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Warner-Czyz AD, Anderson SR, Graham S, Uhler K. Expressive vocabulary word categories of children who are deaf and hard-of-hearing. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:362-376. [PMID: 38240124 PMCID: PMC11195470 DOI: 10.1093/deafed/enad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/02/2023] [Accepted: 12/19/2023] [Indexed: 06/25/2024]
Abstract
This study investigated the acquisition of early expressive vocabulary among young children who are deaf and hard-of-hearing (DHH; n = 68) using auditory technology (hearing aids and cochlear implants). Parents completed a standardized vocabulary checklist, which allowed analyses of (i) the size of their child's spoken vocabulary; (ii) composition of the expressive lexicon (e.g., parts of speech such as nouns and verbs; semantic categories such as routines and body parts); and (iii) demographic and audiologic factors (e.g., chronologic age, degree of hearing access) potentially associated with these metrics. Young children who are DHH and use auditory technology acquired fewer spoken words than peers with typical hearing (TH) matched for chronologic age but more spoken words than peers with TH matched for listening experience. Action verbs-not nouns-significantly increased the odds of a child who is DHH achieving a vocabulary quotient within the normative range. These findings support the exploration of early expressive vocabulary size and composition-especially the number of active verbs-to guide clinical management and decision-making for young children who are DHH.
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Affiliation(s)
- Andrea D Warner-Czyz
- Department of Speech, Language, and Hearing, The University of Texas at Dallas, Dallas, TX, United States
- Callier Center for Communication Disorders, Dallas, TX, United States
| | - Sean R Anderson
- Department of Physiology and Biophysics, Colorado University Anschutz School of Medicine, Denver, CO, United States
| | - Sarah Graham
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Kristin Uhler
- Department of Physical Medicine and Rehabilitation, Colorado University Anschutz School of Medicine, Denver, CO, United States
- Children’s Hospital Colorado, Denver, CO, United States
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de Jong TJ, van der Schroeff MP, Stapersma L, Vroegop JL. A systematic review on the impact of auditory functioning and language proficiency on psychosocial difficulties in children and adolescents with hearing loss. Int J Audiol 2023:1-11. [PMID: 37887640 DOI: 10.1080/14992027.2023.2261074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/13/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE Approximately 20% to 40% of children with hearing loss encounter psychosocial difficulties. This prevalence may be outdated, given the advancements in hearing technology and rehabilitation efforts to enhance the psychosocial well-being of these children. A systematic review of up-to-date literature can help to identify factors that may contribute to the children's psychosocial well-being. DESIGN/STUDY SAMPLE A systematic review was conducted. Original articles were identified through systematic searches in Embase, Medline, PsychINFO, and Web of Science Core Collection. The quality of the papers was assessed using the Newcastle-Ottawa Quality Assessment Scale and custom Reviewers' Criteria. RESULTS A search was performed on 20 October 2022. A total of 1561 articles were identified, and 36 were included for review. Critical appraisal led to 24 good to fair quality articles, and 12 poor quality articles. CONCLUSION Children with hearing loss have a twofold risk of experiencing psychosocial difficulties compared to normal hearing peers. Estimates for functioning in social interactions, like speech perception (in noise) or language proficiency, have proven to be more adequate predictors for psychosocial difficulties than the degree of hearing loss. Our findings can be useful for identifying children at risk for difficulties and offering them earlier and more elaborate psychological interventions.
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Affiliation(s)
- Tjeerd J de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Luuk Stapersma
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Jantien L Vroegop
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
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Goodwin C, Lillo-Martin D. Deaf and Hearing American Sign Language-English Bilinguals: Typical Bilingual Language Development. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2023; 28:350-362. [PMID: 37516457 PMCID: PMC10516340 DOI: 10.1093/deafed/enad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/15/2023] [Accepted: 06/02/2023] [Indexed: 07/31/2023]
Abstract
Some studies have concluded that sign language hinders spoken language development for deaf and hard-of-hearing (DHH) children even though sign language exposure could protect DHH children from experiencing language deprivation. Furthermore, this research has rarely considered the bilingualism of children learning a signed and a spoken language. Here we compare spoken English development in 2-6-year-old deaf and hearing American Sign Language-English bilingual children to each other and to monolingual English speakers in a comparison database. Age predicted bilinguals' language scores on all measures, whereas hearing status was only significant for one measure. Both bilingual groups tended to score below monolinguals. Deaf bilinguals' scores differed more from monolinguals, potentially because of later age of and less total exposure to English, and/or to hearing through a cochlear implant. Overall, these results are consistent with typical early bilingual language development. Research and practice must treat signing-speaking children as bilinguals and consider the bilingual language development literature.
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Affiliation(s)
- Corina Goodwin
- Department of Linguistics, University of Connecticut, Storrs, CT, USA
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, USA
| | - Diane Lillo-Martin
- Department of Linguistics, University of Connecticut, Storrs, CT, USA
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, USA
- Haskins Laboratories, New Haven, CT, USA
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De Raeve L, Cumpăt MC, van Loo A, Costa IM, Matos MA, Dias JC, Mârțu C, Cavaleriu B, Gherguț A, Maftei A, Tudorean OC, Butnaru C, Șerban R, Meriacre T, Rădulescu L. Quality Standard for Rehabilitation of Young Deaf Children Receiving Cochlear Implants. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1354. [PMID: 37512167 PMCID: PMC10386159 DOI: 10.3390/medicina59071354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Background and objectives: More and more children with severe-to-profound hearing loss are receiving cochlear implants (CIs) at an early age to improve their hearing and listening abilities, speech recognition, speech intelligibility, and other aspects of spoken language development. Despite this, the rehabilitation outcomes can be very heterogeneous in this population, not only because of issues related to surgery and fitting or the specific characteristics of the child with his/her additional disabilities but also because of huge differences in the quality of the support and rehabilitation offered by the therapist and the family. These quality standards for the rehabilitation of young deaf children receiving CIs are developed within the European KA202 Erasmus+ project "VOICE"-vocational education and training for speech and language therapists and parents for the rehabilitation of children with CIs, Ref. No.: 2020-1-RO01-KA202-080059. Material and methods: To develop these quality standards, we used the input from the face-to-face interviews of 11 local rehabilitation experts in CIs from the four partner countries of the project and the outcomes of the bibliographic analysis of 848 publications retrieved from six databases: Pub Med, Psych Info, CINAHL, Scopus, Eric, and Cochrane. Based on all this information, we created a first set of 32 quality standards over four domains: general, fitting, rehabilitation, and for professionals. Further on, the Delphi method was used by 18 international rehabilitation experts to discuss and agree on these standards. Results: The results from the literature analysis and the interviews show us that more than 90% of the consulted international experts agreed on 29 quality standards. They focus on different aspects of rehabilitation: the multidisciplinary team, their expertise and knowledge, important rehabilitation topics to focus on, and programming issues related to rehabilitation. Conclusions: These quality standards aim to optimize the activity of speech rehabilitation specialists so that they reach the optimal level of expertise. Also presented is the necessary equipment for the IC team to carry out the rehabilitation sessions in good conditions. This set of quality standards can be useful to ensure the appropriate postoperative care of these children. As a result, the rehabilitation process will be more relaxed, and therapists will have the opportunity to focus more on the specific needs of each child, with the provision of quality services, which will result in better results. This theme is particularly complex and dependent on multifactorial aspects of medicine, education, speech therapy, social work, and psychology that are very intricate and interdependent.
