Parental Involvement in Deaf Children's Education Programs as a Predictor of Child's Language, Early Reading, and Social-Emotional Development

Geographic, Sociodemographic, and Clinical Factors Associated With Parental Self-Efficacy in Pediatric Patients With Hearing Loss

OBJECTIVE

To identify geographic, sociodemographic, and clinical factors associated with parental self-efficacy in a diverse cohort of deaf or hard-of-hearing (DHH) children.

STUDY DESIGN

Cross-sectional study.

SETTING

Tertiary children's hospital.

METHODS

Four hundred forty parents of DHH children aged 0 to 17 completed the 25-item Scale of Parental Involvement and Self-Efficacy (SPISE) survey from 2014 to 2022. Residential addresses were geocoded and assigned Area Deprivation Index and Social Vulnerability Index rankings, and univariable and multivariable analyses were conducted using sociodemographic and clinical variables, including sex, race/ethnicity, insurance type, survey language, age at the survey, comorbidities, newborn hearing screening results, and hearing loss laterality and severity.

RESULTS

Compared to English and Spanish-speaking parents, Chinese-speaking parents were associated with overall lower parental self-efficacy and involvement (regression coefficient = -0.518, [-0.929, -0.106]), Cohen's d = 0.606) and lower scores on items related to their ability to affect multiple aspects of their child's development and expression of thoughts as well as competency in checking and putting on their child's sensory device. Across univariable and multivariable analyses, besides Chinese language, all other sociodemographic, clinical, and geographic variables were not associated with SPISE score.

CONCLUSION

To achieve the best patient outcomes, care teams can use the SPISE to evaluate parental self-efficacy and provide targeted support to parents at risk for having lower knowledge and confidence scores about critical skills necessary to facilitate their child's auditory access and language development. Notably, this study found similar reports of parental efficacy across various sociodemographic, clinical, and geographic variables but significantly lower SPISE scores in Chinese-speaking families.

Deaf children, home language environments, and reciprocal-contingent family interactions

Engaged communication between mother and a child in their early developmental stages is one of the predictors of children's development of higher-order thinking skills. For deaf children, this engaged communication between mother and child hinges on the home language environment (HLE) being fully accessible to the child. This research uses agogical phenomenology in exploring the lived experiences of participants' HLE where sign language is used, with particular focus on the opportunities for extended discourse. Data were collected via semistructured interviews with the deaf children and their parents and observations in the HLEs of five signing families with at least one deaf child in the southwestern United States. The aim of this study was to document and provide insights into how language use in deaf children's HLE can impact their knowledge development; these insights uncovered the essence of reciprocal and contingent family interactions as a central aspect of the deaf child's HLE. It is hoped that the qualitative phenomenological findings will frame subsequent quantitative investigations of the variability in language access to home language components.

A systematic review on the impact of auditory functioning and language proficiency on psychosocial difficulties in children and adolescents with hearing loss

OBJECTIVE

Approximately 20% to 40% of children with hearing loss encounter psychosocial difficulties. This prevalence may be outdated, given the advancements in hearing technology and rehabilitation efforts to enhance the psychosocial well-being of these children. A systematic review of up-to-date literature can help to identify factors that may contribute to the children's psychosocial well-being.

DESIGN/STUDY SAMPLE

A systematic review was conducted. Original articles were identified through systematic searches in Embase, Medline, PsychINFO, and Web of Science Core Collection. The quality of the papers was assessed using the Newcastle-Ottawa Quality Assessment Scale and custom Reviewers' Criteria.

RESULTS

A search was performed on 20 October 2022. A total of 1561 articles were identified, and 36 were included for review. Critical appraisal led to 24 good to fair quality articles, and 12 poor quality articles.

CONCLUSION

Children with hearing loss have a twofold risk of experiencing psychosocial difficulties compared to normal hearing peers. Estimates for functioning in social interactions, like speech perception (in noise) or language proficiency, have proven to be more adequate predictors for psychosocial difficulties than the degree of hearing loss. Our findings can be useful for identifying children at risk for difficulties and offering them earlier and more elaborate psychological interventions.

Parenting Stress in Mothers of Children with Permanent Hearing Impairment

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.

