A Cepstral Peak Prominence (CPP) Voice Analysis in Iranian Post-lingual Deaf Adult Cochlear Implant Users

OBJECTIVE

In standardized connected speech samples, cepstral peak prominence (CPP) and smoothed CPP (CPPS) have been described as accurate parameters to evaluate voice quality. Lack of normal auditory feedback in post-lingually deaf CI users might influence tuning the acoustic parameters in speech production. Based on shreds of evidence, normal hearing results in suitable vocal control through the sensory-motor linkage. The main aim of the present study was to compare the cepstral values between the Iranian cochlear implant group and normal peers.

METHOD

Persian CAPE-V sentences were recorded from 30 CI users and 30 healthy speakers (mean age=36.7 years, SD=13.5, range=18-60 years). Thirteen /a/vowels were extracted manually from syllables. Each subject phonated sustained /a/vowel for 5 seconds. PRAAT was used to calculate CPP and CPPS. To compare two age- and gender-matched groups, the independent sample t-test was applied. Then, ANCOVA was used to assess the impact of demographic factors on cepstral scores in CI participants.

RESULTS

Significant differences between the CI group and normal peers were discovered based on CPP and CPPS in both tasks (reading sentences and sustained vowel) (P < 0.05). Overall, CI users showed higher cepstral values. The implanted ear and prosthesis model had no significant impact on both CPP and CPPS (P ≥ 0.8).

CONCLUSION

Higher CPP and CPPS values in the CI users might be due to increased phonatory instability and spectral noise, with the possibility of decreased vocal control and its quality. The outcome suggests that CI group uses a different voice control strategy. These findings should be kept in mind for intervention methods, especially by assessing vocal characteristics and considering the voice quality in adult CI users.

Evaluation of adjustment behaviour in a semi-supervised self-adjustment fine-tuning procedure for hearing aids

OBJECTIVE

This study investigated the adjustment behaviour of hearing aid (HA) users participating in a semi-supervised self-adjustment fine-tuning procedure for HAs. The aim was to link behaviour with the reproducibility and duration of the adjustments.

DESIGN

Participants used a two-dimensional user interface to identify their HA gain preferences while listening to realistic sound scenes presented in a laboratory environment. The interface allowed participants to adjust amplitude (vertical axis) and spectral slope (horizontal axis) simultaneously. Participants were clustered according to their interaction with the user interface, and their search directions were analysed.

STUDY SAMPLE

Twenty older experienced HA users were invited to participate in this study.

RESULTS

We identified four different archetypes of adjustment behaviour (curious, cautious, semi-browsing, and full-on browsing) by analysing the trace points of all measurements for each participant. Furthermore, participants used predominantly horizontal or vertical paths when searching for their preference. Neither the archetype, nor the search directions, nor the participants' technology commitment was predictive of the reproducibility or the adjustment duration.

CONCLUSIONS

The findings suggest that enforcement of a specific adjustment behaviour or search direction is not necessary to obtain fast, reliable self-adjustments. Furthermore, no strict requirements with respect to technology commitment are necessary.

Simplified cochlear frequency selectivity assessment in normal-hearing and hearing-impaired listeners

OBJECTIVE

The ear's spectral resolution or frequency selectivity (FS) is a fundamental aspect of hearing but is not routinely measured in clinical practice. This study evaluated a simplified FS testing procedure for clinical use by replacing the time-consuming two-interval forced choice (2IFC) method with method of limits (MOL) carried out using a custom-made software and consumer-grade equipment.

DESIGN AND STUDY SAMPLE

Study 1 compared the FS measure obtained with MOL and 2IFC procedure at two centre frequencies (CFs) (1 and 4 kHz) in 21 normal-hearing listeners. Study 2 determined the FS measure using MOL at five CFs (0.5-8 kHz) in 32 normal-hearing and nine sensorineural hearing loss listeners and compared them with their thresholds in quiet.

RESULTS

FS measurements with MOL and 2IFC methods were highly correlated and had statistically comparable intra-subject test-retest reliability. FS measures determined with MOL were reduced in the hearing-impaired compared to normal-hearing listeners at the CF corresponding to their hearing loss. Linear regression analysis showed significant relationship between FS deterioration and quiet threshold loss (p < 0.0001, R2 = 0.56).

CONCLUSIONS

The simplified and affordable FS testing method can be used alongside audiometry to provide additional information about the cochlear function.

Identity change of late-deafened adults after receiving cochlear implants

PURPOSE

The aim of this research was to understand how adults reconceptualise their identity when experiencing hearing loss as an adult, and how their identity might change with a cochlear implant.

MATERIALS AND METHODS

Using an online survey administered through cochlear implant social media groups, with follow-up semi-structured interviews, participants answered questions about their hearing loss and cochlear implant experiences. Forty-four people answered the survey and 16 participated in an in-depth interview. All were older than 18 years, once had heard, became deafened in adulthood and had at least one cochlear implant.

RESULTS

The decision to have a cochlear implant often meant acknowledging they were no longer a hearing person. After having an implant four themes emerged. (1) Some participants maintained a hearing identity through hearing loss and after cochlear implantation, while others returned to their hearing identity. (2) Others acknowledged a confused identity, neither deaf nor hearing. In unexpected findings, (3) during the progression of hearing loss, some participants had identified as hearing but could not hear, however after implantation, they became deaf people who could hear. (4) Furthermore, after implantation, some participants identified as disabled when they had not done so when less able to hear.

CONCLUSION

Given the prevalence of hearing loss in later life, it is important to understand the way these adults understand their identity through the progression of hearing loss and after becoming cochlear implant recipients. The belief people have of themselves impacts healthcare choices and affects their commitment to ongoing rehabilitation.