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Affiliation(s)
- Leo De Raeve
- Independent Information Center on CI's (ONICI), 3520 Zonhoven, Belgium
| | - Marinela-Carmen Cumpăt
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Aimée van Loo
- Prevention Center Zuyd, Zuyd University of Applied Science, Nieuw Eyckholt 300, 6419 DJ Heerlen, The Netherlands
| | - Isabel Monteiro Costa
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Research in Health Technologies and Services (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - Maria Assunção Matos
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Research in Health Technologies and Services (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - João Canossa Dias
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Research in Health Technologies and Services (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - Cristian Mârțu
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | | | - Alois Gherguț
- Faculty of Psychology and Education Sciences, Department of Education Sciences, "Alexandru Ioan Cuza" University of Iași, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Alexandra Maftei
- Faculty of Psychology and Education Sciences, Department of Education Sciences, "Alexandru Ioan Cuza" University of Iași, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Ovidiu-Cristian Tudorean
- Faculty of Psychology and Education Sciences, Department of Education Sciences, "Alexandru Ioan Cuza" University of Iași, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Corina Butnaru
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
| | - Roxana Șerban
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
| | - Tatiana Meriacre
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
| | - Luminița Rădulescu
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
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Aanondsen CM, Jozefiak T, Lydersen S, Heiling K, Rimehaug T. Deaf and hard-of-hearing children and adolescents' mental health, Quality of Life and communication. BMC Psychiatry 2023; 23:297. [PMID: 37118705 PMCID: PMC10148557 DOI: 10.1186/s12888-023-04787-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
Mental health problems and lower Quality of Life (QoL) are more common in deaf and hard-of-hearing - (D)HH - children than in typically hearing (TH) children. Communication has been repeatedly linked to both mental health and QoL. The aims of this study were to compare mental health and QoL between signing deaf and hard-of-hearing (DHH), hard-of-hearing (HH) and TH children and to study associations between mental health/QoL and severity of hearing loss and communication. 106 children and adolescents (mean age 11;8; SD = 3.42), 59 of them DHH and 47 HH, and their parents reported child mental health and QoL outcomes. Parents also provided information about their children's communication, hearing loss and education while their children's cognitive ability was assessed. Although (D)HH and their parents rated their mental health similar to their TH peers, about twice as many (D)HH children rated themselves in the clinical range. However, (D)HH children rated their QoL as similar to their TH peers, while their parents rated it significantly lower. Associations between communicative competence, parent-reported mental health and QoL were found, whereas severity of hearing loss based on parent-report had no significant association with either mental health or QoL. These results are in line with other studies and emphasise the need to follow up on (D)HH children's mental health, QoL and communication.
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Affiliation(s)
- Chris Margaret Aanondsen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, RKBU Midt-Norge, NTNU Postboks 8905 MTFS, 7491, Trondheim, Norway.
- Unit for Deaf and Hard-of-Hearing Children and Adolescents in Central Norway, Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway.
| | - Thomas Jozefiak
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, RKBU Midt-Norge, NTNU Postboks 8905 MTFS, 7491, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, RKBU Midt-Norge, NTNU Postboks 8905 MTFS, 7491, Trondheim, Norway
| | | | - Tormod Rimehaug
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, RKBU Midt-Norge, NTNU Postboks 8905 MTFS, 7491, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Pontecorvo E, Higgins M, Mora J, Lieberman AM, Pyers J, Caselli NK. Learning a Sign Language Does Not Hinder Acquisition of a Spoken Language. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1291-1308. [PMID: 36972338 PMCID: PMC10187967 DOI: 10.1044/2022_jslhr-22-00505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 05/18/2023]
Abstract
PURPOSE The purpose of this study is to determine whether and how learning American Sign Language (ASL) is associated with spoken English skills in a sample of ASL-English bilingual deaf and hard of hearing (DHH) children. METHOD This cross-sectional study of vocabulary size included 56 DHH children between 8 and 60 months of age who were learning both ASL and spoken English and had hearing parents. English and ASL vocabulary were independently assessed via parent report checklists. RESULTS ASL vocabulary size positively correlated with spoken English vocabulary size. Spoken English vocabulary sizes in the ASL-English bilingual DHH children in the present sample were comparable to those in previous reports of monolingual DHH children who were learning only English. ASL-English bilingual DHH children had total vocabularies (combining ASL and English) that were equivalent to same-age hearing monolingual children. Children with large ASL vocabularies were more likely to have spoken English vocabularies in the average range based on norms for hearing monolingual children. CONCLUSIONS Contrary to predictions often cited in the literature, acquisition of sign language does not harm spoken vocabulary acquisition. This retrospective, correlational study cannot determine whether there is a causal relationship between sign language and spoken language vocabulary acquisition, but if a causal relationship exists, the evidence here suggests that the effect would be positive. Bilingual DHH children have age-expected vocabularies when considering the entirety of their language skills. We found no evidence to support recommendations that families with DHH children avoid learning sign language. Rather, our findings show that children with early ASL exposure can develop age-appropriate vocabulary skills in both ASL and spoken English.
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Gärdenfors M. Writing Development in DHH Students: A Bimodal Bilingual Approach. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2023; 28:211-225. [PMID: 36964761 PMCID: PMC10039645 DOI: 10.1093/deafed/enac045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 05/31/2023]
Abstract
This article describes the lexical and syntactic development of written narratives in 24 deaf and hard-of-hearing (DHH) students aged between 8 and 18 and takes into account how their varying linguistic backgrounds may predict their written performance. All participants use spoken Swedish, but the study also considers their proficiency in Swedish Sign language, which ranged from zero to fluent. Their narrative texts were analyzed in regard to syntax and lexicon, which demonstrated a strong developmental trend in which increased age predicted more complex texts. Age of acquisition did not predict any writing outcome, which is suggested to occur because all participants were exposed to language early, that is, within the critical time window for language acquisition. Sign language proficiency showed a tendency to predict adjective density and number of clauses, which encourages future research in this area, especially since this connection argues for the benefits of early access to a language and the positive relationship between sign language proficiency and writing.
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Affiliation(s)
- Moa Gärdenfors
- Correspondence should be addressed to Moa Gärdenfors, Department of Linguistics, Stockholm University, Sweden. E-mail:
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Deaf Children Need Rich Language Input from the Start: Support in Advising Parents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111609. [PMID: 36360337 PMCID: PMC9688581 DOI: 10.3390/children9111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 01/25/2023]
Abstract
Bilingual bimodalism is a great benefit to deaf children at home and in schooling. Deaf signing children perform better overall than non-signing deaf children, regardless of whether they use a cochlear implant. Raising a deaf child in a speech-only environment can carry cognitive and psycho-social risks that may have lifelong adverse effects. For children born deaf, or who become deaf in early childhood, we recommend comprehensible multimodal language exposure and engagement in joint activity with parents and friends to assure age-appropriate first-language acquisition. Accessible visual language input should begin as close to birth as possible. Hearing parents will need timely and extensive support; thus, we propose that, upon the birth of a deaf child and through the preschool years, among other things, the family needs an adult deaf presence in the home for several hours every day to be a linguistic model, to guide the family in taking sign language lessons, to show the family how to make spoken language accessible to their deaf child, and to be an encouraging liaison to deaf communities. While such a support program will be complicated and challenging to implement, it is far less costly than the harm of linguistic deprivation.
