Search Results (34)

Background: Childhood hearing loss is a common chronic condition that may have a broad impact on children’s communication and motor and cognitive development, resulting in functional challenges and decreased quality of life (QoL). Objectives: This pilot study aimed to compare executive functions (EFs) as expressed in daily life and QoL between deaf and hard-of-hearing (D/HH) children and children with typical hearing. Furthermore, we examined the relationship between EFs and QoL in D/HH children. Methods: The participants were 76 children aged 7–11 yr: 38 D/HH and 38 with typical hearing. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and Pediatric Quality of Life Inventory (PedsQL), while the child performed a shopping task in the virtual action planning supermarket (VAP-S) to reflect the use of EFs in daily activity. Results: D/HH children showed significantly poorer EFs (as measured by BRIEF and VAP-S) and reduced QoL. Difficulties in EFs were correlated with lower QoL. BRIEF scores were significant predictors of QoL domains. Conclusions: Difficulties in EFs may characterize children with D/HH and reduce their QoL. Therefore, EFs should be screened and treated. VAP-S and BRIEF are feasible tools for evaluating EFs that reflect children’s challenges due to EF difficulties in real-life contexts. Full article

Background: The aim of this study was to assess the neuromuscular control of adolescents with late unilateral cochlear implantation and compare them to adolescents with hearing aids (HAs) while performing a balance task on a platform with the conditions of an activated hearing device (cochlear implant (CI)/HAs) with eyes opened/closed (EO/EC). Methods: Forty-eight adolescents with hearing loss participated in the study and were divided into SG (unilateral CI and HA) and CG (bilateral HA). The evaluation of the postural stability was performed with a force plate during two repeating testing trials with EO/EC. Results: SG was characterized by greater values of vCOP compared to CG (EO), while, in CG, greater values of vCOP were noted in the second trial. The type of hearing device was found to be related to the values of area (EO) (p < 0.001), which were always greater in SG, regardless of the visual perception. Conclusions: Late unilateral CI may impact the activation of different models of the auditory compensatory mechanism than HA, which is related to neuromuscular control. The values of vCOP can be predicted by age in late-CI individuals. Visual perception seems not to be related to the values of the area, which can be impacted both by CI and HA. Full article

The international recognition of the critical importance of the early childhood phase has been firmly established through decades of rigorous research, evidence-based practices, and undeniable evidence of the returns on investment made during this formative period. Consequently, early childhood development has emerged as a top priority on both national and international agendas. This momentum reached a pinnacle in 2015 with the unanimous adoption of the 17 Sustainable Development Goals (SDGs) by the United Nations, which placed a particular emphasis on children under the age of five within the education-focused SDG 4, notably target 4.2, centered on ensuring that all girls and boys are ready for primary education through the provision of accessible “quality early childhood development, care and pre-primary education”. However, the Global South reflects the glaring omission of addressing the needs of children at risk of poor development due to disabilities. This paper underscores the imperative for specialized early childhood intervention tailored to young children with disabilities and their families, commencing as early as possible following birth. It advocates for Early Childhood Intervention (ECI) as a service distinct from general Early Childhood Development (ECD), emphasizing the crucial role of families as active partners from the outset. Furthermore, the paper strengthens the case for Family-Centered Early Childhood Intervention (Fc-ECI) through the integration of evidence-based practices and an in-depth description of one such program in South Africa with specific reference to deaf and hard-of-hearing infants and their families. This model will be guided by core concepts outlined in WHO and UNICEF Early Childhood Intervention frameworks. Through this exploration, the paper aims to shed light on the urgent need for inclusive approaches to early childhood development, particularly for children with disabilities, and to advocate for the adoption of Family-Centered Early Childhood Intervention as a cornerstone of global efforts to ensure the holistic well-being and development of all children. Full article

