P. Margaret Brown

Early language development in children with profound hearing loss fitted with a device at a young age: part I--the time period taken to acquire first words and first word combinations.

Objective: Increasing numbers of infants and young children are now presenting to implantation centers and early intervention programs as the impact of universal newborn hearing screening programs is felt worldwide. Although results of a number of studies have highlighted the benefit of early identification and early fitting of hearing devices, there is relatively little research on the impact of early fitting of these devices on first language milestones. The aim of this study was to investigate the early spoken language milestones of young children with hearing loss (HL) from two perspectives: first, the acquisition of the first lexicon (i.e., the first 100 words) and second, the emergence of the first word combinations. Design: Two groups of participants, one comprising 24 participants with profound HL and a second comprising 16 participants with normal hearing, were compared. Twenty-three participants in the HL group were fitted with a cochlear implant and one with bilateral hearing aids. All of these were “switched-on” or fitted before 30 months of age and half at <12 months of age. Language data were collected using the Diary of Early Language, a procedure in which parents recorded their childs first 100 spoken single words and any word combinations produced while reaching this single-word target. Acquisition of single words was compared by using the time period (in days) taken to reach several single-word targets (e.g., 50 words, 100 words) from the date of production of the first word. The emergence of word combinations was analyzed from two perspectives: first, the time (in days) from the date of production of the first word to the emergence of the first word combinations and second, the size of the single-word lexicon when word combinations emerged. Results: The normal-hearing group required a significantly shorter time period to acquire the first 50 (mean <1.9 months) and the first 100 (mean <3.9 months) words than the HL group. Although both groups demonstrated acceleration in lexical acquisition, the hearing group took significantly fewer days to reach the second 50 words relative to the first 50 words than did the HL group. Finally, the hearing group produced word combinations significantly earlier (i.e., in fewer days from production of the first word) than the HL group; however, the size of the single-word lexicon when word combinations emerged was similar for both groups. Conclusions: The results of this study suggest that despite fitting of a device at an early age, HL continues to impact early lexical acquisition and the emergence of word combinations. Further, similarities between the hearing and HL groups, such as the overall pattern of lexical acquisition and a lexicogrammatical link, suggest that the processes underpinning early language acquisition for hearing children and those with HL may also be similar.

Pretend Play and Maternal Scaffolding: Comparisons of Toddlers With Advanced Development, Typical Development, and Hearing Impairment.

This study used measures of pretend play and maternal scaffolding to explore and compare the early development of deaf children, typically developing children, and children showing advanced intellectual development. Marked differences were found among the groups in both play development and characteristics of mother‐child interactions. In particular, children who scored above 130 IQ at four years of age were found, as toddlers, to have demonstrated significantly advanced pretend play. In addition, the mothers of the high IQ children engaged in scaffolding behaviors involving higher stages of pretend transformations, verbal analogies and world links. The findings are discussed in relation to childrens learning in Vygotskys Zone of Proximal Development, as well as possible implications for future research on early gifted development.

Language Ability and Verbal and Nonverbal Executive Functioning in Deaf Students Communicating in Spoken English

The internal use of language during problem solving is considered to play a key role in executive functioning. This role provides a means for self-reflection and self-questioning during the formation of rules and plans and a capacity to control and monitor behavior during problem-solving activity. Given that increasingly sophisticated language is required for effective executive functioning as an individual matures, it is likely that students with poor language abilities will have difficulties performing complex problem-solving tasks. The aim of this study was to investigate the relationship between language ability and verbal and nonverbal executive functioning in a group of deaf students who communicate using spoken English, as measured by their performance on two standardized tests of executive function: the Delis-Kaplan Executive Function System (D-KEFS) 20 Questions Test and the D-KEFS Tower Test. Expressive language ability accounted for more than 40% of variability in performance on the D-KEFS 20 Questions Test. There was no significant relationship between language ability and performance on the D-KEFS Tower Test. There was no relationship between language ability and familiarity with the specific problem-solving strategies of both D-KEFS Tests. Implications of the findings are discussed.

Social Interactions of Preschoolers with and without Impaired Hearing in Integrated Kindergarten.

This study investigated the social competence of children with normal hearing (n = 10) and children with impaired hearing (n = 10) who attended an integrated preschool program for 4 to 5 year olds. The study compared the social interactions of the two groups of participants both in sociodramatic play and nonplay activities, their entry behaviors and relative success rates. Entry behaviors were associated both with the hearing status of participants and with the type of activity. The children with normal hearing were more likely initially to survey the group (particularly in sociodramatic play) and then to use behaviors that either oriented themselves to the groups activity or referenced the group to themselves. The children with normal hearing were more successful in gaining entry, particularly to nonplay activities.

Sensitivity in Interactions between Hearing Mothers and their Toddlers with Hearing Loss: The Effect of Cochlear Implantation

Abstract This study investigated the potential effects of cochlear implantation and age at implantation on maternal interactional sensitivity. Three groups of dyads were studied at two points over 1 year. The hearing aid (HA) group wore hearing aids throughout the study, the early cochlear-implanted (ECI) group were implanted prior to 22 months of age, and the later cochlear-implanted (LCI) group were implanted after 25 months of age. Using the Maternal Sensitivity Rating Scale, results showed that for all three groups overall maternal sensitivity and specific dimensions of sensitivity increased over time. There was no significant difference between the HA group and the combined cochlear implant group, however, the mothers of the children in the ECI group showed significant increases in maternal sensitivity when compared with the LCI group. The Maternal Sensitivity Rating Scale appears to be discriminatory over time, and between groups of items relating to the quality of interaction, contingency to the child, and maternal interactional strategies. The scale may prove to be a useful instrument for practitioners.

