Fingerspelling Used in Classrooms by Teachers of the Deaf and Hard-of-Hearing.

Studies have shown the benefits of fingerspelling on literacy skills in school-age deaf and hard-of-hearing students. This study is an observation of 20 first- and second-grade classrooms. The classroom observations were coded for fingerspelling event frequency, type, length, and whether it was chained to print. The observations showed that teachers used an average of 54 fingerspelled events during 40-min lessons. Teachers' frequency of fingerspelling was positively related to students' frequency of fingerspelling. The types of words fingerspelled included Vocabulary (nouns, verbs, adjectives, and adverbs), Function (prepositions, articles, and conjunctions), Abbreviations, and Single Letter Names (i.e., manual alphabet). Teachers most frequently fingerspelled Vocabulary words (57.9%, SD = 22.1%) followed by Function words (15%, SD = 11.2%). The average length of Vocabulary and Function words were 4.2 (SD = 0.7) and 2.9 (SD = 1.1) letters, respectively. Teachers chained fingerspelling to print 20% (SD = 10%) of the time. We suggest that teachers could increase and more systematically use fingerspelling in early-elementary classrooms, explicitly bridging the connection between fingerspelling and print given its association with reading.

Language and Reading Comprehension Abilities of Elementary School-Aged Deaf Children.

Bilingual education programs for deaf children have long asserted that American Sign Language (ASL) is a better language of instruction English-like signing because ASL is a natural language. However, English-like signing may be a useful bridge to reading English. In the present study, we tested 32 deaf children between third and sixth grade to assess their capacity to use ASL or English-like signing in nine different languages and reading tasks. Our results found that there was no significant difference in the deaf children's ability to comprehend narratives in ASL compared to when they are told in English-like signing. Additionally, language abilities in ASL and English-like signing were strongly related to each other and to reading. Reading was also strongly related to fingerspelling. Our results suggest that there may be a role in literacy instruction for English-like signing as a supplement to ASL in deaf bilingual schools.

Language and Reading Progress of Young Deaf and Hard-of-Hearing Children.

We examined the language and reading progress of 336 young DHH children in kindergarten, first and second grades. Trained assessors tested children's language, reading, and spoken and fingerspelled phonological awareness in the fall and spring of the school year. Children were divided into groups based on their auditory access and classroom communication: a spoken-only group (n = 101), a sign-only group (n = 131), and a bimodal group (n = 104). Overall, children showed delays in language and reading compared to norms established for hearing children. For language, vocabulary standard scores were higher than for English syntax. Although delayed in language, children made expected gains based on hearing norms from kindergarten to second grade. Reading scores declined from kindergarten to second grade. Spoken-only and bimodal children had similar word reading and reading comprehension abilities and higher scores than sign-only children. Spoken-only children had better spoken phonological awareness and nonword reading skills than the other two groups. The sign-only and bimodal groups made similar and significant gains in ASL syntax and fingerspelling phonological awareness.

Modality and Interrelations Among Language, Reading, Spoken Phonological Awareness, and Fingerspelling.

Better understanding of the mechanisms underlying early reading skills can lead to improved interventions. Hence, the purpose of this study was to examine multivariate associations among reading, language, spoken phonological awareness, and fingerspelling abilities for three groups of deaf and hard-of-hearing (DHH) beginning readers: those who were acquiring only spoken English (n = 101), those who were visual learners and acquiring sign (n = 131), and those who were acquiring both (n = 104). Children were enrolled in kindergarten, first, or second grade. Within-group and between-group confirmatory factor analysis showed that there were both similarities and differences in the abilities that underlie reading in these three groups. For all groups, reading abilities related to both language and the ability to manipulate the sublexical features of words. However, the groups differed on whether these constructs were based on visual or spoken language. Our results suggest that there are alternative means to learning to read. Whereas all DHH children learning to read rely on the same fundamental abilities of language and phonological processing, the modality, levels, and relations among these abilities differ.

Caregiver-Reported Indicators of Communication and Social Functioning for Young Children Who Are Deaf or Hard of Hearing.