Evaluation of the American English Matrix Test with Cochlear Implant Recipients

OBJECTIVE

Currently, the variety of speech recognition tests used to evaluate cochlear implant (CI) recipients makes it difficult to compare results, especially across languages. The Matrix Test limits contextual cues and is available in multiple languages, including American English. The current study investigated test format and noise type for the American English Matrix Test (AMT) and compared results to AzBio sentence scores in adult CI recipients.

DESIGN

Fifteen experienced CI recipients were administered the AMT in fixed- and adaptive-level formats and AzBio sentences in a fixed-level format. Testing in noise used the AMT-specific noise and 4-talker babble.

RESULTS

Ceiling effects were present for all AMT fixed-level conditions and AzBio sentences in quiet. Group mean AzBio scores were poorer than AMT scores. Noise type affected performance regardless of format; 4-talker babble was more challenging.

CONCLUSIONS

The limited number of word choices in each category likely aided listeners performance for the AMT compared to AzBio sentences. The use of the AMT in the designed adaptive-level format would allow effective evaluation and comparison of CI performance internationally. A test battery with the AMT may also benefit from including AzBio sentences in 4-talker babble to reflect performance during listening challenges.

Two are better than one: Differences in cortical EEG patterns during auditory and visual verbal working memory processing between Unilateral and Bilateral Cochlear Implanted children

Despite the proven effectiveness of cochlear implant (CI) in the hearing restoration of deaf or hard-of-hearing (DHH) children, to date, extreme variability in verbal working memory (VWM) abilities is observed in both unilateral and bilateral CI user children (CIs). Although clinical experience has long observed deficits in this fundamental executive function in CIs, the cause to date is still unknown. Here, we have set out to investigate differences in brain functioning regarding the impact of monaural and binaural listening in CIs compared with normal hearing (NH) peers during a three-level difficulty n-back task undertaken in two sensory modalities (auditory and visual). The objective of this pioneering study was to identify electroencephalographic (EEG) marker pattern differences in visual and auditory VWM performances in CIs compared to NH peers and possible differences between unilateral cochlear implant (UCI) and bilateral cochlear implant (BCI) users. The main results revealed differences in theta and gamma EEG bands. Compared with hearing controls and BCIs, UCIs showed hypoactivation of theta in the frontal area during the most complex condition of the auditory task and a correlation of the same activation with VWM performance. Hypoactivation in theta was also observed, again for UCIs, in the left hemisphere when compared to BCIs and in the gamma band in UCIs compared to both BCIs and NHs. For the latter two, a correlation was found between left hemispheric gamma oscillation and performance in the audio task. These findings, discussed in the light of recent research, suggest that unilateral CI is deficient in supporting auditory VWM in DHH. At the same time, bilateral CI would allow the DHH child to approach the VWM benchmark for NH children. The present study suggests the possible effectiveness of EEG in supporting, through a targeted approach, the diagnosis and rehabilitation of VWM in DHH children.

Assessing parent-child interaction with deaf and hard of hearing infants aged 0-3 years: An international multi-professional e-Delphi

INTRODUCTION

Most deaf babies are born to hearing families who do not yet have the skills to communicate effectively with their child. Adaptations to communication are important because the quality of parent-child interaction (PCI) predicts how a deaf child develops language. Teachers of Deaf children and Speech and Language Therapists support families with communication in the home. Currently, there are no assessments that appraise how a parent interacts with their deaf baby. Previous research has identified which parent behaviours and approaches are used in PCI assessments in research and practice. The current paper forms consensus on the core content and best practices of a new PCI tool for deaf children aged 0-3 years.

METHODS

An international sample of expert academics and practitioners (n = 83) were recruited to take part in a two-round modified electronic Delphi study. Participants were presented with 69 statements focusing on (i) which parent behaviours were important in assessment (ii) the methods to be used in PCI assessment. Participants rated the extent to which they agreed or disagreed with each statement on a five-point Likert scale and gave comments to support their response. Consensus was defined as >80% of participants rating the statement as a (4) 'highly important' or a (5) 'essential'. If consensus was not reached, participant comments were used to generate new statements which were rated in the second round. This project involved a patient and public involvement (PPI) group of hearing and deaf parents and professionals to design and guide the study.

RESULTS

Consensus was achieved on 52 statements and ranged from 80-99%. A further six statements were additionally included. Within the 58 statements included, 36 were parent behaviours which centred on the parent's observation of, and response to, their child's behaviour and/or language. The remaining 22 statements focused on methods used in the assessment such as parents having their PCI filmed, parents having the opportunity to review the video and assess themselves alongside a professional, and parents being involved in subsequent goal setting.

CONCLUSIONS

This e-Delphi presented the parent behaviours and methods of assessment to be included in a new PCI tool for deaf children. Future co-production work and acceptability and feasibility testing are discussed.

Emotion recognition and false belief in deaf or hard-of-hearing preschool children

This study aims to examine emotion recognition and false belief performances of 4-5-year-old (48-71 months) deaf or hard-of-hearing (DHH) children. The performances have been assessed using the Turkish Version of the Theory of Mind Task Battery for Children. The DHH children have been continuing schooling in inclusive settings with an auditory-oral approach. The emotion recognition performances of hearing children (n = 100) and DHH (n = 100) children have appeared to be similar. The ANOVA analysis has revealed that the groups do not differ concerning false belief performances between the ages of 4 and 5.5. However, from the age of 5.5, hearing children have performed better than DHH children. According to correlation analysis, parental education has been determined as a remarkable factor in DHH children's false belief development. The findings point to the need for research across a wide range of ages to better understand the developmental course of false belief in DHH children.

Deaf perceptions about treatment for alcohol use and mental health

INTRODUCTION

Recent research suggests that alcohol use disorder may be more prevalent in the Deaf community, a diverse sociolinguistic minority group. However, rates of treatment-seeking among Deaf individuals are even lower than in the general society. This study used the Theory of Planned Behavior to identify Deaf adults' beliefs about treatment that may prevent their treatment-seeking behaviors.

