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During spoken word recognition, listeners must quickly map sounds to meaning while suppressing competitors. It remains unclear whether domain-general inhibitory control is recruited for resolving lexical competition. Cochlear implant (CI) users present a unique population for addressing this question because they are consistently confronted with degraded auditory input, and may need to rely on domain-general mechanisms to compensate. We examined word recognition in adult CI users who were prelingually deaf (lost their hearing in childhood, N = 21), postlingually deaf (lost their hearing in adulthood, N = 50), and normal hearing controls (NH; N = 71). Participants recognised words during an eye-tracking task and completed an inhibitory control task. CI users were slower to recognise words and did not resolve competition as fully. Better inhibitory control predicted faster word activation in NH controls and postlingual, but not prelingual, CI users. Prolonged experience with acoustic language may thus influence how domain-general mechanisms are recruited for language processing. [ABSTRACT FROM AUTHOR]

Purpose: We provide a case report of "Zoe," a 4-year-old deaf child from a deaf signing family, who presented with a possible case of Childhood Apraxia of Sign (CASign). Method: The description is based on reports from the child's speech-language pathologist, her Individualized Education Program report, and a clinician-created sign imitation task. Results: Zoe's sign articulation errors in American Sign Language differed from those reported for typically developing deaf children and were parallel to the types of errors observed for hearing children with childhood apraxia of speech. Specifically, Zoe produced inconsistent errors across signs, substituted more complex handshapes for simple handshapes, made errors on both unmarked (common) and marked (less common) forms, produced articulatory distortions (rather than substitutions), and exhibited "groping" behaviors (a sequence of attempts to move her hands into the correct position). In addition, Zoe sometimes self-corrected her errors by manipulating her own hands, for example, using her left hand to move the thumb of her right hand into the correct position. Conclusion: Zoe's pattern of sign errors is consistent with an underlying deficit in motor planning and/or programming and may constitute the first reported case of CASign. [ABSTRACT FROM AUTHOR]

Purpose: Many young children who are deaf/hard of hearing (D/HH) using listening and spoken language (LSL) demonstrate improved spoken language outcomes. Anecdotally, one cascading effect of these improved outcomes is that many children are not qualifying for continued services at the age of 3 years during the Individuals with Disabilities Education Act (IDEA) of 2004 Part C to Part B transition due to norm-referenced language performance within the average range. Although norm-referenced performance is one metric for determining language delay and is heavily relied on by educational teams, these siloed measures do not reflect listening, language, and learning demands of a typical preschool classroom. This tutorial highlights the research-to-practice gap currently existing in school-based contexts when evaluating a young child who is D/HH using LSL for special education services. Conclusions: An evidence-based framework for ecologically valid, schoolbased evaluations during the transition period from IDEA (2004) Part C to Part B for young children who are D/HH using LSL between 30 and 35 months of age is presented that balances sensitivity with feasibility. With a particular emphasis on assessment practices for spoken language, the framework connects the purpose of special education eligibility evaluations with evidencebased practice guidance from the literature. [ABSTRACT FROM AUTHOR]

Clinicians utilize various methods for narrative sampling, including oral assessments like story generation and retelling, often aided by visual aids. Assessing language skills in deaf/hard of hearing (DHH) children requires careful narrative technique selection. This comparative observational study investigates the narrative outcomes of story generation and retelling tasks in 21 DHH children, using both book and movie contexts. Most microstructural elements (except for the mean length of utterance) were similar across the book and movie conditions. Differences in word choice, such as the use of action verbs, were evident. Macrostructural differences between book and movie conditions were insignificant regarding story grammar elements. However, movies, being visually engaging, potentially enhance the inclusion of characters, settings, plot, and actions. This research illuminates narrative assessment considerations, emphasizing technology's role in enhancing options for assessment for DHH children. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate family resilience--defined as the capacity of a family to harness its collective strengths and resources to recover from and adapt to significant adversities or crises effectively--in primary care- givers of children who are deaf and hard of hearing (cDHH) and its association with quality of life, life satisfaction, perceived social support, and loneliness. Method: The study involved 108 primary caregivers of cDHH and 139 primary caregivers of children with normal hearing. Participants underwent psychometric evaluations including the Family Resilience Scale, World Health Organization Quality of Life Assessment--Brief Form, Satisfaction with Life Scale, UCLA Lone- liness Scale, and Multidimensional Scale of Perceived Social Support. Results: Significant differences were found in almost every scale and its subdi- mension between the two groups (p < .05). Correlation analysis revealed signifi- cant correlations between all scale total scores for both groups (p < .05, .153 < / r / < .737). Quality of life was found to be a significant predictor of family resil- ience, F(1, 139) = 41.824, R2 = .279, B = 0.495, t = 6.467, p < .001. Conclusions: Our study highlights the significant impact of having cDHH on caregivers' family resilience, quality of life, life satisfaction, feelings of loneliness, and perceived social support. The results underscore the importance of enhanc- ing caregivers' quality of life as a potential strategy to improve their family resil- ience. Further research is needed to understand the complex interplay of factors influencing these outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This pilot study aimed to examine the effects of a caregiversupported, narrative-based intervention program on the story retelling skills of a group of preschoolers who are deaf and hard of hearing (D/HH) using listening and spoken language (LSL). Method: A concurrent multiple baseline design across participants was used to determine the effect of a narrative intervention on the story retelling skills of three preschool-age participants who demonstrated complex language delays. Their primary caregivers also functioned as participants. The 6-week narrative intervention program was implemented using a caregiver coaching model during individual therapy sessions. The dependent variable probes were administered twice per week across phases to assess the preschool participants' story retelling skills, including story grammar, complexity, and completeness. Social validity was also evaluated using a caregiver questionnaire. Results: A functional relation was demonstrated between the intervention and story retelling across all three preschool participants with notable increases in the inclusion of story grammar elements and episodic completeness. All three participants maintained scores above baseline levels on dependent variable probes across the 6-week maintenance period. Social validity was strong according to the results of a caregiver questionnaire completed at the conclusion of the intervention. Conclusion: These findings offer preliminary support for the use of a caregiversupported, narrative-based intervention program to improve storytelling and retelling skills in preschoolers who are D/HH using LSL. [ABSTRACT FROM AUTHOR]

