Literacy Outcomes for Primary School Children Who Are Deaf and Hard of Hearing: A Cohort Comparison Study

Dichotic listening deficits in children with hearing loss

PURPOSE

This correlational study compared dichotic listening among children with significant hearing loss to typically developing children and children clinically assessed for auditory processing disorder.

METHOD

Recorded versions of two dichotic tests were delivered under earphones or in the sound field for children using amplification. Individual ear scores and interaural asymmetry were compared to normative data. Matched deficit patterns from both tests were identified, ranked for severity of deficit, and compared across groups. Relationships between dichotic scores and factors related to amplification were investigated in the children with hearing loss.

RESULTS

Dichotic scores were significantly poorer among children with hearing loss without the large interaural asymmetries seen in children assessed clinically for auditory processing problems. Device type and age of implantation had no effect on scores; non-dominant ear scores on the digits test were significantly correlated to age of device use in the left ear and duration of device use in the right ear. Non-dominant ear scores with digits were also significantly correlated with bilateral word recognition.

CONCLUSIONS

Poor dichotic perception in children with significant hearing losses may be related to the use of recorded test materials, immature skills in attention and working memory, or other factors that contribute to development of vocabulary and language. These weaknesses may interfere with successful mainstream educational placement in these children. Assessment of dichotic performance in this population could lead to deficit-specific interventions that may improve outcomes and enhance educational opportunities for children with hearing loss.

Reading Comprehension of Chinese-Speaking Children With Hearing Loss: The Roles of Metalinguistic Awareness and Vocabulary Knowledge

PURPOSE

This study aims to explore the contributions of phonological awareness (PA) and morphological awareness (MA) to the reading comprehension skills of Chinese-speaking children with hearing loss (HL) and examine the possible mediation effect of vocabulary knowledge on the relationships of PA and MA with their reading comprehension.

METHOD

The participants were 28 Chinese-speaking children with HL, who were followed from Grade 1 through Grade 2. They were administered a series of tests that measured their PA and MA at the beginning of Grade 1, vocabulary knowledge at the end of Grade 1, and reading comprehension at the end of Grade 2.

RESULTS

MA significantly accounted for additional variance in reading comprehension beyond the effect of PA but not vice versa. Both PA and MA contributed uniquely to vocabulary knowledge, which completely mediated the relationships of PA and MA with reading comprehension.

CONCLUSIONS

PA and MA are both essential to the development of vocabulary knowledge and reading comprehension in Chinese-speaking children with HL; however, MA seems to be more important than PA in their reading comprehension. PA and MA significantly affect children's reading comprehension through their influence on vocabulary knowledge. This study has replicated previous evidence on the importance of PA, MA, and vocabulary knowledge in the reading comprehension of children with typical hearing, and has extended its significance to children with HL. In addition, the findings have the potential to inform educational practitioners regarding the importance of teaching essential reading skills to Chinese-speaking children with HL.

Predicting Early Literacy: Auditory and Visual Speech Decoding in Deaf and Hard-of-Hearing Children

The current study investigated the relative contributions of auditory speech decoding (i.e., auditory discrimination) and visual speech decoding (i.e., speechreading) on phonological awareness and letter knowledge in deaf and hard-of-hearing (DHH) kindergartners (Mage = 6;4, n = 27) and hearing kindergartners (Mage = 5;10, n = 42). Hearing children scored higher on auditory discrimination and phonological awareness, with the DHH children scoring at chance level for auditory discrimination, while no differences were found on speechreading and letter knowledge. For DHH children, speechreading correlated with phonological awareness and letter knowledge, for the hearing children, auditory discrimination correlated with phonological awareness. Two regression analyses showed that speechreading predicted phonological awareness and letter knowledge in DHH children only. Speechreading may thus be a compensatory factor in early literacy for DHH children, at least for those who are exposed to spoken language in monolingual or in bilingual or bimodal-bilingual contexts, and could be important to focus on during early literacy instruction.

