Deaf parents of cochlear-implanted children: beliefs on bimodal bilingualism

Deaf signers and hearing aids: motivations, access, competency and service effectiveness

OBJECTIVES

This study concerns culturally Deaf signers in the UK who use hearing aids and (i) explores motivations for hearing aid use (ii) identifies barriers and facilitators to accessing NHS hearing aid services, (iii) examines cultural competency of hearing aid clinics and (iv) identifies factors influencing effective adult hearing aid service provision.

DESIGN

Online survey in British Sign Language and English that was informed by Deaf service users.

STUDY SAMPLE

75 Deaf adult BSL users who wear hearing aids and use NHS hearing aid clinics.

RESULTS

No specific reason emerged as outstandingly important for hearing aid use; however, assisting with lipreading (57%) and listening to music (52%) were rated as very/extremely important. Access issues reported were contacting clinics, poor communication with staff and lack of Deaf awareness. To be an effective and culturally competent hearing aid clinic for Deaf signers, a good understanding of Deaf culture and language was most rated as important (87%).

CONCLUSION

The study is the first that explores hearing aid use and experiences of accessing hearing aid clinics from Deaf signers' perspectives. Enhancements to clinical practice are required to consider culturally Deaf people's motivations for hearing aid use and make services more BSL-friendly.

Family ASL: An Early Start to Equitable Education for Deaf Children

Deaf and hard of hearing (DHH) children experience systematic barriers to equitable education due to intentional or unintentional ableist views that can lead to a general lack of awareness about the value of natural sign languages, and insufficient resources supporting sign language development. Furthermore, an imbalance of information in favor of spoken languages often stems from a phonocentric perspective that views signing as an inferior form of communication that also hinders development of spoken language. To the contrary, research demonstrates that early adoption of a natural sign language confers critical protection from the risks of language deprivation without endangering spoken language development. In this position paper, we draw attention to deep societal biases about language in information presented to parents of DHH children, against early exposure to a natural sign language. We outline actions that parents and professionals can adopt to maximize DHH children's chances for on-time language development.

In an era of bilateral funding and changing criteria, when is unilateral cochlear implantation a better option?

BACKGROUND

Funding for paediatric bilateral cochlear implantation became available in Ireland in 2014. Prior to this, children eligible for cochlear implantation received a unilateral implant.

OBJECTIVE

To examine the cohort of children who received a unilateral cochlear implant in the 4 year period following bilateral cochlear implantation funding becoming available.

METHODS

A clinical audit of all children implanted for the first time between July 2014 and July 2018. The unilaterally implanted children (n = 105) were divided into 3 groups according to whether they met the audiometric thresholds for implantation in neither ear (Group 1), one ear (Group 2) or both ears (Group 3). One year post operative functional outcomes were examined for all 3 groups.

RESULTS

All 3 groups showed significant improvements in functional outcomes at 1 year post op. To date, 20% of the unilaterally implanted children have proceeded to get a sequential CI, often where there was no change in audiological status.

CONCLUSIONS

The number of children in Groups 1 and 2 highlighted how our decision making around cochlear implantation has changed in recent years. Unilateral cochlear implantation in certain circumstances is good practice, independent of the audiological profile when an experienced multi-disciplinary team (MDT) is involved in the decision making process. Decision making using a holistic model approach is key, including involving the parent/carer and, where appropriate, the child/teenager themselves. A staged bilateral cochlear implant is also a good option, where careful monitoring and support for the first implant has resulted in positive outcomes.

Development of the Multidimensional Inventory of Deaf Acculturative Stress

Deaf adults may experience acculturative stress as they navigate within and between the Hearing and Deaf communities. However, no measure has been developed to assess levels of deaf acculturative stress. This study aimed to develop the Multidimensional Inventory of Deaf Acculturative Stress (MIDAS). The MIDAS was developed through a sequential and iterative scale development procedure and then tested on a sample of 104 deaf adults across the United States (age range = 18-79; 74% female). Principal component analyses were run for item refinement and selection. The final analyses yielded four factors for Stress from the Hearing Community, three factors for Stress from the Deaf Community, and two factors for Intersectionality. Construct validity was demonstrated through correlations in the expected directions with measures of Hearing and Deaf acculturation identity and ethnic/racial identity. The utility of the MIDAS is discussed with regard to future research.

The Spoken Language Checklist: A User-Friendly Normed Language Acquisition Checklist

There are many variables having an impact on the spoken language acquisition of deaf and hard of hearing (DHH) children; therefore, it is critical for parents and professionals to have appropriate tools to monitor language acquisition. The Spoken Language Checklist (SLC) was developed to monitor and identify developmental milestones in a user-friendly checklist format that includes norms. The availability of the SLC will help parents and professionals to monitor the spoken language development of DHH children and provide interventions that should any delays be observed. Recognizing these delays early could prevent any insurmountable effects for cognitive development and further language development.