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Löfkvist U, Nilsson S, Thalén Y, Östlund E, Mared H, Johansson C, Anmyr L, Karltorp E. Gender differences in caregiver's use of spoken language with young children who are hard-of-hearing. Int J Pediatr Otorhinolaryngol 2022; 156:111103. [PMID: 35316756 DOI: 10.1016/j.ijporl.2022.111103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/07/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Shared parenting among caregivers of different gender is common in the Swedish society. It is unclear if this includes shared contribution for children's language development. The objective of this cross-sectional study was to explore the natural language environment of children who were hard-of-hearing compared to typically hearing controls. METHODS Seventy-two families with children aged 7-35 months participated; 22 children who were hard-of-hearing (Cochlear implants, n=11; Hearing aids, n=11) and 50 controls with typical hearing. The majority of caregivers had higher education background level, especially in the control group. Families conducted a daylong recording with the Language Environment Analysis technology, when both parents were present at home. An Interpreted Time Segmental analysis was performed to extract information about female versus male caregivers quantitative word use. RESULTS The results showed significant gender differences related to number of adult words, with less male words than female words (p <0.001). Male caregivers of children who were hard-of-hearing contributed with around 27 % of adult words during the recordings while males in the control group contributed with 37 %. There was a larger variation in number of female words in the study group than for controls, especially in mothers of children with cochlear implants. CONCLUSIONS Female caregivers talk significantly more close to young children than male caregivers, and especially in the subgroup of children with cochlear implants. Children who are hard-of-hearing are dependent on a rich language environment, and might be especially vulnerable if male caregivers are less involved as language facilitators. More studies are needed to explore caregiver gender differences, both related to quantitative and qualitative language stimulation.
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Affiliation(s)
- Ulrika Löfkvist
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of CLINTEC, Karolinska Institute, Stockholm, Sweden.
| | - Sandra Nilsson
- Assistive Technology Center of Dalarna, Region Dalarna, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Yvonne Thalén
- County Council of Värmland, Department of Otorhinolaryngology, Central Hospital Karlstad, Karlstad, Sweden
| | - Elisabet Östlund
- Department of ENT, Karolinska University Hospital, Stockholm, Sweden; Karolinska University Hospital, Speech and Language Pathology, Stockholm, Sweden
| | - Hanna Mared
- Karolinska University Hospital, Speech and Language Pathology, Stockholm, Sweden; Department of Hearing & Balance Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Carina Johansson
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Borås, Sweden
| | - Lena Anmyr
- Department of CLINTEC, Karolinska Institute, Stockholm, Sweden; Department of Social Work in Health, Karolinska University Hospital, Sweden
| | - Eva Karltorp
- Department of CLINTEC, Karolinska Institute, Stockholm, Sweden; Department of ENT, Karolinska University Hospital, Stockholm, Sweden
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Clark EF, Labanca L, Miranda ICC, Gonçalves DU. Uso de dispositivos auxiliares da audição e fluência na Libras e na língua oral de estudantes surdos. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222443322s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RESUMO Objetivo: avaliar a relação entre fluência na Libras, fluência na língua oral e o uso de dispositivos auxiliares para audição de estudantes surdos. Métodos: participaram 112 profissionais tradutores, intérpretes ou instrutores de Libras que informaram as características auditivas, fluência na Libras e língua oral dos estudantes acompanhados por eles, matriculados na rede municipal de uma cidade brasileira. A análise da associação entre fluência na Libras, fluência na língua oral, grau da perda auditiva e uso de dispositivo foi realizada por meio do teste qui-quadrado ou teste exato de Fisher, consideraram-se significantes valores de p<0,05. Resultados: as respostas dos profissionais referiram-se a 88% (n=126) do total de estudantes surdos matriculados na rede municipal. A média de idade dos estudantes foi de 13 anos, sendo 72 (57%) meninos, 98 (78%) com perda auditiva severa ou profunda, 57 (45%) usuários de dispositivos eletrônicos auxiliares para audição, 83 (66%) fluentes somente na Libras, 12 (10%) fluentes apenas na língua oral e 18 (14%) fluentes na Libras e língua oral. Estudantes que utilizavam dispositivo auxiliar para audição apresentaram melhor fluência oral (p<0,001). Dos estudantes que apresentavam fluência oral (n=30), 18 (60%) eram fluentes em Libras (p<0,001). Conclusão: a Libras foi a modalidade comunicativa utilizada majoritariamente pelos estudantes surdos, mesmo por aqueles que utilizavam também a língua oral e dispositivos eletrônicos, o que pode indicar mudança de percepção social em relação ao surdo, à sua língua e cultura.
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Affiliation(s)
| | - Ludimila Labanca
- Universidade Federal de Minas Gerais, Brazil; Universidade Federal de Minas Gerais, Brazil
| | | | - Denise Utsch Gonçalves
- Universidade Federal de Minas Gerais, Brazil; Universidade Federal de Minas Gerais, Brazil
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Clark EF, Labanca L, Miranda ICC, Gonçalves DU. Use of hearing devices and fluency in Brazilian Sign Language and oral language in deaf students. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222443322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Purpose: to assess the relationship between deaf students’ fluency in Brazilian Sign Language (BSL) and oral language and hearing aid use. Method: the sample comprised 112 professional BSL translators, interpreters, and instructors. They answered a questionnaire on hearing characteristics and BSL and oral language fluency of students accompanied by them, who attended municipal schools in a Brazilian city. Association analysis between oral language fluency, BSL fluency, the degree of hearing loss, and device use was made with the chi-square test or Fisher’s Exact test. The significance level was set at p<0.05. Results: the professionals’ responses referred to 88% (n = 126) of all deaf students enrolled in municipal schools. The students’ mean age was 13 years; 72 (57%) were males, 98 (78%) had severe or profound hearing loss, 57 (45%) used electronic hearing devices, 83 (66%) were fluent only in BSL, 12 (10%) were fluent only in oral language, and 18 (14%) were fluent in both BSL and oral language. Hearing device use was statistically associated with oral fluency (p < 0.001). Of all students fluent in oral language (n = 30), 18 (60%) were also fluent in BSL (p < 0.001). Conclusion: BSL was the communication modality most used by students, including those who also used oral language and electronic hearing devices. This may indicate a change in the social perception of deaf people, their language, and their culture.
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Affiliation(s)
| | - Ludimila Labanca
- Universidade Federal de Minas Gerais, Brazil; Universidade Federal de Minas Gerais, Brazil
| | | | - Denise Utsch Gonçalves
- Universidade Federal de Minas Gerais, Brazil; Universidade Federal de Minas Gerais, Brazil
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Effectiveness of Aural-Oral Approach Based on Volubility of a Deaf Child with Late-Mapping Bilateral Cochlear Implants. Audiol Res 2021; 11:373-383. [PMID: 34449563 PMCID: PMC8395430 DOI: 10.3390/audiolres11030035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background: The purpose of this study was to investigate the effectiveness of aural-oral habilitation (AO) over the traditional speech-language therapy, based on the number of vocalization-volubility of a deaf child with late-mapping bilateral cochlear implants using sequential measurements. Methods: The spontaneous productions during child interactions were analyzed. The child (CY, 7;0 years old) with a mean unaided pure-tone average (PTA) hearing loss >80 dB HL was assessed by using an assessment battery. Study design consisted of two phases: (a) baseline (end of speech therapy) and (b) end of AO treatment. Protophones were analyzed via acoustical analysis using PRAAT software. Results: One-way repeated-measure ANOVAs were conducted within and between phases. The analyses revealed significant differences between the ‘phase’ and the vocalization outcome (F = 9.4, df = 1, p = 0.035). Post hoc analyses revealed the significant difference between the mean number of disyllable vocalizations of AO approach (p = 0.05). The mean number of vocalizations was calculated for each protophone type, but no other significant difference was measured. Conclusions: AO approach proved effective as measured through volubility. The outcome of this study is indicative and is a starting point for broader research.