We elicited caregiver-reported observations of children aged 5-10 who were deaf or hard of hearing (DHH) that resulted in two age-specific instruments: Caregiver Report of Behaviors and Events (CROBE-DHH 5-7 and 8-10). These new instruments record observations on communication and social behaviors/events. In Study 1, 36 caregivers provided qualitative data on important content on what they were able to observe for instrument development and in Study 2, 271 provided data for studying cross-sectional measurement properties. Two modules resulted in 11 items for children age 5-7 and 15 items for children 8-10 years. Items showing good 7-day reproducibility (ICC over .70) and fair 4-week reproducibility (ICC over .50) were retained. Children with milder hearing loss received higher (better) scores. Items did not distinguish between those with or without cochlear implants. Analyses suggest that the instruments are best used as individual indicator items. In both age groups, caregivers reported youths missed out on family conversations and spent little time on their own. These content-validated indicators apply to all children with DHH. Further work will evaluate the usefulness of these indicators in evaluating change in communication and social behaviors, and the implications of results for intervention.

Reading among diverse DHH learners: what, how, and for whom?

Students whO are deaf and hard of hearing (DHH) face challenges in learning to read. Much has been written about the relative importance of the different factors associated with success in reading, but these factors are disputed within the literature on DHH readers. The Center on Literacy and Deafness, funded by the Institute of Education Sciences, is engaged in a nationwide project to identify child-by-instruction interactions related to instructional factors that are malleable within the classroom context. In the present article, the authors describe the project, present the conceptual model on which it is based, explain the processes and procedures used to choose assessment tools, and discuss their theoretical view of how reading and instruction might differ based on an individual student's language and level of functional hearing.

Quality of life in youth with severe to profound sensorineural hearing loss.

IMPORTANCE: Adolescence is a life stage with rapid and major developmental changes, yet little is known about how these changes influence the quality of life of young people who are deaf or hard of hearing (DHH). OBJECTIVE: To determine differences in the 3 domains of a hearing-specific quality-of-life instrument between youth who had severe to profound sensorineural hearing loss based on whether they used no technology, hearing aids, or cochlear implants. DESIGN AND SETTING: A multi-institutional prospective cohort study. PARTICIPANTS: A convenience sample of 11- to 18-year-old youths with severe to profound sensorineural hearing loss recruited between January 1 and December 31, 2008. MAIN OUTCOME MEASURES: Youth Quality of Life-Research Instrument and Youth Quality of Life Instrument-Deaf and Hard of Hearing (YQoL-DHH) scores. The YQoL-DHH was composed of 3 domains: participation, self-acceptance/advocacy, and stigma-related quality of life. RESULTS: A total of 157 individuals participated. Overall mean (SD) age was 14.1 (2.3) years, and the female-male ratio was 82:75. Forty-nine individuals (31.2%) were not using any technology, 45 (28.7%) were using hearing aids, and 63 (40.1%) were using cochlear implants. Mean age of unilateral or first cochlear implant was 62.9 months. Thirty-eight individuals (24.2%) attended schools with DHH programs, 55 (35.0%) attended schools without DHH programs, and 58 (36.9%) attended schools for the deaf. Statistically significant differences were noted in YQoL-DHH participation and perceived stigma scores between the groups when stratified by technology used and school setting. CONCLUSIONS: These data suggest that the domains of quality of life as measured by our instrument differ significantly among youth based on technology used and school setting. Youth using no technology or cochlear implants tended to score higher than those using hearing aids in mainstream schools with or without DHH programs and in schools for the deaf. The YQoL-DHH instrument is able to detect differences in quality of life within a group of youth with severe to profound hearing loss.

Language and literacy development of deaf and hard-of-hearing children: successes and challenges.

Childhood hearing loss presents challenges to language development, especially spoken language. In this article, we review existing literature on deaf and hard-of-hearing (DHH) children's patterns and trajectories of language as well as development of theory of mind and literacy. Individual trajectories vary significantly, reflecting access to early identification/intervention, advanced technologies (e.g., cochlear implants), and perceptually accessible language models. DHH children develop sign language in a similar manner as hearing children develop spoken language, provided they are in a language-rich environment. This occurs naturally for DHH children of deaf parents, who constitute 5% of the deaf population. For DHH children of hearing parents, sign language development depends on the age that they are exposed to a perceptually accessible 1st language as well as the richness of input. Most DHH children are born to hearing families who have spoken language as a goal, and such development is now feasible for many children. Some DHH children develop spoken language in bilingual (sign-spoken language) contexts. For the majority of DHH children, spoken language development occurs in either auditory-only contexts or with sign supports. Although developmental trajectories of DHH children with hearing parents have improved with early identification and appropriate interventions, the majority of children are still delayed compared with hearing children. These DHH children show particular weaknesses in the development of grammar. Language deficits and differences have cascading effects in language-related areas of development, such as theory of mind and literacy development.

