exposed to Sign Language since birth. Results were compared with data of hearing speaking controls. In both deaf and hearing children, comprehension was significantly higher than production. The deaf group provided a significantly lower number of correct responses in production than did the hearing controls, whereas in comprehension, the 2 groups did not differ. Difficulty and ease of items in comprehension and production was similar for signing deaf children and hearing speaking children, showing that, despite size differences, semantic development followed similar paths. For signing children, predicates production appears easier than nominals production compared with hearing children acquiring spoken language. Findings take into account differences in input modalities and language structures.

Performance after timely cochlear implantation in prelingually deaf children with cerebral palsy

ObjectivesTo investigate auditory perception, speech production, and language ability of prelingually deaf toddlers with cerebral palsy (CP) who were implanted within a sensitive period and who received proper speech therapy. Comparison of their outcomes with age- and sex-matched CI recipients without additional disabilities was also performed. MethodsWe retrospectively reviewed a cohort of pediatric CI in Samsung Medical Center. Eight CP subjects who received CI before 3 years of age and age–sex matched control recipients who had no additional disabilities except idiopathic sensorineural hearing loss (SNHL) were included for the analysis. Preoperative evaluation included the Categories of Auditory Performance (CAP) score, Korean Version of the Ling's Stage (K-Ling), Sequenced Language Scale for Infants (SELSI), Bailey Scales of Infant Development II assessment, Social Maturity Scale test, and grading of CP severity using severity level and Gross Motor Function Classification System for CP (GMFCS). To measure the outcome, the CAP scores, K-Ling, and SELSI were performed at 3, 6, 12, and 24 months after implantation. ResultsFour CP children with outstanding performances showed comparable achievement with matched control recipients. These patients had less severe motor disabilities (mild–moderate severity, GMFCS level 1–3), better social quotient, and better cognitive abilities. Although the others showed poor language abilities and hardly produced meaningful speech, their CAP scores reached 1 or 2 in 24 months after implantation. ConclusionsDeaf children with CP could have various ranges of benefits up to the levels of normal peers whose only disability was hearing loss, when CI was performed within a critical period. Especially, children with mild or moderate CP had a favorable outcome after CI, equivalent to that of normal peers.

Joint Attention and Social Competence in Deaf Children with Cochlear Implants

The authors examined the influence of cochlear implants on joint attention and social competence in severe to profoundly congenitally deaf toddlers. Twenty-seven hearing mothers and hearing toddlers (HH dyads), and 26 hearing mothers and deaf toddlers, 9 with cochlear implantation (HD-cochlear dyads), and 17 with no cochlear implantation (HD-no cochlear dyads) were observed engaging in joint attention. Mothers provided ratings of children’s social competence. HH and HD-cochlear dyads displayed more joint attention than HD-no cochlear dyads. Children who were in dyads who engaged in more joint attention were rated by their mothers as higher on expressive and compliance behaviors and lower on disruptive behaviors compared to children who were in dyads who engaged in lower levels of joint attention. Findings suggest that cochlear implants may aid in the early socio-emotional development of some deaf children.

Symbol-Infused Joint Attention and Language Use in Mothers With Deaf and Hearing Toddlers

Mother-child interactions in 2-year-old deaf toddlers with deaf parents, deaf toddlers with hearing parents, and hearing toddlers with hearing parents were explored. Fifteen dyads were videotaped in free play and symbol-infused joint attention tasks. Dyads with hearing parents displayed similar responsiveness/directiveness patterns and spent similar amounts of time in symbol-infused joint attention regardless of child hearing status. Deaf toddlers with hearing mothers, however, produced significantly fewer different words and spent less time in sustained interactions than hearing toddlers. Compared with hearing mothers with deaf toddlers, deaf mothers tended to be more responsive to their toddler's attention focus, an aspect of maternal responsiveness significantly related to the frequency of sustained interaction. Deaf toddlers with deaf mothers spent significantly less time in symbol-infused joint attention, possibly because of deaf toddlers' need to divide visual attention between looking at objects and attending to their mother's language.

The “dual usage problem” in the explanations of “joint attention” and children’s socioemotional development: A reconceptualization

The term “joint attention”, which first gained currency in the early 1960s in studies of the development of language and symbolic thought, remains significant in the developmental literature. However, its meaning is unclear. A definitional problem exists similar to what Patterson [Patterson, M. L. (1982). A sequential functional model of nonverbal exchange. Psychological Review, 89, 231–249] described as the “dual usage” problem in the study of behaviour. The dual usage problem manifests when the behaviours of interest are used interchangeably with the function served by those behaviours. Similarly, the behaviours or skills that are taken to show joint attention are used interchangeably with the functions served by these behaviours. Scant attention is given to how the behaviours are generated and regulated and how they contribute to development. The purpose of the present position paper was: (1) to identify and illustrate the ways in which the behaviours and functions of joint attention have been confounded in the literature; (2) to provide a revised operationalization of joint attention incorporating the idea of Consummative Joint Attention, which is defined as a process variable that integrates these two theoretically different and complementary aspects of “joint attention;” and (3) to test this revised definition with evidence from a sample of hearing mothers and their 18- to 36-month-old hearing or deaf toddlers. We suggest that a reconceptualization and revised definition of joint attention as a process served by a particular sequence of complementary and well-timed events in the behaviour of mother–child interaction are particularly well-suited to testing joint attention as an early prelingual mechanism and to detecting early problems with psychosocial and adaptive development created by ineffective patterns of social interaction.