METHODS

This study conducted elicitation interviews with 16 Deaf adults. The study team recruited participants from across the U.S. and conducted interviews on Zoom. Participant ages ranged from 27 to 67 years (M = 40, SD =10.8). Seventy-five percent of the sample was male, 75 % were White, and 12.5 % were Hispanic/Latine. The study conducted interviews in American Sign Language, subsequently interpreted into English by a nationally certified interpreter, and transcribed for data analyses. The study analyzed transcripts using the Framework Method. The study team coded the interviews in groups and assessed for saturation (≤ 5 % new themes) of themes throughout the analysis. This study reached saturation in the third group (six total groups).

RESULTS

Identified themes followed the Theory of Planned Behavior constructs. The study identified nine Behavioral Beliefs with four advantages and five disadvantages of seeking treatment, four Normative Beliefs with one support and three oppositions to seeking treatment, and thirteen Control Beliefs with five facilitators and eight barriers to seeking treatment. Overall, the Deaf participants reported several unique beliefs based on their cultural and linguistic perspectives, including a concern about unqualified providers, experiencing stress in treatment with hearing providers, stigma within the Deaf community, less access to cultural information about alcohol and mental health, less encouragement of traditional treatment in marginalized communities, and additional barriers (e.g., communication, limited Deaf treatment options, discrimination, etc.).

CONCLUSIONS

A thorough understanding of individual beliefs about treatment is necessary to develop interventions that may increase treatment-seeking behaviors. Previous research has demonstrated that individual beliefs may be modified using Cognitive Behavioral Therapy techniques to increase treatment-seeking behaviors among hearing individuals. Similar interventions may be useful with Deaf individuals; however, they must consider the unique cultural and linguistic perspectives of the community.

Factors that influence health service access in deaf and hard-of-hearing children: a narrative review

OBJECTIVES

Early diagnosis and intervention of deaf and hard-of-hearing (DHH) children leads to improved language and psychosocial outcomes. However, many child, parent and provider related factors can influence access to early intervention services, including hearing devices. This narrative review aims to explore factors that influence health service access in DHH children.

DESIGN

A systematic search was conducted to identify articles that explored factors that influenced health service access in DHH children in countries with Universal Newborn Hearing Screening, published between 2010 and 2022.

STUDY SAMPLES

Fifty-nine articles met the inclusion criteria for data extraction. This included 4 systematic reviews, 2 reviews, 39 quantitative and 5 mixed methods studies and 9 qualitative studies.

RESULTS

The identified factors were grouped into the following themes: (a) demographic factors, (b) family related factors, (c) child related factors, (d) factors specific to hearing devices, (e) service delivery, f) telehealth and (g) COVID-19.

CONCLUSION

This review provided a comprehensive summary of multiple factors that affect access to health services in DHH children. Psychosocial support, consistent clinical advice, allocation of resources to rural communities and use of telehealth are possible ways to address barriers and improve health service access.

Focusing on Positive Listening Experiences Improves Speech Intelligibility in Experienced Hearing Aid Users

Negativity bias is a cognitive bias that results in negative events being perceptually more salient than positive ones. For hearing care, this means that hearing aid benefits can potentially be overshadowed by adverse experiences. Research has shown that sustaining focus on positive experiences has the potential to mitigate negativity bias. The purpose of the current study was to investigate whether a positive focus (PF) intervention can improve speech-in-noise abilities for experienced hearing aid users. Thirty participants were randomly allocated to a control or PF group (N = 2 × 15). Prior to hearing aid fitting, all participants filled out the short form of the Speech, Spatial and Qualities of Hearing scale (SSQ12) based on their own hearing aids. At the first visit, they were fitted with study hearing aids, and speech-in-noise testing was performed. Both groups then wore the study hearing aids for two weeks and sent daily text messages reporting hours of hearing aid use to an experimenter. In addition, the PF group was instructed to focus on positive listening experiences and to also report them in the daily text messages. After the 2-week trial, all participants filled out the SSQ12 questionnaire based on the study hearing aids and completed the speech-in-noise testing again. Speech-in-noise performance and SSQ12 Qualities score were improved for the PF group but not for the control group. This finding indicates that the PF intervention can improve subjective and objective hearing aid benefits.

On the Feasibility of Using Behavioral Listening Effort Test Methods to Evaluate Auditory Performance in Cochlear Implant Users

Realistic outcome measures that reflect everyday hearing challenges are needed to assess hearing aid and cochlear implant (CI) fitting. Literature suggests that listening effort measures may be more sensitive to differences between hearing-device settings than established speech intelligibility measures when speech intelligibility is near maximum. Which method provides the most effective measurement of listening effort for this purpose is currently unclear. This study aimed to investigate the feasibility of two tests for measuring changes in listening effort in CI users due to signal-to-noise ratio (SNR) differences, as would arise from different hearing-device settings. By comparing the effect size of SNR differences on listening effort measures with test-retest differences, the study evaluated the suitability of these tests for clinical use. Nineteen CI users underwent two listening effort tests at two SNRs (+4 and +8 dB relative to individuals' 50% speech perception threshold). We employed dual-task paradigms-a sentence-final word identification and recall test (SWIRT) and a sentence verification test (SVT)-to assess listening effort at these two SNRs. Our results show a significant difference in listening effort between the SNRs for both test methods, although the effect size was comparable to the test-retest difference, and the sensitivity was not superior to speech intelligibility measures. Thus, the implementations of SVT and SWIRT used in this study are not suitable for clinical use to measure listening effort differences of this magnitude in individual CI users. However, they can be used in research involving CI users to analyze group data.

Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language

INTRODUCTION

This study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL - psychosocial, deafness/hearing and communication related, and sociodemographic.

METHODS

The participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I-Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ).

RESULTS

The SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL.

CONCLUSIONS

Prelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.

