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

This single case study concerns an 11-year-old girl, Agata, who recently moved to a rural community in the United States from the Philippines. Agata is profoundly deaf, has had no access to amplification, and has had very limited access to language and formal school. The journey through the next year, including the COVID-19 pandemic, saw Agata's language and literacy skills blossom at an unexpected rate. The study examines the how and why of Agata's progress by using multiple sources of both quantitative and qualitative data. A conceptual framework of both direct instruction theory (Engelmann & Carnine, 1982) and resilience theory (Garmezy, 1993) was used to systematically analyze the factors that contributed to Agata's growth and offer a more thorough understanding of the complex challenges and potential successes in supporting students from Asian communities who are d/Deaf or hard of hearing (d/DHH).

There is a nationwide shortage of qualified Teachers of Deaf (TOD) and teacher attrition is an important component of the shortage. This qualitative research study examines the experiences of thirty-three former TODs in the United States who left their teaching positions in the last decade and the reasons why they resigned. Data sources include open-ended survey questions and focus groups. While TODs experienced the concept of "the last straw," themes in the reasons they exited the field included: (1) Work life's adverse effects on personal well-being, (2) Lack of support from the school community, and (3) Inadequate training in teacher preparation programs. This study brings attention to some TODs' struggles, contextualizes previous quantitative findings about TOD dissatisfaction, and makes recommendations for deaf education to maintain a strong teacher force that effectively serves deaf students.

Through in-depth interviews, this qualitative study explored the perceptions of seven teachers of students who are d/Deaf and hard of hearing (D/HH) regarding inclusive and interpreted education. The findings revealed central themes of concern including inadequate support in inclusive placements, communication modality mismatches, and insufficient quality of interpreted education. The teachers' experiences underscore the need for more comprehensive educational support systems and the development of robust support mechanisms to effectively navigate the challenges of inclusive placements for students who are D/HH. Specifically, further attention must be given to improving the qualifications, training, support, and supervision of educational interpreters facilitating education in inclusive settings. These findings have implications for multiple stakeholders, including policymakers, educators, and supportive personnel involved in shaping inclusive education practices to ensure equitable access and the creation of supportive spaces where all students can thrive.

The COVID-19 pandemic placed stress on all aspects of the educational system. Many state departments of education acknowledged the disruption to individualized education program evaluation and implementation but insisted that evaluation timelines and services continue undisrupted. School psychologists were therefore forced to navigate the viability of virtual assessment without established research supporting this type of student evaluation. Formal assessments used in the identification of learning disabilities and other areas of disability were not standardized with virtual administration procedures; however, many test publishers have offered guidelines for online administration. These guidelines may not be suitable for test administration with deaf and hard of hearing (DHH) children. Through the presentation of two case studies, this article explores some of the available administration guidelines and evaluates their appropriateness for use with DHH children. Information in this article informs current practice of school psychology in a virtual environment.

The discussion on the role of American Sign Language (ASL) in deaf students' reading development has been long and contentious. The students' limited knowledge of English has been commonly perceived as a culprit in making reading difficult. However, a more nuanced explanation of reading performance and its relationship with competence in ASL's potential role is needed. In the present study, multivariate analyses of the variance in the ASL and English comprehension performance of 91 middle school students at an ASL-English bilingual school revealed some important insights. Inference-making skills in ASL are an important predictor. For the students with hearing parents, the quality of communicative access at home contributed significantly to the overall explanation of the variance in English passage comprehension; along with the age at exposure to ASL, it accounted for a large part of the variance in the ASL passage comprehension.

For much of the history of deaf education, spoken language bilingualism was not considered a viable goal. It was believed that given the challenges of meaningful auditory access, age-appropriate development in even one language would be daunting. However, implementation of universal newborn hearing screening during the early 2000s, along with early fitting of hearing technologies, including cochlear implants, has afforded significantly improved access to spoken language during the critical early years of language acquisition for most deaf children. In this context, it is timely to reconsider the possibilities of spoken language bilingualism in the education of deaf students. The present article therefore focuses on examining the available literature with a view to summarizing current understandings and reflecting on how these understandings can inform future research and practice and the multiple ways in which bilingualism can be operationalized in the education of deaf students.