Correlates of Korean Hangul Reading in Children With Hearing Loss

This study examined the associations of vocabulary and phonological and orthographic awareness with Hangul word reading in Korean children, aged between 7 and 10 years, who were deaf and hard of hearing (DHH) and children with typical hearing (TH). The participants were 24 children with hearing aids (HAs), 24 children with cochlear implants (CIs), and 24 TH children in Korea. The three groups were matched for chronological age, vocabulary age, and nonverbal intelligence. Results showed that there were no differences between children with CIs and those with HAs in reading fluency and cognitive skills, except word-reading accuracy, whereas children with CIs and HAs were delayed in all measures compared with their TH peers. Regression analyses showed that syllable and phoneme awareness uniquely explained word-reading accuracy in children with DHH and those with TH. However, word-reading fluency was uniquely explained by syllable awareness in the DHH children and by vocabulary and orthographic awareness in the TH children. These results suggest that DHH and TH children in Korea rely on phonological awareness for Korean word recognition. However, DHH and TH Korean children tend to use different strategies based on sublexical versus lexical information, respectively, to read Korean words fluently.

Relationship Between Vocabulary Knowledge and Reading Comprehension in Deaf and Hard of Hearing Students

Deaf and hard of hearing (DHH) students face great challenges in becoming proficient readers. Vocabulary knowledge is consistently considered to be an important factor affecting DHH students' reading ability. However, the mechanism that underlies the relationship between vocabulary knowledge and reading comprehension in DHH students remains unclear. Thus, the aim of this study was to determine the roles of word segmentation and reading fluency in the contribution of vocabulary knowledge to Chinese DHH students' reading comprehension. A battery of tasks were administered to 116 Chinese DHH students from Grades 4 to 6 (mean age = 14.66 years). The results showed that vocabulary knowledge contributed to reading comprehension significantly in Chinese DHH students, and word segmentation and reading fluency played mediating roles in this relationship. Besides, the chain mediation effect of word segmentation and reading fluency was also significant. Revealing these mechanisms, which underlie the relationship between vocabulary knowledge and reading comprehension, is helpful to tailor remediation for DHH students.

The contribution of spectral processing to the acquisition of phonological sensitivity by adolescent cochlear implant users and normal-hearing controls

This study tested the hypotheses that (1) adolescents with cochlear implants (CIs) experience impaired spectral processing abilities, and (2) those impaired spectral processing abilities constrain acquisition of skills based on sensitivity to phonological structure but not those based on lexical or syntactic (lexicosyntactic) knowledge. To test these hypotheses, spectral modulation detection (SMD) thresholds were measured for 14-year-olds with normal hearing (NH) or CIs. Three measures each of phonological and lexicosyntactic skills were obtained and used to generate latent scores of each kind of skill. Relationships between SMD thresholds and both latent scores were assessed. Mean SMD threshold was poorer for adolescents with CIs than for adolescents with NH. Both latent lexicosyntactic and phonological scores were poorer for the adolescents with CIs, but the latent phonological score was disproportionately so. SMD thresholds were significantly associated with phonological but not lexicosyntactic skill for both groups. The only audiologic factor that also correlated with phonological latent scores for adolescents with CIs was the aided threshold, but it did not explain the observed relationship between SMD thresholds and phonological latent scores. Continued research is required to find ways of enhancing spectral processing for children with CIs to support their acquisition of phonological sensitivity.

Reading Achievement of Deaf Students: Challenging the Fourth Grade Ceiling

Historically it has been reported that deaf students do not achieve age-appropriate outcomes in reading, with this performance often being characterized in terms of a fourth grade ceiling. However, given the shifts in the field during the past 20 years (e.g., widespread implementation of newborn hearing screening, advances in hearing technologies), it would be timely to question whether this continues to serve as a meaningful benchmark. To this end, the purpose of this study was to investigate reading outcomes of a Canadian cohort of school-aged deaf learners (N = 70) who all used listening and spoken language as the primary mode of communication. Specifically, the goal was to establish whether their achievement approached that of their hearing age peers and to identify demographic factors influencing performance (i.e., gender, unilateral/bilateral hearing loss, personal amplification, level of auditory functioning, grade placement, additional disabilities, home language). Results indicate that participants obtained standard scores in the average range on both the Basic Reading and Reading Comprehension clusters of the Woodcock Johnson III-Diagnostic Reading Battery (Woodcock et al., 2004), surpassing the fourth grade reading achievement ceiling often reported for this population.

