MPZL2-a common autosomal recessive deafness gene related to moderate sensorineural hearing loss in the Chinese population

BACKGROUND

Mutations in MPZL2, the characteristic genetic etiology of autosomal recessive deafness loci 111 (DFNB111), cause non-syndromic and moderate sensorineural hearing loss.

METHODS

In this study, we analyzed the phenotype and genotype of eight pedigrees consisting of 10 hearing loss patients with bi-allelic pathogenic or likely pathogenic variants in MPZL2. These patients were identified from a 3272 Chinese patient cohort who underwent genetic testing.

RESULTS

Apart from symmetrical and moderate sensorineural hearing loss, the MPZL2-related phenotype was characterized by progressive hearing loss with variation in the onset age (congenital defect to onset at the young adult stage). We determined that in the Chinese population, the genetic load of MPZL2 defects was 0.24% (8/3272) in patients diagnosed with hearing loss and 7.02% (8/114) in patients diagnosed with hereditary moderate sensorineural hearing loss caused by STRC, OTOA, OTOG, OTOGL, TECTA, MPZL2 and others. Three known MPZL2 variants (c.220C > T (p.Gln74*), c.68delC (p.Pro23Leufs*2), c.463delG (p.Ala155Leufs*10)) and a novel start loss variant (c.3G > T (p.Met1?)) were identified. MPZL2 c.220C > T was identified as the hotspot variant in the Chinese population and even in East Asia compared with c.72delA (p.Ile24Metfs*22) in European and West Asia through allele frequency.

CONCLUSIONS

We concluded that apart from moderate HL, progressive HL is another character of MPZL2-related HL. No specified variant was verified for the progression of HL, the penetrance and expressivity cannot be determined yet. A novel MPZL2 variant at the start codon was identified, enriching the variant spectrum of MPZL2. The hotspot variants of MPZL2 vary in different ethnicities. This study provides valuable data for the diagnosis, prognosis evaluation and genetic counseling of patients with moderate sensorineural hearing loss related to MPZL2.

Examining the Language and Communication Factors of a Deaf Child with Autism Spectrum Disorder from an Immigrant Korean Family

Extant research on learners who are d/Deaf or hard of hearing with disabilities who come from Asian immigrant families is extremely sparse. The authors conducted an intrinsic case study of a deaf student with autism who comes from a Korean immigrant family. To acquire a comprehensive understanding of language and communication characteristics, they analyzed (a) interview data of three administrators who worked with the student and family and (b) school documents/reports issued to the parents. Themes are reported across the three components of the tri-focus framework (Siegel-Causey & Bashinski, 1997): the learner, partner, and environment. Implications for practitioners who work with these learners and their families are discussed, including (a) compiling an individualized language and communication profile that encompasses the framework; (b) utilizing culturally and linguistically responsive practices with the family; (c) practicing interprofessional collaboration; and (d) modifying physical and social environments to increase accessibility.

Health disparities among Black deaf and hard of hearing Americans as compared to Black hearing Americans: A descriptive cross-sectional study

There is a dearth of literature on health outcomes for Black people who identify as deaf or hard of hearing (DHH). Black DHH individuals generally experience at least 2 types of oppression, racism and audism, both of which contribute to health disparities within the Black and Deaf communities.To understand the prevalence of health outcomes in a Black DHH adult sample and compare this to a Black hearing sample.A descriptive cross-sectional study with primary Health Information National Trends Survey (HINTS)- American Sign Language survey data from Black DHH adults and secondary National Cancer Institute-HINTS English survey data from Black hearing adults.Black DHH adults and Black hearing adults (18 years or older).Using NCI's health information national trends survey in American Sign Language and English, self-reported data was gathered for all medical conditions as diagnosed by healthcare providers.The study showed that Black DHH adults had a higher likelihood for diabetes, hypertension, lung disease, cancer, and comorbidity compared to their hearing Black counterparts.Black DHH adults are at disparity for certain medical conditions compared to the general Black adult population. Future directions are needed to ensure that anti-racist policies include consideration of people with sensory disabilities. Inclusion of cultural and language needs of Black DHH patients in cultural humility training for healthcare providers is recommended to address health disparity in this population.

Case report: Novel GJB2 variant c.113T>C associated with autosomal recessive non-syndromic hearing loss (ARNSHL) in a Han family

RATIONALE

Molecular mechanism underlying the autosomal recessive non-syndromic hearing loss (ARNSHL) is still plausible. Pathogenic mutations of the gap junction beta 2 protein (GJB2) are reported to be the primary causes of ARNSHL.

PATIENT CONCERNS

A propositus was diagnosed as ARNSHL with bilateral congenital profound hearing loss.

DIAGNOSIS

With microarray and target gene sequencing testing methods, a novel GJB2 mutant was found to be associated with ARNSHL in this Han Chinese family.

INTERVENTIONS/OUTCOMES

Based on the finding in this research, prenatal screening of GJB2 mutation and genetic counseling are recommended to this family for their next pregnancy. Our interventions allow the family to plan informatively.

LESSONS

In this family, we discovered 2 heterozygous carriers of c.113T>C variation in the GJB2 gene. The propositus, who had profound hearing loss, had inherited the c.113T>C variation from his normal mother and the c.235delC from his father.

Deafness and Ethnicity: Taking Identity, Language, and Culture Into Account

Deaf education professionals are regularly challenged by the linguistic and cultural diversity of deaf youth. The present article focuses on how young deaf people residing in France who are migrants or the children of migrants define themselves, and how parents and professionals perceive their linguistic and cultural diversity. The theoretical frameworks of interactionism and intersectionality were both used to analyze deafness and ethnicity. Qualitative data were collected in French schools through interviews with different members of the school community: students, parents, and professionals. The results show that deafness prevails over ethnicity in regard to self-identification, even if linguistic and cultural diversity can also be taken into account in an inclusive education.