In this concluding article of an American Annals of the Deaf Special Issue, we draw on Vygotsky's Fundamentals of Defectology to argue that the essence of deaf pedagogy is not centered on constructing deaf students' hearing abilities but on a biosocial orientation that considers the whole multimodal child with unfettered access to natural signed languages. In alignment with this biosocial view, we recognize and resist the overarching influence of biomedical professionals and systems on deaf education. Such biomedical influence comes with convenient detachment from accountability in education systems while arguably causing at least significant, if not maximal, harm to the optimal developmental outcomes of deaf children. The article ties together the articles of the Annals Special Issue, along with additional Vygotskian perspectives, to bring forth the emergence and exploration of biosocial accountability in deaf education.

Deaf and hard of hearing (d/DHH) students are often labeled with one or more educationally significant disabilities in addition to their hearing loss. According to the Gallaudet Research Institution's most recent Annual Survey of Deaf and Hard of Hearing Children and Youth (2013), almost 40% of d/DHH students nationwide receive special education services for one or more comorbid disabilities. However, relatively few prevalence rate estimates have been published over the last decade. Knowledge regarding the current prevalence of educationally significant disabilities among d/DHH students is therefore limited. The present study surveyed teachers of the deaf and hard of hearing (TODHHs) in a midwestern state regarding the number of d/DHH students on their caseloads with one or more comorbid disabilities. Within the sample population (N = 451), nearly 65% were reported to receive special education services for disabilities other than deafness or hearing impairment.

During the COVID-19 pandemic, many children experienced multiple challenges while transitioning from traditional to online schooling. Teachers, administrators, and parents were expected to work together to provide students an optimal educational experience through those turbulent times. This experience generated new insights into how to teach deaf and hard of hearing (DHH) students and assess their knowledge. New tools were invented and used during the pandemic, and though teachers and students are slowly returning to traditional learning environments, educators now know that alternative forms of teaching and learning exist. We acknowledge the ways teachers, administrators, and parents can innovate and bring new knowledge to the table. The present article introduces an American Annals of the Deaf Special Issue that offers further research and discussion in the event that another, comparable challenge occurs. Multiple issues must be considered in DHH education, from academic rigor to social-emotional wellness.

The language wars have driven decision-making and educational options for D/deaf and hard of hearing children for over a century, yet we still have not made sufficient progress in closing the linguistic and educational gaps between D/deaf and hard of hearing children and their hearing peers. Perhaps it is time to abandon the bifurcated approach that has driven our field since the infamous Milan Conference of 1880. This commentary explores how a "Radical Middle" approach can frame the way we prepare teachers of the deaf, how we conduct and disseminate research, how we support families, and how the D/deaf and hearing communities can work together in positive and proactive ways. There is strength in unity. We are stronger as a field when we come together to support one another and find ways for collaboration and partnership across philosophical lines and communication preference.