Diversity of Child and Family Characteristics of Children with Hearing Loss in Family-Centered Early Intervention in The Netherlands

Background: Family-centered early intervention (FCEI) for children with hearing loss (HL) supports caregivers to promote their children’s language development. To provide FCEI services that are relevant and accessible to meet diverse needs, insight into the characteristics of children with HL is important. In the current study, various characteristics of children with HL and intervention-related factors are examined in relation to spoken language outcomes. Methods: Child and family characteristics, language outcomes and data on intervention were extracted from FCEI records for 83 children. Family involvement ratings were obtained from EI providers. Relations between characteristics, intervention, family involvement and language outcomes were analyzed and predictors for children’s language outcomes were investigated. Results: The characteristics of children with HL in FCEI are very diverse. Family involvement and the occurrence of additional disabilities were predictive for children’s receptive and expressive language abilities; the start of FCEI was not. Maternal education was predictive for expressive language outcomes only. Conclusions: The current study showed the diversity in characteristics of children with HL and their families in the degree of HL, etiology, cultural background, home language, family involvement and additional disabilities. We conclude that ’one size does not fit all’, and FCEI programs should acknowledge the unique strengths and challenges of every individual family.

Parenting Stress, Self-Efficacy, and Involvement: Effects on Spoken Language Ability Three Years After Cochlear Implantation

OBJECTIVE

This study evaluated associations among parenting stress, self-efficacy, and involvement in relation to spoken language outcomes in young children 3 years following cochlear implantation.

STUDY DESIGN

Cross-sectional.

SETTING

Six university tertiary medical centers.

PATIENTS

One hundred sixty-four young children with bilateral, severe-to-profound sensorineural hearing loss who had 3 years of experience with a CI; children with substantial cognitive impairments were excluded from the study.

MAIN OUTCOME MEASURESS

Family Stress Scale (FSS), Scale of Parental Involvement and Self-Efficacy (SPISE), Oral and Written Language Scales (OWLS).

RESULTS

Correlations were of moderate strength between FSS scores and SPISE scores (Parental Self-Efficacy, r = -0.45, p < 0.01, Parental Involvement r = -0.32, p < 0.01). As hypothesized, parents reporting higher levels of stress reported lower perceptions of self-efficacy and involvement. In addition, results showed that family stress had a direct, negative effect on spoken language (-4.43 [95% confidence interval: -6.97; -1.89]). After controlling for maternal education and activation age, parental self-efficacy mediated the negative effect between family stress and spoken language (indirect effect = -1.91 [3.45; -0.69]; proportion mediated = 0.43). No mediating effects were found for parental involvement.

CONCLUSIONS

These findings highlight the need for parenting interventions that focus on reducing stressors and increasing parents' perceptions of self-efficacy in families of children using cochlear implants. Integration of mental health screening and tailored parenting interventions in CI clinics may increase parental self-efficacy and involvement, with measurable benefits in the child's use of spoken language.

Coaching Caregivers of Children who are Deaf or Hard of Hearing: A Scoping Review

Caregiver coaching is an expected practice in early intervention. However, little is known about coaching with caregivers of children who are deaf or hard of hearing, receiving services for listening and spoken language (LSL). A systematic review of 7 databases, the gray literature, and consultation with 7 expert LSL practitioners yielded 506 records for full-text review, 22 of which were ultimately included in the review. Our findings are presented as 3 themes: coaching practices, training for coaching, and effectiveness of coaching. Eight models of coaching were identified in the literature, from which we identified commonalities to propose a consolidated model that illustrates the recommendations and process of caregiver coaching found in the LSL literature.

Parental Rearing Patterns and Interpersonal Skills in Deaf Chinese College Students: The Mediating Role of Theory of Mind

This study examined the associations between parental rearing patterns and interpersonal skills via the mediation of Theory of Mind (ToM) in a sample of 369 deaf Chinese college students. The results showed that negative parental rearing patterns were directly and negatively associated with interpersonal skills, and positive parental rearing patterns were directly and positively associated with interpersonal skills. There were also indirectly associated with interpersonal skills via ToM. We also considered whether the mediation of ToM was different for male participants and female participants. The indirect associations between parental rearing patterns and interpersonal skills via ToM existed for female participants, but not for male participants. These results indicated that deaf college students’ perceived parental rearing patterns are associated with their interpersonal skills, and parents of deaf children should incorporate ToM in their everyday rearing patterns to improve their children’s interpersonal skills, especially for girls.

The Impact of Family Environment on Language Development of Children With Cochlear Implants: A Systematic Review and Meta-Analysis

OBJECTIVES

The authors conducted a systematic review of the literature and meta-analyses to assess the influence of family environment on language development in children with cochlear implants.