Service Providers' Perspective on the Education of Students Who Are Deaf or Hard of Hearing and English Learners

The researchers examine the perspectives of service providers involved in educating students who are both deaf or hard of hearing (DHH) and English Learners (EL). Using qualitative phenomenology methodology, the researchers interviewed eight service providers in one school district about their perspectives on the unique challenges and issues related to educating students who are DHH EL. An overarching finding was the uniqueness of each individual student, which was found in the combination of factors, or "influencers of diversity" (Leigh, 2008, p. 25), for each student. The service providers reported that the students had unique communication, academic, and cultural needs beyond what one would expect to see only in EL or only in DHH learners. The results provide insights into service providers' challenges and needs and how they are met in the provision of effective services to DHH EL students.

The impact of ethnicity on cochlear implantation in Norwegian children

OBJECTIVES

To explore the impact of parental ethnicity on cochlear implantation in children in Norway with regard to incidence rates of cochlear implants (CIs), comorbidies, age at onset of profound deafness (AOD), age at first implantation, uni- or bilateral CI, and speech recognition.

METHOD

This retrospective cohort study included all children (N = 278) aged <18 years in Norway who received their first CI during the years 2004-2010.

RESULTS

86 children (30.9%) in our study sample had parents of non-Nordic ethnicity, of whom 46 were born in Nordic countries with two non-Nordic parents. Compared with the background population, children with non-Nordic parents were 1.9 times more likely to have received CI than Nordic children (i.e., born in Nordic countries with Nordic parents). When looking at AOD, uni-vs. bilateral CIs, and comorbidities, no significant differences were found between Nordic children and children with a non-Nordic ethnicity. Among children with AOD <1 year (n = 153), those born in non-Nordic countries with two non-Nordic parents (n = 6) and adopted non-Nordic children (n = 6) received their first CI on average 14.9 and 21.1 months later than Nordic children (n = 104), respectively (p = 0.006 and 0.005). Among children with AOD <1 year, those born in Nordic countries with two non-Nordic parents (n = 31) received their CI at an older age than Nordic children, but this difference was not significant after adjusting for calendar year of implantation and excluding comorbidity as a potential cause of delayed implantation. The mean age at implantation for children with AOD <1 year dropped 2.3 months/year over the study period. The mean monosyllable speech recognition score was 84.7% for Nordic children and 76.3% for children born in Norway with two non-Nordic parents (p = 0.002).

CONCLUSIONS

The incidence of CI was significantly higher in children with a non-Nordic vs. a Nordic ethnicity, reflecting a higher incidence of profound deafness. Children born in Norway have equal access to CIs regardless of their ethnicity, but despite being born and receiving care in Norway, prelingually deaf children with non-Nordic parents are at risk of receiving CI later than Nordic children. Moreover, prelingually deaf children who arrive in Norway at an older age may be at risk for a worse prognosis after receiving a CI due to lack of auditory stimulation in early childhood, which is critical for language development and late implantation; this is a serious issue with regard to deafness among refugees.

Investigating Black ASL: A Systematic Review

The authors reviewed the literature regarding linguistic variations seen in American Sign Language. These variations are influenced by region and culture. Features of spoken languages have also influenced sign languages as they intersected, e.g., Black ASL has been influenced by African American English. A literature review was conducted to investigate the existence of Black ASL and to document empirical studies on this topic. The included articles were (a) published between 1970 and 2012 in scholarly journals, (b) included a hypothesis, (c) described the participants, and (d) described the research design. Seven articles met the inclusion criteria. All seven addressed differences between Black ASL and mainstream ASL. Only a few research articles meeting the review criteria were revealed. This suggests that empirical research regarding linguistic variation in ASL is a field of study in its infancy and that continued exploration of this topic is needed.

Deafness and Diversity: Reflections and Directions

Concluding a two-part American Annals of the Deaf special issue on deafness and diversity (DAD), the editors provide reflections and guidance to the field regarding d/Deaf and hard of hearing (d/Dhh) children with a disability (DWD; e.g., learning or intellectual disability, autism) and d/Dhh children from homes where parents use a language other than English or American Sign Language (d/Dhh Multilingual Learners; DMLs). Contributing authors addressed the application of theory, research, and practice to five topics: (a) early intervention, (b) communication/language, (c) assessment, (d) transition, (e) teacher preparation. An overview of the main recommendations of the contributors and editors is presented in an effort to advance research and pedagogy with these learners. In conclusion, the editors discuss the "Radical Middle" approach (Easterbrooks &amp; Maiorana-Basas, 2015) to working with students who are DAD: providing learners with all options for academic, social, and emotional success.

A New Kind of Heterogeneity: What We Can Learn From d/Deaf and Hard of Hearing Multilingual Learners

The present article introduces a special issue of the American Annals of the Deaf. Students who are d/Deaf or hard of hearing and come from homes where a language other than English or American Sign Language is used constitute 19.4%-35.0% of the U.S. d/Dhh population (Gallaudet Research Institute, 2013). The authors propose moving beyond the standardized use of the designation English Language Learners to embrace terminology encompassing these learners as diverse and rich in language: d/Dhh Multilingual Learners (DMLs). The authors present (a) a discussion of terminology, (b) an overview of available demographic data, (c) a synopsis of the special issue, (d) themes across three case study vignettes, and (e) overall recommendations to advance curriculum design and pedagogy for DMLs. Questions are posed challenging researchers and practitioners to investigate theory, research, and pedagogy that can enhance practice with DMLs and their families.