This study explores Deaf individuals' and sign language interpreters' perspectives on what it is like to work together in K-12 education. A group of 41 formerly mainstreamed Deaf individuals and interpreters offers insights into interactional dynamics (e.g., the deaf student-interpreter relationship) that influence interpreters' work, deaf students' participation and learning, and feedback practices. This study illustrates the significance of the deaf student-interpreter relationship and suggests a correlation between this relationship and deaf students' participation and positioning in mainstream classrooms. In addition, the findings suggest a correlation between the deaf student-interpreter relationship and feedback practices in mainstream education. Finally, this study finds that deaf students do not always know that they can engage in feedback conversations with interpreters or know how to engage interpreters to ask for what they need to learn. This article concludes with considerations and recommendations for the deaf education and interpreter education communities., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Luft is professor emerita, School of Lifespan Development and Educational Sciences, College of Education, Health and Human Services, Kent State University, Kent, OH. She was president of the Council on Education of the Deaf (CED) from 2018 to 2020. Fischgrund is adjunct faculty, Department of Special Education, Saint Joseph's University, Philadelphia, PA. He was CED executive director from 2012 to 2019. Eardley is the owner of Future Endeavors Consulting, Cleveland, OH. Tanner is a teacher of deaf and hard of hearing students, Pasco County (FL) Schools. Reusser is a staff interpreter, Cleveland Hearing and Speech Center. Eardley, Tanner, and Reusser were graduate assistants at Kent State University when the research for the present article was conducted.Teacher shortages and alternative licensure requirements, in combination with inconsistent state licensure regulations, suggest that not all teachers of deaf and hard of hearing students have the expertise to successfully educate their students. Most national, regional, and specialized professional accreditations do not assess DHH-specific instructional and communication proficiencies, and thus may contribute to DHH students' low achievement levels relative to those of their hearing peers. The study surveyed teaching licensure requirements across the 50 states and District of Columbia regarding compliance with federal requirements and state variations. Results showed that 39% of states did not require a DHH-specific teacher-training program; 45% did not employ a DHH-specific licensure exam. Only 25% required documentation of language/communication skills. A specialized accrediting organization, such as the Council on Education of the Deaf, could help identify well-prepared teachers to fill current and future vacancies and thereby improve DHH students' achievement.

Further education (FE) colleges are the most usual postsecondary education destination for deaf young people in England. The role of college contexts in promoting deaf students' learning warrants further exploration given the gaps in educational attainment common to deaf students and the potential for FE context to provide new and/or enhanced linguistic resources in comparison with school. The main research question is: How do deaf students' translanguaging practices change according to the different contexts of interlocution in college? Translanguaging entails the flexible use of semiotic resources not bounded by named languages. This ethnographic study reports on five deaf college students' translanguaging practices. Findings are presented under three moments of translanguaging: (1) translanguaging expanded, or deaf students widening their repertoires to engage in communication; (2) translanguaging restricted, or deaf students accommodating to their communicative partners' needs; (3) translanguaging channeled, or the dominance of English countering the flexibility of translanguaging. It is argued that translanguaging should be promoted in whole classrooms. Otherwise, it will reinforce the dominance of hearing communication practices and hinder deaf students' multilingual/multimodal repertoires., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: On March 11, 2020, the World Health Organization declared COVID-19 to be a global pandemic. This prompted many countries, including Saudi Arabia, to suspend students' attendance at schools and to start distance education. This sudden shift in the educational system has affected students' learning, particularly for d/Deaf and hard-of-hearing (d/Dhh) students, who have unique language and communication needs., Aim: This study explores the challenges and support methods for d/Dhh students during their distance education in Saudi Arabia., Methods: A qualitative research study using semistructured interviews was conducted with 37 parents of d/Dhh students to answer the research questions., Results: Three themes emerged from the parents' responses: (1) the challenges faced by d/Dhh students in distance education; (2) the specific needs of d/Dhh students in distance education; and (3) the supports provided to d/Dhh students in distance education., Conclusions: Distance education is a strategic choice, and parents must be informed about how to use the Madrasati e-learning platform effectively by providing solutions and supports. Additionally, d/Dhh students require various forms of ongoing support from both their families and schools to ensure that they succeed and benefit from their experiences., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