Early Intervention Protocols: Proposing a Default Bimodal Bilingual Approach for Deaf Children

Despite advances in hearing technology, a growing body of research, as well as early intervention protocols, deaf children largely fail to meet age-based language milestones. This gap in language acquisition points to the inconsistencies that exist between research and practice. Current research suggests that bimodal bilingual early interventions at deaf identification provide children language foundations that can lead to more effective outcomes. Recommendations that support implementing bimodal bilingualism at deaf identification include early intervention protocols, language foundations, and the development of appropriate bimodal bilingual environments. All recommendations serve as multifaceted tools in a deaf child’s repertoire as language and modality preferences develop and solidify. This versatile approach allows for children to determine their own language and communication preferences.

Relationship Between Parental Stress and their Attitudes Towards Cochlear Implantation Outcomes in Children Referred to Besat Cochlear Implant Center in Hamadan 2018

PURPOSE

This study aimed to investigate the relationship between parental stress and their attitudes towards post-cochlear implantation outcomes in children referred to Besat cochlear implant center in Hamadan during 2018.

DESIGN AND METHODS

In this descriptive cross-sectional study, 100 parents of children with cochlear implantation were selected from Besat cochlear implant center in Hamadan through census method from April to October 2018. The data were collected using a demographic characteristic questionnaire, parental stress scale developed by Berry and Jones, and Parental Attitudes of Various Aspects of Cochlear Implantation. The data were analyzed using SPSS software (version 16) through correlation coefficient, one-way ANOVA, and t-test. P-value <0.05 was considered statistically significant.

RESULTS

The results of this study indicated that parental stress negatively correlated with their attitudes towards the outcomes of cochlear implantation (r = -0.420), including the aspects of communication (r = -0.462), educational (r = -0.398), and social skills (r = -0.445), as well as services provided by the health care centers (r = -0.277), and the efficiencies of cochlear implantation center (r = -0.118) (P < 0.05).

CONCLUSION

According to the results, parents with more positive attitudes towards the areas of communication, educational, and social skills, as well as services provided by the health care centers, and the efficiencies of cochlear implantation center experienced lower levels of stress.

PRACTICE IMPLICATIONS

Nurses can measure the stress and attitudes towards cochlear implantation outcomes in children to accurately assess the needs of the family in order to improve their nursing process and advance the child's rehabilitation program.

The moral case for sign language education

Here, a moral case is presented as to why sign languages such as Auslan should be made compulsory in general school curricula. Firstly, there are significant benefits that accrue to individuals from learning sign language. Secondly, sign language education is a matter of justice; the normalisation of sign language education and use would particularly benefit marginalised groups, such as those living with a communication disability. Finally, the integration of sign languages into the curricula would enable the flourishing of Deaf culture and go some way to resolving the tensions that have arisen from the promotion of oralist education facilitated by technologies such as cochlear implants. There are important reasons to further pursue policy proposals regarding the prioritisation of sign language in school curricula.

The Understanding of Communicative Intentions in Children with Severe-to-Profound Hearing Loss

The ability to distinguish lies from sincere false statements requires understanding a speaker's communicative intentions and is argued to develop through linguistic interaction. We tested whether this ability was delayed in 26 children with severe-to-profound hearing loss who, based on vocabulary size, were thought to have relatively limited access to linguistic exchanges compared to typically hearing peers (n = 93). Children were presented with toy bears who either lied or made a false statement sincerely. Despite identifying speakers' knowledge/ignorance, deaf or hard of hearing (DHH) children were delayed in identifying lies and sincere false statements when matched for chronological age. When matched for receptive vocabulary, observed discrepancies diminished. Deaf children who experienced early access to conversations with their deaf parents demonstrated no delay. Findings suggest limited access to linguistic exchanges delays the development of a key pragmatic skill.

Culture and Deaf Women's Body Image

The sociocultural model of eating disorders highlights the role of internalization of the thin ideal in the development of negative body image and disordered eating. Considering the limited diversity of models in mainstream media, individuals belonging to minoritized cultural groups may resist identifying with and internalizing mainstream beauty messages. The extent of internalization may also depend on an individual's acculturation status and experiences of acculturative stress. This study applied the sociocultural model to culturally Deaf women. Data were collected from 96 deaf, female, undergraduate students. Results support the sociocultural model; higher rates of internalization were associated with negative body image and disordered eating behaviors. However, neither Deaf nor Hearing acculturation predicted internalization. Despite this finding, stronger acculturation with either Deaf or Hearing culture predicted more positive body image, and higher rates of acculturative stress predicted negative body image and disordered eating behaviors. Implications for clinical practice are discussed.