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Chen L, Wang Y, Wen H. Numerical Magnitude Processing in Deaf Adolescents and Its Contribution to Arithmetical Ability. Front Psychol 2021; 12:584183. [PMID: 33841229 PMCID: PMC8026863 DOI: 10.3389/fpsyg.2021.584183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
Although most deaf individuals could use sign language or sign/spoken language mix, hearing loss would still affect their language acquisition. Compensatory plasticity holds that the lack of auditory stimulation experienced by deaf individuals, such as congenital deafness, can be met by enhancements in visual cognition. And the studies of hearing individuals have showed that visual form perception is the cognitive mechanism that could explain the association between numerical magnitude processing and arithmetic computation. Therefore, we examined numerical magnitude processing and its contribution to arithmetical ability in deaf adolescents, and explored the differences between the congenital and acquired deafness. 112 deaf adolescents (58 congenital deafness) and 58 hearing adolescents performed a series of cognitive and mathematical tests, and it was found there was no significant differences between the congenital group and the hearing group, but congenital group outperformed acquired group in numerical magnitude processing (reaction time) and arithmetic computation. It was also found there was a close association between numerical magnitude processing and arithmetic computation in all deaf adolescents, and after controlling for the demographic variables (age, gender, onset of hearing loss) and general cognitive abilities (non-verbal IQ, processing speed, reading comprehension), numerical magnitude processing could predict arithmetic computation in all deaf adolescents but not in congenital group. The role of numerical magnitude processing (symbolic and non-symbolic) in deaf adolescents' mathematical performance should be paid attention in the training of arithmetical ability.
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Affiliation(s)
- Lilan Chen
- School of Psychology, Hainan Normal University, Haikou, China
| | - Yan Wang
- Faculty of Education, Beijing Normal University, Beijing, China
| | - Hongbo Wen
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
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Crowe K, Dammeyer J. A Review of the Conversational Pragmatic Skills of Children With Cochlear Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:171-186. [PMID: 33740059 DOI: 10.1093/deafed/enab001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/03/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Many children who use cochlear implants (CI) have strong skills in many aspects of spoken language; however, limited information is available about their mastery of the pragmatic skills required to participate in conversation. This study reviewed published literature describing the pragmatic skills of children who use CIs in conversational contexts. Twenty-five studies met the inclusion criteria, and data were extracted describing participant characteristics, methodology, data type, outcomes, and factors associated with outcomes. Pragmatic skills were described in three broad categories: speech acts, turns, and breakdowns and repairs. Participants showed heterogeneity in age, age at implantation, duration of implant use, and languages used. Studies employed a variety of methodologies, used a range of different sample types and coding strategies, and considered different factors associated that might be associated with children's pragmatic skills. Across studies, children with CIs were reported to have a range of pragmatic skills in conversational contexts, from few to severe difficulties. The body of literature on this topic is small and considered heterogeneous children with CIs with a wide range of skills. Further research is needed to understand the pragmatics language skills of children with CIs and the factors influencing the diversity in skills observed.
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Affiliation(s)
- Kathryn Crowe
- Schools of Health Sciences and Education, University of Iceland, Reykjavík, Iceland
- School of Teacher Education, Charles Sturt University, Bathurst, Australia
| | - Jesper Dammeyer
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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White KR. Progress in Helping Children Who are Deaf or Hard of Hearing Achieve Their Potential. Pediatrics 2021; 147:peds.2020-032508. [PMID: 33452062 DOI: 10.1542/peds.2020-032508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Karl R White
- Department of Psychology, Utah State University, Logan, Utah
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16
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Hall ML, De Anda S. Measuring "Language Access Profiles" in Deaf and Hard-of-Hearing Children With the DHH Language Exposure Assessment Tool. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:134-158. [PMID: 33375841 DOI: 10.1044/2020_jslhr-20-00439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The purposes of this study were (a) to introduce "language access profiles" as a viable alternative construct to "communication mode" for describing experience with language input during early childhood for deaf and hard-of-hearing (DHH) children; (b) to describe the development of a new tool for measuring DHH children's language access profiles during infancy and toddlerhood; and (c) to evaluate the novelty, reliability, and validity of this tool. Method We adapted an existing retrospective parent report measure of early language experience (the Language Exposure Assessment Tool) to make it suitable for use with DHH populations. We administered the adapted instrument (DHH Language Exposure Assessment Tool [D-LEAT]) to the caregivers of 105 DHH children aged 12 years and younger. To measure convergent validity, we also administered another novel instrument: the Language Access Profile Tool. To measure test-retest reliability, half of the participants were interviewed again after 1 month. We identified groups of children with similar language access profiles by using hierarchical cluster analysis. Results The D-LEAT revealed DHH children's diverse experiences with access to language during infancy and toddlerhood. Cluster analysis groupings were markedly different from those derived from more traditional grouping rules (e.g., communication modes). Test-retest reliability was good, especially for the same-interviewer condition. Content, convergent, and face validity were strong. Conclusions To optimize DHH children's developmental potential, stakeholders who work at the individual and population levels would benefit from replacing communication mode with language access profiles. The D-LEAT is the first tool that aims to measure this novel construct. Despite limitations that future work aims to address, the present results demonstrate that the D-LEAT represents progress over the status quo.
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Affiliation(s)
- Matthew L Hall
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
| | - Stephanie De Anda
- Communication Disorders and Sciences Program, University of Oregon, Eugene
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17
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Holzinger D, Hofer J, Dall M. Frühe Prädiktoren der Sprachentwicklung von Kindern mit permanenter Hörstörung. KINDHEIT UND ENTWICKLUNG 2021. [DOI: 10.1026/0942-5403/a000325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Sprachentwicklungsverläufe bei Kindern mit Hörstörungen zeigen eine hohe und überwiegend ungeklärte Varianz. Fragestellung und Methode: Unsere Übersichtsarbeit präsentiert aktuelle Evidenz zu frühen Prädiktoren der Sprachentwicklung. Ergebnisse und Diskussion: Trotz deutlicher positiver Trends erreicht nur jedes zweite Kind ein Sprachentwicklungsniveau im Normbereich. Der Literaturüberblick ergibt signifikante kindbezogene und familiäre Prädiktoren mit eher geringer Beeinflussbarkeit. Als hoch prädiktiv für sprachliche Ergebnisse und zudem der Intervention zugänglich erweisen sich die frühe Erkennung und technische Versorgung mit Hörgeräten oder -implantaten und Aufnahme in die Frühförderung, konsistente Hörtechnikverwendung und/oder früher Zugang zur Gebärdensprache. Zudem zeigt sich die Qualität der täglichen Eltern-Kind-Interaktion als hocheffektiv für die Sprachentwicklung. Schlussfolgerung: Es bestätigt sich die Wirksamkeit aktueller Best Practice früher Erkennung, Versorgung und familienzentrierter Frühförderung.