This study examines the last 10 years of medical literature on the benefits of cochlear implantation in children who are deaf or hard of hearing (DHH) with additional disabilities. The most recent literature concerning cochlear implants (CIs) in DHH children with additional disabilities was systematically explored through PubMed, Embase, Scopus, PsycINFO, and Web of Science from January 2012 to July 2023. Our two-stage search strategy selected a total of 61 articles concerning CI implantation in children with several forms of additional disabilities: autism spectrum disorder, cerebral palsy, visual impairment, motor disorders, developmental delay, genetic syndromes, and intellectual disability. Overall, many children with additional disabilities benefit from CIs by acquiring greater environmental sound awareness. This, in turn, improves non-verbal communication and adaptive skills, with greater possibilities to relate to others and to be connected with the environment. Instead, despite some improvement, expressive language tends to develop more slowly and to a lesser extent compared to children affected by hearing loss only. Further studies are needed to better appreciate the specificities of each single disability and to personalize interventions, not restricting the analysis to auditory and language skills, but rather applying or developing cross-culturally validated instruments able to reliably assess the developmental trajectory and the quality of life of DHH children with additional disabilities before and after CI. Full article

(1) Background: While spoken language learning delays are assumed for deaf and hard of hearing (DHH) children after cochlear implant (CI), many catch up with their hearing peers. Some DHH children with CIs, however, show persistent delays in language, despite protective factors being in place. This suggests a developmental language disorder (DLD). However, at present there is little consensus on how to diagnose DLD in DHH children. (2) Methods: Given the lack of consensus in this area, a set of case studies provides an appropriate first step. The goal of this paper is to show the plausibility of a DLD diagnosis, following careful analysis of protective and risk factors. A retrospective case study review was conducted for three children. Their long-term language outcomes up to four years after CI were considered in the context of access to sound, speech sound discrimination, social skills and non-verbal cognition. (3) Results: It was possible to posit DLD in one child who had experienced good access to sound, alongside good speech discrimination abilities and social development, and normal non-verbal cognition, but who presented with severe language learning difficulties. (4) Conclusions: Finding markers for DLD in DHH children is important for diagnosis and intervention. The implications for clinical practice are discussed. Full article

The present narrative synthesis summarizes perspectives on the development of identity, or a sense of self, and the intersectionality of salient factors related to individuals who are d/Deaf and hard of hearing. Prior research indicates that identity encompasses the stories of an individual’s experiences and relationships; identity development may not be static but rather dynamic and ongoing throughout an individual’s lifetime. After this general background, the article focuses on identity and deafness, particularly for children in K-12 educational settings. There are a multitude of factors—physiological (e.g., hearing acuity, appearance, gender), psychological (e.g., memory, intelligence, affective behaviors), and social (e.g., education, home or immigrated environment, ethnicity, group membership)—that contribute to the development of identity. This discussion is based on a synthesis of a variety of published sources; however, as much as possible, the focus is on empirical research conducted with children and young adults who are d/Deaf and hard of hearing. Results of the narrative synthesis suggest several topics around which the extant research coalesce: traditional and evolving views of d/Dhh identity, d/Dhh identity as fluid, identity development through relationships, identity and children with cochlear implants and those who are hard of hearing, the role of educational experiences, and intersectional identity development. The article concludes with a summary and recommendations for further investigation. Full article

The population of students who are d/Deaf or hard of hearing (d/Dhh) with a disability have unique educational needs. Various terms have been used to describe this population, including “deaf plus”, “deaf with additional disabilities”, and most recently, “deaf with disabilities (DWD)”. Currently, there is no agreement on the percentage of DWD students in PreK-21 settings but is considered to comprise at least 40–50%. An individual who is DWD has a hearing loss and one or more disabilities, including (but not limited to) visual impairment or blindness, autism spectrum disorder, intellectual or developmental disabilities, specific learning disabilities, health impairments, etc. The critical consideration is that the interaction between hearing loss and the disability(ies) is not simply additive but rather multiplicative, impacting communication, cognition, social development, and behavior. Furthermore, the presence of hearing loss may decrease accurate identification of other disabilities and vice versa. Although the incidence of students who are DWD is quite high, there is inadequate research as these students are often excluded from studies focused on children who are d/Dhh. This article explores what we currently know about DWD students, and the knowledge and skills needed by teachers in the 21st century to meet the needs of these students and their families. Full article