Introduction: The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infants' early auditory development in aspects of detection, discrimination, and identification of sounds. The present study aims to evaluate the reliability and criterion validity of the Persian version of the IT-MAIS (IT-MAIS-P) for children with hearing loss (HL). Materials and Methods: In this study, due to the limitations of COVID-19 and the lack of access to samples, 23 available children with HL were sampled. The cause of participants› HL was 43.5% congenital, 30.4% acquired, and 26.1% unknown. The Mean±SD of the age of these children was 21.6±6.3 months. To evaluate the predictive validity and concurrent validity, the speech intelligibility rating (SIR) and categories of auditory performance (CAP) were used, respectively. Also, to assess the inter-rater reliability, both parents of each child completed the IT-MAIS-P. Results: A significant correlation (concurrent validity) was observed between the IT-MAIS-P and the CAP scores (r=0.87, P<0.001). Predictive validity was not confirmed by comparing it with the SIR (P>0.05). Also, the inter-rater reliability (kappa=0.44, P<0.001) of the IT-MAIS-P was confirmed. Conclusion: The IT-MAIS-P is a valid tool to investigate the progress of auditory skills in infants, although the predictive validity was not confirmed. [ABSTRACT FROM AUTHOR]

Research has demonstrated that deaf children of deaf signing parents (DOD) are afforded developmental advantages. This can be misconstrued as indicating that no DOD children exhibit early language delays (ELDs) because of their early access to a visual language. Little research has studied this presumption. In this study, we examine 174 ratings of DOD 3- to 5-year-old children, for whom signing in the home was indicated, using archival data from the online database of the Visual Communication and Sign Language Checklist. Our goals were to (1) examine the incidence of ELDs in a cohort of DOD children; (2) compare alternative scaling strategies for identifying ELD children; (3) explore patterns among behavioral ratings with a view toward developing a greater understanding of the types of language behaviors that may lie at the root of language delays; and (4) suggest recommendations for parents and professionals working with language-delayed DOD children. The results indicated that a significant number of ratings suggested ELDs, with a subset significantly delayed. These children likely require further evaluation. Among the less delayed group, ASL skills, rather than communication or cognition, were seen as the major concern, suggesting that even DOD children may require support developing linguistically accurate ASL. Overall, these findings support the need for early and ongoing evaluation of visual language skills in young DOD children. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the auditory performance and speech perception of 104 children with isolated large vestibular aqueduct syndrome (LVAS) and 523 children with no inner ear malformation (IEM) for 5 years after cochlear implantation, in order to explore whether isolated LVAS can affect the long-term hearing and speech rehabilitation of deaf children after cochlear implantation. Method: A cohort study was established consisting of 627 children who underwent cochlear implantation at Beijing Tongren Hospital from 1999 to 2016. The children were examined at 0, 6, 12, 24, 36, 48, and 60 months after cochlear implantation to assess their auditory performance and speech perception using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) questionnaires. Results: The CAP scores of the isolated LVAS group increased significantly during the baseline to the 24th month, after which they gradually rose until reaching the plateau during the 24th to the 60th month. The CAP scores of the non-IEM group increased significantly during the baseline to the 36th month and then increased steadily. The SIR scores went up significantly during the baseline to the 48th month, and increased in a gradual manner in other stages of isolated LVAS evaluation. In comparison, The SIR scores of non-IEM group grew remarkably from the baseline to the 60th month. There were no significant differences in the CAP or SIR scores between isolated LVAS and non-IEM groups in each stage of evaluation, with the only exception being the CAP score at baseline month after cochlear implantation. Conclusions: The CAP and SIR questionnaires are helpful tools for quantifying the early hearing and speech skills of younger prelingually deafened cochlear implant recipients. This long-term follow-up study shows that the speech and hearing development of children in isolated LVAS and non-IEM groups follow similar patterns, and isolated LVAS does not affect the long-term rehabilitation of deaf children after cochlear implantation. [ABSTRACT FROM AUTHOR]

Early diagnosis and intervention of deaf and hard-of-hearing (DHH) children leads to improved language and psychosocial outcomes. However, many child, parent and provider related factors can influence access to early intervention services, including hearing devices. This narrative review aims to explore factors that influence health service access in DHH children. A systematic search was conducted to identify articles that explored factors that influenced health service access in DHH children in countries with Universal Newborn Hearing Screening, published between 2010 and 2022. Fifty-nine articles met the inclusion criteria for data extraction. This included 4 systematic reviews, 2 reviews, 39 quantitative and 5 mixed methods studies and 9 qualitative studies. The identified factors were grouped into the following themes: (a) demographic factors, (b) family related factors, (c) child related factors, (d) factors specific to hearing devices, (e) service delivery, f) telehealth and (g) COVID-19. This review provided a comprehensive summary of multiple factors that affect access to health services in DHH children. Psychosocial support, consistent clinical advice, allocation of resources to rural communities and use of telehealth are possible ways to address barriers and improve health service access. [ABSTRACT FROM AUTHOR]

This article is the fifth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The 10 FCEI-DHH Principles are organized conceptually into three sections (a) Foundation Principles , (b) Support Principles , and (c) Structure Principles. Collectively, they describe the essential Principles that guide FCEI for children who are DHH and their families. This article describes the Foundation Principles (Principles 1 and Principle 2). The Foundation Principles emphasize the essential elements of ensuring that families with children who are DHH can access early intervention (EI) and other appropriate supports, as well as highlight the need for provision of EI that is family-centered. Implementation of these FCEI-DHH Principles is intended to improve the lives and the outcomes of children who are DHH and their families around the globe. [ABSTRACT FROM AUTHOR]

