A significant number of d/Deaf and hard of hearing (d/Dhh) children and adolescents experience challenges in acquiring a functional level of English language and literacy skills in the United States ...(and elsewhere). To provide an understanding of this issue, this book explores the theoretical underpinnings and synthesizes major research findings. It also covers critical controversial areas such as the use of assistive hearing devices, language, and literacy assessments, and inclusion. Although the targeted population is children and adolescents who are d/Dhh, contributors found it necessary to apply our understanding of the development of English in other populations of struggling readers and writers such as children with language or literacy disabilities and those for whom English is not the home language. Collectively, this information should assist scholars in conducting further research and enable educators to develop general instructional guidelines and strategies to improve the language and literacy levels of d/Dhh students. It is clear that there is not a ‘one-size-fits-all’ concept, but, rather, research and instruction should be differentiated to meet the needs of d/Dhh students. It is our hope that this book stimulates further theorizing and research and, most importantly, offers evidence- and reason-based practices for improving language and literacy abilities of d/Dhh students.
Examine the association between sociodemographic factors and Individualized Education Program (IEP) establishment.
Retrospective cohort study.
Tertiary referral center.
Participants included deaf or ...hard-of-hearing children who were eligible for an IEP with "deafness" or "hard of hearing" as a primary or secondary disability. Primary outcome measures were time intervals between initial referral for services and parental consent; parental consent to determination of eligibility; and initial referral to eligibility (the sum of the previous 2 intervals). Student's t tests and linear regression were used to examine the association between sociodemographic factors and the primary outcome variables.
Of the 88 participants, 51 (58%) were male, 45 (51%) were from underrepresented minority (URM) groups, 35 (40%) spoke a primary language other than English, and 53 (60%) utilized public insurance. IEP establishment was significantly delayed in participants who required an English-language interpreter. Most of the delay occurred in the time between the initial referral and parental consent (mean: 115 vs 37 days, P = .02). There were also significant delays from the time of referral for services to eligibility in URM participants (mean: 159 vs 85 days, P = .04). Significant delays were also associated with Minority Status and Language within social vulnerability index percentile rankings.
This study found that IEP establishment was delayed in both URM participants and those who required an English-language interpreter. These results highlight the importance of clear communication between the school system and caregivers in the IEP establishment process, particularly with families who require an English-language interpreter or identify as URM.
This study examined the language outcomes of children with mild to severe hearing loss during the preschool years. The longitudinal design was leveraged to test whether language growth trajectories ...were associated with degree of hearing loss and whether aided hearing influenced language growth in a systematic manner. The study also explored the influence of the timing of hearing aid fitting and extent of use on children's language growth. Finally, the study tested the hypothesis that morphosyntax may be at particular risk due to the demands it places on the processing of fine details in the linguistic input.
The full cohort of children in this study comprised 290 children who were hard of hearing (CHH) and 112 children with normal hearing who participated in the Outcomes of Children with Hearing Loss (OCHL) study between the ages of 2 and 6 years. CHH had a mean better-ear pure-tone average of 47.66 dB HL (SD = 13.35). All children received a comprehensive battery of language measures at annual intervals, including standardized tests, parent-report measures, and spontaneous and elicited language samples. Principal components analysis supported the use of a single composite language score for each of the age levels (2, 3, 4, 5, and 6 years). Measures of unaided (better-ear pure-tone average, speech intelligibility index) and aided (residualized speech intelligibility index) hearing were collected, along with parent-report measures of daily hearing aid use time. Mixed modeling procedures were applied to examine the rate of change (227 CHH; 94 children with normal hearing) in language ability over time in relation to (1) degree of hearing loss, (2) aided hearing, (3) age of hearing aid fit and duration of use, and (4) daily hearing aid use. Principal components analysis was also employed to examine factor loadings from spontaneous language samples and to test their correspondence with standardized measures. Multiple regression analysis was used to test for differential effects of hearing loss on morphosyntax and lexical development.