[The audiological analysis in the patients homozygous for the c.-23+1G>A mutation in the GJB2 gene presenting with the loss of hearing in Yakutiya]

In the course of previous investigations carried out in the Republic of Sakha (Yakutiya), we have identified the main molecular-genetic factor responsible for the hereditary impairment of hearing among the indigenous population (mostly the Yakuts).The disease was shown to be attributable to the c.-23+1G>A mutation localized in the splice donor site (exon 1) of the GJB2 (Cx26) gene. The present study involved the comprehensive audiological analysis of the patients homozygous for the c.-23+1G>A mutation in the GJB2 gene based on the results of the study of a large sample of the patients residing in Yakutiya. All individuals with the GJB2 genotype c.-23+1G>A/c.-23-1G>A (n=108) at the mean age of 14.32±4.7 years (all ethnic Yakuts)were examined with the use oftonal threshold audiometry for air conduction testing at the frequencies of 0.25, 0.5, 1.0, 2.0, 4.0, and 8.0 kHz and bone conduction testing at the frequencies of 0.25, 0.5, 1.0, and 4.0 with a step of 5.0 dB.The results of the ASSR test were used whenever tonal threshold audiometry proved impracticable The data obtained in the study characterize the allelic form of the disease associated with the GJB2 genotype c.-23+1G>A/c.-23-1G>A as the congenital bilateral symmetric (90.1%), sensorineural (90.1%) form of hearing impairment of variable severity (from grade 1 to complete deafness) with the «flat» audiological profile (median slope not more than 5.0 dB in the extended frequency range (EFR) of 0.5, 1.0, 2.0, and 4.0, kHz). It is concluded that the results of the audiological analysis performed in the present study give evidence of relatively homogeneous but variable in terms of severity impairment of hearing in the patients homozygous for the c.-23+1G>A mutation in the GJB2 (Cx26) gene. It may serve as a positive prognostic sign to be used in the development and prescription of hearing aids.

d/Deaf and Hard of Hearing Multilingual Learners: The Development of Communication and Language

The author examines the theory and research relevant to educating d/Deaf and Hard of Hearing Multilingual Learners (DMLs). There is minimal research on this population, yet a synthesis of related theory, research, and practice on spoken-language bilinguals can be used to add to the body of knowledge on these learners. Specifically, the author reports on three major areas: (a) population characteristics of DMLs, (b) theories relevant to understanding the language development of DMLs, and (c) considerations for programs in designing and implementing educational services for DMLs. In the interest of ensuring that children receive the foundation for linguistic success, aspects of linguistically responsive teaching (Lucas &amp; Villegas, 2013) are addressed, with a focus on adopting an asset-based perspective on educating DMLs that honors all of a child's language, identity, and cultural memberships.

Early Intervention: A Multicultural Perspective on d/Deaf and Hard of Hearing Multilingual Learners

Today's pluralistic society is characterized by families from many linguistic and cultural backgrounds, including families with infants and toddlers who are deaf or hard of hearing (d/Dhh). Taking a multicultural perspective, the author examines family-centered early intervention (FCEI) and the transition to school services for children who are d/Dhh. Working with d/Dhh Multilingual Learners (DMLs) and their families presents a unique challenge to early intervention professionals: ensuring that families have adequate information and resources to make informed choices, particularly regarding communication. The author presents information and research related to (a) family and professional partnerships, (b) cultural contexts for early intervention,

Assessment and d/Deaf and Hard of Hearing Multilingual Learners: Considerations and Promising Practices

The authors address considerations and promising practices relating to assessment of d/Deaf and Hard of Hearing Multilingual Learners. DMLs' unique culture(s), language(s), and learning needs must be considered when assessments of this population are being planned, conducted, and interpreted. The authors address theory and research on (a) general considerations for the overarching assessment process, (b) specific assessment approaches used to assess DMLs, and (c) assessment of language proficiency for diverse language learners. In addition, basic recommendations for the assessment of DMLs are made, including increased availability of assessments in various languages, use of multiple sources of individual and family data, assessment of all languages, and incorporation of a strong assessment component (that includes nondiscrimination practices) into teacher preparation programs.

Sociocultural and Academic Considerations for School-Age d/Deaf and Hard of Hearing Multilingual Learners: A Case Study of a Deaf Latina

For decades , research has focused on American Sign Language/English bilingual education for d/Deaf and hard of hearing students whose families used English or ASL. However, a growing population of d/Dhh children come from households where languages other than English (e.g., Spanish, Chinese, Vietnamese) are used. In a longitudinal case study, the authors document the K-12 educational pathway of a deaf Latina student. Anecdotal records, semistructured interviews, assessment data, and document reviews of the participant's school and clinical records are used to develop the case study. The findings provide the basis for recommendations for future research and for critical factors to consider to improve the education of d/Dhh Multilingual Learners (DMLs). These include ensuring appropriate educational placements, addressing early communication and language needs, determining effective instructional techniques and assessments, strengthening the L1 to support L2 learning, and providing students with opportunities to learn their heritage language.

Case Studies of Multilingual/Multicultural Asian Deaf Adults: Strategies for Success

Case studies of adult d/Deaf or Hard of Hearing Multilingual Learners (DMLs) are few, especially studies of DMLs who learn more than one sign language and read logographic and alphabetic scripts. To reduce this paucity, two descriptive case studies are presented. Written questionnaires, face-to-face interviews, and self-appraisals of language-use rubrics were used to explore (a) the language and literacy histories of two adult Asian DMLs who had learned multiple languages: Chinese (spoken/written), English (written), Chinese Sign Language, and American Sign Language; and (b) how each language was used in different cultural communities with diverse conversational partners. Home literacy environment, family support, visual access to languages, peer and sibling support, role models, encouragement, perseverance, and Deaf identity all played vital roles in the participants' academic success. The findings provide insights into the acquisition of multiple languages and bi-literacy through social communication and academic content.