This study examined the effects of (a) schema-enriched communication and (b) computer-based messaging on the sharing of knowledge and problem solving in teams with deaf or hard of hearing (DHH) and typical hearing (TH) postsecondary students. Four-member teams comprising either all DHH, all TH, or two DHH and two TH postsecondary students solved a complex problem. Measures consisted of (a) shared written information, (b) creation of a matrix with information for solving the problem, (c) recognition of information shared by team members, and (d) quality of the team's problem solution. A total of 126 DHH and 126 TH postsecondary students participated in the study in teams with one of the three combinations of hearing status. Enriched communication increased teams' sharing of written information, creation of a matrix, recognition of information shared by teammates and quality of the problem solution in teams., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Purpose The COVID-19 pandemic has necessitated a quick shift to virtual speech-language services; however, only a small percentage of speech-language pathologists (SLPs) had previously engaged in telepractice. The purpose of this clinical tutorial is (a) to describe how the Early Language and Literacy Acquisition in Children with Hearing Loss study, a longitudinal study involving speech-language assessment with children with and without hearing loss, transitioned from in-person to virtual assessment and (b) to provide tips for optimizing virtual assessment procedures. Method We provide an overview of our decision making during the transition to virtual assessment. Additionally, we report on a pilot study that calculated test-retest reliability from in-person to virtual assessment for a subset of our preschool-age participants. Results Our pilot study revealed that most speech-language measures had high or adequate test-retest reliability when administered in a virtual environment. When low reliability occurred, generally the measures were timed. Conclusions Speech-language assessment can be conducted successfully in a virtual environment for preschool children with hearing loss. We provide suggestions for clinicians to consider when preparing for virtual assessment sessions. Supplemental Material https://doi.org/10.23641/asha.14787834.

Purpose The COVID-19 pandemic introduced new educational challenges for students, teachers, and caregivers due to the changed and varied learning environments, use of face masks, and social distancing requirements. These challenges are particularly pronounced for students with hearing loss who often require specific accommodations to allow for equal access to the curriculum. The purpose of this study was to document the potential difficulties that students with hearing loss faced during the pandemic and to generate recommendations to promote learning and engagement based on findings. Method A qualitative survey was designed to document the frequency of various learning situations (i.e., in person, remote virtual, and blended), examine the accessibility of technology and course content, and quantify hearing issues associated with safety measures and technology use in school-age students with hearing loss. Survey questions were informed from key educational issues reported in published articles and guidelines. The survey was completed by 416 educational personnel who work with students with hearing loss. Results Respondents indicated that most of their schools were providing remote or blended (in-person and remote) learning consisting of synchronous and asynchronous learning. Common accommodations for students with hearing loss were only provided some of the time with the exception of sign language interpreters, which were provided for almost all students who required them. According to the respondents, both students and caregivers reported issues or discomfort with the technology required for remote learning. Conclusion To ensure that students with hearing loss are provided equal access to the curriculum, additional accommodations should be considered to address issues arising from pandemic-related changes to school and learning practices including closed captioning, transcripts/notes, recordings of lectures, sign language interpreters, student check-ins, and family-directed resources to assist with technology issues.

This study compared the observed and the self-reported engagement of 16 students who are Deaf or hard-of-hearing (DHH) attending mainstream schools to that of matched controls with typical hearing. Observed engagement was measured through observations in the classroom setting using the Mainstream Version of the Code for Instructional Structure and Student Academic Reponses. Self-reported engagement was measured using the Classroom Participation Questionnaire. The results revealed no significant differences for either observed or self-reported engagement between the DHH and the control groups; however, three individual DHH participants had lower levels of observed engagement compared to their matched controls. As such, including engagement in the evaluation of students who are DHH may be important for some individuals to provide a better understanding of the daily challenges they experience at school. Where needs are identified, the support that students who are DHH receive should include a specific focus on engagement to assist with their successful inclusion., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The authors discuss Pinyin, a phonetic system based on the Latin alphabet, as an auxiliary pedagogical tool in literacy instruction in China. They provide a brief history of Pinyin and its educational purposes, then describe how it is used in its spoken/auditory, written, and signed forms by teachers with students who are deaf and hard of hearing (DHH). Classroom transcripts demonstrate how Pinyin is taught via visual and tactile/kinesthetic tools such as pictures, sign language, and the Chinese Manual Alphabet for purposes of making the phonological information visible to DHH learners. The authors further discuss the different functions of Pinyin for students who are hearing versus students who are DHH and present new insights that may lead to future empirical studies on Pinyin use in early literacy interventions.