Parents of children who are newly identified as deaf or hard of hearing (DHH) face many decisions surrounding communication and intervention, including where to receive early intervention (EI) services. This study explored the experiences and perspectives of parents of DHH children enrolled in a center-based, family-centered EI program focused on developing listening and spoken language in California. Seventeen families participated in biannual focus groups following a semi-structured interview protocol that focused on parental decision-making and experiences receiving center-based services. Qualitative thematic analysis was used to code transcripts of the focus groups. The data coalesced around three main themes: (a) a variety of influences on technology and communication decisions, (b) the value of center-based services, and (c) a sense of empowerment and drive for advocacy. Caregivers particularly valued connections to other families of DHH children and the expertise of center-based EI providers as they navigated the first few years following identification. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this small-scale study was to assess the content validity of a modified subset of 10 items from the Speech, Spatial and Qualities of Hearing Scale for Parents (SSQ-P) via a survey of expert opinion. Material and methods: An online survey was used to obtain opinions from 10 experts in the field of children's hearing and hearing assessment. Experts were asked to rate the relevance and representativeness of each SSQ-P item to deaf and hard of hearing children aged 5 years and over. Content validity was assessed by the item content validity index (ICVI), with excellent content validity identified as an ICVI above 0.8. Experts were also asked to suggest where they felt the wording of items could be improved. Results: For all items, ICVIs > 0.8 were obtained for both relevance and representativeness, indicating excellent content validity. Some minor rewording suggestions were made. Conclusions: The 10 items tested are candidates for inclusion in an abbreviated version of SSQ-P. Some minor rewording of items may be required, along with assessment of internal consistency and test--retest stability. [ABSTRACT FROM AUTHOR]

Background: More than 90% of deaf children are born to hearing families who know little about deafness. Benefits from hearing screening at birth are often lost, as families find little information about pathways for deaf children but are key to ensuring deaf children receive relevant language and communication support. Systems surrounding deaf children and family members are crucial for children's health and social development. Experiences of hearing parents raising deaf children and understanding factors that influence families' experience of navigating pathways for deaf children through health and education services are currently underreported. Methods: An exploratory study was conducted in Wales, UK. Twenty participants were interviewed, including 10 hearing parents of deaf children and 10 people who work with deaf children using semistructured interviews. Bronfenbrenner's ecological systems theory was used as a lens to explore the micro‐, meso‐, exo‐, macro‐ and chronosystems that surround children and families. This study explores potential supports and barriers in those systems. Findings: Findings are reported under two broad headings: enablers and barriers. Under enablers, it was found that provision of resources, supporting people and knowledge were key factors. Under barriers, a lack of knowledge, lack of provision and battling services and attitudes were key issues that need addressing. Conclusion: Hearing parents of deaf children in Wales, UK reported experiencing a range of enablers and barriers that impact upon their experiences of raising a deaf child. Further provision is needed by policymakers and governments to recognise support needs to improve the outcomes for deaf children. Patient or Public Contribution: This project was developed from initial discussions with the stakeholder reference group and progressed with the group's deaf panel and hearing parents with deaf children. The project's steering group was involved in study design, recruitment and continuous feedback on all stages of the research process. [ABSTRACT FROM AUTHOR]

In research on the psychological development of deaf and hard-ofhearing (DHH) children, there is a wealth of studies focused on aspects such as speech and language, communication, and socialemotional development, but some other spheres have been disregarded. This study looks more generally at the developmental outcomes of DHH children who use cochlear implants (CIs). The participants were one group of DHH children 3 and 4 years old who used a CI and another age-matched control group with normal hearing and typical development (the TD group). The Psychomotor Development Evaluation Cards were used to evaluate the groups. Additionally, information about deafness, the CI, and health of the child and mother was obtained from medical records. For 3-year-olds, DHH children had lower scores than TD children in motor development, communication and speech, behavioural development, and knowledge and learning. However, 4-year-old DHH children had lower scores than TD children only in the socialemotional domain. In the 4-year-olds, positive correlations were also found between speech and communication development and knowledge and learning. Our results show that it is essential to offer early holistic support to DHH children who use a CI in terms of their global development, including social-emotional development. [ABSTRACT FROM AUTHOR]

Purpose: Children who are deaf and hard of hearing (DHH) have documented deficits with complex syntax and vocabulary knowledge. Mental state verbs (MSVs) are necessary for some kinds of complex syntax use and communicate abstract concepts needed for academic language. The purpose of this study was to examine the frequency, diversity, and syntactic context of MSV use in children who are DHH compared to children with typical hearing (CTH). Method: Seventy-three preschool children (23 with cochlear implants, 22 with hearing aids, and 28 with typical hearing) completed a structured language sample as part of a larger assessment battery. Samples were analyzed and compared across groups for use of MSVs, diversity in MSV use, and syntactical context for MSVs. Results: Children who are DHH used significantly fewer MSV in complex syntax, a smaller diversity of MSV, and significantly fewer MSV in obligatory contexts compared to CTH. Results for the cochlear implants and hearing aid groups were not significantly different from one another despite differing levels of hearing loss. Conclusion: Children who are DHH demonstrate significant differences in the rate, diversity, and complexity of MSV use compared to peers with typical hearing. Supplemental Material: https://doi.org/10.23641/asha.24091860 [ABSTRACT FROM AUTHOR]