DESIGN

The Pubmed, excerpta medica dataBASE (EMBASE), Education Research Information Center, cumulative index to nursing and allied health literature (CINAHL), Healthcare Literature Information Network, PubPsych, and Social SciSearch databases were searched. The search strategy included terms describing family environment, child characteristics, and language development. Studies were included that (a) assessed distal family variables (such as parental income level, parental education, family size, and parental stress) with child language outcomes, and/or more proximal correlates that directly affect the child (such as family engagement and participation in intervention, parenting style, and more specifically, the quantity and quality of parental linguistic input) on child language; (b) included children implanted before the age of 5 years; (c) measured child language before the age of 21 years with standardized instruments; (d) were published between 1995 and February 2018; and (e) were published as peer-reviewed articles. The methodological quality was assessed with an adaptation of a previously validated checklist. Meta-analyses were conducted assuming a random-effects model.

RESULTS

A total of 22 study populations reported in 27 publications were included. Methodological quality was highly variable. Ten studies had a longitudinal design. Three meta-analyses on the correlations between family variables and child language development could be performed. A strong effect of the quality and quantity of parental linguistic input in the first 4½ years postimplantation on the child's language was found, r = 0.564, p ≤ 0.001, 95% confidence interval (CI) = 0.449 to 0.660, accounting for 31.7% of the variance in child language outcomes. Results demonstrated high homogeneity, Q(3) = 1.823, p = 0.61, I = 0. Higher-level facilitative language techniques, such as parental expansions of the child's utterances or the use of open-ended questions, predicted child language skills. Risk of publication bias was not detected. The results on the impact of family involvement/participation in intervention on child language development were more heterogeneous. The meta-analysis included mainly cross-sectional studies and identified low to moderate benefits, r = 0.380, p ≤ 0.052, 95% CI = -0.004 to 0.667, that almost attained significance level. Socioeconomic status, mainly operationalized by parental level of education, showed a positive correlation with child language development in most studies. The meta-analysis confirmed an overall low and nonsignificant average correlation coefficient, r = 0.117, p = 0.262, 95% CI = -0.087 to 0.312. A limitation of the study was the lack of some potentially relevant variables, such as multilingualism or family screen time.

CONCLUSIONS

These data support the hypothesis that parental linguistic input during the first years after cochlear implantation strongly predicts later child language outcomes. Effects of parental involvement in intervention and parental education are comparatively weaker and more heterogeneous. These findings underscore the need for early-intervention programs for children with cochlear implants focusing on providing support to parents for them to increase their children's exposure to high-quality conversation.

Parental views on informational counselling provided by audiologists for children with permanent childhood hearing loss

Background

The absence of best practice guidelines on informational counselling, has caused lack of clarity regarding the information audiologists should provide to parents and caregivers following the diagnosis of a hearing loss. Research shows that informational counselling provided by audiologists is limited and often biased, with little evidence of how parents experience this service.

Objectives

To explore the nature and practice of informational counselling by audiologists.

Method

This study was descriptive in nature and adopted a survey design to obtain information on the current practices of informational counselling from the perspective of parents and primary caregivers. Ninety-seven face-to-face semi-structured interviews were conducted across KwaZulu-Natal province of South Africa. Descriptive statistics and thematic analysis using Nvivo software were conducted.

Results

The majority of the parents reported receiving some form of informational counselling. However, the information provided by audiologists was considered to be biased as it included a favoured communication option, school and rehabilitative technology. There was a lack of information related to aural rehabilitation and family-centred intervention. The provision of all communication options, school options and rehabilitative technology were identified as gaps that contribute to an unfavourable decision-making process.

Conclusion

There are inefficiencies experienced by families of deaf and hard of hearing children during informational counselling. However, this understanding, together with the identified gaps by parents, can help address the professional response to caring for families with deaf and hard of hearing children.

Toward Sustainable Learning during School Suspension: Socioeconomic, Occupational Aspirations, and Learning Behavior of Vietnamese Students during COVID-19

The overspread of the novel coronavirus—SARS-CoV-2—over the globe has caused significant damage to manufacturing and service businesses, regardless of whether they are commercial, public, or not-for-profit sectors. While both the short-term and long-term impacts of most companies can be approximately measured or estimated, it is challenging to address the enduring effects of COVID-19 on teaching and learning activities. The target of this research is to investigate students’ manners of studying at home during the school suspension time as a result of COVID-19. Through analyzing original survey data from 420 K6–12 students in Hanoi, Vietnam, this work demonstrates the different learning habits of students with different socioeconomic statuses and occupational aspirations during the disease’s outbreak. In particular, we featured the differences in students’ learning behaviors between private schools and public schools, as well as between students who plan to follow STEM-related careers and those who intend to engage in social science-related careers. The empirical evidence of this study can be used for the consideration of the local government to increase the sustainability of coming policies and regulations to boost students’ self-efficacy, as it will affect 1.4 million students in Hanoi, as well as the larger population of nearly 10 million Vietnamese students. These results can also be the foundation for future investigations on how to elevate students’ learning habits toward Sustainable Development Goal 4 (SDG4)—Quality Education—especially in fanciful situations in which the regular school operation has been disrupted, counting with limited observation and support from teachers and parents.