Research rarely focuses on how deaf and hard of hearing (DHH) students address mathematical ideas. Complexities involved in using sign language (SL) in mathematics classrooms include not just challenges, but opportunities that accompany mathematics learning in this gestural-somatic medium. The authors consider DHH students primarily as learners of mathematics, and their SL use as a special case of language in the mathematics classroom. More specifically, using SL in teaching and learning mathematics is explored within semiotic and embodiment perspectives to gain a better understanding of how using SL affects the development, conceptualization, and representation of mathematical meaning. The theoretical discussion employs examples from the authors' work and research on geometry, arithmetic, and fraction concepts with Deaf German and Austrian learners and experts. The examples inform the context of mathematics teaching and learning more generally by illuminating SL features that distinguish mathematics learning for DHH learners.

Coeditors of a special issue of the American Annals of the Deaf on mathematics instruction in deaf education, the authors provide a context for the five featured articles. First, the authors establish the importance of mathematics. They then give a historical account of previously related "stepping-stones." Beginning at 1990, the authors follow key events in the field that have led to the special issue. They summarize each article, highlighting three common themes: deaf and hard of hearing (DHH) persons as distinct and capable mathematics learners, the significance of conceptual understanding of mathematics concepts, and the role of language as a key component of mathematics instruction and learning. The authors conclude with a call for further research that recognizes the heterogeneity of DHH learners.

To promote dialogue among literacy researchers from East and West along the "'Silk Road' to literacy" for Chinese d/Deaf and hard of hearing (d/Dhh) students (Andrews et al., 2021), this epilogue to an American Annals of the Deaf special issue on language development and literacy learning of d/Dhh students in Chinese communities poses questions and provides reflections from the perspective of the Chinese Deaf lens on the ideas in the six articles that make up the special issue. This perspective reframes literacy instruction toward an asset-based model that emphasizes visual sensory strengths, sign-to-print mapping strategies, and Deaf cultural capital. This special issue includes a tribute (Q. Wang et al., 2021) to the authors' late colleague Dr. Ye (Angel) Wang, who encouraged collaborative work with deaf and hearing literacy researchers employing different paradigms of literacy instruction.