Deaf and hearing children: A comparison of face perception

Deaf and hearing adults perceive faces differently. This study investigates whether these differences are acquired during childhood development. We characterized facial perception in deaf and hearing children aged 7-17 using a perceptual discrimination task. Configural and featural information was manipulated in the eye and mouth facial regions. Participants were asked whether two faces presented simultaneously were different. Deaf and hearing children performed better in featural than configural discriminations and in mouth than eye discriminations. Compared with children with typical hearing, deaf children performed better in featural and mouth judgments but had longer reaction times with strongest effects at 7-8 and 13-14 years old. Type and location contributed jointly in deaf children's face perception with different configural but similar featural discriminations in mouth and eye locations. However, children with typical hearing showed different featural and configural judgments in both locations. Thus, featural and configural information effects on location processing differ between the two groups.

Voices of Young Deaf Adults: Supporting Adolescent Social Capital Development

For most young people, social capital plays an important role in transitioning to postsecondary education and employment. For youth who are deaf or hard of hearing (DHH), social capital can mitigate negative effects of challenges they will likely encounter after high school. In phase 2 of a two-phase qualitative study in Australia, we investigated DHH young adults' perspectives on how DHH adolescents could best be supported to develop and use social capital to benefit their postschool transition. Nine university students whose primary communication mode was spoken language participated in semistructured interviews, discussing practical ways educators and families could assist DHH high school students. We close by recommending ways schools and families can facilitate social capital development of DHH adolescents in preparation for postsecondary education and employment. Importantly, this research gives voice to young DHH adults with the objective of improving DHH adolescents' outcomes.

Virtual Assessment of Deaf and Hard of Hearing Students in the Schools

The COVID-19 pandemic placed stress on all aspects of the educational system. Many state departments of education acknowledged the disruption to individualized education program evaluation and implementation but insisted that evaluation timelines and services continue undisrupted. School psychologists were therefore forced to navigate the viability of virtual assessment without established research supporting this type of student evaluation. Formal assessments used in the identification of learning disabilities and other areas of disability were not standardized with virtual administration procedures; however, many test publishers have offered guidelines for online administration. These guidelines may not be suitable for test administration with deaf and hard of hearing (DHH) children. Through the presentation of two case studies, this article explores some of the available administration guidelines and evaluates their appropriateness for use with DHH children. Information in this article informs current practice of school psychology in a virtual environment.

Prevalence of Educationally Significant Disabilities Among Deaf and Hard of Hearing Students

Deaf and hard of hearing (d/DHH) students are often labeled with one or more educationally significant disabilities in addition to their hearing loss. According to the Gallaudet Research Institution's most recent Annual Survey of Deaf and Hard of Hearing Children and Youth (2013), almost 40% of d/DHH students nationwide receive special education services for one or more comorbid disabilities. However, relatively few prevalence rate estimates have been published over the last decade. Knowledge regarding the current prevalence of educationally significant disabilities among d/DHH students is therefore limited. The present study surveyed teachers of the deaf and hard of hearing (TODHHs) in a midwestern state regarding the number of d/DHH students on their caseloads with one or more comorbid disabilities. Within the sample population (N = 451), nearly 65% were reported to receive special education services for disabilities other than deafness or hearing impairment.

Explicating the Relationship Between ASL and English in Text Comprehension

The discussion on the role of American Sign Language (ASL) in deaf students' reading development has been long and contentious. The students' limited knowledge of English has been commonly perceived as a culprit in making reading difficult. However, a more nuanced explanation of reading performance and its relationship with competence in ASL's potential role is needed. In the present study, multivariate analyses of the variance in the ASL and English comprehension performance of 91 middle school students at an ASL-English bilingual school revealed some important insights. Inference-making skills in ASL are an important predictor. For the students with hearing parents, the quality of communicative access at home contributed significantly to the overall explanation of the variance in English passage comprehension; along with the age at exposure to ASL, it accounted for a large part of the variance in the ASL passage comprehension.

Invited Article-It's Time to Rethink Our Future: "Radical" Perspectives on Deaf Education in the United States and Beyond

The language wars have driven decision-making and educational options for D/deaf and hard of hearing children for over a century, yet we still have not made sufficient progress in closing the linguistic and educational gaps between D/deaf and hard of hearing children and their hearing peers. Perhaps it is time to abandon the bifurcated approach that has driven our field since the infamous Milan Conference of 1880. This commentary explores how a "Radical Middle" approach can frame the way we prepare teachers of the deaf, how we conduct and disseminate research, how we support families, and how the D/deaf and hearing communities can work together in positive and proactive ways. There is strength in unity. We are stronger as a field when we come together to support one another and find ways for collaboration and partnership across philosophical lines and communication preference.

The Effects of American Sign Language on English Reading Proficiency

The authors examine the effects of American Sign Language (ASL) on English reading achievement and English reading comprehension. A systematic review of relevant primary research and research-integrated journal articles was conducted. Based on interpretations of a few salient articles and other sources (e.g., books) selected in a professional review, background on the ASL-English situation is provided. The authors discuss whether the findings reflect a pattern or suggest instructional implications for improving English reading comprehension. Also discussed is whether the findings are confounded by a lack of desirable research characteristics associated with sample sociodemography, teacher-student interactions, or school environment. The article concludes with recommendations for further research to examine the merits of ASL-English approaches or bilingual programs, focusing on improvement of the English reading skills of d/Deaf and hard of hearing children and adolescents.

Chinese Grammatical Development of Deaf and Hard of Hearing Children in a Sign Bilingualism and Coenrollment Program

The literacy development of d/Deaf and hard of hearing (d/Dhh) children has always been a matter of grave concern among educators, and grammatical knowledge is said to constitute a major component such development. The present article reports on a study that examined the development of Chinese grammar among groups of d/Dhh and hearing children who received education through a sign bilingualism and coenrollment (SLCO) approach. Findings from administration of a prestandardized assessment tool showed that while the d/Dhh children generally lagged behind their hearing peers at all levels, the gap began to narrow from Primary 2 onward, and they caught up with their hearing peers in most except for a few grammatical constructions by Primary 4. Qualitative analysis revealed a similar developmental profile and similar degrees of difficulty in mastering the more complex constructions in written Chinese between the two groups of children.