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Affiliation(s)
- Daniel Holzinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Linz
- Institut für Sprachwissenschaft, Karl-Franzens-Universität Graz
| | - Johannes Hofer
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Linz
- Abteilung für Pädiatrie I, Medizinische Universität Innsbruck
| | - Magdalena Dall
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz
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Zakay D, Zakay MJ, Rosenfeld RM. Choices in deaf education and cochlear implantation: Suggesting a more inclusive approach. Int J Pediatr Otorhinolaryngol 2021; 140:110419. [PMID: 33059896 DOI: 10.1016/j.ijporl.2020.110419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/02/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Affiliation(s)
- David Zakay
- Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, United States.
| | - Madeline J Zakay
- Strivright / Auditory Oral School of New York, 3321 Avenue M, Brooklyn, NY, 11210, United States
| | - Richard M Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, United States; Strivright / Auditory Oral School of New York, 3321 Avenue M, Brooklyn, NY, 11210, United States
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Vaillant E, Geytenbeek JJM, Jansma EP, Oostrom KJ, Vermeulen RJ, Buizer AI. Factors associated with spoken language comprehension in children with cerebral palsy: a systematic review. Dev Med Child Neurol 2020; 62:1363-1373. [PMID: 32852786 PMCID: PMC7692918 DOI: 10.1111/dmcn.14651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 12/01/2022]
Abstract
AIM To identify factors that are relevant for spoken language comprehension in children with cerebral palsy (CP), following the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) framework. METHOD A systematic literature search was conducted using the electronic literature databases PubMed, Embase, PsycInfo, and Cochrane Library, from January 1967 to December 2019. Included studies involved children with CP, results regarding spoken language comprehension, and analysis of at least one associated factor. Factors were classified within ICF-CY domains. RESULTS Twenty-one studies met inclusion criteria. Factors in the ICF-CY domains of body functions and structure were most frequently reported. White brain matter abnormalities, motor type, functional mobility, and intellectual functioning appear to be relevant factors in spoken language comprehension in CP. Factors in the domain of activities and participation, as well as contextual factors, have rarely been studied in the context of spoken language comprehension in CP. INTERPRETATION Most factors known to be important for spoken language comprehension in typically developing children and/or known to be susceptible to change by interventions are understudied in CP.
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Affiliation(s)
- Emma Vaillant
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Johanna J M Geytenbeek
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Elise P Jansma
- Department of Epidemiology and BiostatisticsEMGO+ Institute for Health and Care Research and Medical LibraryAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Kim J Oostrom
- Psychosocial DepartmentAmsterdam Reproduction and DevelopmentEmma Children’s HospitalAmsterdam UMCUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdamthe Netherlands
| | | | - Annemieke I Buizer
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
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20
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Hall ML, Dills S. The Limits of "Communication Mode" as a Construct. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:383-397. [PMID: 32432678 DOI: 10.1093/deafed/enaa009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 06/11/2023]
Abstract
Questions about communication mode (a.k.a. "communication options" or "communication opportunities") remain among the most controversial issues in the many fields that are concerned with the development and well-being of children (and adults) who are d/Deaf or hard of hearing. In this manuscript, we argue that a large part of the reason that this debate persists is due to limitations of the construct itself. We focus on what we term "the crucial question": namely, what kind of experience with linguistic input during infancy and toddlerhood is most likely to result in mastery of at least one language (spoken or signed) by school entry. We argue that the construct of communication mode-as currently construed-actively prevents the discovery of compelling answers to that question. To substantiate our argument, we present a review of a relevant subset of the recent empirical literature and document the prevalence of our concerns. We conclude by articulating the desiderata of an alternative construct that, if appropriately measured, would have the potential to yield answers to what we identify as "the crucial question."
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St John M, Columbus G, Brignell A, Carew P, Skeat J, Reilly S, Morgan AT. Predicting speech-sound disorder outcomes in school-age children with hearing loss: The VicCHILD experience. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:537-546. [PMID: 32374456 DOI: 10.1111/1460-6984.12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Congenital hearing loss is the most common birth anomaly, typically influencing speech and language development, with potential for later academic, social and employment impacts. Yet, surprisingly, the nuances of how speech is affected have not been well examined with regards to the subtypes of speech-sound disorder (SSD). Nor have the predictors of speech outcome been investigated within a sizeable population cohort. AIMS (1) To describe the subtypes and prevalence of SSD in children with hearing loss. (2) To determine which characteristics of hearing loss predict the presence of SSD. METHODS & PROCEDURES A total of 90 children (5-12 years of age) with permanent hearing loss were recruited from an Australian population cohort. Children completed a standardized speech assessment to determine the presence and subtype of SSD. Logistic regression was used to determine the predictors of speech outcome. Demographic, developmental and hearing-related predictors were examined. OUTCOMES & RESULTS The prevalence of speech disorder overall was 58%, with the most common subtype being phonological delay in 49% of the sample. Factors most predictive of speech disorder were being male, younger and a bimodal user (i.e., using both a hearing aid and a cochlear implant). CONCLUSIONS & IMPLICATIONS This is the first study, in a sizeable cohort, to describe the prevalence and predictive factors for SSD associated with hearing loss. Clinically, it could be beneficial to implement earlier targeted phonological interventions for children with hearing loss. What this paper adds What is already known on this subject Speech issues are common in children with hearing loss; however, the breakdown of subtypes of SSD (e.g., articulation versus phonological disorder) have not been previously described in a population cohort. This distinction is relevant, as each subtype calls for specific targeted intervention. Studies examining factors predictive of speech outcomes, across a range of hearing levels, are also lacking in a population cohort. What this paper adds to existing knowledge Data suggest the most common type of SSD in children with hearing loss is phonological delay. Males, younger children, and bimodal users were at greater risk of having a subtype of SSD. What are the potential or actual clinical implications of this work? The results are clinically pertinent as the speech diagnosis determines the targeted treatment. Phonological delay is responsive to treatment, and early targeted intervention may improve prognosis for speech outcomes for children with hearing loss.
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Affiliation(s)
- Miya St John
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Georgie Columbus
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
| | - Amanda Brignell
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Peter Carew
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jemma Skeat
- University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
- Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
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Hall ML. The Input Matters: Assessing Cumulative Language Access in Deaf and Hard of Hearing Individuals and Populations. Front Psychol 2020; 11:1407. [PMID: 32636790 PMCID: PMC7319016 DOI: 10.3389/fpsyg.2020.01407] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/26/2020] [Indexed: 11/13/2022] Open
Abstract
Deaf and hard-of-hearing (DHH) children present several challenges to traditional methods of language assessment, and yet language assessment for this population is absolutely essential for optimizing their developmental potential. Whereas assessment often focuses on language outcomes, this Conceptual Analysis argues that assessing cumulative language input is critically important both in clinical work with DHH individuals and in research/public health contexts concerned with DHH populations. At the individual level, paying attention to the input (and the person's access to it) is vital for discriminating disorder from delay, and for setting goals and strategies for reaching them. At the population level, understanding relationships between cumulative language input and resulting language outcomes is essential to the broader public health efforts aimed at identifying strategies to improve outcomes in DHH populations and to theoretical efforts to understand the role that language plays in child development. Unfortunately, several factors jointly result in DHH children's input being under-described at both individual and population levels: for example, overly simplistic ways of classifying input, and the lack of tools for assessing input more thoroughly. To address these limitations, this Conceptual Analysis proposes a new way of characterizing a DHH child's cumulative experience with input, and outlines the features that a tool would need to have in order to measure this alternative construct.
