Evidence-based practice in educating deaf and hard-of-hearing children: teaching to their cognitive strengths and needs
This paper examines research findings concerning the loci of the pervasive academic underachievement among deaf and hard-of-hearing (DHH) children and issues associated with interventions and instructional methods that could help to reduce or eliminate it. Investigators have hypothesised that at least 50% of the variability in DHH students’ achievement may be because of instructional factors, and several studies have indicated that when taught by experienced teachers of the deaf in mixed classrooms, DHH students may gain just as much as their hearing peers. Only recently, however, have findings begun to emerge concerning related language and cognitive differences between DHH and hearing students as well as instructional differences between teachers with and without experience in teaching DHH students. Building on convergent evidence from such studies offers the prospect of a significant improvement in academic outcomes for those children in the future.
Deaf and hard-of-hearing (DHH) children typically lag behind hearing age-mates in academic achievement. This paper describes recent findings indicating language and cognitive differences between DHH and hearing students that appear to explain some of their classroom challenges. There is currently only limited evidence with regard to the effectiveness of particular interventions, and thus relatively few are offered here. However, recognition of the language and cognitive differences both between DHH and hearing students and within a population of DHH students suggests opportunities for modification of instructional materials and methods in ways to accommodate DHH students’ needs and build on their strengths.
Influences on parental evaluation of the content of early intervention following early identification of deafness: a study about parents’ preferences and satisfaction
Conclusion These findings underscore the importance of understanding how parents’ beliefs, values and perceived need impact on their experience of early intervention
The notion that young children form and test hypotheses about early print is well established in relation to children from different cultures who use different languages. This study demonstrates that this also obtains for young deaf children still in the early stages of developing spoken language. Data collected from the homes of 13 deaf children (aged from 3 years 3 months to 4 years 4 months at the start of the study) over a two-year period showed hypothesising and experimenting around writing. Spontaneous drawing and writing samples were collected and a method of eliciting data was devised that did not rely on the children knowing vocabulary related to print (e.g. word or sentence). The data revealed that these children had internalised print concepts but this knowledge could easily be overlooked. Implications for educational settings are discussed. Copyright © 2009 John Wiley & Sons, Ltd.
Conclusions & Implications: The results indicate that hearing mothers were sensitive to the needs of their deaf children. This sensitivity was to children’s word knowledge. Mothers seemed aware of what words were in their children’s lexicon. Mothers did not rely on their children’s ability to use novel mapping, even for the linguistically advanced children.
Expressive spoken language development in deaf children with cochlear implants who are beginning formal education
This paper assesses the expressive spoken grammar skills of young deaf children using cochlear implants who are beginning formal education, compares it with that achieved by normally hearing children and considers possible implications for educational management. Spoken language grammar was assessed, three years after implantation, in 45 children with profound deafness who were implanted between ten and 36 months of age (mean age = 27 months), using the South Tyneside Assessment of Syntactic Structures (Armstrong and Ainley, 1983) which is based on the Language Assessment and Remediation Screening Procedure (Crystal et al., 1976). Of the children in this study aged between four and six years, 58 per cent (26) were at or above the expressive spoken language grammatical level of normally hearing three year olds after three years of consistent cochlear implant use: however, 42 per cent (19) had skills below this level. Aetiology of deafness, age at implantation, educational placement, mode of communication and presence of additional disorders did not have a statistically significant effect (accepted at p 0.05) on the development of expressive spoken grammar skills. While just over half of the group had acquired spoken language grammar skills equivalent to or above those of a normally hearing three year old, there remains a sizeable group who, after three years of cochlear implant use, had not attained this level. Spoken language grammar therefore remains an area of delay for many of the children in this group. All the children were attending school with hearing children whose language skills are likely to be in the normal range for four to six year olds. We therefore need to ensure that the ongoing educational management of these deaf children with implants addresses their spoken grammar delay in order that they can benefit more fully from formal education. Copyright © 2009 John Wiley & Sons, Ltd.
Pediatric hearing impairment caregiver experience: Impact of duration of hearing loss on parental stress
Caregivers of children who are deaf/hard of hearing have been reported to have greater stress than caregivers of children with normal hearing. The time of diagnosis is a particularly stressful time and stress levels may change over time based on varying needs at different life events. Thus, we hypothesized that stress experienced by caregivers evolves over time and is impacted by the duration since the diagnosis of hearing loss.