Deaf and hard of hearing (DHH) children in Victoria, Australia, were exposed to strict public health restrictions, including sustained lockdowns, during the COVID-19 pandemic. DHH children have higher health and socio-emotional needs than their hearing peers. We aimed to (1) describe the socio-emotional experiences of DHH children and their parents and (2) compare child and parent socio-emotional wellbeing, before and during the COVID-19 pandemic. Between May and September 2020, 497 (62%) parents of DHH children from the Victorian Childhood Hearing Longitudinal Databank completed an online survey. Measures were drawn from the CoRonavIruS Health Impact Survey (CRISIS) v3.0. Data were summarized using descriptive statistics to compare outcomes before and during the pandemic. Parents reported their children to have more negative socio-emotional wellbeing (mean emotions/worries score, EWS, changed from 0.76 pre-pandemic to 1.10 during the pandemic, mean difference 0.34, 95% CI: 0.28 to 0.39), regardless of the type or severity of hearing loss. Parents also had more negative socio-emotional wellbeing (mean EWS changed from 1.05 pre-pandemic to 1.43 during the pandemic, mean difference 0.38, 95% CI: 0.31 to 0.44). Negative socio-emotional experiences co-occurred with large social changes during the pandemic. Additional services should support the socio-emotional wellbeing of DHH children during significant adverse childhood experiences. Full article

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. Full article

Parent-to-parent support is an important component of early hearing detection and intervention (EHDI) programs for deaf and hard of hearing (DHH) children. In this study, we asked parents of DHH children what advice they would give to new parents in their situation. Seventy-one hearing parents of DDH children living in Canada, Switzerland, France, and Belgium participated in interviews that included the following question: “What advice you would give to parents who just learned that their child is deaf?”. We performed a thematic analysis and developed three overarching themes, revolving around the importance of trust, the need for reassurance, and finally, the quest for help. The findings allow to better understand how parental expertise can be used to improve early intervention services for DHH children. Full article

The movement towards inclusive public education for deaf and hard of hearing children (DHH) has steadily gathered momentum during the last fifty years. Both within the United States and abroad, inclusive public education has been facilitated through legislative action with varied results. Varied interpretation of inclusion policy, notably the “Least Restrictive Environment” (LRE) clause of the Individuals with Disabilities Education Act in the United States, an emphasis on assimilation, and a default preference for auditory-oral communication have often resulted in isolating and inaccessible experiences for DHH students in the mainstream. The purpose of this article is to review theory and research on effective practices in inclusion for DHH students. The research is summarized with respect to accessibility, social-emotional considerations, and language policy. It is often asserted that communication access and cultural identity are major factors that impact the successful inclusion of these students with bicultural identity related to greater wellbeing. Deaf schools may be the LRE placement option for some students and source of resource and support for DHH students and educators in all settings. The authors suggest that a shift towards a more inclusive experience in mainstream settings is emerging through the use of Universal Design for Learning (UDL), classroom technology, and culturally responsive education that integrates sign language and Deaf culture to foster bicultural identities. Strategies for effective inclusion include co-enrollment, deaf awareness programming, and consistent policy that equalizes the status of sign languages. Future research is recommended in effective practices in auditory and visual accommodations, integration of technology in K-12 classrooms, and the relation of policy to practice in inclusive education for DHH students. Full article