Increasing Cultural And Linguistic Diversity In Deaf Education Teacher Preparation Programs

As the field of education of the d/Deaf and hard of hearing (d/Dhh) continues to diversify, postsecondary institutions must pay close attention not only to the changing needs of d/Dhh students but to the practitioners they are preparing to serve this population. Students who are d/Dhh and come from homes where a language other than English or American Sign Language is used--d/Dhh Multilingual Learners (DMLs)--constitute 19.4%-35.0% of the d/Dhh student population (Gallaudet Research Institute, 2013). In the present article, part of a special American Annals of the Deaf issue on DMLs, the authors review demographic trends, examine the theory behind teacher effectiveness and culturally responsive teaching, provide examples from research on effective components of teacher preparation programs and discuss how they align with the field's certification standards, and recommend practices for programs and teachers to meet these standards within the field's ever-changing landscape.

Common molecular etiology of nonsyndromic hearing loss in 484 patients of 3 ethnicities in northwest China

CONCLUSIONS

In the study population in northwest China, a total of 33.06% of deaf patients have inherited hearing impairment caused by GJB2, SLC26A4, and mtDNA 1555A>G mutations. The mutation frequencies of GJB2, SLC26A4, and mtDNA 1555A>G genes were 16.12%, 10.54%, and 6.4%, respectively, in our study cohort. Thus, screening is conventionally performed for GJB2, SLC26A4, and mtDNA 1555A>G in these populations.

OBJECTIVE

This study aimed to investigate the mutations of GJB2, mitochondrial DNA 12S rRNA1555A>G, and SLC26A4 genes in Han Chinese, Hui people, and Tibetan ethnicities in patients with nonsyndromic hearing loss (NSHL) in northwest China.

METHODS

A total of 484 unrelated subjects with hearing loss who attended special education schools in northwest China were enrolled in this study. Three prominent deafness-related genes, GJB2, SLC26A4, and mtDNA 1555A>G, were screened for mutations in our study cohort.

RESULTS

The mutation frequencies of GJB2, SLC26A4, and mtDNA 1555A>G genes were 16.12%, 10.54%, and 6.4%, respectively. The prevalence of GJB2 mutations was 17.52%, 15.35%, and 11.43% in Han Chinese, Hui people, and Tibetan participants, respectively. c.235delC was the most prevalent mutation, accounting for 65.71% of all GJB2 mutant alleles. The prevalence of SLC26A4 mutations was 12.39%, 8.84%, and 8.57% in Han Chinese, Hui people, and Tibetan participants, respectively. The c.919-2 A>G mutation was the most common form, accounting for 60.47% of all SLC26A4 mutant alleles. The prevalence of the homoplasmic mtDNA 1555A>G mutation was 8.97%, 3.72%, and 5.71% in Han Chinese, Hui people, and Tibetan participants, respectively, which represents a statistically significant difference between the Han Chinese and Hui people (χ(2) = 5.118, p < 0.05).

Deaf native signers are better readers than nonnative signers: myth or truth?

The central aim of this study was to clarify whether sign language (SL) nativeness is a significant factor in determining prelingually deaf individuals' reading skills and whether its contribution is modified by the reader's orthographic background. A second aim was to elucidate similarities and differences between native and nonnative signers in processing written information at different processing levels in order to understand how SL nativeness sustains the reading process, if at all. Participants were 176 students with prelingual deafness recruited from two education levels (6th-7th graders and 9th-10th graders) and three orthographic backgrounds (Hebrew, German, and Turkish). Sixty-six students were native and the remainder nonnative signers. They were tested with a battery of eight experimental paradigms, each assessing their information processing skills in a specific reading-related or reading-unrelated domain. Findings corroborate SL nativeness enhancing the reading process in some regard. However, its contribution was not found to scaffold the structural processing of a written text to turn reading into a tool for learning. Rather, gains were restricted to facilitating processing written words from a perceptual to a conceptual level. Evidence suggests that compared with other determining factors, the contribution of SL nativeness to proficient reading may be rather marginal.

Concurrent correlates of Chinese word recognition in deaf and hard-of-hearing children

The aim of this study was to explore the relative contributions of phonological, semantic radical, and morphological awareness to Chinese word recognition in deaf and hard-of-hearing (DHH) children. Measures of word recognition, general intelligence, phonological, semantic radical, and morphological awareness were administered to 32 DHH and 35 hearing children in Hong Kong. Hierarchical regression analyses showed that tone, semantic radical, and morphological awareness made independent contributions to word recognition in DHH children after the effects of age and intelligence were statistically controlled for. Semantic radical and morphological awareness was found to explain significantly more variance than tone awareness in predicting word recognition in DHH children. This study has replicated previous evidence regarding the importance of semantic radical and morphological awareness in Chinese word recognition in hearing children and extended its significance to DHH children.

Analysis of common deafness gene mutations in deaf people from unique ethnic groups in Gansu Province, China

CONCLUSIONS

The GJB2 gene mutation characteristic of Dongxiang was the interaction result of ethnic background and geographical environment, and Yugur exhibited the typical founder effect. The SLC26A4 gene mutation characteristic of Dongxiang was related to caucasian backgrounds and selection of purpose exons, i.e. ethnic background and the penetrance of ethnic specificity caused the low mtDNA1555A>G mutation frequency in Dongxiang.