The researchers investigated parents' perspectives on the outcome of cochlear implantation on the deaf child and the family in Saudi Arabia with respect to linguistic, social, psychological, and educational aspects. They also explored potential factors influencing parents' perspectives on the outcome of a cochlear implant (CI). Seventy-seven parents completed the questionnaire, and multiple linear regression and descriptive statistics were used to answer the research questions. Most of the parents (88.5%) reported choosing a CI for their deaf child because they wanted their child to be part of the hearing world. About half of the parents (49.4%) expressed the belief that the CI would help their child find a better job in the future. The study also found that, overall, the model was not significant, and the independent variables explained little of the variance in parents' perspectives on the outcome of their child's cochlear implantation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to (a) compare outcomes between children who are deaf or hard of hearing (DHH) and children with typical hearing (CTH) on the Dynamic Indicators of Basic Early Literacy Skills (DIBELS), Eighth Edition assessment and (b) compare outcomes of children who are DHH on the DIBELS to other standardized literacy assessments. Method: Participants included 19 children who are DHH and 19 CTH in kinder-garten or first grade. All participants who are DHH had bilateral hearing loss and used listening technology. The participants completed timed and untimed standardized literacy assessments. Data were analyzed using independent-samples t test, chi-square analysis, and Pearson correlation analysis. Results: Only one of five subtests on the DIBELS, the Oral Reading Fluency subtest, revealed a significant difference in scores between children who are DHH and CTH. Despite this difference, there were no differences in the distribution of risk between the groups. The DIBELS scores of children who are DHH strongly correlated to their scores on other standardized literacy assessments. Conclusions: The results indicate that the DIBELS is an adequate measure to screen early literacy skills for children who are DHH. The DHH and CTH groups differ in reading comprehension using a standardized measure; however, the DIBELS does not measure this skill. Further assessments of reading comprehension along with the DIBELS are recommended when assessing these skills in children who are DHH. [ABSTRACT FROM AUTHOR]

Objective Deafness is one of the most complex sensory disorders that leads to a major decline in auditory (listening) and preverbal skills. Research shows that reading books has provided patterns of communication and preverbal skills to deaf children. This study was conducted to investigate the effect of online dialogic parent-child book reading on the preverbal and listening skills of deaf children under three years old. Materials & Methods This research was a one-group quasi-experimental study with a pre-test-post-test design. The study sample comprised 10 hearing parents with their deaf children under 3 years old who were members of the Deaf Family Association of Iran and the Deaf Center of Iran. First, the parents and their qualified children were purposefully identified (based on inclusion criteria). Then, from all the people who met the study criteria, the people who declared their readiness to participate were selected as study samples. Before starting the online dialogic parent-child book reading program, the preverbal skills test (pointing, joint attention, imitation, and take turns) and listening skills (little ears) were administered as a pre-test. Online reading sessions were held for 20 sessions, three days a week. Parents went online at a specific time (10 AM on Saturdays, Mondays, and Wednesdays). Each day a book with pictures and story-related content, book descriptions, questions, and more was posted in the WhatsApp group. After the online dialogic parent-child book reading program, the test of preverbal and listening skills (little ears) was performed as a post-test for the sample group. The paired t-test was used to analyze the obtained data. Results The results of this study showed that the online dialogic parent-child book reading program caused a significant increase (P<0.005) in the post-test preverbal skills test score (imitation, joint attention, pointing and take turns) and listening skills (P<0.005) compared with the pre-test score of the sample group. Conclusion Dialogic parent-child book reading is one of the parent-centered programs that is benefecial for deaf toddlers. The results showed the applicability of dialogic parent-child book reading in improving the listening and preverbal skills of deaf children. [ABSTRACT FROM AUTHOR]

Relations between parental stress and children's behavior problems have been studied, but the role of parenting styles in these relations remains to be clarified. For families of children who are deaf or hard-of-hearing (DHH), exploring the associations among the three factors (i.e., parental stress, parenting styles, and children's behavior problems) can help provide a more appropriate developmental environment for DHH children. In this study, 100 parents of hearing children and 74 parents of DHH children from Hong Kong and Macau were surveyed to investigate the role of parenting styles in the relations between parental stress and children's internalizing and externalizing behavior problems. We have several key findings. First, families with DHH children were more likely to engage in permissive parenting, and their children exhibited more externalizing and internalizing behavior problems than their hearing peers. Second, parents who experienced high levels of stress tended to adopt authoritarian and permissive parenting styles, regardless of their children's hearing status. Third, authoritative parenting was related to fewer externalizing and internalizing problems in DHH children, but such an association was not found in hearing children. However, the relation that authoritarian parenting may contribute to more behavior problems was found in both groups. Implications for family interventions to decrease behavior problems in DHH and hearing children, as well as for future research, are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study presents an exploration of facilitative language techniques (FLTs) used by fathers of children who are deaf or hard of hearing (DHH) in the natural environment. Method: This investigation utilized the Language ENvironment Analysis (LENA) to collect full-day audio samples from three families with children who were DHH and between 22 and 27 months of age. A total of 6 hr of audio recordings per participant was manually coded for the presence of 10 FLTs used by fathers in the natural environment. These data were compared with FLT use by mothers from the same samples. Results: Fathers of children who are DHH used fewer overall FLTs, fewer responsive FLTs, and more directives compared with mothers. Conclusions: Results of this analysis indicate that fathers provide less linguistic input to their children who are DHH in the natural environment. Furthermore, their input tends to be directive in nature rather than responsive to the child. Implications for clinical practice are discussed. Supplemental Material: https://doi.org/10.23641/asha.23511948 [ABSTRACT FROM AUTHOR]

Parents of deaf children must decide whether to raise their child using spoken and/or signed language. Multilingual parents have the additional decision of whether to use multiple spoken languages (with or without a signed language as well). These communication choices – which can be both explicit and implicit – can change over time and are known as a Family Language Policy (FLP). This study provides a reflexive thematic analysis of semi-structured interviews with multilingual parents of deaf children who chose spoken language multilingualism (SLM), and with multilingual parents of hearing children who also chose to raise their children with more than one language. We identified four key themes which influenced the decisions parents made on SLM: (1) additional benefits for the child; (2) knowledge and professional advice; (3) family and social influences; and (4) family dynamics and negotiation. The results highlight the complexity of the decisions behind FLPs for multilingual parents of deaf children and the strong influence that factors within and outside the family can have. [ABSTRACT FROM AUTHOR]

Parents of children with hearing loss (HL) often navigate an unfamiliar and uncertain path. This qualitative study investigated the nature of parental uncertainty: (1) immediately after a child's HL was identified; (2) prior to primary school entry; and (3) during primary school. Open-ended questions in online surveys were completed by participants (N = 61) with: (a) personal experience as a parent of a child with HL (n = 35); (b) professional experience with children who have HL (n = 19); or (c) a combination of both parental and professional experience (n = 7). Six major themes were abstracted using thematic analysis, including uncertainty about: (1) the Pervasive Impact of HL, (2) the Nature and Causes of HL, (3) Developmental Impacts, (4) Family Life, (5) Family Decision-Making, and (6) Education and Support Services. The salience of these depended on the stage in time following identification. [ABSTRACT FROM AUTHOR]