Spoken Language Bilingualism in the Education of Deaf Learners

For much of the history of deaf education, spoken language bilingualism was not considered a viable goal. It was believed that given the challenges of meaningful auditory access, age-appropriate development in even one language would be daunting. However, implementation of universal newborn hearing screening during the early 2000s, along with early fitting of hearing technologies, including cochlear implants, has afforded significantly improved access to spoken language during the critical early years of language acquisition for most deaf children. In this context, it is timely to reconsider the possibilities of spoken language bilingualism in the education of deaf students. The present article therefore focuses on examining the available literature with a view to summarizing current understandings and reflecting on how these understandings can inform future research and practice and the multiple ways in which bilingualism can be operationalized in the education of deaf students.

A Novel Domain Adversarial Networks Based on 3D-LSTM and Local Domain Discriminator for Hearing-Impaired Emotion Recognition

Recent research on emotion recognition suggests that deep network-based adversarial learning has an ability to solve the cross-subject problem of emotion recognition. This study constructed a hearing-impaired electroencephalography (EEG) emotion dataset containing three emotions (positive, neutral, and negative) in 15 subjects. The emotional domain adversarial neural network (EDANN) was carried out to identify hearing-impaired subjects' emotions by learning hidden emotion information between the labeled data and the data with no-label. For the input data, we propose a spatial filter matrix to reduce the overfitting of the training data. A feature extraction network 3DLSTM-ConvNET was used to extract comprehensive emotional information from the time, frequency, and spatial dimensions. Moreover, emotion local domain discriminator and emotion film group local domain discriminator were added to reduce the distribution distance between the same kinds of emotions and different film groups, respectively. According to the experimental results, the average accuracy of subject-dependent is 0.984 (STD: 0.011), and that of subject-independent is 0.679 (STD: 0.140). In addition, by analyzing the discrimination characteristics, we found that the brain regions with emotional recognition in the hearing-impaired are distributed in the wider areas of the parietal and occipital lobes, which may be caused by visual processing.

Reading Habits of Deaf and Hard of Hearing Adults

Few studies exist on the reading habits of the deaf population, and most of those that do were published more than 20 years ago. Hence, changes in reading habits due to the availability to the deaf population of online reading material and portable electronic devices have likely occurred. Additionally, in the hearing population, confinement causes changes in reading habits. We used an online questionnaire to compare the reading habits of 102 deaf and hard of hearing adult residents of Spain both before and during COVID-19 confinement. In general, more reading occurred during confinement, although not all participants showed this pattern: Regular readers read more during lockdown. Motivations for reading were largely unaffected by confinement. Furthermore, the time spent reading was not related to the availability of books at home: More was read in digital format during confinement.

Investigating the Writing Achievement of Deaf Learners

This study investigated writing achievement in a Canadian cohort of school-aged deaf learners (N = 64). In the current context, in which most students are educated in inclusive settings and use hearing technologies, the goal was to establish whether outcomes approach those of hearing-age peers and identify demographic factors (e.g., gender, grade, additional disability, home language, hearing loss, hearing technology, auditory perception) influencing performance. Results indicated that a high percentage of participants performed in the average range or higher on a standardized, norm-referenced assessment, the Test of Written Language-Fourth Edition (TOWL-4, Hammill & Larsen, 2009). Grade, type of hearing loss, higher auditory perception scores, and absence of an additional disability were identified as variables of significance. As auditory access continues to improve, additional investigations of writing achievement in this population will be essential to further inform educational policy and pedagogical practice.

Discrimination and Deaf Adolescents' Subjective Well-Being: The Role of Deaf Identity

This study tested the influence of Deaf identity (cognitive identification and affective identification) on the association between perceived deaf discrimination and subjective well-being among Chinese adolescents who are deaf and hard-of-hearing (DHH), based on the rejection-identification model. Questionnaires on perceived deaf discrimination, subjective well-being, Deaf identity, and demographic information were completed by 246 DHH students (15-23 years old) from special residential schools in China. The results indicated that: (1) higher level of perceived deaf discrimination was significantly associated with lower level of subjective well-being (direct effect = -0.24, 95% confidence interval [CI] = [-0.37, -0.12], p < .001); (2) there was a significant indirect effect of perceived deaf discrimination on subjective well-being via cognitive identification (indirect effect = -0.07, 95% CI = [-0.12, -0.01], p < .05); and (3) positive affective identification due to increased cognitive identification with Deaf community may help counteract the negative impact of perceived deaf discrimination on subjective well-being (indirect effect = 0.06, 95% CI = [0.03, 0.10], p < .001). These findings further support the notion that the different components of group identification should be examined separately.

Development of a Health Behavior Screening Tool for Deaf College Students

Young adults who are Deaf or Hard-of-Hearing (D/HH) face behavioral health risks similar to hearing adults. Despite the emphasis on health behavior screening in health care settings, a brief screening tool in American Sign Language (ASL) does not exist. This manuscript describes the development and pilot testing of an online survey in ASL called the Deaf Health Behavior Report. The Deaf Health Behavior Report includes standardized questions for general health, health behaviors, and psychosocial topics. We invited all D/HH students at a university in Southern California to complete the Deaf Health Behavior Report. A total of 31 D/HH students completed the survey. The most prevalent health risks were related to nutrition, stress, and binge drinking. The Deaf Health Behavior Report is a useful tool for health promotion efforts on college campuses and in general health settings.