Increasingly, across the globe, deaf and hard of hearing (DHH) students are educated in mainstream schools using spoken language for communication. Classroom interactions require the use of sophisticated pragmatic language skills. Pragmatic skills can be delayed in DHH students and create challenges for the social and emotional adjustment of DHH students at school. School-aged DHH children may present to pediatric health care providers with concerns about communicating effectively and forming friendships with hearing school peers. This review of pragmatic research between school-aged DHH students and their typically hearing peers reveals that this group of students displays some well-developed pragmatic skills such as turn taking, questioning, seeking general clarifications, and using a range of turn types. In it, we identify key areas in which DHH students experience significant challenges in both the social use of language and expository interactions (involving descriptions or explanations) that characterize classroom communication. DHH students tend to dominate interactions and have challenges with being contingent on their partners' contributions. In addition, many DHH students display some difficulty with sequencing instructions and may use referents poorly, making it difficult for peers to follow their instructions and fully grasp their meaning. The conversation model is presented in this article as a guide for pediatric health care providers, clinicians, educators, and parents and/or caregivers to understand these pragmatic challenges. The model guides medical and education practitioners with the development of targeted intervention that will support these students' ability to interact with others, learn more effectively, and develop friendships., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Objectives: The goals of the current study were to (1) examine differences in pragmatic abilities and peer relationship behaviors among deaf and hard of hearing (DHH) adolescents who use spoken language, in comparison with their hearing peers; and (2) explore the contribution of pragmatic skills and speech (ie, articulation and intelligibility [AI]) to social aspects of school functioning among DHH and typically hearing adolescents., Methods: Thirty-three DHH adolescents and 34 adolescents with typical hearing participated. All DHH adolescents attended mainstream school settings and used spoken language. Teacher reports were obtained on prosocial behaviors, peer problems, pragmatic abilities, and speech AI of the adolescents. Adolescents self-reported on the supportiveness of their peer relationships and their school emotional engagement., Results: Multiple hierarchical regression analyses revealed that DHH adolescents had greater difficulties with peers than their hearing counterparts. Increased pragmatic difficulties were related to more peer problems and decreased prosocial behaviors, regardless of adolescents' hearing status. A significant positive correlation was found between pragmatic competence and adolescents' perceptions of peers' support. Finally, better speech AI were associated with higher levels of school emotional engagement., Conclusions: The results emphasize the significant role of pragmatics for both DHH and typically hearing adolescents. Medical care providers and allied health professionals should be aware of possible difficulties that DHH adolescents may have in complex and nuanced pragmatic skills. Some adolescents may require a referral to specialized services to support the development of their pragmatic understanding and their skills., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Speakers and signers naturally and spontaneously gesture when they use language to communicate. These gestures not only play a central role in how language is used in social situations but also offer insight into speakers' and signers' cognitive processes. The goals of this article are twofold: (1) to document how gesture can be used to identify concerns in language development and (2) to illustrate how gesture can be used to address those concerns, particularly with respect to pragmatic development. These goals are explored in this article, with a focus on deaf and/or hard of hearing (DHH) children. Medical providers and allied health professionals, as well as educators and parents, can use the information gleaned from the gestures of DHH children to determine if intervention is needed. Gesture can also be used to design interventions, including interventions in which children who are DHH are presented gestures in combination with speech or signs and interventions in which they are encouraged to gesture themselves. Children's gestures not only increase their learning potential but also create opportunities for medical and health professionals, as well as educators and parents, to gain access to a DHH child's unspoken and unsigned ideas, capitalizing on the opportunity to provide intervention when it is likely to be effective., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

This study examined the relationships between adult language input and child language production in regard to the quantity and diversity of spoken language, as well as children's knowledge of basic concepts and vocabulary. The quantity and diversity of language provided by teachers and parents were related to children's language output and knowledge. Language ENvironment Analysis technology audio-recorded the language environments of 26 preschool children with hearing loss over 2 days. The language samples were analyzed for quantity (adult word count, child vocalization count, and conversational turn count) and diversity (lexical diversity, syntactical complexity, and clausal complexity) of language. Results indicated a relationship between adult language input and child language production, but only in regard to the quantity of language. Significant differences between the teachers and parents were reported in regard to the diversity of adult language input. These results suggest that the language input provided by adults across environments (school versus home) is considerably different and warrants further investigation., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Deaf students are members of a linguistic and cultural minority whose background and experiences provide a unique backdrop for the navigation of higher education. Using the framework of Deaf community cultural wealth, this study examines the experiences of Deaf students in community college and their utilization of various forms of capital. Findings showed that they exhibited instances of resistant, navigational, social, and familial capital in accessing and persisting in higher education., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: To examine health-related quality of life (HRQoL) in young children with low language or congenital hearing loss and to explore the value of assessing HRQoL by concurrently administering 2 HRQoL instruments in populations of children., Methods: Data were from 2 Australian community-based studies: Language for Learning (children with typical and low language at age 4 years, n = 1012) and the Statewide Comparison of Outcomes study (children with hearing loss, n = 108). HRQoL was measured using the parent-reported Health Utilities Index Mark 3 (HUI3) and the Pediatrics Quality of Life Inventory 4.0 (PedsQL) generic core scale. Agreement between the HRQoL instruments was assessed using intraclass correlation and Bland-Altman plots., Results: Children with low language and with hearing loss had lower HRQoL than children with normal language; the worst HRQoL was experienced by children with both. The lower HRQoL was mainly due to impaired school functioning (PedsQL) and speech and cognition (HUI3). Children with hearing loss also had impaired physical and social functioning (PedsQL), vision, hearing, dexterity, and ambulation (HUI3). Correlations between instruments were poor to moderate, with low agreement., Conclusions: Children with low language and congenital hearing loss might benefit from interventions targeting overall health and well-being, not just their impairments. The HUI3 and PedsQL each seemed to provide unique information and thus may supplement each other in assessing HRQoL of young children, including those with low language or congenital hearing loss., (Copyright © 2019 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)