U.S. Policy Considerations for Telehealth Provision in Audiology

The demand for telehealth services will continue to grow alongside an increased need for audiology services among both children and adults. Insurance coverage policies for audiologic services are specific to each payer and vary widely in the level of coverage provided for both in-person and telehealth-based audiology services. While benefits for children are fairly comprehensive, coverage for audiology services for adults is generally poor. Traditional Medicare does not cover hearing aids or other rehabilitative audiologic services, and other payer policies vary widely. Lack of benefits for hearing and balance services is inconsistent with the evidence base and leaves many beneficiaries without access to meaningful care for hearing and balance disorders, which are highly prevalent among and disproportionately affect Medicare beneficiaries. The purpose of this article is to discuss regulatory and reimbursement considerations for telehealth provision in audiology and elucidate opportunities to influence related health policy at both state and federal levels.

Deaf Children of Hearing Parents Have Age-Level Vocabulary Growth When Exposed to American Sign Language by 6 Months of Age

OBJECTIVE

To examine whether children who are deaf or hard of hearing who have hearing parents can develop age-level vocabulary skills when they have early exposure to a sign language.

STUDY DESIGN

This cross-sectional study of vocabulary size included 78 children who are deaf or hard of hearing between 8 and 68 months of age who were learning American Sign Language (ASL) and had hearing parents. Children who were exposed to ASL before 6 months of age or between 6 and 36 months of age were compared with a reference sample of 104 deaf and hard of hearing children who have parents who are deaf and sign.

RESULTS

Deaf and hard of hearing children with hearing parents who were exposed to ASL in the first 6 months of life had age-expected receptive and expressive vocabulary growth. Children who had a short delay in ASL exposure had relatively smaller expressive but not receptive vocabulary sizes, and made rapid gains.

CONCLUSIONS

Although hearing parents generally learn ASL alongside their children who are deaf, their children can develop age-expected vocabulary skills when exposed to ASL during infancy. Children who are deaf with hearing parents can predictably and consistently develop age-level vocabularies at rates similar to native signers; early vocabulary skills are robust predictors of development across domains.

Differences and Similarities in the Contributions of Phonological Awareness, Orthographic Knowledge and Semantic Competence to Reading Fluency in Chinese School-Age Children With and Without Hearing Loss

Compared with the large number of studies on reading of children with hearing loss (HL) in alphabetic languages, there are only a very limited number of studies on reading of Chinese-speaking children with HL. It remains unclear how phonological, orthographic, and semantic skills contribute to reading fluency of Chinese school-age children with HL. The present study explored this issue by examining the performances of children with HL on reading fluency and three linguistic skills compared with matched controls with normal hearing (NH). Specifically, twenty-eight children with HL and 28 chronological-age-matched children with NH were tested on word/sentence reading fluency (WRF/SRF), phonological awareness (PA) which was composed of onset/vowel/lexical tone awareness, orthographic knowledge (OK), and semantic competence (SC) which comprised animal word identification, pseudo-homophone detection, and word segmentation. Results showed that children with HL lagged behind their peers with NH in WRF/SRF and most of the phonological, orthographic, and semantic subskills except onset awareness and pseudo-homophone detection. Furthermore, the significant contributors to WRF differed between the two groups with PA being the significant contributor in the children with NH while OK being the significant contributor in the children with HL. However, the significant contributor to SRF did not differ between the two groups with SC being the only significant contributor. These results revealed not only between-group differences but also similarities in the relative contributions of PA, OK, and SC to reading fluency at both word and sentence levels, which has practical implications for developing better training programs to improve reading for children with HL.