Interactive Effects of Temperament and Family-Related Environmental Confusion on Spoken Language in Children Who Are Deaf and Hard of Hearing

PURPOSE

The aim of this study was to examine the influence of caregivers' reports of family-related environmental confusion-which refers to the level of overstimulation in the family home environment due to auditory and nonauditory (i.e., visual and cognitive) noise-on the relation between child temperament and spoken language outcomes in children who are deaf and hard of hearing (DHH) in comparison to age-matched children with typical hearing (TH).

METHOD

Two groups of families with children between 3 and 7 years of age (TH = 59, DHH = 58) were sequentially recruited from a larger longitudinal study on developmental outcomes in children who are DHH. Caregivers (all TH) completed questionnaires measuring three dimensions of child temperament (i.e., effortful control, negative affectivity, and surgency-extraversion) and family-related environmental confusion. A norm-referenced language measure was administered to children. Testing took place within the families' homes.

RESULTS

For children who are DHH, effortful control was positively related to spoken language outcomes, but only when levels of family-related environmental confusion were low to moderate. Family-related environmental confusion did not interact with temperament to influence spoken language in children with TH.

CONCLUSIONS

Homes with low-to-moderate levels of environmental confusion provide an environment that supports DHH children with better effortful control to harness their self-regulatory skills to achieve better spoken language comprehension than those with lower levels of effortful control. These findings suggest that efforts to minimize chaos and auditory noise in the home create an environment in which DHH children can utilize their self-regulatory skills to achieve optimal spoken language outcomes.

Working Memory-Based Cognitive Rehabilitation: Spoken Language of Deaf and Hard-of-Hearing Children

This research examined the effect of the Working Memory-based Cognitive Rehabilitation (WMCR) intervention on the spoken language development of deaf and hard-of-hearing (DHH) children. In this clinical trial study, 28 DHH children aged between 5 and 6 years were selected by random sampling method. The participants were randomly assigned to experimental and control groups. The experimental group participated in the WMCR intervention involving 11 sessions. All participants were assessed pre-and postintervention. Data were collected by the Newsha Development Scale and analyzed through MANCOVA. The results revealed a significant difference between the scores of the receptive and expressive language of the experimental group that were exposed to the WMCR intervention compared with the control group. The receptive and expressive language skills of the experimental group indicated a significant improvement after the intervention. Therefore, the WMCR intervention is an effective method that affects the spoken language skills of DHH children. These findings have critical implications for teachers, parents, and therapists in supporting DHH young children to develop their language skills.

Characteristics of Psychologists Assessing Deaf and Hard of Hearing Clients

Psychological assessment plays a large part in the practice of psychology. Over the years, steps have been taken towards ensuring ethical and culturally sensitive psychological assessment for underserved populations, but little is known about the current state of the field of assessment of deaf and hard-of-hearing (DHH) individuals. An exploratory survey of school and clinical psychologists who work with DHH clients (n = 30) was conducted to obtain a snapshot of the state of the field. The current article focuses on sociodemographic characteristics, clinical training, clinical experiences, and language abilities of clinical psychologists who work with DHH clients. Participants averaged 15 years of assessment experience and almost all participants had some type of specialized training in assessing DHH clients. More than half of participants reported their ability to use multiple languages and communication approaches as either excellent or good. Current findings were compared with a similar survey from nearly 50 years ago (Levine, E. S. (1974). Psychological tests and practices with the deaf: A survey of the state of the art. Volta Review, 76, 298-319), and significant differences were found in participants' self-reported experience with DHH clients, training, and methods of communication.

Family Systems and Emotional Functioning in Deaf or Hard-of-Hearing Preschool Children

This study examined how deaf or hard-of-hearing (DHH) and typically hearing (TH) children may differ in their family system and emotional functioning and examined the relations between family system and children's emotional functioning. Parents of 106 DHH and 99 TH children (2-6 years) reported on family cohesion and adaptability, parental emotion communication, and their child's emotional functioning. The DHH children were rated lower on family cohesion and positive emotion expression than the TH children. Higher levels of family cohesion related to more positive emotion expression in TH children but not in DHH children. For all children, higher levels of family cohesion related to fewer negative emotion expressions and more parental emotion communication related to more negative emotion expression. The results emphasize the importance of sharing leisure activities together and open communication within the family, which can support DHH and TH children's experience of emotions and their expressions of them.

Deaf and hard of hearing plus: Preliminary estimates of child and parent functioning

PURPOSE/OBJECTIVE

Children who are Deaf and Hard of Hearing (DHH) with additional special needs ("DHHPlus") have complex differences in psychological development that, when combined with aspects of their environment, often place them at an increased risk for psychological challenges. Further, their combination of special needs places unique demands on their parents. Despite the high proportion of DHH children in this particular subgroup, little research has been done to identify estimates of broad psychological functioning, the parent-child relationship, parent stressors, and parent satisfaction with resources independent of other samples. This study addresses that gap through collecting preliminary data on broad psychological functioning and related parent-child variables in a sample of children who are DHHPlus. Research Method/Design: Thirty-one primary caregivers of children who were DHH with additional medical and/or mental health diagnoses completed several questionnaires about their child and family, including the Behavior Assessment System for Children (BASC-3) Parent Rating Scale, BASC-2 Parenting Relationship Questionnaire, and Family Stress Scale. The current DHHPlus sample was separated into two subgroups by age, including a preschool group (ages 2-5 years, n = 14) and child group (ages 6-11, n = 17) for visual comparison of mean scores with respective normative and clinical samples from each measure.

RESULTS

When compared to normative and clinical samples, parents of DHHPlus children endorsed more concerns about their child's behavior, adaptive skills, the parent-child relationship, and higher levels of family-related stress, with a unique rank order of family stressors.