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Affiliation(s)
- Matthew L Hall
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, United States
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Antia SD, Lederberg AR, Easterbrooks S, Schick B, Branum-Martin L, Connor CM, Webb MY. Language and Reading Progress of Young Deaf and Hard-of-Hearing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:334-350. [PMID: 32052022 DOI: 10.1093/deafed/enz050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 11/21/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
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.
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Gabouer A, Oghalai J, Bortfeld H. Parental use of multimodal cues in the initiation of joint attention as a function of child hearing status. DISCOURSE PROCESSES 2020; 57:491-506. [PMID: 32669749 PMCID: PMC7363029 DOI: 10.1080/0163853x.2020.1759022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In the current study, we examine how hearing parents use multimodal cuing to establish joint attention with their hearing (N=9) or deaf (N=9) children during a free-play session. The deaf children were all candidates for cochlear implantation who had not yet been implanted, and each hearing child was age-matched to a deaf child. We coded parents' use of auditory, visual, and tactile cues, alone and in different combinations, during both successful and failed bids for children's attention. Although our findings revealed no clear quantitative differences in parents' use of multimodal cues as a function of child hearing status, secondary analyses revealed that hearing parents of deaf children used shorter utterances while initiating joint attention than did hearing parents of hearing children. Hearing parents of deaf children also touched their children twice as often throughout the play session than did hearing parents of hearing children. These findings demonstrate that parents differentially accommodate the specific needs of their hearing and deaf children in subtle ways to establish communicative intent.
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Affiliation(s)
| | - John Oghalai
- Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California
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26
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Contemporary Speech and Oral Language Care for Deaf and Hard-of-Hearing Children Using Hearing Devices. J Clin Med 2020; 9:jcm9020378. [PMID: 32019213 PMCID: PMC7073554 DOI: 10.3390/jcm9020378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 11/16/2022] Open
Abstract
Contemporary speech and language interventions are not limited to disabilities but embrace the pragmatics of communication behaviors from the perspective of functional social participation. Accordingly, current speech and language therapies for deaf and hard-of-hearing children include a broad spectrum of approaches and techniques. This paper explores contemporary approaches and techniques for speech and oral language interventions for deaf and hard-of-hearing children using hearing devices, evidence of efficacy and how they are implemented in diverse clinical practices.
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Demers D, Bergeron F. Effectiveness of Rehabilitation Approaches Proposed to Children With Severe-to-Profound Prelinguistic Deafness on the Development of Auditory, Speech, and Language Skills: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4196-4230. [PMID: 31652408 DOI: 10.1044/2019_jslhr-h-18-0137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of this systematic review is to identify and evaluate the available scientific evidence on the effectiveness of rehabilitation approaches proposed to children with severe-to-profound prelinguistic deafness on the hearing, speech, and language skills development. Method Databases (PubMed, CINHAL, PsycInfo, Cochrane, ERIC, and EMBASE) were searched with relevant key words (children, deafness, rehabilitation approach, auditory, speech, and language). Studies published between 2000 and 2017 were included. The methodological quality of the studies was evaluated with the Quality Assessment Tool for Quantitative Studies, and the level of evidence was evaluated with the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Every step of the selection and analysis was made by 2 independent judges. Results Of 1,739 articles listed in different databases, 38 met the inclusion criteria and were selected for analysis. The majority of included articles present a relatively low level of evidence. Rehabilitation approaches that do not include signs appear more frequently associated with a better auditory, speech, and language development, except for receptive language, than approaches that included any form of signs. Conclusion More robust studies are needed to decide on the approach to prioritize with severe-to-profound deaf children.
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Affiliation(s)
- Dominique Demers
- Rehabilitation Department, Faculty of Medicine, Université Laval, Québec, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Canada
| | - François Bergeron
- Rehabilitation Department, Faculty of Medicine, Université Laval, Québec, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Canada
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Goodwin C, Lillo-Martin D. Morphological Accuracy in the Speech of Bimodal Bilingual Children with CIs. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2019; 24:435-447. [PMID: 31063195 PMCID: PMC6786513 DOI: 10.1093/deafed/enz019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/19/2019] [Accepted: 04/17/2019] [Indexed: 05/29/2023]
Abstract
Sign language use in the (re)habilitation of children with cochlear implants (CIs) remains a controversial issue. Concerns that signing impedes spoken language development are based on research comparing children exposed to spoken and signed language (bilinguals) to children exposed only to speech (monolinguals), although abundant research demonstrates that bilinguals and monolinguals differ in language development. We control for bilingualism effects by comparing bimodal bilingual (signing-speaking) children with CIs (BB-CI) to those with typical hearing (BB-TH). Each child had at least one Deaf parent and was exposed to ASL from birth. The BB-THs were exposed to English from birth by hearing family members, while the BB-CIs began English exposure after cochlear implantation around 22-months-of-age. Elicited speech samples were analyzed for accuracy of English grammatical morpheme production. Although there was a trend toward lower overall accuracy in the BB-CIs, this seemed driven by increased omission of the plural -s, suggesting an exaggerated role of perceptual salience in this group. Errors of commission were rare in both groups. Because both groups were bimodal bilinguals, trends toward group differences were likely caused by delayed exposure to spoken language or hearing through a CI, rather than sign language exposure.
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Wass M, Anmyr L, Lyxell B, Östlund E, Karltorp E, Löfkvist U. Predictors of Reading Comprehension in Children With Cochlear Implants. Front Psychol 2019; 10:2155. [PMID: 31607988 PMCID: PMC6769823 DOI: 10.3389/fpsyg.2019.02155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/06/2019] [Indexed: 11/24/2022] Open
Abstract
Children with a profound hearing loss who have been implanted with cochlear implants (CI), vary in terms of their language and reading skills. Some of these children have strong language skills and are proficient readers whereas others struggle with language and both the decoding and comprehension aspects of reading. Reading comprehension is dependent on a number of skills where decoding, spoken language comprehension and receptive vocabulary have been found to be the strongest predictors of performance. Children with CI have generally been found to perform more poorly than typically hearing peers on most predictors of reading comprehension including word decoding, vocabulary and spoken language comprehension, as well as working memory. The purpose of the current study was to investigate the relationships between reading comprehension and a number of predictor variables in a sample of twenty-nine 11–12-year-old children with profound hearing loss, fitted with CI. We were particularly interested in the extent to which reading comprehension in children with CI at this age is dependent on decoding and receptive vocabulary. The predictor variables that we set out to study were word decoding, receptive vocabulary, phonological skills, and working memory. A second purpose was to explore the relationships between reading comprehension and demographic factors, i.e., parental education, speech perception and age of implantation. The results from these 29 children indicate that receptive vocabulary is the most influential predictor of reading comprehension in this group of children although phonological decoding is, of course, fundamental.