Children with mild to severe hearing loss, on average, showed depressed language levels compared with peers with normal hearing who were matched on age and socioeconomic status. The degree to which CHH fell behind increased with greater severity of hearing loss. The amount of improved audibility with hearing aids was associated with differential rates of language growth; better audibility was associated with faster rates of language growth in the preschool years. Children fit early with hearing aids had better early language achievement than children fit later. However, children who were fit after 18 months of age improved in their language abilities as a function of the duration of hearing aid use. These results suggest that the language learning system remains open to experience provided by improved access to linguistic input. Performance in the domain of morphosyntax was found to be more delayed in CHH than their semantic abilities.
The data obtained in this study largely support the predictions, suggesting that mild to severe hearing loss places children at risk for delays in language development. Risks are moderated by the provision of early and consistent access to well-fit hearing aids that provide optimized audibility.
The difficulty that deaf and hard of hearing students have in
attaining language and literacy skills has led to postulations that
attribute their struggle to a developmental deficit. Recent
research ...reveals, however, that deaf students acquire language
structures, produce errors, and employ strategies in the same
fashion as younger hearing students, though at later ages. The
ability of all students to learn language and literacy skills in a
similar manner at different stages forms the foundation of the
Qualitative Similarity Hypothesis (QSH). This volume describes the
theoretical underpinnings and research findings of the QSH. It
presents the educational implications for deaf and hard of hearing
children and offers reason-based practices for improving their
English language and literacy development. This collection also
stresses the critical importance of exposing educators to the
larger fields of literacy and second-language learning. Providing
this background information expands the possibility of
differentiating instruction to meet the needs of deaf students.
Deaf Students and the Qualitative Similarity Hypothesis
includes commentary on the QSH for both first- and second-language
English learners and reflects on how the QSH can effect a better
future for all language students.
Thoroughly updated with three new chapters, Foundations of Aural Rehabilitation: Children, Adults, and Their Family Members, Sixth Edition introduces the fundamentals of audiologic rehabilitation and ...hearing-related speech-language pathology in an easy-to-read, concise resource for the field of communication sciences and disorders. The text offers creative coverage of theory, clinical practice, and research-based approaches for identifying, diagnosing, and treating hearing-related communication disorders in children and adults. The book includes case studies, and general demographic, medical, and pop-cultural trends are considered in parallel with corresponding developments in aural rehabilitation.
Objective
Deaf and hard‐of‐hearing (DHH) patients are understudied in emergency medicine health services research. Theory and limited evidence suggest that DHH patients are at higher risk of ...emergency department (ED) utilization and poorer quality of care. This study assessed ED condition acuity, length of stay (LOS), and acute ED revisits among DHH patients. We hypothesized that DHH patients would experience poorer ED care outcomes.
Methods
We conducted a retrospective chart review of a single health care system using data from a large academic medical center in the southeast United States. Data were received from the medical center's data office, and we sampled patients and encounters from between June 2011 and April 2020. We compared DHH American Sign Language (ASL) users (n = 108), DHH English speakers (n = 358), and non‐DHH English speakers (n = 302). We used multilevel modeling to assess the differences among patient segments in outcomes related to ED use and care.
Results
As hypothesized, DHH ASL users had longer ED LOS than non‐DHH English speakers, on average 30 min longer. Differences in ED condition acuity, measured through Emergency Severity Index and triage pain scale, were not statistically significant. DHH English speakers represented a majority (61%) of acute ED revisit encounters.
Conclusions
Our study identified that DHH ASL users have longer ED LOS than non‐DHH English speakers. Additional research is needed to further explain the association between DHH status and ED care outcomes (including ED LOS and acute revisit), which may be used to identify intervention targets to improve health equity.
Deaf and hard-of-hearing (DHH) people are at higher risk than their non-DHH counterparts of experiencing adverse birth outcomes. There is a lack of research focusing on social, linguistic, and ...medical factors related to being DHH which may identify groups of DHH people who experience more inequity.
Examine difference in prevalence of cesarean and adverse birth outcomes among diverse sub-groups of DHH people.
We conducted a cross-sectional survey of DHH birthing people in the U.S. who gave birth within the past 10 years. The sample was predominantly white, college educated, and married. We assessed cesarean birth and three adverse birth outcomes: preterm birth, low birthweight, and NICU admission post-delivery. DHH-specific variables were genetic etiology of hearing loss, preferred language (i.e., American Sign Language, English, or bilingual), severity of hearing loss, age of onset of hearing loss, and self-reported quality of perinatal care communication. We estimated prevalence, 95 % confidence intervals, and unadjusted prevalence ratios.