Studies of deaf and hard-of-hearing (henceforth, deaf) children tend to make comparisons with typically hearing children for the purpose of either identifying deficits to be remediated or understanding the impact of auditory deprivation on visual or domain general processing. Here, we eschew these clinical and theoretical aims, seeking instead to understand factors that explain variability in cognitive function within deaf children. A total of 108 bilingual deaf children ages 7–13 years who use both English and American Sign Language (ASL) participated in a longitudinal study of executive function (EF) development. We report longitudinal data from a visual continuous performance task that measured sustained selective attention and response inhibition. Results show that the impact of deafness on these processes is negligible, but that language skills have a positive relationship with both: better English abilities were associated with better selective sustained attention, and better ASL abilities with better response inhibition. The relationship between sustained selective attention and English abilities may reflect the cognitive demands of spoken language acquisition for deaf children, whereas better ASL abilities may promote an "inner voice," associated with improved response inhibition. The current study cannot conclusively demonstrate causality or directionality of effects. However, these data highlight the importance of studies that focus on atypical individuals, for whom the relationships between language and cognition may be different from those observed in typically developing populations. [ABSTRACT FROM AUTHOR]

Prior work with hearing children acquiring a spoken language as their first language shows that spatial language and cognition are related systems and spatial language use predicts spatial memory. Here, we further investigate the extent of this relationship in signing deaf children and adults and ask if late sign language exposure, as well as the frequency and the type of spatial language use that might be affected by late exposure, modulate subsequent memory for spatial relations. To do so, we compared spatial language and memory of 8-year-old late-signing children (after 2 years of exposure to a sign language at the school for the deaf) and late-signing adults to their native-signing counterparts. We elicited picture descriptions of Left-Right relations in Turkish Sign Language (Türk İşaret Dili) and measured the subsequent recognition memory accuracy of the described pictures. Results showed that late-signing adults and children were similar to their native-signing counterparts in how often they encoded the spatial relation. However, late-signing adults but not children differed from their native-signing counterparts in the type of spatial language they used. However, neither late sign language exposure nor the frequency and type of spatial language use modulated spatial memory accuracy. Therefore, even though late language exposure seems to influence the type of spatial language use, this does not predict subsequent memory for spatial relations. We discuss the implications of these findings based on the theories concerning the correspondence between spatial language and cognition as related or rather independent systems. [ABSTRACT FROM AUTHOR]

Les aérateurs transtympaniques (ATT) sont indiqués chez l'enfant en cas d'otite séromuqueuse avec retentissement auditif ou en cas d'otites moyennes aiguës récidivantes. En cas de situation à risque (malformation cranio-faciale, difficultés développementales, rétraction tympanique), la pose d'ATT est conseillée dès la première constatation d'un épanchement rétrotympanique. Un test auditif adapté à l'âge est indispensable avant toute pose d'ATT, de même que dans les 6 mois après l'intervention, pour contrôler la normalisation de l'audition. Les alternatives médicales ne sont pas efficaces sur le long terme, et les décongestionnants et antihistaminiques sont contre-indiqués en raison de leurs effets indésirables possibles. L'adénoïdectomie diminue le risque de récidive de l'otite séromuqueuse après pose d'ATT après 4 ans, et ne doit être réalisée qu'en cas d'hypertrophie adénoïdienne symptomatique avant cet âge. Insertion of tympanostomy tubes (TT) is recommended in patients with otitis media with effusion (OME) and hearing impairment or recurrent acute otitis media. TT insertion should be also discussed in case of retrotympanic effusion for children at risk (craniofacial malformations, developmental delay, tympanic retraction). Hearing has to be assessed before and in the 6 months following tubes placement. Medical treatments have no proven long-lasting effects on OME evolution or hearing. Antihistaminics and decongestants need to be avoided because of their side effects. Adenoidectomy can reduce the recurrence of OME for children older than 4 years, but should be considered only in those with significant nasal obstruction or infection before this age. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to determine whether and how learning American Sign Language (ASL) is associated with spoken English skills in a sample of ASL–English bilingual deaf and hard of hearing (DHH) children. Method: This cross-sectional study of vocabulary size included 56 DHH chil)dren between 8 and 60 months of age who were learning both ASL and spoken English and had hearing parents. English and ASL vocabulary were indepen)dently assessed via parent report checklists. Results: ASL vocabulary size positively correlated with spoken English vocabu)lary size. Spoken English vocabulary sizes in the ASL–English bilingual DHH children in the present sample were comparable to those in previous reports of monolingual DHH children who were learning only English. ASL–English bilingual DHH children had total vocabularies (combining ASL and English) that were equivalent to same-age hearing monolingual children. Children with large ASL vocabularies were more likely to have spoken English vocabularies in the aver)age range based on norms for hearing monolingual children. Conclusions: Contrary to predictions often cited in the literature, acquisition of sign language does not harm spoken vocabulary acquisition. This retrospective, correlational study cannot determine whether there is a causal relationship between sign language and spoken language vocabulary acquisition, but if a causal relationship exists, the evidence here suggests that the effect would be positive. Bilingual DHH children have age-expected vocabularies when consid)ering the entirety of their language skills. We found no evidence to support rec)ommendations that families with DHH children avoid learning sign language. Rather, our findings show that children with early ASL exposure can develop age-appropriate vocabulary skills in both ASL and spoken English. [ABSTRACT FROM AUTHOR]

Researchers have focused on how deaf signing children acquire and use American Sign Language (ASL). One sub-skill of ASL proficiency is ASL phonology. This includes the ability to isolate and manipulate parameters within signs (i.e. handshape, location, and movement). Expressively, signed language phonological fluency tasks have investigated signers' abilities to produce signs given handshape constraints. We expanded the handshape task with the addition of sign production for two given locations with deaf adults and students. We also investigated how adjacent signs were recalled and produced within semantic and phonological clusters. Deaf adults frequently recalled signs with semantic connections and shared location. Students did the same, although shared handshape also facilitated their sign production. Finally, we present implications for ASL instruction with deaf students. [ABSTRACT FROM AUTHOR]