The 68-item pediatric hearing impairment caregiver experience (PHICE) is a validated questionnaire used to measure stress. The PHICE was administered to 152 caregivers of children with permanent hearing loss. Domain scores were converted into z-scores for analysis of trends of stress over time.
Parents of children whose hearing loss was identified more than 60 months ago reported higher stress levels regarding educational aspects of their child’s needs as compared to parents of children with less than 24 months or 24–60 months duration since diagnosis. Parents of children diagnosed with hearing loss within the preceding 24 months reported higher stress levels in the area of healthcare than parents of children diagnosed greater than 24 months ago.
Parental stressors change over time with respect to the time of diagnosis of hearing impairment. This phenomenon was observed irrespective of the age of diagnosis of hearing loss. As professionals serving families of children with hearing loss, we should be aware of changing stressors over time and identify the appropriate support services for families to meet those changing needs. By addressing those evolving stressors, the families’ ability to support and improve the outcomes for their children who are deaf or hard of hearing may be enhanced.
There is a surprising lack of systematic research evaluating the effects of reading exercises for young deaf children. Therefore, for this article, two computer-based exercises were developed and learning effects were determined by posttests. One (spelling oriented) exercise was to select the correct word among three orthographically similar alternatives that corresponds to a drawing or a sign (digital video). The other (meaning oriented) exercise was to select the correct sign or picture among three alternatives that corresponds to a written word. Eleven deaf Dutch children with a mean age of 7 years 10 months participated in the study. A first question was whether in single-word exercises the meaning or the spelling of a word should be emphasized. A second question was whether there was any effect of using drawings or signs to refer to the meaning of the word. The results reveal that emphasizing the word spelling is most effective for learning to read for deaf children and the findings also suggest that drawings are more efficient in the current exercises.
Reading abilities after cochlear implantation: The effect of age at implantation on outcomes at 5 and 7 years after implantation
The reading skills of deaf children have typically been delayed and this delay has been found to increase with age. This study explored the reading ability of a large group of children who had received cochlear implants 7 years earlier and investigated the relationship between reading ability and age at implantation.
The reading ages of 105 children, with age at implantation less than 7 years and onset of deafness below the age of three, were assessed 5 and 7 years after implantation using the Edinburgh reading test. Net reading age was calculated by using the difference between chronological age and reading age. Non-verbal intelligence was measured for a subset of 71 children, using Raven’s coloured progressive matrices. Further investigation of this subset looked at the association of nonverbal intelligence, age at implantation and reading ability.
There was a strong negative correlation at both 5 and 7 years after implant between net reading score and age at implantation. In the subset of 71 children who had an IQ score within normal range, those implanted at or before 42 months had age-appropriate reading both 5 and 7 years post-implant. This was not the case for children implanted after 42 months. Reading progress at the two post-implant assessment intervals were found to be highly related.
Age at implantation was a significant factor in the development of reading skills in this group. In children implanted below the age of 42 months, reading progress was in line with chronological age, which has not been the case previously with profoundly deaf children. With earlier implantation more common in present groups, and improved technology, there is every reason to be optimistic about the influence of cochlear implantation on the development of reading skills in deaf children.
Purpose: The purpose of this study was to compare speech production at 12 months of age for children with hearing loss (HL) who were identified and received intervention before 6 months of age with those of children with normal hearing (NH).
Method: The speech production of 10 children with NH was compared with that of 10 children with HL whose losses were identified (better ear pure-tone average at 0.5, 1, and 2 kHz poorer than 50 dB HL) and whose intervention started before 6 months of age. These children were recorded at 12 months of age interacting with a parent. Three properties of speech production were analyzed: (a) syllable shape, (b) consonant type, and (c) vowel formant frequencies.
Results: Children with HL had (a) fewer multisyllable utterances with consonants, (b) fewer fricatives and fewer stops with alveolar-velar stop place, and (c) more restricted front-back tongue positions for vowels than did the children with NH.
Conclusion: Even when hearing loss is identified shortly after birth, children with HL do not develop speech production skills as their peers with NH do at 12 months of age. This suggests that researchers need to consider their approaches to early intervention carefully.