When language outgrows them: Comprehension of ambiguous sentences in children with normal hearing and children with hearing loss

BACKGROUND

In spite of recent gains in language development made by children with hearing loss (HL) as a result of improved auditory prostheses and earlier starts to intervention, these children continue to struggle academically at higher grade levels. We hypothesize that one reason for these incongruent outcomes for language and academics may be that the language demands of school escalate as grade level increases, outstripping the language abilities of children with HL. We tested that hypothesis by examining a higher level skill that is essential for success with academic language, the ability to access multiple interpretations for a sentence.

METHOD

122 children participated at the end of middle school: 56 with normal hearing (NH), 15 with moderate HL who used hearing aids (HAs), and 51 with severe-to-profound HL who used cochlear implants (CIs). Children's abilities to provide more than one interpretation for an ambiguous sentence were assessed. These sentences were ambiguous due either to words having multiple meanings or to syntactic structure that could evoke more than one interpretation. Potential predictors of those abilities were evaluated, including expressive vocabulary, comprehension of syntactic structures, grammaticality judgments, forward digit span, and several audiologic factors.

RESULTS

Children with NH performed best, children with CIs performed poorest, and children with HAs performed intermediately to those groups. Children in all groups achieved higher scores on the multiple meanings than on the syntactic structure items. The variables that were associated with performance varied across groups. Audiologic factors did not explain any variability in performance on the ambiguous sentences task for children with HL.

CONCLUSIONS

The kind of linguistic flexibility needed to consider more than one interpretation for sentences lacking immediate, real-world context is essential to processing academic language. Children with HL - especially those with severe-to-profound HL who required CIs - showed deficits in this skill, which could contribute to their ongoing academic struggles. Continued language support is needed for these children to allow them to acquire the higher level language skills necessary for success through all of their years in school.

The Devil in the Details Can Be Hard to Spot: Malapropisms and Children With Hearing Loss

Purpose Better auditory prostheses and earlier interventions have led to remarkable improvements in spoken language abilities for children with hearing loss (HL), but these children often still struggle academically. This study tested a hypothesis for why this may be, proposing that the language of school becomes increasingly disconnected from everyday discourse, requiring greater reliance on bottom-up phonological structure, and children with HL have difficulty recovering that structure from the speech signal. Participants One hundred nineteen fourth graders participated: 48 with normal hearing (NH), 19 with moderate losses who used hearing aids (HAs), and 52 with severe-to-profound losses who used cochlear implants (CIs). Method Three analyses were conducted. #1: Sentences with malapropisms were created, and children's abilities to recognize them were assessed. #2: Factors contributing to those abilities were evaluated, including phonological awareness, phonological processing, vocabulary, verbal working memory, and oral narratives. #3: Teachers' ratings of students' academic competence were obtained, and factors accounting for those ratings were evaluated, including the five listed above, along with word reading and reading comprehension. Results #1: Children with HAs and CIs performed more poorly on malapropism recognition than children with NH, but similarly to each other. #2: All children with HL demonstrated large phonological deficits, but they were especially large for children with CIs. Phonological awareness explained the most variance in malapropism recognition for children with CIs. Vocabulary knowledge explained malapropism recognition for children with NH or HAs, but other factors also contributed. #3: Teachers rated academic competence for children with CIs more poorly than for children with NH or HAs, and variance in those ratings for children with CIs were primarily explained by malapropism scores. Conclusion Children with HL have difficulty recognizing acoustic-phonetic detail in the speech signal, and that constrains their abilities to follow conversations in academic settings, especially if HL is severe enough to require CIs. Supplemental Material https://doi.org/10.23641/asha.13133018.