Purpose: Unilateral cochlear implants (CIs) can restore binaural hearing in single-sided deafness (SSD). Direct stimulation of the CI can be obtained via the Bluetooth connection of a device to the CI, thus excluding the typical-hearing ear. This study aims to investigate the use of CI connectivity features as a rehabilitative strategy in a small cohort of children affected by SSD. Method: A newly developed training protocol was presented to children with SSD who have less than 2 years of experience with CI. We developed a user-friendly and short-term (six sessions within 20 days) training protocol for speech perception that patients themselves can manage independently at home using CI connectivity systems. Children were telematically tested before and after the training by trained speech and language therapists. Results: Four patients met the inclusion criteria. They all showed better results in the final online assessment, when compared with the initial one. Conclusions: To our knowledge, this is the first clinical focus article presenting an auditory training protocol for SSD patients with CI using the Bluetooth connectivity systems for teletherapy. The results, although preliminary, support the efficacy of this rehabilitative strategy. Further research is needed to support our findings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this longitudinal investigation was to compare the developmental trajectories of code-related emergent literacy skills of children who are deaf and hard of hearing (DHH) who use amplification and spoken language across the preschool years. Method: Thirty children who are DHH and 31 children with typical hearing completed a language and emergent literacy assessment at 6-month intervals from age 4 through 6 years. Growth curve analysis was used to compare developmental trajectories between groups of the code-related skills of phonological awareness, phonological memory, phonological recoding, alphabet knowledge, and conceptual print knowledge. Results: Growth across the preschool years was observed on all code-related emergent literacy skills across groups. Children who are DHH scored consistently lower than children with typical hearing on phonological awareness, phonological memory, and conceptual print knowledge; no group differences were observed for phonological recoding or alphabet knowledge. No interactions of time and group were significant. Conclusions: Children who are DHH exhibit consistent deficits in phonological awareness, phonological memory, and conceptual print knowledge across the preschool years and begin formal literacy instruction with a weaker foundation in emergent literacy skills. Future work should focus on optimizing emergent literacy interventions for children who are DHH during the preschool years. [ABSTRACT FROM AUTHOR]

Deaf and hard-of-hearing (DHH) children with cochlear implants (CwCIs) constitute a heterogeneous population. A multitude of factors influence their spoken language development. There is evidence that CwCIs follow similar trajectories in language development as typically developing (TD) children but there is a lack of research on specific types of skills. This study aimed to (1) map the trajectory of receptive and expressive language skill development of a representative group of CwCIs and (2) evaluate the impact of age at switch-on (ASO) on skill development. This paper presents a detailed analysis of the language outcomes of 44 CwCIs with ASO between 11 and 45 months (M = 26.02 SD = 8.31). These children were tracked for the first two years following implantation. Clustered bar charts were used to compare specific types of skills acquired by CwCIs with ASO ≤2 years versus >2 years. The results suggest that CwCIs generally acquire receptive and expressive language skills along a similar sequence to TD children, but there is individual variability relating to specific skills. However, the language outcomes of CwCIs are ultimately the result of a complex interplay of demographic variables. [ABSTRACT FROM AUTHOR]

This paper discusses the role of mediation as it arose in developing and teaching two online American Sign Language (ASL) courses for parents of deaf children during the COVID-19 pandemic. Deaf children and their families who are still acquiring ASL have ongoing learning needs that are most often not met in mainstream educational systems, and these inequities have deepened during the pandemic. Combining reception, production, and interaction, mediation is a mode of language activity in the Common European Framework of Reference for Languages (CEFR) that involves "languaging" to develop ideas and facilitate understanding and communication. In this nine-month study, intensive parent ASL courses were adapted and developed for rapid implementation of online instruction in order to meet the second or additional language ASL learning needs of parents of deaf children. Online questionnaire, interview, observational, and assessment data were gathered regarding participating parents' learning processes and experiences. As study findings reveal, a main theme that arose was the role of mediation in terms of alleviating various barriers for participants and facilitating the linguistic and cultural dimensions of parents' online ASL learning and understanding through cognitive and relational means. [ABSTRACT FROM AUTHOR]

13% of deaf children in the UK use more than one spoken language. Parents of deaf children from bilingual backgrounds must decide whether to communicate with their child using more than one spoken language, with or without a signed language(s) as well. As most deaf children are born to hearing parents with little or no knowledge of deafness, professional guidance received during this decision-making process is critical. This study examined the beliefs of professionals on the ability of a deaf child to acquire two spoken languages and the advice professionals give to parents considering spoken language bilingualism for their deaf child. 108 professionals who work with deaf children in the UK (50 Teachers of the Deaf [ToDs], 47 speech and language therapists [SLTs] and 11 audiologists) completed an online questionnaire between the 24th May 2019 and the 1st July 2019. Most participants believed deaf children can achieve spoken language bilingualism and would advise parents to speak in their home language, regardless of the parents' English proficiency. However, audiologists were 11 times more likely than SLTs to report linguistic confusion, and ToDs at least 11 times more likely than SLTs to report reduced proficiency in English and the home language because of bilingualism. ToDs and SLTs were found to play a key role in bilingual parents' decision-making process. Consequently, there is a need for specific training and interprofessional learning to ensure parents receive consistent evidence-based advice. [ABSTRACT FROM AUTHOR]