Thirty-one percent of our sample reported a cesarean birth. Overall, there were no significant differences in prevalence across the outcome variables with respect to preferred language, genetic etiology, severity, and age of onset. Poorer perinatal care communication quality was associated with higher prevalence of preterm birth (PR = 2.37) and NICU admission (PR = 1.91).
Our study found no evidence supporting differences in obstetric outcomes among DHH birthing people across medical factors related to deafness. Findings support the important role of communication access for DHH people in healthcare environments.
Spoken language outcomes after cochlear implantation are highly variable. Some variance can be attributed to individual characteristics. Research with typically hearing children suggests that the ...amount of language directed to children may also play a role. However, several moderating factors may complicate the association between language input and language outcomes in children with cochlear implants. In this article, I present a conceptual framework that posits that the association between total language input directed to children and language outcomes is moderated by factors that influence what is accessible, attended to, and coordinated with the child. The framework also posits that children with cochlear implants exhibit more variability on those moderating factors, which explains why the relation between language input and language outcomes may be more complex even if language input is more important for successful language outcomes in this population.
Pandemic public health measures, such as masks and social distancing, present unique challenges for people who are hard-of-hearing. This study sought to understand how adolescents with varying levels ...of hearing loss would describe their experiences communicating in a classroom environment during a pandemic and its associated public health measures.
Qualitative study utilizing one-on-one semi-structured interviews conducted from July 2021 to April 2022. Interviews were transcribed and analyzed using a reflexive thematic analysis to conceptualize the main themes from the data. Adolescents ages 12–17 who attended school in person during the COVID-19 pandemic with either normal hearing or; bilateral cochlear implants or; bone-anchored hearing aids or; unilateral moderate to severe (40–70 dB) conductive hearing loss secondary to mastoidectomy, were interviewed. Participants were recruited from BC Children's Hospital Otolaryngology clinic via a convenience sample.
Fourteen adolescents were interviewed with a median age of 15, 9 with hearing loss and 5 with normal hearing. Pandemic associated challenges such as masks muffling speech, protocol fatigue, and missing pre-pandemic life were present in both the hearing loss and normal hearing groups. Classroom communication for adolescents with hearing loss was disproportionately affected by pandemic measures, leading to challenges making friends, feeling behind their peers in learning, and listening fatigue. Resilience was noted among adolescents with hearing loss in their ability to adapt to pandemic measures and changing classroom dynamics. For adolescents with unilateral hearing loss, the pandemic provided an improved listening environment via a reduction in background noise.
Pre-existing classroom communication challenges for adolescents with hearing loss were amplified under pandemic public health measures and shared, in part, by those with normal hearing. These findings can be used to further inform classroom design to the optimize learning environment for deaf and hard of hearing students.
•Classroom communication for adolescents with hearing loss was disproportionately affected by pandemic measures, leading to challenges making friends, feeling behind their peers in learning, and listening fatigue.•For adolescents with unilateral hearing loss, the pandemic provided an improved listening environment via a reduction in background noise.•Pandemic public health measures exacerbated pre-existing communication challenges for deaf and hard of hearing students and were shared in part by those with normal hearing.
Hearing loss is a common and complex condition that can occur at any age, can be inherited or acquired, and is associated with a remarkably wide array of etiologies. The diverse causes of hearing ...loss, combined with the highly variable and often overlapping presentations of different forms of hearing loss, challenge the ability of traditional clinical evaluations to arrive at an etiologic diagnosis for many deaf and hard-of-hearing individuals. However, identifying the etiology of hearing loss may affect clinical management, improve prognostic accuracy, and refine genetic counseling and assessment of the likelihood of recurrence for relatives of deaf and hard-of-hearing individuals. Linguistic and cultural identities associated with being deaf or hard-of-hearing can complicate access to and the effectiveness of clinical care. These concerns can be minimized when genetic and other health care services are provided in a linguistically and culturally sensitive manner. This clinical practice resource offers information about the frequency, causes, and presentations of hearing loss and suggests approaches to the clinical and genetic evaluation of deaf and hard-of-hearing individuals aimed at identifying an etiologic diagnosis and providing informative and effective patient education and genetic counseling.
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