OBJECTIVES

To determine the prevalence of GJB2 and SLC26A4 genes and mtDNA1555A>G mutations and analyze the ethnic specificity in the non-syndromic sensorineural hearing loss (NSHL) of unique ethnic groups in Gansu Province.

METHODS

Peripheral blood samples were obtained from Dongxiang, Yugur, Bonan, and ethnic Han groups with moderately severe to profound NSHL in Gansu Province. Bidirectional sequencing (or enzyme digestion) was applied to identify the sequence variations.

RESULTS

The pathogenic allele frequency of the three gene mutations was different. The frequency of the GJB2 gene among the Dongxiang, Yugur, Bonan, and ethnic Han groups was 9.03%, 12.5%, 5.88%, and 12.17%, respectively. No difference was found between the ethnic groups. The frequencies of the SLC26A4 genes were 3.23%, 8.33%, 0%, and 9.81%, respectively. The mutation frequency of mtDNA1555A>G was 0%, 0%, 0%, and 6.03%, respectively. No difference was found between the ethnic groups, except for the Dongxiang and ethnic Han groups, both in SLC26A4 gene and mtDNA1555A>G.

Identification of a Novel TECTA mutation in a Chinese DFNA8/12 family with prelingual progressive sensorineural hearing impairment

Tectorial membrane, an extracellular matrix of the cochlea, plays a crucial role in the transmission of sound to the sensory hair cells. Alpha-tectorin is the most important noncollagenous component of the tectorial membrane and the otolith membrane in the maculae of the vestibular system. Defects in TECTA, the gene encodes alpha-tectorin, are cause of both dominant (DFNA8/12) and recessive (DFNB21) forms of deafness. Here, we report a three-generation Chinese family characterized by prelingual progressive sensorineural hearing impairment. We mapped the disease locus to chromosome 11q23-24 region, overlapping with the DFNA8/12 locus. Sequencing of candidate gene TECTA revealed a heterozygous c.5945C>A substitution in exon 19, causing amino acid substitution of Ala to Asp at a conservative position 1982. The A1982D substitution is consistent with hearing loss in this Chinese family and has not been found in 200 random control chromosomes. To our knowledge, this is the first TECTA mutation identified in Chinese population. Our data provides additional molecular and clinical information for establishing a better genotype–phenotype understanding of DFNA8/12.

Cochlear implants with fine structure processing improve speech and tone perception in Mandarin-speaking adults

CONCLUSION

This study indicates that Mandarin-speaking subjects acquire significant benefit from a cochlear implant (CI) and audio processor with the fine structure processing (FSP) coding strategy. It can take adult Mandarin CI users time to become accustomed to their CI and appreciate the benefits.

OBJECTIVES

This study aimed to determine speech perception outcomes in Mandarin-speaking adults who received the FSP coding strategy.

METHODS

This was a prospective study. Ten adults who were implanted unilaterally with a PULSARCI(100), and received an OPUS 1 or OPUS 2 speech processor, were included in this study. The mean age at implantation was 31.1 years. We determined the benefit to postlingually deafened Mandarin-speaking adults with a severe to profound hearing loss using the tests: monosyllables in quiet, sentences in quiet and the Mandarin Hearing in Noise Test (MHINT). Tone perception was evaluated using a tone perception test. A visual analog scale (VAS) was used to score sound quality and ease of listening.

RESULTS

The results showed a significant improvement between first fitting and 6 months in all speech tests and in tone perception. The VAS scores showed a significant improvement over 6 months in sound quality and an immediate benefit in ease of listening.

A transversion mutation in non-coding exon 3 of the TMC1 gene in two ethnically related Iranian deaf families from different geographical regions; evidence for founder effect

OBJECTIVES

Transmembrane channel-like 1 (TMC1) gene is a member of the transmembrane channel-like (TMC) gene family that encodes an integral membrane protein of the inner ear. It is suggested that mutation in this gene is one of the main causes of autosomal recessive non-syndromic hearing loss (ARNSHL) in different populations. The aim of this study was to determine the contribution of the TMC1 gene mutations in causing hearing loss in Iran.

METHODS

In total 54 unrelated Iranian families containing 159 affected individuals with ARNSHL detected by audiometric and otologic examinations were analyzed. Haplotype analysis of all members of 45 GJB2- & GJB6-negative families, using four microsatellite markers linked to DFNB7/11 was performed.

RESULTS

Co-segregation of hearing loss with all investigated markers for the DFNB7/11 locus was found in one family. DNA sequencing of all coding and non-coding exons and intron boundaries of the TMC1 gene identified c.-258A>C mutation in non-coding exon 3 only in individuals with hearing loss. This mutation has been previously reported in another Iranian family (G9) that share similar ethnicity. This variant was not detected in 300 ethnically matched healthy controls.

CONCLUSIONS

These results increase the probability that this nucleotide variation may be a pathogenic mutation. This study showed that the ethnicity may be more useful than geographical location to design research strategy for determining which genes should be considered when a heterogeneous disorder is under investigation.

Deaf and hard of hearing adolescents' processing of pictures and written words for taxonomic categories in a priming task of semantic categorization

Inspired by research by Li, Yi, and Kim (2011), the authors examined Chinese deaf and hard of hearing adolescents' responses to pictures for taxonomic categories of basic level (exemplar pictures) preceded by exemplar pictures, and to written words for taxonomic categories of basic level (exemplar words) preceded by exemplar words or by written words for those of superordinate level (category names), in a priming task of semantic categorization. Stimulus onset asynchrony (SOA) was manipulated. The adolescents were less aware of taxonomic relations and were more likely to show the advantage of pictures over written words than their hearing counterparts. Their processing of exemplar primes steadily deepened as SOA increased, reaching its deepest level when SOA was 237 ms. Their processing of category names seemed immune to changes in SOA, probably because of their fuzzy representations of taxonomic categories of superordinate level.