The Development of Proto-Performative Utterances in Deaf Toddlers

The purpose of this study was to examine and compare the development of proto-imperative and proto-declarative utterances in normally developing, non-neonatally screened, profoundly deaf toddlers. Both types of proto-declarative are considered to be the most basic prelinguistic and early linguistic communicative functions. Eighteen normally developing, non-neonatally screened, profoundly deaf toddlers participated in a longitudinal study. All children were enrolled in the same oral-aural home guidance program. At the time of the study, none of the children had received a cochlear implant. At the ages of 18, 24, and 30 months, proto-imperative utterances were elicited using an adapted version of M. Casby and J. A. Cumpata's (1986) Protocol for the Assessment of Prelinguistic Intentional Communication. For eliciting proto-declarative intentions, a video clip was used. Results revealed a significant increase in both frequency and level of utterances for both types of proto-performatives. Although there was a clear development from nonlinguistic toward linguistic communication, utterances remained predominantly deictic-gestural for the imperative intentions and referential-gestural for declaratives. The data support the notion from the literature that both types of performatives are susceptible to elicitation. Results also suggest that after neonatal screening, both total communication and oral-aural approaches might accelerate conventionalization of the earliest communicative utterances of profoundly deaf toddlers.

The Impact of Visual Communication on the Intersubjective Development of Early Parent-Child Interaction With 18- to 24-Month-Old Deaf Toddlers

This article presents a study that examined the impact of visual communication on the quality of the early interaction between deaf and hearing mothers and fathers and their deaf children aged between 18 and 24 months. Three communication mode groups of parent-deaf child dyads that differed by the use of signing and visual-tactile communication strategies were involved: (a) hearing parents communicating with their deaf child in an auditory/oral way, (b) hearing parents using total communication, and (c) deaf parents using sign language. Based on Loots and colleagues' intersubjective developmental theory, parent-deaf child interaction was analyzed according to the occurrence of intersubjectivity during free play with a standard set of toys. The data analyses indicated that the use of sign language in a sequential visual way of communication enabled the deaf parents to involve their 18- to 24-month-old deaf infants in symbolic intersubjectivity, whereas hearing parents who hold on to oral-only communication were excluded from involvement in symbolic intersubjectivity with their deaf infants. Hearing parents using total communication were more similar to deaf parents, but they still differed from deaf parents in exchanging and sharing symbolic and linguistic meaning with their deaf child.

Reciprocal utterances during interactions between deaf toddlers and their hearing mothers

This study compared reciprocal utterances of six hearing mother–hearing toddler dyads and six hearing mother–deaf toddler dyads. Child participants were matched by language stage based on Brown's stages of morphological development and were aged between 25 and 45 months. Child participants were observed interacting with their mothers during videotaped free play sessions.Language samples containing up to a maximum of 100 child utterances from each dyad were transcribed, coded and analysed. Reciprocal utterance units (RUUs) were compared between the hearing and deaf dyads. Results indicated that significant differences existed between dyads having hearing toddlers and dyads having deaf toddlers with regard to the type and frequency of reciprocal utterance units. Some variations to this general finding are discussed.

Reciprocal utterances during interactions between deaf toddlers and their hearing mothers

Abstract This study compared reciprocal utterances of six hearing mother–hearing toddler dyads and six hearing mother–deaf toddler dyads. Child participants were matched by language stage based on Brown's stages of morphological development and were aged between 25 and 45 months. Child participants were observed interacting with their mothers during videotaped free play sessions.Language samples containing up to a maximum of 100 child utterances from each dyad were transcribed, coded and analysed. Reciprocal utterance units (RUUs) were compared between the hearing and deaf dyads. Results indicated that significant differences existed between dyads having hearing toddlers and dyads having deaf toddlers with regard to the type and frequency of reciprocal utterance units. Some variations to this general finding are discussed.

Pausing during interactions between deaf toddlers and their hearing mothers

Abstract This study investigated the prosodic feature of ‘pausing’ during interactions between profoundly deaf toddlers and their hearing mothers. The participants in the study were 12 mother–toddler dyads comprising six normally hearing toddlers and their hearing mothers and six profoundly deaf toddlers and their hearing mothers. Child participants were matched by language stage based on Brown's stages of morphological development and were aged between 25 and 45 months. Child participants were observed interacting with their mothers during videotaped free play sessions. Language samples containing up to a maximum of 100 child utterances from each dyad were transcribed, coded and analysed. The association between the prosodic feature of pausing (using measured time intervals) and the hearing status of the dyads was investigated. Results indicated that significant differences existed between dyads having hearing toddlers and dyads having deaf toddlers with regard to the length of pause between reciprocal u...