Speechreading Ability Is Related to Phonological Awareness and Single-Word Reading in Both Deaf and Hearing Children

Purpose Speechreading (lipreading) is a correlate of reading ability in both deaf and hearing children. We investigated whether the relationship between speechreading and single-word reading is mediated by phonological awareness in deaf and hearing children. Method In two separate studies, 66 deaf children and 138 hearing children, aged 5-8 years old, were assessed on measures of speechreading, phonological awareness, and single-word reading. We assessed the concurrent relationships between latent variables measuring speechreading, phonological awareness, and single-word reading. Results In both deaf and hearing children, there was a strong relationship between speechreading and single-word reading, which was fully mediated by phonological awareness. Conclusions These results are consistent with ideas from previous studies that visual speech information contributes to the development of phonological representations in both deaf and hearing children, which, in turn, support learning to read. Future longitudinal and training studies are required to establish whether these relationships reflect causal effects.

Cross-modal plasticity and central deficiencies: the case of deafness and the use of cochlear implants

The primary objective of this chapter is to describe the consequences of central deficiencies on the neurodevelopment of children. We approach this topic from the standpoint of congenital deafness. Thus we first present the current state of knowledge on cortical reorganization following congenital deafness. The allocation of auditory cortices to other sensory systems can enhance sensory processing and therefore the cognitive functions related to them. Second, we explore the linguistic development of deaf children. Given that the English written system is speech-based, its acquisition is complex and atypical for deaf children, usually leading to poorer achievements. Next, we explore the impact of a neural prosthesis named the cochlear implant on the neurocognitive and linguistic development of deaf children. In some cases, it allows the individuals to, at least partially, regain access to the lost sense. We also comment on the specific needs of the deaf population when it comes to neuropsychological assessment. Finally, we touch on the specific context of deaf children born of deaf parents, and therefore naturally exposed to sign language as the only means of communication.

Orthographic, Phonological, and Semantic Dynamics During Visual Word Recognition in Deaf Versus Hearing Adults

Purpose Studies on reading in individuals with severe-to-profound hearing loss (deaf) raise the possibility that, due to deficient phonological coding, deaf individuals may rely more on orthographic-semantic links than on orthographic-phonological links. However, the relative contribution of phonological and semantic information to visual word recognition in deaf individuals was not directly assessed in these studies. The aim of the present study, therefore, was to examine the interplay between orthographic, phonological, and semantic representations during visual word recognition, in deaf versus hearing adults. Method Deaf and hearing participants were asked to perform a visual lexical decision task in Hebrew. The critical stimuli consisted of three types of Hebrew words, which differ in terms of their relationship between orthography, phonology, and semantics: unambiguous words, homonyms, and homographs. Results In the hearing group, phonological effects were more pronounced than semantic effects: Homographs (multiple pronunciations) were recognized significantly slower than homonyms or unambiguous words (one pronunciation). However, there was no significant difference between homonyms (multiple meanings) and unambiguous words (one meaning). In contrast, in the deaf group, there was no significant difference among the three word types, indicating that visual word recognition, in these participants, is driven primarily by orthography. Conclusion While visual word recognition in hearing readers is accomplished mainly via orthographic-phonological connections, deaf readers rely mainly on orthographic-semantic connections.

Exploring the Potential Impact of Sentence-Level Comprehension and Sentence-Level Fluency on Deaf Students' Passage Comprehension

Purpose This exploratory study aimed to investigate the potential impact of sentence-level comprehension and sentence-level fluency on passage comprehension of deaf students in elementary school. Method A total of 159 deaf students, 65 students (M _age = 13.46 years) in Grades 3 and 4 and 94 students (M _age = 14.95 years) in Grades 5 and 6, were assessed for nonverbal intelligence, vocabulary knowledge, sentence-level comprehension, sentence-level fluency, and passage comprehension. Group differences were examined using t tests, whereas the predictive and mediating mechanisms were examined using regression modeling. Results The regression analyses showed that the effect of sentence-level comprehension on passage comprehension was not significant, whereas sentence-level fluency was an independent predictor in Grades 3-4. Sentence-level comprehension and fluency contributed significant variance to passage comprehension in Grades 5-6. Sentence-level fluency fully mediated the influence of sentence-level comprehension on passage comprehension in Grades 3-4, playing a partial mediating role in Grades 5-6. Conclusions The relative contributions of sentence-level comprehension and fluency to deaf students' passage comprehension varied, and sentence-level fluency mediated the relationship between sentence-level comprehension and passage comprehension.