Working with Hispanic women who are deaf: recommendations from the literature

The authors used the hermeneutics approach within social cognitive career theory to explore employment trends and issues over the past 20 years relevant to Hispanic women who are deaf. Barriers to employment were discovered including discrepancies due to gender, race/ethnicity, and severity of hearing loss. Recommendations for policymakers and professionals suggest a need for research that addresses the unique experiences of Hispanic women who are deaf within vocational rehabilitation, the use of social cognitive career theory as it relates to career development and choices, and an increase in education and training to better prepare vocational rehabilitation counselors to work with individuals from multiple minority backgrounds. While information about Hispanic women who are deaf is limited, this review provides a better understanding of Hispanic deaf women and encourages expansion of knowledge in practice and research for professionals working with this unique population.

Factors distinguishing skilled and less skilled deaf readers: evidence from four orthographies

This study aims to enhance understanding of the factors underlying variance in the reading comprehension skills of prelingually deaf individuals. Participants were 213 sixth through tenth graders with prelingual deafness recruited from four orthographic backgrounds (Hebrew, Arabic, English, and German) and allocated to three distinct reading profiles (levels). A sentence comprehension test manipulating the semantic plausibility of sentences and a word processing experiment requiring rapid determination of the semantic relationship between two real words or between a real word and a pseudohomophonic letter string were used to determine the factors distinguishing skilled from less skilled deaf readers. Findings point to deficits in structural (syntactic) knowledge and deficient knowledge structures, rather than differences in phonological processing skills, as making that distinction. Moreover, the acquisition of such knowledge seems to be modified by particularities of the read orthography.

Chinese deaf and hard of hearing adolescents' awareness of thematic and taxonomic relations among ordinary concepts represented by pictures and written words

Inspired by a previous study of Korean deaf and hard of hearing adolescents, the researchers conducted a priming task of living-nonliving categorization with a sample of Chinese deaf and hard of hearing adolescents. The sample in this study had significantly lower accuracy levels for the thematically related items than for the taxonomically related items and significantly larger differences in reaction times than a group of hearing adolescents when stimuli were changed from pictures to written words. However, they were not significantly different from the hearing adolescents in their performance with the taxonomically related written words. Furthermore, unlike the hearing adolescents, they did not have significantly different reaction times as the result of changes in positions of stimulus presentations.

Family counseling in the Netherlands for Turkish-origin parents of deaf children with a cochlear implant

Cultural elements such as language, beliefs about health, and family context play important roles in the uptake of rehabilitation and treatment of deafness. Because of cultural issues, minority groups often do not receive optimal care. Focusing on the Netherlands, the researchers explored how the rehabilitation and counseling of deaf children of Turkish-origin parents can be improved. The most important findings were that (a) most parents initially did not believe their child was deaf and regretted later that they did not start hearing rehabilitation earlier; (b) parents had little confidence in the Dutch health care system and sought a second opinion from a medical doctor of their own national origin; (c) parents did not know how to be actively involved in the care of their deaf child. Implications for practice aimed at improving rehabilitation and counseling for these children are described.

Resilience factors associated with adaptation in families with deaf and hard of hearing children

The study objective was to identify and explore resilience qualities that help protect and support families facing the adversity associated with having a child with hearing loss. The Resiliency Model of Family Stress, Adjustment, and Adaptation (M. A. McCubbin & H. I. McCubbin, 1993, 1996) provided the study's theoretical framework. The 54 participating families resided in Western Cape Province, South Africa, and were identified according to the nature of the crisis (having a child with hearing loss) and the family's developmental phase. Quantitative and qualitative measures were used for data collection. The results showed that family time and routines, social support, affirming communication, family hardiness, problem-solving skills, religion, a search for meaning, and acceptance of the child's hearing status were associated with family resilience. Strengthening these elements helps families to grow, meet challenges, and reestablish balance and harmony within the family system.

[Common gene mutations study in Uyghur population with deafness in Kashgar region of Xinjiang]

OBJECTIVE

To investigate the frequency of the mutations in Uyghur nonsyndromic deafness groups in Kashgar region of Xinjiang province by means of screening the common mutations of known deafness genes in China.

METHODS

One hundred and seventy-four Uyghur patients with hearing loss were involved in this study. Questionnaire survey was conducted and peripheral blood samples were collected for polymerase chain reaction. Screening was performed for 35delG, 176-191del16, 235delC, 299-300delAT, 1555A > G, 1494C > T, 2168A > G and IVS7-2A > G. DNA sequence analysis was performed for the samples with absent signals at some loci. SPSS 17.0 software was used to analyze the data.

RESULTS

Mutation of GJB2 was the most common among the three known deafness genes. 187delG was found for the first time in Uyghur groups with hearing loss and was a new pathological mutation of GJB2. The mutation rate of SLC26A4 was low in the experimental group with no significant difference when compared with the control group. The mtDNA 12S rRNA mutation rate in the deaf group was low but not detected in the control group. In addition, mutations were not detected in 17 cases among the 20 patients with positive family history.

CONCLUSION

The mutation rate and dominant mutation of Uyghur ethnic nonsyndromic deaf groups have their own characteristics, it is necessary to conduct a sequence analysis and a stemma studying for an aim of perfecting the mutation spectrum of Uyghur deafness gene.