This study examines the relationship between the early identification of hearing loss and language outcomes for deaf/hard of hearing (D/HH) children, with bilateral or unilateral hearing loss and with or without additional disabilities. It was hypothesized that hearing loss identified by 3 months of age would be associated with better language outcomes. Using a prospective, longitudinal design, 86 families completed developmental instruments at two time points: at an average age of 14.8 months and an average age of 32.1 months. Multiple regression examined how hearing loss identified by 3 months of age contributed to later language outcomes while controlling for developmental level at the first time point. Hearing loss identified by 3 months of age was positively associated with better language outcomes for D/HH children at 32 months of age; however, D/HH children still exhibited language delays, compared to normative scores for same-aged hearing peers for reported measures. Language outcomes of children with unilateral hearing loss were not better than those of children with mild-to-moderate bilateral hearing loss. Children with additional disabilities and more severe bilateral hearing loss had lower language scores than those without. Full article

Naturalistic playground observations are a rich source of information when studying the social interactions of preschool children. On the playground, children can interact with their peers, explore different places and activities, and engage in different types of play. For deaf and hard of hearing (DHH) children, interactions at a playground can be more difficult because of the large number of auditory stimuli surrounding them. Constraints in the access to the social world on the playground might hamper DHH children’s interactions with their typically hearing (TH) peers, activities, and play. This pilot study aimed to examine the playground behaviors of preschool DHH children across three aspects: social levels, type of activities, and play choices. For this purpose, 12 preschool DHH children were observed during recess time, and their behaviors were coded and compared to their 85 TH peers. The preliminary findings indicate that DHH children spend less time in social interactions compared to their TH peers and that they still face difficulties when socially engaging with their TH peers. These findings suggest that interventions should focus on three aspects: the physical environment awareness of TH peers about communicating with DHH children, and the use of exercise play to facilitate social interactions between DHH children and their TH peers. Full article

Background: An early hearing detection and intervention program (EHDI) is the first step for the habilitation of children with permanent hearing impairment (PHI). Actually, early intervention programs have increasingly shifted toward family involvement, emphasizing that the child’s family should take an active role in the habilitation process. Therefore, familiar empowerment is the best way to improve a child’s emerging abilities. The aim of this study was to investigate parental self-efficacy beliefs and involvement as well as the language skills of deaf or hard of hearing DHH children who were habilitated with hearing aids and followed using the T.A.T.A web app (NeonaTal Assisted TelerehAbilitation), an example of asynchronous telepractice. Methods: The study describes the early stages of the habilitation program of 15 PHI children followed through the T.A.T.A. web app, which empowers families through a weekly questionnaire submitted during the first 270 to 360 days of their child’s life, for 14 weeks. The family involvement rate scale (FIRS) was used to evaluate parental compliance, and all children received in-person visits at the beginning and at the end of the training period. Results: The children showed greater auditory perceptual skills at the end of the training period on the basis of both the Infant Listening Progress Profile (ILiP) score and the Categories of Auditory Performance (CAP) and FIRS scales. In other words, the auditory skills improved with age as well as with parental participation. Conclusions: The T.A.T.A. web app promotes a proactive management and a tailored habilitation through an active familiar involvement, easily achieved in clinical routine and in emergency settings without additional costs. Full article

We quantified the intensity of early intervention (EI) services allocated to 1262 children who were deaf or hard of hearing (DHH) within a state program and identified factors associated with intervention intensity. Child specific data were collected on children born between 2008 and 2014. Data from Individualized Family Service Plans of children enrolled in Part C EI programming were evaluated for the type and duration of services during their EI enrollment. Associations between EI intensity and child/family variables were examined. Median age of EI enrollment was 5.3 months. The most frequently received services included primary service coordination, specialized DHH service, special instruction, language therapy, and family training; 60% of children received 4 or more different EI services. The median service intensity was 138.1 min per month across all EI years. The factors associated with higher EI intensity included severe hearing loss, bilateral hearing loss and presence of a disability. Children enrolled in EI at later ages received higher intensity of specialized DHH services, suggesting a need to “catch up” due to late acquisition of services. Evaluating EI service intensity broadens our understanding of effective components of state-based programs that support the developmental needs of children who are DHH. Full article