CONCLUSIONS/IMPLICATIONS

Results provide initial child and parent estimates to support assessment and treatment services for this diverse and underserved population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Unveiling teachers’ beliefs on visual cognition and learning styles of deaf and hard of hearing students: A Portuguese-Swedish study

Vision is considered a privileged sensory channel for deaf and hard of hearing (DHH) students to learn, and, naturally, they recognize themselves as visual learners. This assumption also seems widespread among schoolteachers, which led us to analyse the intersection between teachers’ beliefs on deaf and hard of hearing students’ academic achievement, visual skills, attentional difficulties, and the perceived importance of image display in class. An online survey was designed to analyse the beliefs of the schoolteachers about the deaf and hard of hearing students learning in educational settings from Portugal and Sweden. Participated 133 teachers, 70 Portuguese and 63 Swedish, from the preschool to the end of mandatory education (ages 3–18) with several years of experience. The content analysis and the computed SPSS statistical significance tests reveal that surveyed teachers believe that deaf and hard of hearing students have better visual skills when compared with their hearing peers yet show divergent beliefs about visual attentional processes. Within the teachers’ perceptions on learning barriers to DHH students, the distractibility and cognitive effort factors were highlighted, among communicational difficulties in class. Conclusions about the prevalence of learning misconceptions in teachers from both countries analysed, corroborate previous studies on neuromyths in education, and bring novelty to Deaf Education field. The work of translation of scientific knowledge, teacher training updating, and partnership between researchers and educators are also urgently needed in special education.

Exploring the Experiences of d/Deaf and Hard of Hearing Children in a Mainstream School in Zimbabwe: A Narrative Analysis

The experiences of d/Deaf and hard of hearing children enrolled in a mainstream school in Zimbabwe are explored. The study used a qualitative approach and a narrative case study design. A sample consisting of two boys and three girls whose ages ranged from 13 to 14 years was purposively selected. Face-to-face semistructured interviews were employed as a data collection tool. The narrative analysis revealed that although d/Deaf and hard of hearing children in the school communicated through sign language, they could develop friendships with hearing children. However, the d/Deaf and hard of hearing children experienced behavioral and mental health issues, including, among others, lack of support, discrimination, and labeling.

An Initial Investigation of the American Sign Language Version of the Self-Determination Inventory

Self-determination is a potential predictor of in-school and postschool success, yet it has not previously been examined in youth and young adults who are deaf or hard of hearing (DHH). The present study used a cross-sectional survey design to examine the reliability and validity of the American Sign Language (ASL) version of the Self-Determination Inventory: Student Report (ASL SDI:SR) and to develop an understanding of mean self-determination strengths and areas of need in a sample of youth and young adults who were DHH; 221 participants completed the ASL SDI:SR, including individuals representing each type of educational setting and each type of communication mode. The component with the highest mean score was psychological empowerment; the lowest mean score was for self-realization. The findings showed that the ASL SDI:SR produced reliable scores. Implications for future practice and research are discussed.

The Relation Between Numerical Magnitude Processing and Mathematical Performance in d/Deaf and Hard of Hearing Children: The Influence of Fluency

Pursuant to the criterion of fluency, two types of mathematical achievement tests were used in the present study: simple subtraction (to measure mathematical fluency) and number series completion (to serve as a nonfluency mathematics test). A cohort of 223 d/Deaf and hard of hearing (d/Dhh) students in grades 3-9 in special education schools took a series of cognitive and mathematical tests. After outlying data were considered, the sample was reduced to 198 students; the findings were consistent with expectations: The numerical magnitude processing did not add significantly to the prediction of mathematical reasoning (nonfluency mathematics) but did make a significant contribution to the prediction of arithmetic computation (fluency mathematics) after demographic variables and general cognitive processing were controlled for. The findings suggest that the effect of numerical magnitude processing on d/Dhh children's mathematical performance can be influenced by mathematical fluency.

Implicit learning of non-verbal regularities by deaf children with cochlear implants: An investigation with a dynamic temporal prediction task

Some deaf children continue to show difficulties in spoken language learning after cochlear implantation. Part of this variability has been attributed to poor implicit learning skills. However, the involvement of other processes (e.g. verbal rehearsal) has been underestimated in studies that show implicit learning deficits in the deaf population. In this study, we investigated the relationship between auditory deprivation and implicit learning of temporal regularities with a novel task specifically designed to limit the load on working memory, the amount of information processing, and the visual-motor integration skills required. Seventeen deaf children with cochlear implants and eighteen typically hearing children aged 5 to 11 years participated. Our results revealed comparable implicit learning skills between the two groups, suggesting that implicit learning might be resilient to a lack of early auditory stimulation. No significant correlation was found between implicit learning and language tasks. However, deaf children's performance suggests some weaknesses in inhibitory control.

Food Worry in the Deaf and Hard-of-Hearing Population During the COVID-19 Pandemic

OBJECTIVE

The coronavirus disease 2019 (COVID) pandemic has highlighted preexisting health disparities, including food insecurity, in the deaf and hard-of-hearing (DHH) population. We examined factors associated with food worry during the COVID-19 pandemic.

METHODS

We collected survey data on worry about food shortages, worry about contracting COVID-19, and concerns about DHH people staying home and being lonely from April 17 through May 1, 2020, via a bilingual American Sign Language/English online survey platform. The sample consisted of 537 DHH adults living in the United States. We examined the relationship between demographic characteristics and food worry. We used logistic regression and model fitting to predict the likelihood of experiencing food worry.

RESULTS

The mean (SD) age of survey respondents was 47 (16), and 25% of the sample identified as people of color. Forty-two percent of survey respondents had a high level of food worry. Increased worry about contracting COVID-19 and concerns about DHH people staying home and being lonely among DHH younger adults or those without a college degree predicted food worry. Gender and race/ethnicity did not contribute to the model for food worry.

CONCLUSIONS

Food worry was explained by multiple, intersecting factors, including demographic variables, worry about contracting COVID-19, and concerns about loneliness. Interventions or programs implemented by DHH-serving organizations as well as government programs, social service providers, and food banks should be fully accessible to subgroups of DHH young adults without a college degree who are at risk for food insecurity.