Early language development in children with profound hearing loss fitted with a device at a young age: part II--content of the first lexicon.

Objective: Lexical content is commonly understood to refer to the various categories of words that children produce and has been studied extensively in children with normal hearing. Unlike the hearing child, however, little is known about the word categories that make up the first lexicon of children with hearing loss (HL). Knowledge of the first lexicon is increasingly important, as infants with HL are now being detected through universal newborn hearing screening programs and fitted with hearing aids and cochlear implants in before 12 months of age. For these children, emergence of the first spoken words is a major milestone eagerly awaited by parents and one of the first verbal language goals of teachers and therapists working with such children. The purpose of this study was to evaluate the lexical content of the first 50 and 100 words produced by children with HL and to contrast this with that of a group of hearing children. Design: Lexical content was compared in two groups of children: one group composed of 24 participants with severe profound or profound HL and a second group composed of 16 participants with normal hearing. Twenty-three participants in the HL group were fitted with a cochlear implant and one with bilateral hearing aids. All were “switched on” or fitted before 30 months of age. The Diary of Early Language (Di-EL) was used to collect a 100-word lexicon from each participant. All single word and frozen phrase data from each child’s Di-EL were allocated to 1 of 15 word types grouped into four word categories (noun, predicate, grammatical, and paralexical), and the results were compared for both groups. Results: The hearing and HL groups showed similar distributions of word categories, with nouns constituting the largest portion of the lexicon followed by predicates and paralexicals. Grammaticals made up the smallest portion of the lexicon. However, several significant differences were evident between the two groups. In both the 50- and 100-word lexicons, the hearing group used proportionately more nouns, fewer predicates, more common nouns, and fewer onomatopoeic words compared with the HL group. Further, more participants in the hearing group used grammatical word types other than adverbs (including pronouns) compared with the HL group. Conclusion: Overall, lexical content of the HL group was similar to that of the hearing group for both the 50- and 100-word lexicons, although some differences in proportional use were noted across word categories and types. It is suggested that differences in the quantity and diversity of language experienced by children with normal hearing compared with those with HL, together with differences in the input they receive, might in part explain these differences. The effect of quality of speech input and therapy method on the emerging lexicon and subsequent language development will be particularly important in informing appropriate intervention strategies for children with HL.

Mental Health of Australian Deaf Adolescents: An Investigation using an Auslan Version of the Strengths and Difficulties Questionnaire

Abstract This study investigated mental health problems in 54 deaf adolescents between 11 and 18 years of age residing in the states of New South Wales and Tasmania in Australia. Mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ; ). The SDQ Self Report was translated into Australian Sign Language (Auslan; ) using a rigorous iterative process of translation and back-translation. Both the written and Auslan Self Report versions of the instrument were administered to establish test–retest reliability and internal consistency of the signed version. Parent and teacher reports were also obtained. Results showed acceptable levels of reliability and internal consistency for the Auslan version of the self-report commensurate with those obtained for the written version on a normative hearing sample. Modest correlations were found between some of the syndrome scales in the two versions. Modest to strong correlations emerged between parent and teacher reports, parent and child written versions, and for some of the syndrome scales between teacher and child self-reports and between the parent and Auslan Self Report version. The prevalence rates yielded by the different respondents differed with parents reporting higher prevalence than teachers or children. Differences also emerged between the rates identified using the different versions of the Child Self Report. The implications of these findings are discussed.

Mental Health of Deaf and Hard-of-Hearing Adolescents: What the Students Say

This study investigated the mental health problems of 89 deaf and hard-of-hearing (DHH) adolescents in New South Wales, Tasmania, and Western Australia. Participants completed the written (for oral students) or signed version for competent Australian Sign Language (Auslan) users version of the Youth Self Report (YSR). Students were educated in a range of educational settings, had varying degrees of hearing loss, and used a range of communication modes. Results showed that, overall, DHH students reported increased levels of mental health problems compared with hearing peers. The broadband syndromes were more than 3 times more likely to be reported, while the narrowband syndromes were between 2 and 7 times more likely. A binary logistic regression analysis showed that the language used at home was a significant predictor of mental health problems. The implications of these findings for the social, emotional, and mental well-being of DHH students and the training of professionals are discussed.

Young learners: Aspects of home literacy environments supporting hypotheses about the structure of printed words:

This study investigated the relationships between children’s home literacy environments and their early hypotheses about printed words in the year prior to entering school. There were 147 children (70 girls and 77 boys: mean age 57 months, range = 47–66 months, standard deviation = 4.5 months) in the study. Results showed that the children had varying degrees of knowledge about printed words. Significant associations between age of the child and the application of hypotheses about printed words were found. In relation to the home literacy environments, parents with stronger literacy profiles and habits, whether to do with traditional forms of print or new techno-literacies, were more likely to read to their children on a daily basis, and these children were more likely to have developed hypotheses about the structure of printed words. The implications for understanding children’s early literacy knowledge and relevance for educators of young children are discussed.

Beliefs, practices, and expectations of oral teachers of the deaf

Abstract This study investigated the beliefs and practices of 28 teachers of the deaf about their practices. The teachers were all working in oral settings either as visiting teachers or teachers in a mainstream school facility supporting groups of students with hearing loss. Teachers who used an Auditory Verbal approach largely adopted a positivist paradigm, whereas those using an Auditory Oral approach were more likely to adopt a constructivist paradigm. Those using a mixed approach (AV/AO) adopted a paradigm that was a mix of both positivist and constructivist. Results suggest that there is a strong relationship between the underlying beliefs of teachers and the model of practice that they adopt, and that professional experience, professional development and the inclusion movement exert an influence on those beliefs and practices.