Peripheral Auditory Involvement in Childhood Listening Difficulty

OBJECTIVES

This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities.

DESIGN

Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history.

RESULTS

There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history.

CONCLUSIONS

Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.

Language and Reading Progress of Young Deaf and Hard-of-Hearing Children

We examined the language and reading progress of 336 young DHH children in kindergarten, first and second grades. Trained assessors tested children's language, reading, and spoken and fingerspelled phonological awareness in the fall and spring of the school year. Children were divided into groups based on their auditory access and classroom communication: a spoken-only group (n = 101), a sign-only group (n = 131), and a bimodal group (n = 104). Overall, children showed delays in language and reading compared to norms established for hearing children. For language, vocabulary standard scores were higher than for English syntax. Although delayed in language, children made expected gains based on hearing norms from kindergarten to second grade. Reading scores declined from kindergarten to second grade. Spoken-only and bimodal children had similar word reading and reading comprehension abilities and higher scores than sign-only children. Spoken-only children had better spoken phonological awareness and nonword reading skills than the other two groups. The sign-only and bimodal groups made similar and significant gains in ASL syntax and fingerspelling phonological awareness.

A survey of pediatric cochlear implant recipients as young adults

OBJECTIVES

To identify the influence of pediatric cochlear implantation on long term communication modality, education, and income.

METHODS

A telephone survey was conducted with 56 young adults who had received cochlear implants (CI) as children. The participants were, on average, 10.6 (SD = 64) when they received their CI and 21 (SD = 2.29) when they participated in this study. All of the participants used a unilateral CI at the time of the survey. Where applicable, survey results were compared to the general population of similar aged individuals in Ontario using chi-squared tests of proportionality.

RESULTS

Participants (49/56, 88%) indicated that they used their CI all waking hours and 75% (42/56) reported using spoken language as their primary mode of communication. They attended post-secondary school at higher rates than the general population (χ²(1) = 14.35, p < .001); a wide range of study areas were identified with a greater proportion involved in fine arts than the general population (χ²(1) = 25.50, p < .001). The rates of employment in this group were below general rates (χ²(1) = 21.87, p < .001). However, those who were employed reported salaries similar to their hearing peers.

CONCLUSION

The findings from this study suggest that young adults who received a unilateral CI in childhood typically continue to use their CIs to support spoken language. Their increased rates of post-secondary education are encouraging and they may be choosing unique areas of study. Longer term studies are required to further investigate lower rates of employment in this cohort.

A Technology-based Intervention to Increase Reading Comprehension of Morphosyntax Structures

The purpose of this study was to examine the effectiveness of a technology-based intervention (LanguageLinks: Syntax Assessment and Intervention®; Laureate Learning Systems, Inc., 2013) to improve reading comprehension for d/Deaf and hard of hearing (DHH) elementary students. The intervention was a self-paced, interactive program designed to scaffold learning of morphosyntax structures. Participants included 37 DHH students with moderate to profound hearing levels, 7-12 years of age, in Grades 2-6. Assessment data were collected pre- and post- an 8-week intervention using a randomized control trial methodology. Findings indicate the intervention did not appear to be effective in improving performance, and 17 out of 36 morphosyntax structures were found difficult to comprehend for participants in the treatment group. These difficult structures included aspects of pronominalization, the verbal system, and number in nouns. Results are compared to previous research, with recommendations for future areas of research related to increasing knowledge of morphosyntax for learners who are DHH.

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

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

Support for parents of deaf children: Common questions and informed, evidence-based answers

To assist medical and hearing-science professionals in supporting parents of deaf children, we have identified common questions that parents may have and provide evidence-based answers. In doing so, a compassionate and positive narrative about deafness and deaf children is offered, one that relies on recent research evidence regarding the critical nature of early exposure to a fully accessible visual language, which in the United States is American Sign Language (ASL). This evidence includes the role of sign language in language acquisition, cognitive development, and literacy. In order for parents to provide a nurturing and anxiety-free environment for early childhood development, signing at home is important even if their child also has the additional nurturing and care of a signing community. It is not just the early years of a child's life that matter for language acquisition; it's the early months, the early weeks, even the early days. Deaf children cannot wait for accessible language input. The whole family must learn simultaneously as the deaf child learns. Even moderate fluency on the part of the family benefits the child enormously. And learning the sign language together can be one of the strongest bonding experiences that the family and deaf child have.