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Our objective was to examine the effects of hearing aid amplification on auditory detection and discrimination in infants who were hard of hearing (IHH) using a physiological measure of auditory perception. We recorded EEG from 41 sleeping IHH aged 1.04 to 5.62 months while presenting auditory stimuli in a mismatch response paradigm. Responses were recorded during two listening conditions for each participant: aided and unaided. Temporal envelopes of the mismatch response in the EEG alpha band (6–12 Hz) were extracted from the latent, time-frequency transformed data. Aided alpha band responses were greater than unaided responses for the deviant trials but were not different for the standard trials. Responses to the deviant trials were greater than responses to the standard trials for the aided conditions but were not different for the unaided conditions. These results suggest that the alpha band mismatch can be used to examine both detection and discrimination of speech and non-speech sounds in IHH. With further study, the alpha band mismatch could expand and refine our abilities to validate hearing aid fittings at younger ages than current clinical protocols allow. [ABSTRACT FROM AUTHOR]

Permanent childhood hearing impairment (PCHI) represents the most frequent sensory pathology at birth. PCHI has a relevant psychological impact on the life of both the affected children and their families. Thus, the aim of this work is to explore the degree of parental distress felt by mothers of a deaf or hard-of-hearing child, to determine if this stress is associated with variables related to the children's health (e.g., the severity of hearing loss, presence of other conditions, difficulty with treatment options, difficulty with rehabilitation) or family characteristics such as socio-economic and educational status. The study used the Parenting Stress Index–Short Form (PSI-SF) questionnaire administered to mothers. The results were analyzed in relation to variables such as parents' education level, number of children, severity of hearing loss, presence of other chronic conditions, presence of cognitive delay, familiarity with hearing loss, time of diagnosis, use of prosthetics, and start in a rehabilitation program. The data indicate a correlation between maternal stress levels and low-educational levels, as well as the presence of congenital infections and cognitive delay. These results highlight the need for a comprehensive physical and psychological approach for hearing-impaired children, as stress factors can affect the adherence to effective rehabilitation. [ABSTRACT FROM AUTHOR]

The article highlights the work of Hands & Voices, an organization dedicated to supporting families of children who are deaf or hard of hearing. Topics include background of the organization, coverage of their work, and their advocacy for universal newborn screening for congenital CMV and raise awareness of its impact on childhood haring loss.

Purpose: Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanishspeaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency. Method: Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency. Results: We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not. Conclusions: Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English. [ABSTRACT FROM AUTHOR]

Research highlights the complex needs of parents of children with hearing loss. These complex needs include the need for parents to have access to information, be connected with social support networks, consider communication options and have collaborative partnerships with professionals. A mixed-methods approach with a sequential explanatory design using a two-phased approach was implemented in the study. This article reports on the last phase of the study, the consensus workshop. The consensus workshop approach allowed for greater participation, interaction and discussion in the decision-making process in the co-development of a framework to support parents. This phase consisted of two workshops where experts, stakeholders and parents reached consensus on four topics and fifteen sub-topics. Each topic with its sub-topics offers insights into the kind of professional support parents require. The consensus workshop can be considered a valuable tool for multidisciplinary engagement to support parents of children with hearing loss. [ABSTRACT FROM AUTHOR]

Introduction: The study aims to reveal the function of diagnosis, evaluation, and monitoring processes in Guidance Research Center (GRC) on children with hearing loss. In addition, it examines whether there is a difference between the applications of GRCs and the reasons for possible differences. Method: The study is designed as a descriptive case study, including semi-structured interviews, document analysis, and reflective diaries for the researcher's observation. The research data collection process was carried out in GRCs in two districts of a medium-sized Central Anatolian city. 13 teachers from two GRCs participated in the research. Findings: The data analysis showed that the findings pointing to the functioning of GRC processes were grouped under seven themes: Opinions on diagnosis, evaluation, referral, placement, monitoring process, individualized education program (IEP) and report renewal, problems experienced in GRC processes, and suggestions for GRC processes. The prominent findings can be exemplified as the lack of cooperation between the hospital and the GRC, the inadequacy of the evaluation forms, the lack of materials, the failure to provide the physical conditions suitable for the evaluation, and the attempt to monitor with annual reports. Discussion: The function of diagnosis, evaluation, orientation, placement, and monitoring processes and the problems experienced in these processes were compared with previous literature. [ABSTRACT FROM AUTHOR]

Language development is an important facet of early life. Deaf children may have exposure to various languages and communication modalities, including spoken and visual. Previous research has documented the rate of growth of English skills among young deaf children, but no studies have investigated the rate of ASL acquisition. The current paper examines young deaf children's acquisition of ASL skills, the rate of growth over time, and factors impacting levels and growth rates. Seventy-three children ages birth to 5 were rated three times using the Visual Communication and Sign Language Checklist and given a scaled score at each rating. An average monthly gain score was calculated for each participant. The presence of a deaf parent, use of ASL at home, use of cochlear implant(s), whether the child was born deaf, and age of initial diagnosis were analyzed for their impact on the level of ASL skill and rate of growth. Results indicated that the use of ASL in the home has a significant positive effect on deaf children's ASL skill level. Additionally, children with lower initial ratings showed higher rates of growth than those with higher initial ratings, especially among school-aged children. The paper discusses implications and directions for future studies. [ABSTRACT FROM AUTHOR]

Design features of American Sign Language (ASL)-English bilingual storybook apps on the tablet computers, based on learning research, are intended to facilitate independent and interactive learning of English print literacy and of ASL skill among young learners. In 2013, the Science of Learning Center on Visual Language and Visual Learning introduced the first in a series of storybook apps for the iPad based on literacy and reading research. The current study, employing a sample of signing deaf children examined children's self-motivated engagement with the various design features presented in the earliest of the apps, The Baobab, and analyzed the relationships of engagement with ASL skill and age of first exposure to ASL, ASL narrative ability, and grade-appropriate English reading ability. Results indicated a robust level of engagement with the app, and a relationship between app pages specifically targeting reading and early exposure and skill levels in ASL. No evidence of relationships between narrative and vocabulary skills and app reading engagement was found. Topics for future research, and strategies for app improvement are discussed. [ABSTRACT FROM AUTHOR]