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Affiliation(s)
- Malin Wass
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, Luleå, Sweden
| | - Lena Anmyr
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Social Work in Health, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Lyxell
- Department of Special Needs Education, University of Oslo, Oslo, Norway.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Elisabet Östlund
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Karltorp
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrika Löfkvist
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Special Needs Education, University of Oslo, Oslo, Norway
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Bilateral Cochlear Implants: Maximizing Expected Outcomes. J Dev Behav Pediatr 2019; 39:177-179. [PMID: 29324475 DOI: 10.1097/dbp.0000000000000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Sonia is a 4 years 1 month-year-old girl with Waardenburg syndrome and bilateral sensorineural hearing loss who had bilateral cochlear implants at 2 years 7 months years of age. She is referred to Developmental-Behavioral Pediatrics by her speech/language pathologist because of concerns that her language skills are not progressing as expected after the cochlear implant. At the time of the implant, she communicated using approximately 20 signs and 1 spoken word (mama). At the time of the evaluation (18 months after the implant) she had approximately 70 spoken words (English and Spanish) and innumerable signs that she used to communicate. She could follow 1-step directions in English but had more difficulty after 2-step directions.Sonia was born in Puerto Rico at 40 weeks gestation after an uncomplicated pregnancy. She failed her newborn hearing test and was given hearing aids that did not seem to help.At age 2 years, Sonia, her mother, and younger sister moved to the United States where she was diagnosed with bilateral severe-to-profound hearing loss. Genetic testing led to a diagnosis of Waardenburg syndrome (group of genetic conditions that can cause hearing loss and changes in coloring [pigmentation] of the hair, skin, and eyes). She received bilateral cochlear implants 6 months later.Sonia's mother is primarily Spanish-speaking and mostly communicates with her in Spanish or with gestures but has recently begun to learn American Sign Language (ASL). In a preschool program at a specialized school for the deaf, Sonia is learning both English and ASL. Sonia seems to prefer to use ASL to communicate.Sonia receives speech and language therapy (SLT) 3 times per week (90 minutes total) individually in school and once per week within a group. She is also receiving outpatient SLT once per week. Therapy sessions are completed in English, with the aid of an ASL interpreter. Sonia's language scores remain low, with her receptive skills in the first percentile, and her expressive skills in the fifth percentile.During her evaluation in Developmental and Behavioral Pediatrics, an ASL interpreter was present, and the examiner is a fluent Spanish speaker. Testing was completed through a combination of English, Spanish, and ASL. Sonia seemed to prefer ASL to communicate, although she used some English words with errors of pronunciation. On the Beery Visual-Motor Integration Test, she obtained a standard score of 95. Parent and teacher rating scales were not significant for symptoms of attention-deficit/hyperactivity disorder.What factors are contributing to her slow language acquisition and how would you modify her treatment plan?
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Mastrantuono E, Burigo M, Rodríguez-Ortiz IR, Saldaña D. The Role of Multiple Articulatory Channels of Sign-Supported Speech Revealed by Visual Processing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1625-1656. [PMID: 31095442 DOI: 10.1044/2019_jslhr-s-17-0433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The use of sign-supported speech (SSS) in the education of deaf students has been recently discussed in relation to its usefulness with deaf children using cochlear implants. To clarify the benefits of SSS for comprehension, 2 eye-tracking experiments aimed to detect the extent to which signs are actively processed in this mode of communication. Method Participants were 36 deaf adolescents, including cochlear implant users and native deaf signers. Experiment 1 attempted to shift observers' foveal attention to the linguistic source in SSS from which most information is extracted, lip movements or signs, by magnifying the face area, thus modifying lip movements perceptual accessibility (magnified condition), and by constraining the visual field to either the face or the sign through a moving window paradigm (gaze contingent condition). Experiment 2 aimed to explore the reliance on signs in SSS by occasionally producing a mismatch between sign and speech. Participants were required to concentrate upon the orally transmitted message. Results In Experiment 1, analyses revealed a greater number of fixations toward the signs and a reduction in accuracy in the gaze contingent condition across all participants. Fixations toward signs were also increased in the magnified condition. In Experiment 2, results indicated less accuracy in the mismatching condition across all participants. Participants looked more at the sign when it was inconsistent with speech. Conclusions All participants, even those with residual hearing, rely on signs when attending SSS, either peripherally or through overt attention, depending on the perceptual conditions. Supplemental Material https://doi.org/10.23641/asha.8121191.
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Affiliation(s)
- Eliana Mastrantuono
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Spain
| | - Michele Burigo
- Cognitive Interaction Technology, University of Bielefeld, Germany
| | | | - David Saldaña
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Spain
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Ching TY, Scarinci N, Marnane V, Sjahalam-King J, Button L, Whitfield J. Factors influencing parents' decisions about communication choices during early education of their child with hearing loss: a qualitative study. DEAFNESS & EDUCATION INTERNATIONAL : THE JOURNAL OF THE BRITISH ASSOCIATION OF TEACHERS OF THE DEAF 2018; 20:154-181. [PMID: 30872975 PMCID: PMC6411083 DOI: 10.1080/14643154.2018.1512393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To explore the factors influencing parents' choice of communication mode during early education of their child with hearing loss. DESIGN Qualitative descriptive analysis of semi-structured interviews of parents of children with hearing loss. STUDY SAMPLE Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. RESULTS Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents' preferred outcomes for their children drive their choices; (3) child's preference and proficiency drive parental choice; and (4) parents' fears and worries influence decisions. Parents required unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. They required continual support for implementation of their choices as they adjusted to their children's changing needs. CONCLUSIONS Decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices and "future-proofing" the child's future communication options.
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Affiliation(s)
- Teresa Yc Ching
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | | - Vivienne Marnane
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | | - Laura Button
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
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Hall ML, Eigsti IM, Bortfeld H, Lillo-Martin D. Executive Function in Deaf Children: Auditory Access and Language Access. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1970-1988. [PMID: 30073268 PMCID: PMC6198917 DOI: 10.1044/2018_jslhr-l-17-0281] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/28/2017] [Accepted: 04/17/2018] [Indexed: 05/04/2023]
Abstract
Purpose Deaf children are frequently reported to be at risk for difficulties in executive function (EF); however, the literature is divided over whether these difficulties are the result of deafness itself or of delays/deficits in language that often co-occur with deafness. The purpose of this study is to discriminate these hypotheses by assessing EF in populations where the 2 accounts make contrasting predictions. Method We use a between-groups design involving 116 children, ages 5-12 years, across 3 groups: (a) participants with normal hearing (n = 45), (b) deaf native signers who had access to American Sign Language from birth (n = 45), and (c) oral cochlear implant users who did not have full access to language prior to cochlear implantation (n = 26). Measures include both parent report and performance-based assessments of EF. Results Parent report results suggest that early access to language has a stronger impact on EF than early access to sound. Performance-based results trended in a similar direction, but no between-group differences were significant. Conclusions These results indicate that healthy EF skills do not require audition and therefore that difficulties in this domain do not result primarily from a lack of auditory experience. Instead, results are consistent with the hypothesis that language proficiency, whether in sign or speech, is crucial for the development of healthy EF. Further research is needed to test whether sign language proficiency also confers benefits to deaf children from hearing families.
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Affiliation(s)
- Matthew L. Hall
- Department of Psychology, University of Massachusetts Dartmouth
- Department of Linguistics, University of Connecticut, Storrs
| | | | - Heather Bortfeld
- Department of Psychological Sciences, University of California, Merced
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Humphries T, Kushalnagar P, Mathur G, Napoli DJ, Padden C, Rathmann C, Smith S. Discourses of prejudice in the professions: the case of sign languages. JOURNAL OF MEDICAL ETHICS 2017; 43:648-652. [PMID: 28280057 PMCID: PMC5827712 DOI: 10.1136/medethics-2015-103242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 09/15/2016] [Accepted: 02/13/2017] [Indexed: 05/29/2023]
Abstract
There is no evidence that learning a natural human language is cognitively harmful to children. To the contrary, multilingualism has been argued to be beneficial to all. Nevertheless, many professionals advise the parents of deaf children that their children should not learn a sign language during their early years, despite strong evidence across many research disciplines that sign languages are natural human languages. Their recommendations are based on a combination of misperceptions about (1) the difficulty of learning a sign language, (2) the effects of bilingualism, and particularly bimodalism, (3) the bona fide status of languages that lack a written form, (4) the effects of a sign language on acquiring literacy, (5) the ability of technologies to address the needs of deaf children and (6) the effects that use of a sign language will have on family cohesion. We expose these misperceptions as based in prejudice and urge institutions involved in educating professionals concerned with the healthcare, raising and educating of deaf children to include appropriate information about first language acquisition and the importance of a sign language for deaf children. We further urge such professionals to advise the parents of deaf children properly, which means to strongly advise the introduction of a sign language as soon as hearing loss is detected.