School placement and perceived quality of life in youth who are deaf or hard of hearing.

In the education of students who are deaf and hard of hearing (DHH), there is much debate about how placement affects educational outcomes and quality of life. This study examined the relationship between quality of life and educational placement that include and do not include other DHH youth. Participants included 221 DHH youth, ages 11-18 with bilateral hearing loss. Results showed that there were few differences in quality of life related to school placement (with age, gender, depression symptoms, and hearing level as covariates). For both participation and perceived stigma, there was an interaction between school placement and parent hearing status, with no single school placement showing the best results. DHH youth with hearing parents in schools specifically for DHH students scored lower than DHH with deaf parents in some domains (Participation and Perceived Stigma). When the DHH youth were compared with the general population, those in schools that included DHH students scored lower in some aspects of quality of life, particularly Self and Relationships. This study demonstrates that DHH students may not differ much in terms of quality of life across schools placements, but that there may be differences in subsets of DHH youth.

Validation of a quality-of-life measure for deaf or hard of hearing youth.

OBJECTIVE: Quality-of-life (QOL) measures targeting youth with hearing loss are useful in population needs assessment, educational placement, and program design and evaluation. This study assesses the cross-sectional validity of the Youth Quality of Life Instrument-Deaf and Hard of Hearing Module (YQOL-DHH). STUDY DESIGN. Instrument development and cross-sectional survey. SETTING: Recruitment through schools, professional organizations, clinics, and programs for youth who are deaf or hard of hearing. SUBJECTS AND METHODS. Thirty-five candidate items were administered to 230 adolescents aged 11 to 18 years: 49% female, 61% white, 11% mild hearing loss, 20% moderate/moderate-severe, 41% severe/profound, and 28% with cochlear implants. Participants completed individual or group-administered questionnaires by paper and pencil (58%), Web-based English (29%), American Sign Language (ASL) or Pidgin Signed English (PSE) (9%) on DVD, or interviewer-supervised ASL or PSE DVD (4%). The Children's Depression Inventory (CDI-S) was also completed. Factor structure, reliability, construct validity, and respondent burden were assessed. RESULTS: Thirty-two items were retained in the final instrument covering 3 domains: self-acceptance/advocacy (14 items, Cronbach α = 0.84), perceived stigma (8 items, Cronbach α = 0.85), and participation (10 items, Cronbach α = 0.86). QOL was not significantly associated with hearing level. One-week test-retest coefficients were acceptable: self-acceptance/ advocacy (0.70), perceived stigma (0.78), and participation 0.92). As predicted, the total CDI-S score was associated in the appropriate direction (P < .0001) with all YQOL-DHH domains. Time to complete the paper-and-pencil version was 12 minutes. CONCLUSION: The YQOL-DHH shows good reliability and validity for assessing hearing-specific QOL in adolescents.

Symbol-infused joint attention and language use in mothers with deaf and hearing toddlers.

Mother-child interactions in 2-year-old deaf toddlers with deaf parents, deaf toddlers with hearing parents, and hearing toddlers with hearing parents were explored. Fifteen dyads were videotaped in free play and symbol-infused joint attention tasks. Dyads with hearing parents displayed similar responsiveness/directiveness patterns and spent similar amounts of time in symbol-infused joint attention regardless of child hearing status. Deaf toddlers with hearing mothers, however, produced significantly fewer different words and spent less time in sustained interactions than hearing toddlers. Compared with hearing mothers with deaf toddlers, deaf mothers tended to be more responsive to their toddler's attention focus, an aspect of maternal responsiveness significantly related to the frequency of sustained interaction. Deaf toddlers with deaf mothers spent significantly less time in symbol-infused joint attention, possibly because of deaf toddlers' need to divide visual attention between looking at objects and attending to their mother's language.

Toward extending the educational interpreter performance assessment to cued speech.