Deaf and Hard of Hearing Students' Configurational and Phonological Processing in Chinese One- and Two-Character Word Recognition

To examine deaf and hard of hearing (DHH) students' configurational and phonological processing in Chinese one- and two-character word recognition, two experiments were conducted in a primed semantic categorization task. Configurational priming was observed in DHH participants' reaction times (RTs) at the SOA (stimulus onset asynchrony) of 47 ms and in their probability of making erroneous responses at SOAs of 47 and 187 ms in Experiment 1. Phonological priming was revealed in hearing and DHH participants' probability of making erroneous responses in Experiment 2. Hearing participants' RTs indicated facilitation and inhibition at the SOAs of 47 and 187 ms, respectively; DHH participants' RTs showed priming at the SOA of 187 ms. It is concluded that DHH college students are more likely to use the configurational information but less likely to use the phonological information than hearing college students in one- and two-character word recognition.

Cognitive Autonomy and Social Support Among Adults With Different Hearing Status

Previous research has demonstrated relationships between cognitive autonomy (ability to think independently) and perceived social support (perceptions of available quality environmental support) among different samples (e.g., Michael &amp; Attias, 2016). The present study examined 116 typically hearing and 91 deaf or hard of hearing (DHH) adults, who completed the Cognitive Autonomy and Self-Evaluation Inventory (Beckert, 2007) and the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988). Significant correlations were found between most of the cognitive autonomy and social support variables, with no significant differences between the correlations for the two groups. Participants who were DHH reported higher levels of four of the five cognitive autonomy variables than the participants with typical hearing. Additionally, for the DHH group, family status, education level, and age at detection of hearing loss significantly predicted some of the cognitive autonomy variables. Implication for research and practice are discussed.

The Experiences of and Teaching Strategies for Deaf and Hard of Hearing Foreign Language Learners: A Systematic Review of the Literature

Although foreign language (FL) educational experiences for students with disabilities including deaf and hard of hearing (DHH) students, are becoming more common, there is little research available on this topic. The purpose of the present review was to identify research examining DHH students' FL learning experiences and teaching strategies used in the FL class to facilitate language learning. The search showed that few studies have explored this area, and even fewer have met quality standards. Among the existing studies, the results revealed that communication methods in FL class instruction that do not meet the communicative needs of DHH students can hinder learning and lead to demotivation. Conversely, the presence of individualized learning goals and an emphasis on reading and writing, over speaking and listening, appear to support FL learning. Finally, the use of technology is a promising tool for FL instruction.

Deaf Community Cultural Wealth in Community College Students

Deaf students are members of a linguistic and cultural minority whose background and experiences provide a unique backdrop for the navigation of higher education. Using the framework of Deaf community cultural wealth, this study examines the experiences of Deaf students in community college and their utilization of various forms of capital. Findings showed that they exhibited instances of resistant, navigational, social, and familial capital in accessing and persisting in higher education.

Lies and Irony Understanding in Deaf and Hearing Adolescents

Lies and irony are paradigmatic examples of nonliteral communication; many deaf children and even adults have difficulty in understanding them. The present study assessed the understanding of lies and irony in 96 adolescents living in Spain in urban settings (58 deaf participants, 38 hearing participants; 10-19 years old). We investigated whether deaf and hearing participants differ in their performance, and the effects of age, theory of mind (ToM), and language on the understanding of these nonliteral meanings in deaf participants. The results show that deaf participants do not find it difficult to detect nonliteral statements, but they experience difficulty in attributing the real motivation to the speaker. ToM and language explained performance in the understanding of nonliteral communication in the deaf group. The results suggest the need to focus on promoting the ability to attribute real motivations to speakers. We propose an assessment sequence that differs from those used in other studies. In the proposed sequence, ToM skills would be combined with other skills that influence the understanding of lies and irony and would be sequenced according to the observed performance in deaf adolescents.

What's That You Say? Communication Breakdowns and Their Repairs in Children Who Are Deaf or Hard of Hearing

Conversational fluency is important to form meaningful connections and relationships with the people around us but is understudied in children who are deaf or hard of hearing (D/HH). Communication breakdowns reduce conversational fluency. They occur when a speaker says something that interrupts the flow of conversation requiring a request for clarification or confirmation from their listener to repair the misunderstanding. Young children who are D/HH are at risk of more frequent communication breakdowns and fewer successful repairs than children with typical hearing (The missing link in language development of deaf and hard of hearing children: Pragmatic language development. Seminars in Speech and Language, 33 (04), 297-309). About 14 children who were D/HH aged 7-12 year and 15 children with typical hearing were matched on chronological age. Comparisons of the number and duration of communication breakdowns, requests for repair, and responses to requests used by children in a 10-min conversation with an adult were completed. Results showed that while children who were D/HH demonstrated some differences, they were more similar to their typically hearing peers in communication breakdowns and repairs than previously reported in the literature.

The Effects of a Vocabulary Intervention on Teaching Multiple-Meaning Words to Students Who Are d/Deaf and Hard of Hearing

Building vocabulary knowledge, especially breadth and depth of word meanings, is a crucial step in assisting students to read and comprehend print independently. A large body of research has documented the low reading achievement levels of a number of Deaf and hard-of-hearing (DHH) students. The goal of the present study was to examine the effects of a vocabulary intervention to teach 24 multiple-meaning words to fourth-grade DHH students in Saudi Arabia by utilizing a single-case experimental design (multiple probe design across participants). A total of 5 students with a profound hearing loss participated in the study. About 3 of 5 received the intervention, whereas two other students served as an additional control component and were administered the pretest and posttest only. The data showed that there was a significant improvement in the recognition and comprehension scores of students who received the intervention. In contrast, students who did not receive the intervention showed no significant improvement on the posttest.