Science, Not Philosophy, Will Help Deaf and Hard-of-Hearing Children Reach Their Potential

Mindful Parenting: Attachment of Deaf Children and Resilience in Their Mothers

Attachment and resilience are crucial in parent-child interaction. In this study, we investigated the effect of a mindful parenting program on the attachment of deaf children and the resilience of their hearing mothers. The present study was a semi-randomized controlled trial design. Thirty mothers with deaf children were randomly selected from Deaf School in Tehran, Iran. They were randomly assigned to intervention (n = 15) and control (n = 15) groups. The intervention group participated in an eight-session mindful parenting program, while the control group did not participate in this program. Both groups completed the Kinship Center Attachment Questionnaire and Connor-Davidson Resilience Scale before and after the intervention. The data were analyzed using the repeated measures analysis of variance test. The results showed that the intervention significantly and positively influenced the attachment of deaf children and resilience in their mothers in the post-test, and the persistence of this effect was maintained in the follow-up stage (p < .001). This study suggests that mindful parenting can promote attachment of deaf children and resilience in their mothers. In addition, the mothers attested to the social validity of the program.

Deaf Children and Adolescents: Social Skills Discriminant Profile

Abstract The objectives of the study were to compare social skills among deaf children and adolescents and to outline the discriminant profile in relation to skilled social behaviors. The research had a quantitative, cross-sectional and comparative design. Seventy-one deaf people aged 7 to 16 years old participated in the study, assessed by a sociodemographic questionnaire and by the Social Skills Test for Children and Adolescents in School Situation. Results revealed that deaf adolescents have more elaborate social skills when compared to deaf children. Children have a profile related to the Conversation and Social Resourcefulness and Assertiveness while adolescents were included in the Civility and Altruism profile. These results were discussed based on the development and specificities of deafness. Future research may assess these skills beyond the school settings.

Using Propensity Score Matching to Address Clinical Questions: The Impact of Remote Microphone Systems on Language Outcomes in Children Who Are Hard of Hearing

Purpose Children who are hard of hearing (CHH) have restricted access to acoustic and linguistic information. Increased audibility provided by hearing aids influences language outcomes, but the benefits of hearing aids are often limited by acoustic factors and distance. Remote microphone (RM) systems further increase auditory access by reducing the negative consequences of these factors. The purpose of this article was to identify factors that influence likelihood of RM system receipt and to investigate the effects of RM systems in home settings on later language outcomes. We used propensity score matching to compare language outcomes between children with and without access to personal RM systems in home settings. This article provides a description of how and why to perform propensity score-matching analyses with clinical populations. Method Participants were 132 CHH. Through parent report, we identified children who received RM systems for home use by 4 years of age. Logistic regression was used to determine factors that predict likelihood of RM system receipt in home settings. Propensity score matching was conducted on a subgroup of 104 participants. Performance on language measures at age 5 years was compared across propensity-matched children who did and did not receive RMs for personal use. Results Likelihood of RM receipt was associated with degree of hearing loss, maternal education, and location (recruitment site). Comparisons between matched pairs of children with and without RM systems in early childhood indicated significantly better discourse skills for children whose families owned RM systems, but no significant differences for vocabulary or morphosyntax. Conclusion Results provide preliminary evidence that the provision of personal RM systems for preschool-age CHH enhances higher-level language skills. The propensity score-matching technique enabled us to use an observational, longitudinal data set to examine a question of clinical interest.

Mild-moderate congenital hearing loss: secular trends in outcomes across four systems of detection

BACKGROUND

Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5-8 years with congenital mild-moderate hearing loss; (ii) determine whether age of detection predicts outcomes; and (iii) compare outcomes between children identified via well-established UNHS and the general population.

METHODS

Linear regression adjusted for potential confounding factors was used throughout. Via a quasi-experimental design, language and psychosocial outcomes were compared across four population-based Australian systems of hearing loss detection: opportunistic detection, born 1991-1993, n = 50; universal risk factor referral, born 2003-2005, n = 34; newly established UNHS, born 2003-2005, n = 41; and well-established UNHS, born 2007-2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well-established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217.

RESULTS

Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild-moderate losses exposed to well-established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference -8.9 points, 95% CI -14.7 to -3.1).

CONCLUSIONS

Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing losses. However, rigorous trials are needed to quantify benefits, versus costs and potential harms, of early aiding of children with mild losses.

Language Outcomes in Children Who Are Deaf and Hard of Hearing: The Role of Language Ability Before Hearing Aid Intervention

PURPOSE

Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well understood.

METHOD

This study examined Ontario Infant Hearing Program birth cohorts to explore predictors of performance on the Preschool Language Scale-Fourth Edition at the time of (N = 47) and after (N = 19) initial hearing aid intervention.

RESULTS

Regression analyses revealed that, before the hearing aid fitting, severity of hearing loss negatively predicted 19% and 10% of the variance in auditory comprehension and expressive communication, respectively. After hearing aid fitting, children's standard scores on language measures remained stable, but they made significant improvement in their progress values, which represent individual skills acquired on the test, rather than standing relative to same-age peers. Magnitude of change in progress values was predicted by a negative interaction of prefitting language ability and severity of hearing loss for the Auditory Comprehension scale.

CONCLUSIONS

These findings highlight the importance of considering a child's prefitting language ability in interpreting eventual language outcomes. Possible mechanisms of hearing aid benefit are discussed.

SUPPLEMENTAL MATERIALS

https://doi.org/10.23641/asha.5538868.