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

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

Predicting reading ability in teenagers who are deaf or hard of hearing: A longitudinal analysis of language and reading

BACKGROUND

Deaf and hard of hearing (D/HH) children and young people are known to show group-level deficits in spoken language and reading abilities relative to their hearing peers. However, there is little evidence on the longitudinal predictive relationships between language and reading in this population.

AIMS

To determine the extent to which differences in spoken language ability in childhood predict reading ability in D/HH adolescents.

METHODS

and procedures: Participants were drawn from a population-based cohort study and comprised 53 D/HH teenagers, who used spoken language, and a comparison group of 38 normally hearing teenagers. All had completed standardised measures of spoken language (expression and comprehension) and reading (accuracy and comprehension) at 6-10 and 13-19 years of age.

OUTCOMES

and results: Forced entry stepwise regression showed that, after taking reading ability at age 8 years into account, language scores at age 8 years did not add significantly to the prediction of Reading Accuracy z-scores at age 17 years (change in R² = 0.01, p = .459) but did make a significant contribution to the prediction of Reading Comprehension z-scores at age 17 years (change in R²  = 0.17, p < .001).

CONCLUSIONS

and implications: In D/HH individuals who are spoken language users, expressive and receptive language skills in middle childhood predict reading comprehension ability in adolescence. Continued intervention to support language development beyond primary school has the potential to benefit reading comprehension and hence educational access for D/HH adolescents.

Superordinate Precision: An Examination of Academic Writing Among Bilingual Deaf and Hard of Hearing Students

Academic English is an essential literacy skill area for success in post-secondary education and in many work environments. Despite its importance, academic English is understudied with deaf and hard of hearing (DHH) students. Nascent research in this area suggests that academic English, alongside American Sign Language (ASL) fluency, may play an important role in the reading proficiency of DHH students in middle and high school. The current study expands this research to investigate academic English by examining student proficiency with a sub-skill of academic writing called superordinate precision, the taxonomical categorization of a term. Currently there is no research that examines DHH students' proficiency with superordinate precision. Middle and high school DHH students enrolled in bilingual schools for the deaf were assessed on their ASL proficiency, academic English proficiency, reading comprehension, and use of superordinate precision in definitions writing. Findings indicate that student use of superordinate precision in definitions writing was correlated with ASL proficiency, reading comprehension, and academic English proficiency. It is possible that degree of mastery of superordinate precision may indicate a higher overall level of proficiency with academic English. This may have important implications for assessment of and instruction in academic English literacy.

Early Reading Development in Chinese-speaking Children with Hearing Loss

This study aims to explore early reading comprehension in Chinese-speaking children with hearing loss (HL) by examining character recognition and linguistic comprehension. Twenty-five children with HL received three measures relevant to character reading: phonological awareness (PA), morphological awareness (MA), and character recognition; two linguistic-comprehension measures: receptive vocabulary knowledge and listening comprehension; and one reading comprehension measure. Three demographic variables pertinent to children with HL were also taken into account. The results showed that the degree of HL was significantly related to reading comprehension, receptive vocabulary knowledge, and listening comprehension, the latter two of which were further correlated with the type of hearing device; however, the hearing age was associated with neither of the measures. MA made a unique contribution to character reading in the presence of PA, but the reverse was not true. Linguistic comprehension significantly accounted for additional variance in reading comprehension over and above character recognition but not vice versa. A further analysis controlling for character recognition revealed that receptive vocabulary knowledge was more contributive to early reading comprehension than was listening comprehension. The results of the current investigation have potential to inform educational practice in teaching and/or intervening Chinese children with HL regarding their reading skills.