"I listened with my eyes": writing speech and reading deafness in the fiction of Charles Dickens and Wilkie Collins

While characters with disabilities appear frequently in Victorian fiction, deaf characters, specifically, are almost entirely absent. In fact, the only deaf characters who use sign language in Victorian fiction are Madonna Blyth in Wilkie Collins’s Hide and Seek and Sophy Marigold in Charles Dickens’s “Doctor Marigold.” Grounding its analysis in these two texts, this article contends that it is, in particular, a deaf character’s relationship to language that disqualifies him or her from conventional representation in Victorian fiction. Through reading Hide and Seek and “Doctor Marigold” in the context of Victorian deaf history, Collins and Dickens’s realist aims, and Victorian generic conventions rooted in transcribing orality, this essay argues that the absence of deaf characters reveals the investment of mid-Victorian fiction in a particular and normativized relationship between bodies, spoken language, and textuality.

Analysis of trace elements in the deaf-muted children among ethnic minorities in Urumchi

OBJECTIVE

To explore the relationship between trace elements and auditory function in the deafness children among ethnic minorities in Urumchi.

METHODS

There were 27 deaf-muted children in this study and 30 children with normal hearing as control. Sample of serum and hair from two groups were collected, and we tested 17 kinds of trace elements by using atomic absorption spectrophotometer and inductively coupled plasma emission spectrometer.

RESULTS

The content of trace elements in serum including Zn, Cu, Fe, Cd, Se, V and Pb from deaf-muted group was more higher than that of control group (P < 0.01), however, other trace elements including Mn, Sr, Sn, and Bi was much lower than that of control group (P < 0.01). Then, the content of those trace elements including Ba, Cr, Ag, Co, Ti, and Ni in serum from both testing and control groups was found no significant difference with each other (P > 0.05). On the other hand, the content of the trace elements including Sn and Se in hairs from deaf-muted group was more higher than that of control group (P < 0.05), but the content of the trace elements including Zn, Fe, Co, Mn, Sr, V, Pb, Ni, Cr, Ti and Ba in hairs from deaf-muted group was much lower than that of control group (P < 0.05), while the content of the trace element including Cu, Ag, Cd, and Bi in hairs from deaf-muted group was found no significant difference between each other (P > 0.05).

CONCLUSIONS

The content of some trace elements in serum and hairs of deaf-muted children is found a significant difference compared with children with normal hearing. This study indicates that some trace elements may relate to auditory function among ethnic minorities in Urumchi.

Mutations in MYH9 exons 1, 16, 26, and 30 are infrequently found in Japanese patients with nonsyndromic deafness

Mutations in MYH9 result in the autosomal dominant giant platelet disorders with leukocyte inclusion bodies with varying degrees of Alport manifestations, including nephritis, deafness, and cataracts. A specific MYH9 mutation in exon 16, R705H, causes nonsyndromic deafness DFNA17. We searched for mutations in MYH9 exons 1, 16, 26, and 30 in a total of 157 Japanese patients with nonsyndromic deafness without known cause of hearing loss, but no mutations were found. We conclude that mutations in MYH9 are infrequently found in patients with nonsyndromic deafness and suggest that MYH9 mutations infrequently cause isolated sensorineural hearing loss. Thus, MYH9 may not currently be a good candidate gene for efficient screening of genetic causes in nonsyndromic deafness.

Introduction: toward an understanding of epistemology and deafness

The major concept of epistemology--or epistemologies--is discussed, as well as related terms such as paradigm and science. Also covered are two broad paradigms, the clinical and the cultural, that seem to drive theorizing, research, and practice regarding individuals who are d/Deaf or hard of hearing. The two paradigms emanate from different epistemologies and might account for much of the tension in research and practice. Finally, the authors present their view on the nature of scholarly inquiries-namely, that theory, research, and practice should adhere to the principles of a multiparadigmatic science.

Deaf epistemologies as a critique and alternative to the practice of science: an anthropological perspective

In the last decade, and responding to the criticism of orientalism, anthropology has engaged in a self-critical practice, working toward a postcolonial perspective on science and an epistemological stance of partial and situated knowledge (Pinxten, 2006; Pinxten & Note, 2005). In deaf studies, anthropological and sociological studies employing qualitative and ethnographic methods have introduced a paradigm shift. Concepts of deaf culture and deaf identity have been employed as political tools, contributing to the emancipation process of deaf people. However, recent anthropological studies in diverse local contexts indicate the cultural construction of these notions. From this viewpoint, deaf studies faces a challenge to reflect on the notions of culture, emancipation, and education from a nonexclusive, noncolonial perspective. Deaf studies research in a global context needs to deal with cultural and linguistic diversity in human beings and academia. This calls for epistemological reflection and new research methods.

[Comparative analysis of the recurrent mutations between Uigur and Han ethnic deaf group in Xinjiang region of China]

OBJECTIVE

To investigate the recurrent mutations between Uigur and Han ethnic deaf group in Xinjiang region and determine the relationship between ethnicity and mutations.

METHOD

DNA were extracted from peripheral blood of 125 deaf patients from Urumqi and Korla special educational schools in Xinjiang. Audiologic examinations showed that all patients had severe to profound bilateral sensorineural hearing hoss. The coding region of GJB2 gene, SLC26A4 and mitochondrial DNA target fragments were amplified by polymerase chain reaction (PCR). Mutations in GJB2 gene, SLC26A4IVS7-2 A>G, mtDNA 1494C>T and mtDNA1555 A>G were identified by sequencing analysis.