This study investigated the pragmatic skills of 41 deaf and hard-of-hearing (DHH) students, enrolled in a Deaf Facility within a mainstream primary school. Five groups of DHH students (aged 6–12 years) across Foundation to Year 6 participated in two small-group wellbeing lessons with their teachers of the deaf. Video recordings of these lessons were analysed into two types of interactions: (1) peer-to-peer, and (2) teacher-led group interactions. Peer-to-peer interactions were further analysed to explore the pragmatic skills of these students. Results showed that the highest percentage of time at all year levels was spent in group interactions led by the teacher. However, the trend across the data showed that the opportunities provided for peer-to-peer interactions increased for the students in the older year levels. The DHH students demonstrated a range of effective pragmatic skills in peer-to-peer interactions including turn-taking, contingency, and showing sensitivity to their partners during collaborative learning. However, the use and sophistication of these pragmatic skills varied according to the nature of the task set by the teachers, and the age and language abilities of the students. The findings suggest that further opportunities for spontaneous interactions between peers would support the development of pragmatic skills in DHH students. In addition, teachers would benefit from professional learning to highlight the advantages of providing opportunities for spontaneous peer-to-peer interactions to support social communication in DHH students. [ABSTRACT FROM AUTHOR]

This study examines the family resilience of deaf children through the perspective of family communication. We examine the relationship between family communication patterns (including conformity and conversation orientation) with family resilience and compare differences in processes in family resilience of family types. Parents of deaf children (n = 129) in Indonesia completed a survey of family communication patterns and family resilience. Our findings show that there is a significant positive relationship between family communication patterns and family resilience, with preference to conversation orientations. All family types were identified as having a relationship with family resilience with different uniqueness in their resilience processes. With the relationship between these two concepts, perhaps the concept of communication patterns in the family can become a theoretical framework that binds the literature on family resilience in a sample of families with deaf children. Implications and direction for future research are discussed. [ABSTRACT FROM AUTHOR]

Deciding on an educational setting for children who are deaf or hard of hearing (DHH) is a complex process that is not well understood. In the present study, the researchers' objective was to understand the factors caregivers consider when choosing a school for their child. Six caregivers of children who were DHH participated in semistructured interviews, which were coded into three themes (Child-Centered, Familial, School) and five subthemes (Inclusion, Additional Needs and Well-Being, Complex Process, Information Input and Flow, School Systems and Personnel). An unexpected theme (On Reflection) and three additional subthemes (Caregiver Perceptions of Education, School Character, No Regrets) were also identified. A highlighted finding is that when choosing an educational setting, caregivers of children who are DHH use decision-making processes that are complex and multifaceted. Practical implications for professionals supporting caregivers through decision-making processes are outlined, and applications for practice are suggested. [ABSTRACT FROM AUTHOR]

Purpose: More than 80% of children who are deaf/hard of hearing (DHH) receive services in mainstream school settings. This means they are often served as part of a broader caseload rather than by someone who has specific training in serving this population. While best practice outlines specific skills and expertise from highly qualified providers, in reality, many lack confidence related to hearing technology and resources related to serving children who are DHH. Method: This study surveyed 459 professionals within the American Speech- Language-Hearing Association who serve children who are DHH with the intent of comparing differences in confidence, training, and resource use between providers who have self-selected interest in working with children who are DHH (i.e., membership in Special Interest Group [SIG] 9, Pediatric Hearing and Hearing Disorders) and those who serve children who are DHH but are not part of the pediatric hearing--related SIG. Results: Results indicated that many providers, particularly those not in SIG 9, did not have confidence in serving young children who are DHH (particularly in early intervention or preschool). Graduate experiences (classes and practicum) played little role in providers' confidence working with children who are DHH. Conclusions: While most children who are DHH are enrolled in school settings, there is limited provider confidence in working with this population. Graduate training programs should explore opportunities to provide more intensive, comprehensive experiences to prepare providers in this area. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe the Language Access Profile Tool (LAPT) and its psychometric properties with the aim of evaluating its suitability as an alternative to the deaf or hard of hearing (DHH) Language Exposure Assessment Tool (D-LEAT) in clinical practice with DHH children age 12 years and younger.*** Method: We administered both the LAPT and D-LEAT to the caregivers of 105 DHH children 12 years old and younger from across the United States, 40% of whom were interviewed again after a delay of at least 1 month. Each interview resulted in a child-specific estimate of their cumulative experience with language input, expressed as a proportion divided across eight categories.*** Results: Participants in the sample reported experience with all eight input categories, but four categories were common and four were rare. Estimates for all input categories were consistent at both initial and follow-up interviews. Estimates for each input category were also strongly correlated with the corresponding estimates from the D-LEAT, although correlations for the rare categories should be interpreted cautiously.*** Conclusions: The LAPT demonstrates sufficient test-retest reliability and convergent validity to be a useful and more user-friendly alternative to the D-LEAT. We provide recommendations for how the LAPT and the D-LEAT can be best used in their current form. [ABSTRACT FROM AUTHOR]

Purpose: Children who are hard of hearing (CHH) are at risk for literacy difficulties. Speech sound production is related to literacy skills in typically hearing children. Speech sound production abilities can also be markedly weak in CHH due to inconsistent access to the speech signal. We longitudinally examined relations between auditory experience, speech sound production abilities, and literacy (i.e., nonword reading and spelling in second grade) in CHH.*** Method: Participants included 166 CHH. All participants used hearing aids (HAs). Auditory experience is a weighted measure of the number of hours of daily HA use and the amount of audibility with and without their HAs. Children's speech sound production was tested 2-3 times between the ages of 3 and 9 years. At age 5 years and again in second grade, children were tested on a battery of language and literacy measures.*** Results: Auditory experience was significantly correlated with speech sound production abilities, but age at HA fitting was not. Speech sound production abilities at age 5 years did not predict nonword reading in second grade but did predict spelling skills in second grade.*** Conclusions: Our results support the importance of auditory experience and speech sound production for later literacy abilities. Specifically, we found that speech sound production abilities and print knowledge at age 5 years are related to second grade spelling outcomes. Interestingly, we found that morphological knowledge at age 5 years was more predictive of decoding in second grade than was speech sound production. Although there are multiple factors that contribute to literacy success, our results underscore the unique contributions of speech sound production abilities in CHH. [ABSTRACT FROM AUTHOR]