Multilingual children with hearing loss: Factors contributing to language use at home and in early education

Caregiver Experiences With Oral Bilingualism in Children Who Are Deaf and Hard of Hearing in the United States: Impact on Child Language Proficiency

PURPOSE

Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanish-speaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency.

METHOD

Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency.

RESULTS

We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not.

CONCLUSIONS

Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21644846.

Diversity of Child and Family Characteristics of Children with Hearing Loss in Family-Centered Early Intervention in The Netherlands

Background: Family-centered early intervention (FCEI) for children with hearing loss (HL) supports caregivers to promote their children’s language development. To provide FCEI services that are relevant and accessible to meet diverse needs, insight into the characteristics of children with HL is important. In the current study, various characteristics of children with HL and intervention-related factors are examined in relation to spoken language outcomes. Methods: Child and family characteristics, language outcomes and data on intervention were extracted from FCEI records for 83 children. Family involvement ratings were obtained from EI providers. Relations between characteristics, intervention, family involvement and language outcomes were analyzed and predictors for children’s language outcomes were investigated. Results: The characteristics of children with HL in FCEI are very diverse. Family involvement and the occurrence of additional disabilities were predictive for children’s receptive and expressive language abilities; the start of FCEI was not. Maternal education was predictive for expressive language outcomes only. Conclusions: The current study showed the diversity in characteristics of children with HL and their families in the degree of HL, etiology, cultural background, home language, family involvement and additional disabilities. We conclude that ’one size does not fit all’, and FCEI programs should acknowledge the unique strengths and challenges of every individual family.

Professionals' Perspectives on Supporting Deaf Multilingual Learners and Their Families

Parents frequently report that advice from professionals is important in making decisions about how their child with hearing loss will communicate. Little is currently known about how professionals support parents raising children with hearing loss in spoken language multilingual environments, children who are described as d/Deaf multilingual learners (DMLs). The purpose of this phenomenological study was to gain insight into professionals' perspectives and experiences working with such families, particularly in relation to supporting parents in decision-making about multilingualism and language choice. Nineteen professionals discussed their experiences working with DMLs and their families, the role of professionals in decision-making about multilingualism and language choice, and the factors that they considered were important when supporting DMLs and their families. Inductive thematic analysis yielded three themes: child characteristics (language, development), negotiating and supporting language (information, parents' language, role of language, timing, leadership, language management), and professional issues (knowledge, resources). This paper provides an important insight into professional considerations in supporting DMLs and their families, such as the role and functioning of evidence-based practice.

Parent perceptions of their child's communication and academic experiences with cochlear implants

OBJECTIVE

To explore parent perceptions of communication and academic experiences of cochlear implant (CI) recipients under the age of 18.

DESIGN

Cross-sectional survey design. Two surveys (K-12, birth-5) queried parent perceptions of the impact of CI on communication, listening in various environments and academic achievement. Surveys contained 16-23 multiple choice and/or Likert ratings, plus four open-ended questions to assess reasons for obtaining a CI, satisfaction with CI and suggestions for professionals.

STUDY SAMPLE

Surveys were sent to 156 parents of CI recipients; 81 surveys returned; response rate 52%.

RESULTS

According to parent report, 95% of K-12 children and 100% of preschool children used spoken language as their primary mode of communication; majority of K-12 children performed same as or better than peers across academic subjects; 99% of respondents were pleased with their decision to obtain a CI. The most important reasons reported for choosing CIs were for their child to use the same language as their families and to effectively communicate in hearing society. Satisfaction with CI was better in quiet than in noise. Respondents stressed the importance of audiologists having excellent skills in CI management and programming.

CONCLUSIONS

Respondents were positive about the benefits of obtaining CI for their child.

Expert opinion: Assessing cochlear implant candidacy and progress for people with English as an additional language

Special considerations relating to cochlear implants (CIs) are necessary for deaf people for whom English is an additional language (EAL). The audiological and pre-linguistic skills criteria for CI candidacy are the same for children with EAL as for children from English-speaking families. However, thorough assessment is not straightforward, for example, requiring employment of experienced interpreters. To ensure family engagement and thus appropriate support in the home, clear understanding of the family's social and cultural framework and of their needs and requirements is essential. Equally, the family must be enabled to understand the implications of CI. Additional training of staff in CI teams may be needed. This article will address these and other issues for children and also consider the situation for adults.

What can we expect of normally-developing children implanted at a young age with respect to their auditory, linguistic and cognitive skills?

As a result of neonatal hearing screening and subsequent early cochlear implantation (CI) profoundly deaf children have access to important information to process auditory signals and master spoken language skills at a young age. Nevertheless, auditory, linguistic and cognitive outcome measures still reveal great variability in individual achievements: some children with CI(s) perform within normal limits, while others lag behind. Understanding the causes of this variation would allow clinicians to offer better prognoses to CI candidates and efficient follow-up and rehabilitation. This paper summarizes what we can expect of normally developing children with CI(s) with regard to spoken language, bilateral and binaural auditory perception, speech perception and cognitive skills. Predictive factors of performance and factors influencing variability are presented, as well as some novel data on cognitive functioning and speech perception in quiet and in noise. Subsequently, we discuss technical and non-technical issues which should be considered in the future in order to optimally guide the child with profound hearing difficulties. This article is part of a Special Issue entitled <Lasker Award>.