RESULT

Allelic Frequency of the GJB2 35delG and SLC26A4IVS7-2 A>G mutations in Han deaf students were 7.4% and 10.1%, respectively, whereas not found in Uigur deaf groups. The difference was statistically significant. We did not find significant differences in GJB2 235 delC, 299-300delAT, mtDNA A1555G and C1494T allelic frequency between Uigur and Han students.

CONCLUSION

Prevalence of the recurrent mutations between Uigur and Han ethnic deaf group in Xinjiang has a great diversity.

Without boundaries: an inquiry into deaf epistemologies through a metaparadigm

The ongoing debate on Deaf epistemologies reflects two major paradigms in deaf education: positivism and constructivism. The present article investigates Deaf epistemologies through a metaparadigm, which should blur the boundaries among different paradigms and connect the epistemological inquiry to instructional practice for d/Deaf students. The author states that researchers and educators should not be obsessed with defending a particular paradigm and attacking others, but should move toward paradigmatic integration. If successful instructional practices are to be fully understood, each paradigm needs insights from the others. Furthermore, effective classroom instruction should be based on the goal of the educational activity and the ability of the students in the classroom. Mainstream theories and research in English literacy education can and should be applicable to d/Deaf students; furthermore, using appropriate instructional tools, teachers of the d/Deaf can and should teach phonologically related skills to their students.

A new mitochondrial mutation in a patient with diabetes mellitus, deafness, hydronephrosis and joint contractures

A 28-year-old man presented with multiple flexion contractures of hands and feet, deafness, diabetes mellitus and obstructive nephropathy because of bilateral ureterovesicular stricture. Other prominent clinical findings were short stature, bilateral proptosis, multiple freckles and sacralisation of LS. In order to investigate the role of mitochondrial mutations in various clinical manifestations observed in this patient, we performed mutation screening of 1.6 kb mtDNA around the tRNA (Leu(UUR)) part of 16SrRNA and the ND1 gene. No mutation was present at position 3243 which is associated with diabetes mellitus and deafness. A new point mutation (A/G) at position 4093 of the ND1 gene was found. In conclusion, we found a novel mitochondrial mutation in a patient with diabetes and deafness. This mutation has not been reported before and is the first mutation described in the ND1 gene which is related to insulin dependent diabetes mellitus and deafness and could be specific to the Iranian population. All other unusual clinical findings in this patient can be attributed to the presence of this new mutation.

Two common and three novel PDS mutations in Thai patients with Pendred syndrome

Pendred syndrome is an autosomal recessive disorder characterized by congenital sensorineural deafness, goiter, and impaired iodide organification. It is caused by mutations in the PDS gene. Most published mutation studies of Pendred syndrome have dealt with Western populations. In this study, we examined clinical and molecular characteristics of 16 affected individuals in 6 unrelated Thai families. Of all the affected, 100% (16/16) had bilateral deafness, 68.8% (11/16) goiters, and 25% (4/16) hypothyroidism. Follicular thyroid carcinoma and Hürthle cell adenoma were found in affected members of a family, raising the possibility of an increased risk of thyroid carcinoma in Pendred syndrome patients. Sequence analysis of the entire coding region of the PDS gene successfully identified all 12 mutant alleles in these 6 families. The 12 identified mutant alleles constituted 6 distinct mutations including 3 splice site mutations (IVS4-1G>A, IVS7-2A>G, IVS9- 1G>A), one frame shift mutation (1548insC) and 2 missense mutations (T67S, H723R). Eight mutations out of 12 were constituted by IVS7- 2A>G and 1548insC, each one being present in 4 distinct alleles in our studied group. The identification of these two frequent PDS mutations will facilitate the molecular diagnosis of Pendred syndrome in Thai populations. In addition, three newly identified mutations, T67S, IVS4-1G>A, and IVS9-1G>A, were not observed in 50 unrelated healthy Thai controls.

[Prevalence of GJB2 mutations in Uigur and Han ethnic populations with deafness in Xinjiang region of China]

OBJECTIVE

To investigate the prevalence of GJB2 mutations in Uigur and Han ethnic groups in Xinjiang Uigur Autonomous Region, China and to understand the mutation spectrum and frequency of the GJB2 gene in these 2 ethnic groups.

METHODS

Questionnaire survey was conducted among 61 Uigur deaf-mute students, 60 Han deaf-mute students, and 98 normal Uigurs and 301 normal Han people as controls. Peripheral blood samples were collected to undergo PCR and sequencing of GJB2 gene.

RESULTS

The GJB2 mutation rate of the Uigur deaf-mute students was 19.7%, not significantly different from that of the Han deaf-mute students (17.2%). GJB2 35delG was found only in the Uigur deaf-mutes with a carrier rate of 11.5%, whereas 235delC was identified in both Uigur and Han deaf-mutes. The allelic frequency of 35delG mutation in the Uigur and Han deaf-mutes and the Uigur controls were 7.4% (9/122), 0 (0/128), and 0 (0/196) respectively. The allelic frequencies of the GJB2 235delC mutations in the Uigur and Han deaf-mute students were 5.7% and 9.8%, and the allelic frequencies of 299 - 300delAT were 0.8% and 5.5%. V27I and E114G were the most frequent types of polymorphism.

CONCLUSION

There is a rather high mutation rate of GJB2 gene in Xinjiang. The carrier frequency of 35delG of the Uigurs is significantly higher than that of the Han population. 235delC is common in both Uigur and Han people.

Communication strategies for nurses interacting with deaf patients

Nurses play a pivotal role in promoting access to culturally competent health care services for those who experience linguistic and cultural barriers. Nursing strategies to facilitate and enhance the deaf community's access to health care services are provided.