The Educational Interpreter Performance Assessment (EIPA) is as an important research tool for examining the quality of interpreters who use American Sign Language or a sign system in classroom settings, but it is not currently applicable to educational interpreters who use Cued Speech (CS). In order to determine the feasibility of extending the EIPA to include CS, a pilot EIPA test was developed and administered to 24 educational CS interpreters. Fifteen of the interpreters' performances were evaluated two to three times in order to assess reliability. Results show that the instrument has good construct validity and test-retest reliability. Although more interrater reliability data are needed, intrarater reliability was quite high (0.9), suggesting that the pilot test can be rated as reliably as signing versions of the EIPA. Notably, only 48% of interpreters who formally participated in pilot testing performed at a level that could be considered minimally acceptable. In light of similar performance levels previously reported for interpreters who sign (e.g., Schick, Williams, & Kupermintz, 2006), these results suggest that interpreting services for deaf and hard-of hearing students, regardless of the communication option used, are often inadequate and could seriously hinder access to the classroom environment.

Language and theory of mind: a study of deaf children.

Theory-of-mind (ToM) abilities were studied in 176 deaf children aged 3 years 11 months to 8 years 3 months who use either American Sign Language (ASL) or oral English, with hearing parents or deaf parents. A battery of tasks tapping understanding of false belief and knowledge state and language skills, ASL or English, was given to each child. There was a significant delay on ToM tasks in deaf children of hearing parents, who typically demonstrate language delays, regardless of whether they used spoken English or ASL. In contrast, deaf children from deaf families performed identically to same-aged hearing controls (N=42). Both vocabulary and understanding syntactic complements were significant independent predictors of success on verbal and low-verbal ToM tasks.

The transition from fingerspelling to English print: facilitating English decoding.

Fingerspelling is an integral part of American Sign Language (ASL) and it is also an important aspect of becoming bilingual in English and ASL. Even though fingerspelling is based on English orthography, the development of fingerspelling does not parallel the development of reading in hearing children. Research reveals that deaf children may initially treat fingerspelled words as lexical items rather than a series of letters that represent English orthography and only later begin to learn to link handshapes to English graphemes. The purpose of this study is to determine whether a training method that uses fingerspelling and phonological patterns that resemble those found in lexicalized fingerspelling to teach deaf students unknown English vocabulary would increase their ability to learn the fingerspelled and orthographic version of a word. There were 21 deaf students (aged 4-14 years) who participated. Results show that students were better able to recognize and write the printed English word as well as fingerspell the word, when training incorporated fingerspelling that is more lexicalized. The discussion focuses on the degree to which fingerspelling can serve as a visual phonological bridge as an aid to decode English print.

Relations between maternal input and theory of mind understanding in deaf children.

This study investigates the relationship between theory of mind (ToM) skills in deaf children and input from their hearing mothers. Twenty-two hearing mothers and their deaf children (ages 4-10 years) participated in tasks designed to elicit talk about the mind. The mothers' mental state talk was compared with that of 26 mothers with hearing children (ages 4-6 years). The frequency of mothers' mental talk was correlated with deaf children's performance on ToM tasks, after controlling for effects of child language and age. Maternal sign proficiency was correlated with child language, false belief, and mothers' talk about the mind. Findings are discussed in relation to experiential accounts of ToM development and roles of maternal talk in children's social understanding.

Look who's being left behind: educational interpreters and access to education for deaf and hard-of-hearing students.

For many deaf and hard-of-hearing students, access to the general education curriculum is provided, in part, by using the services of an educational interpreter. Even with a highly qualified interpreter, full access to the content and social life in a hearing classroom can be challenging, and there are many aspects of the educational placement that can affect success. The skills and knowledge of the educational interpreter are one critical aspect. This study reports results from a study of approximately 2,100 educational interpreters from across the United States. All the interpreters were evaluated using the Educational Interpreters Performance Assessment (EIPA), an evaluation instrument used to assess and certify classroom interpreters (see Schick, Williams, & Bolster, 1999). The results show that approximately 60% of the interpreters evaluated had inadequate skills to provide full access. In addition, educational interpreters who had completed an Interpreter Training Program had EIPA scores only .5 of an EIPA level above those who had not, on average. Demographic data and its relationship with EIPA ratings are explored. In general, the study suggests that many deaf and hard-of-hearing students receive interpreting services that will seriously hinder reasonable access to the classroom curriculum and social interaction.