Speech, Sign, or Multilingualism for Children With Hearing Loss: Quantitative Insights Into Caregivers' Decision Making

Purpose

The authors sought to investigate the influence of a comprehensive range of factors on the decision making of caregivers of children with hearing loss regarding the use of speech, the use of sign, spoken language multilingualism, and spoken language choice. This is a companion article to the qualitative investigation described in Crowe, Fordham, McLeod, and Ching (2014).

Method

Through a questionnaire, 177 caregivers of 157 Australian children with hearing loss (ages 3;5 to 9;4 [years;months], M age = 6;6) rated the importance of a range of potential influences on their decision making regarding their children's communication. The majority of children were reported to use speech (96.6%) as part or all of their communication system, with fewer children reported to use sign (20.9%). Few children used more than one spoken language (8.3%).

Results

Proportional analyses and exploratory factor analyses were conducted. Overall, caregivers' decisions were influenced by their children's audiological and intervention characteristics, communication with those around them, community participation, access to intervention and education services in English, and concerns about their children's future lives. The advice of speech-language pathologists, audiologists, and specialist teachers was more important to caregivers than advice from medical practitioners and nonprofessionals.

Conclusion

Caregivers' decision making regarding communication mode and language use is influenced by factors that are not equally weighted and that relate to child, family, community, and advice from others. Knowledge of these factors can assist professionals in supporting caregivers making choices regarding communication.

Supplemental Material

https://doi.org/10.23641/asha.6170282

Resourcing speech-language pathologists to work with multilingual children

Speech-language pathologists play important roles in supporting people to be competent communicators in the languages of their communities. However, with over 7000 languages spoken throughout the world and the majority of the global population being multilingual, there is often a mismatch between the languages spoken by children and families and their speech-language pathologists. This paper provides insights into service provision for multilingual children within an English-dominant country by viewing Australia's multilingual population as a microcosm of ethnolinguistic minorities. Recent population studies of Australian pre-school children show that their most common languages other than English are: Arabic, Cantonese, Vietnamese, Italian, Mandarin, Spanish, and Greek. Although 20.2% of services by Speech Pathology Australia members are offered in languages other than English, there is a mismatch between the language of the services and the languages of children within similar geographical communities. Australian speech-language pathologists typically use informal or English-based assessments and intervention tools with multilingual children. Thus, there is a need for accessible culturally and linguistically appropriate resources for working with multilingual children. Recent international collaborations have resulted in practical strategies to support speech-language pathologists during assessment, intervention, and collaboration with families, communities, and other professionals. The International Expert Panel on Multilingual Children's Speech was assembled to prepare a position paper to address issues faced by speech-language pathologists when working with multilingual populations. The Multilingual Children's Speech website ( http://www.csu.edu.au/research/multilingual-speech ) addresses one of the aims of the position paper by providing free resources and information for speech-language pathologists about more than 45 languages. These international collaborations have been framed around the World Health Organization's International Classification of Functioning, Disability and Health (ICF-CY) and have been established with the goal of supporting multilingual children to participate in society.

Impact of the presence of auditory neuropathy spectrum disorder (ANSD) on outcomes of children at three years of age

OBJECTIVE

To determine the influence of the presence of auditory neuropathy spectrum disorder (ANSD) on speech, language, and psycho-social development of children at three years of age.

DESIGN

A population-based, longitudinal study was performed on outcomes of children with hearing impairment (LOCHI) in Australia. The demographic characteristics of the children were described, and their developmental outcomes were evaluated at three years of age. Performance of children with ANSD was compared with that of children without ANSD in the LOCHI study.

STUDY SAMPLE

There were 47 children with ANSD in the study sample.

RESULTS

Sixty-four percent of children with ANSD have hearing sensitivity loss ranging from mild to severe degree, and the remaining have profound hearing loss. At three years, 27 children used hearing aids, 19 used cochlear implants, and one child did not use any hearing device. Thirty percent of children have disabilities in addition to hearing loss. On average, there were no significant differences in performance level between children with and without ANSD. Also, the variability of scores was not significantly different between the two groups.

CONCLUSIONS

There was no significant difference in performance levels or variability between children with and without ANSD, both for children who use hearing aids, and children who use cochlear implants.

The cultural and linguistic diversity of 3-year-old children with hearing loss

Understanding the cultural and linguistic diversity of young children with hearing loss informs the provision of assessment, habilitation, and education services to both children and their families. Data describing communication mode, oral language use, and demographic characteristics were collected for 406 children with hearing loss and their caregivers when children were 3 years old. The data were from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, a prospective, population-based study of children with hearing loss in Australia. The majority of the 406 children used spoken English at home; however, 28 other languages also were spoken. Compared with their caregivers, the children in this study used fewer spoken languages and had higher rates of oral monolingualism. Few children used a spoken language other than English in their early education environment. One quarter of the children used sign to communicate at home and/or in their early education environment. No associations between caregiver hearing status and children's communication mode were identified. This exploratory investigation of the communication modes and languages used by young children with hearing loss and their caregivers provides an initial examination of the cultural and linguistic diversity and heritage language attrition of this population. The findings of this study have implications for the development of resources and the provision of early education services to the families of children with hearing loss, especially where the caregivers use a language that is not the lingua franca of their country of residence.