Objective: To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received., Method: A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received., Results: The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients., Conclusion: A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA., (Copyright © 2019 Elsevier B.V. All rights reserved.)

In low-level perceptual tasks and reading tasks, deaf individuals show a redistribution of spatial visual attention toward the parafoveal and peripheral visual fields. In the present study, the experiment adopted the modified flanker paradigm and utilized a lexical decision task to investigate how these unique visual skills may influence foveal lexical access in deaf individuals. It was predicted that irrelevant linguistic stimuli presented in parafoveal vision, during a lexical decision task, would produce a larger interference effect for deaf college student readers if the stimuli acted as distractors during the task. The results showed there was a larger interference effect in deaf college student readers compared to the interference effect observed in participants with typical levels of hearing. Furthermore, deaf college student readers with low-skilled reading levels showed a larger interference effect than those with high-skilled reading levels. The current study demonstrates that the redistribution of spatial visual attention toward the parafoveal visual regions in deaf students impacts foveal lexical processing, and this effect is modulated by reading skill. The findings are discussed in relation to the potential effect that enhanced parafoveal attention may have on everyday reading for deaf individuals., Competing Interests: The authors have declared that no competing interests exist.

Objectives: Children who are hard of hearing (CHH) have restricted access to auditory-linguistic information. Remote-microphone (RM) systems reduce the negative consequences of limited auditory access. The purpose of this study was to characterise receipt and use of RM systems in young CHH in home and school settings., Design: Through a combination of parent, teacher, and audiologist report, we identified children who received RM systems for home and/or school use by 4 years of age or younger. With cross-sectional surveys, parents estimated the amount of time the child used RM systems at home and school per day., Study Sample: The participants included 217 CHH., Results: Thirty-six percent of the children had personal RMs for home use and 50% had RM systems for school. Approximately, half of the parents reported that their children used RM systems for home use for 1-2 hours per use and RM systems for school use for 2-4 hours per day., Conclusions: Results indicated that the majority of the CHH in the current study did not receive RM systems for home use in early childhood, but half had access to RM technology in the educational setting. High-quality research studies are needed to determine ways in which RM systems benefit pre-school-age CHH.

The authors provide guidelines, based on an extensive review of the international literature, for conducting, interpreting, and reporting primary and secondary research on children who are deaf and hard of hearing in Bosnia and Herzegovina. The purpose of the review is to present arguments in support of conceptualizing education and rehabilitation, to explore the educational implications of such conceptualizations, and to suggest directions for future inquiry. Problematic areas are covered, such as research on the structure of a signed language, the use of information technology, inclusion, vocational and professional orientation, and motoric abilities and skills. The article concludes with recommendations for further investigating the educational achievement of students who are deaf and hard of hearing so as to improve educational practice.

Fingerspelling and its relationship with literacy skills among deaf and hard of hearing children who use American Sign Language is an increasingly popular research topic. However, there is limited research on whether reading interventions that systematically include fingerspelling are more effective for improving literacy skills than reading interventions that do not. In an adapted alternating-treatment single-case study, the authors contrasted the number of words learned under three conditions: a productive fingerspelling condition, in which word reading was taught through activities that emphasized productive fingerspelling; a chaining condition, in which teachers chained written words with receptive fingerspelling; and a sign-to-print condition, in which fingerspelling was not used. Five of the 6 participants learned most of the words taught with no differentiation by condition. Participants could recognize and fingerspell taught words, even if those words were not taught via fingerspelling.