Pausing during interactions between deaf toddlers and their hearing mothers

This study investigated the prosodic feature of ‘pausing’ during interactions between profoundly deaf toddlers and their hearing mothers. The participants in the study were 12 mother–toddler dyads comprising six normally hearing toddlers and their hearing mothers and six profoundly deaf toddlers and their hearing mothers. Child participants were matched by language stage based on Brown's stages of morphological development and were aged between 25 and 45 months. Child participants were observed interacting with their mothers during videotaped free play sessions. Language samples containing up to a maximum of 100 child utterances from each dyad were transcribed, coded and analysed. The association between the prosodic feature of pausing (using measured time intervals) and the hearing status of the dyads was investigated. Results indicated that significant differences existed between dyads having hearing toddlers and dyads having deaf toddlers with regard to the length of pause between reciprocal utterances. The findings also suggested that there was a significant relationship between the language stage of the toddler and the dyad's use of pause length. Some variations in this general finding were noted. The implications of this study in terms of educational strategies for parents, teachers and speech pathologists are discussed.

Assessing intentional communication in deaf toddlers.

This study examines the eliciting potential of two tasks, one for proto-imperative and another for protodeclarative communicative intentions. The task to elicit proto-imperative utterances and the scoring form are partially based on Casby and Cumpata's (1986) Protocol for the Assessment of Prelinguistic Intentional Communication (PAPIC). However, a number of modifications are proposed for use with young deaf children. For the protodeclaratives, a new eliciting task called Tac-Tic was created. These tasks were offered to 18 normally developing profoundly deaf toddlers at the ages of 18, 24, and 30 months. Results indicate that both tasks possess sufficient eliciting potential to measure both the prelinguistic and early linguistic "illocutionary force" of profoundly deaf children. Moreover, the new eliciting task Tac-Tic seems to have a higher eliciting potential than the corresponding task used in the PAPIC. For clinical aims, a more adapted and more efficient scoring form than the one Casby and Cumpata used was created.

Assessment of visual acuity in toddlers and children with developmental delays: The joint contribution of ophthalmology, orthoptics, and psychology

This study presents the concept of visual acuity assessment as well as the difficulties found for this assessment in low vision persons, particularly toddlers and children with developmental delays. The BUST (Lindstedt) and LH (Hyvarinen) tests, specifically designed for this population, are described here. In addition, a study aimed at testing the feasibility of obtaining visual acuity measures in seven children, who would possibly have difficulties in responding to conventional visual acuity tests, is presented. The subjects included one deaf toddler and six low vision children, some with developmental delays. It was possible to arrive at numerical values for six of the children. The importance of paying attention to the psychological aspects of the procedure is discussed and emphasized.

Reciprocity, Responsiveness, and Timing in Interactions Between Mothers and Deaf and Hearing Children

The Greenspan-Lieberman Observational System-Revised (GLOS-R; Greenspan & Lieberman, 1980) was used to describe characteristics of dyadic interactions between hearing mothers and hearing toddlers (HH), deaf mothers and deaf toddlers (DD), and hearing mothers and deaf toddlers (HD). Deaf mothers produced fewer interactive behaviors than hearing mothers, apparently in order to accommodate infants' visual attention needs. DD and HD children were more likely than hearing children to react in a manner initially indicated by GLOS-R coding to be anticontingent. Additional analysis indicated this was a misinterpretation for DD, for whom this reflected adaptive attentional patterns. This adaptive pattern did not account for anticontingency among HD children. Assessment instruments require some modifications and results must be interpreted with caution when applied to dyads of deaf mothers and children.

The Association between Language and Symbolic Play at Two Years: Evidence from Deaf Toddlers

The association between expressive language and symbolic play was investigated in 3 groups of 2-year-olds: deaf children with hearing parents (dH), deaf children with deaf parents (dD), and hearing children with hearing parents (hH). (Each group included 6 girls and 4 boys.) 3 language-level groups were defined. The highest group was well into the vocabulary "explosion" and frequently produced multiword/sign utterances; a middle group was beginning the period of vocabulary expansion and occasionally produced utterances of more than 1 word/sign; a third group produced single word/sign utterances only, and had a limited vocabulary. Hearing status was associated with duration of symbolic play (deaf > hearing). Higher language levels were associated with more canonically sequenced and preplanned play, even when language delays were due to exogenous factors.

The Association between Language and Symbolic Play at Two Years: Evidence from Deaf Toddlers

The Association between Language and Symbolic Play at Two Years: Evidence from Deaf Toddlers