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Affiliation(s)
- Tom Humphries
- Emeritus, Education Studies and Department of Communication, University of California at San Diego, La Jolla, California, USA
| | | | - Gaurav Mathur
- Department of Linguistics and Dean, Graduate School and Continuing Studies, Gallaudet University, Washington, DC, USA
| | - Donna Jo Napoli
- Department of Linguistics, Swarthmore College, Swarthmore, Pennsylvania, USA
| | - Carol Padden
- Division of Social Sciences, Department of Communication and Dean, University of California at San Diego, La Jolla, California, USA
| | - Christian Rathmann
- Section Deaf Studies and Sign Language Interpreting Humboldt-Universität, Berlin, Germany
| | - Scott Smith
- Office of the President, National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, New York, USA
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Hall WC. What You Don't Know Can Hurt You: The Risk of Language Deprivation by Impairing Sign Language Development in Deaf Children. Matern Child Health J 2017; 21:961-965. [PMID: 28185206 DOI: 10.1007/s10995-017-2287-y] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A long-standing belief is that sign language interferes with spoken language development in deaf children, despite a chronic lack of evidence supporting this belief. This deserves discussion as poor life outcomes continue to be seen in the deaf population. This commentary synthesizes research outcomes with signing and non-signing children and highlights fully accessible language as a protective factor for healthy development. Brain changes associated with language deprivation may be misrepresented as sign language interfering with spoken language outcomes of cochlear implants. This may lead to professionals and organizations advocating for preventing sign language exposure before implantation and spreading misinformation. The existence of one-time-sensitive-language acquisition window means a strong possibility of permanent brain changes when spoken language is not fully accessible to the deaf child and sign language exposure is delayed, as is often standard practice. There is no empirical evidence for the harm of sign language exposure but there is some evidence for its benefits, and there is growing evidence that lack of language access has negative implications. This includes cognitive delays, mental health difficulties, lower quality of life, higher trauma, and limited health literacy. Claims of cochlear implant- and spoken language-only approaches being more effective than sign language-inclusive approaches are not empirically supported. Cochlear implants are an unreliable standalone first-language intervention for deaf children. Priorities of deaf child development should focus on healthy growth of all developmental domains through a fully-accessible first language foundation such as sign language, rather than auditory deprivation and speech skills.
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Affiliation(s)
- Wyatte C Hall
- Clinical & Translational Science Institute, University of Rochester Medical Center, Rochester, NY, USA.
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36
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White KR, Cooper LZ. Opportunities and Shared Decision-Making to Help Children Who Are Deaf to Communicate. Pediatrics 2017; 140:peds.2017-1287. [PMID: 28759420 DOI: 10.1542/peds.2017-1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Karl R White
- Department of Psychology, Utah State University, Logan, Utah; and
| | - Louis Z Cooper
- Department of Pediatrics, Columbia University, New York, New York
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37
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Geers AE, Mitchell CM, Warner-Czyz A, Wang NY, Eisenberg LS. Early Sign Language Exposure and Cochlear Implantation Benefits. Pediatrics 2017; 140:peds.2016-3489. [PMID: 28759398 PMCID: PMC5495521 DOI: 10.1542/peds.2016-3489] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Most children with hearing loss who receive cochlear implants (CI) learn spoken language, and parents must choose early on whether to use sign language to accompany speech at home. We address whether parents' use of sign language before and after CI positively influences auditory-only speech recognition, speech intelligibility, spoken language, and reading outcomes. METHODS Three groups of children with CIs from a nationwide database who differed in the duration of early sign language exposure provided in their homes were compared in their progress through elementary grades. The groups did not differ in demographic, auditory, or linguistic characteristics before implantation. RESULTS Children without early sign language exposure achieved better speech recognition skills over the first 3 years postimplant and exhibited a statistically significant advantage in spoken language and reading near the end of elementary grades over children exposed to sign language. Over 70% of children without sign language exposure achieved age-appropriate spoken language compared with only 39% of those exposed for 3 or more years. Early speech perception predicted speech intelligibility in middle elementary grades. Children without sign language exposure produced speech that was more intelligible (mean = 70%) than those exposed to sign language (mean = 51%). CONCLUSIONS This study provides the most compelling support yet available in CI literature for the benefits of spoken language input for promoting verbal development in children implanted by 3 years of age. Contrary to earlier published assertions, there was no advantage to parents' use of sign language either before or after CI.
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Affiliation(s)
- Ann E. Geers
- Callier Center for Communication Disorders, University of Texas at Dallas, Dallas, Texas
| | - Christine M. Mitchell
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland; and
| | - Andrea Warner-Czyz
- Callier Center for Communication Disorders, University of Texas at Dallas, Dallas, Texas
| | - Nae-Yuh Wang
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland; and
| | - Laurie S. Eisenberg
- Tina and Rick Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California
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Korver AMH, Smith RJH, Van Camp G, Schleiss MR, Bitner-Glindzicz MAK, Lustig LR, Usami SI, Boudewyns AN. Congenital hearing loss. Nat Rev Dis Primers 2017; 3:16094. [PMID: 28079113 PMCID: PMC5675031 DOI: 10.1038/nrdp.2016.94] [Citation(s) in RCA: 268] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Congenital hearing loss (hearing loss that is present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing screening programmes enable early detection; early intervention will prevent delays in speech and language development and has long-lasting beneficial effects on social and emotional development and quality of life. A diagnosis of hearing loss is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus infection, are also a common risk factor for hearing loss. Genetic causes probably account for the majority of cases in developed countries; mutations can affect any component of the hearing pathway, in particular, inner ear homeostasis (endolymph production and maintenance) and mechano-electrical transduction (the conversion of a mechanical stimulus into electrochemical activity). Once the underlying cause of hearing loss is established, it might direct therapeutic decision making and guide prevention and (genetic) counselling. Management options include specific antimicrobial therapies, surgical treatment of craniofacial abnormalities and implantable or non-implantable hearing devices. An improved understanding of the pathophysiology and molecular mechanisms that underlie hearing loss and increased awareness of recent advances in genetic testing will promote the development of new treatment and screening strategies.
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Affiliation(s)
- Anna M H Korver
- Department of Pediatrics, St Antonius Hospital, PO BOX 2500, 3430 EM Nieuwegein, The Netherlands
| | - Richard J H Smith
- Molecular Otolaryngology and Renal Research Laboratories and the Genetics PhD Program, University of Iowa, Iowa City, Iowa, USA
| | - Guy Van Camp
- Department of Medical Genetics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Mark R Schleiss
- Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Maria A K Bitner-Glindzicz
- Genetics and Genomic Medicine Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Lawrence R Lustig
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York, USA
| | - Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - An N Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
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