Lived Experience: Deaf Professionals' Stories of Resilience and Risks

Navigating a phonocentric and audistic society can be challenging for Deaf people, yet some of them adapt and exhibit resilience. Although there is a plethora of resilience studies, Deaf people's narratives are largely unexplored. This phenomenological study explored from a Deaf cultural-linguistic lens 10 Deaf professionals who use American Sign Language in the United States and their observation of other Deaf people's lived experience. The study focused particularly on their experiences in overcoming significant barriers in their lives and the factors that strengthen Deaf people's resilience. Based on qualitative data gathered from narrative interviews, three main themes emerged from this study: (a) Barriers to Incidental Learning: The Dinner Table Syndrome; (b) Importance of Family Involvement; and (c) Protective Role of the Deaf Community as a Second Family. The stories in this study highlight how Deaf professionals and other Deaf people navigate barriers and manifest resilience.

Parents' views about factors facilitating their involvement in the oral early intervention services provided for their children with hearing loss in Kuwait

OBJECTIVES

Developed countries (such as the Unites States of America, the United Kingdom, and Australia) provide high-quality services to children with hearing loss and their parents, including universal newborn hearing screening, early fitting of hearing devices and access to high quality early, aural intervention. In contrast, many developing countries lack the resources to provide these services. Research evidence suggests that one way to compensate for delays in identification and rehabilitation for children with hearing loss is to involve the family in the early intervention process. However, evidence is deficient around the facilitation of parental involvement in early intervention for families from developing countries. The aim of this study was to investigate the perception of parents from a developing country who have a child with hearing loss to discover the factors that may influence their involvement in early intervention, identify facilitators/barriers for their involvement, and identify the specific needs of involved parents.

METHOD

A qualitative collective case study methodology was used in the form of semi-structured interviews with twenty-one participants.

RESULTS

Two global themes emerged. Firstly, factors influencing parental involvement. This included five subthemes: better communication as the key to building rapport and providing support; disappointment with the service; physical and human resources make a difference; consideration of life beyond the habilitation sessions; and my child matters the most. The second global theme-parental needs-included four subthemes: building trust; ensuring generalization; improving child outcomes; and managing needs of parents versus services. All the discussed themes are supported by quotations from the interviews.

CONCLUSION

The findings suggest that parents of children with hearing loss in developing countries perceive the services provided for their children to be disjointed and not well coordinated. Based on the parent perceptions a set of guidelines that provide a scaffold for service providers working with children with hearing loss in developing countries is outlined. The guidelines are designed to assist services for children with hearing loss in developing countries improve the delivery of their services and increase family involvement, which in turn; will assist in improving their child and family related outcomes.

INFLUENCE OF FAMILY ENVIRONMENT ON DEVELOPMENTAL OUTCOMES IN CHILDREN WITH COCHLEAR IMPLANTS: A MATCHED CASE STUDY

This case study analyzes and describes the language, executive function, and psychosocial outcomes of two 6-year-old children with cochlear implants in the context of their respective family environments. Despite having nearly identical audiological histories, their language abilities and social skills are markedly different from one another, exemplifying the variability in outcomes of children with cochlear implants. Families play a critical role in child development. Including analyses of the family environment serves to draw attention to the importance of expanding the variables of potential influence beyond child characteristics to more fully encompass the factors that influence children's performance in future studies.

Analysis of Amount and Style of Oral Interaction Related to Language Outcomes in Children With Hearing Loss: A Systematic Review (2006-2016)

Purpose This systematic review summarizes the evidence for differences in the amount of language input between children with and without hearing loss (HL). Of interest to this review is evaluating the associations between language input and language outcomes (receptive and expressive) in children with HL in order to enhance insight regarding what oral language input is associated with good communication outcomes. Method A systematic review was conducted using keywords in 3 electronic databases: Scopus, PubMed, and Google Scholar. Keywords were related to language input, language outcomes, and HL. Titles and abstracts were screened independently, and full-text manuscripts meeting inclusion criteria were extracted. An appraisal checklist was used to evaluate the methodological quality of studies as poor, good, or excellent. Results After removing duplicates, 1,545 study results were extracted, with 27 eligible for full-text review. After the appraisal, 8 studies were included in this systematic review. Differences in the amount of language input between children with and without HL were noted. Conversational exchanges, open-ended questions, expansions, recast, and parallel talk were positively associated with stronger receptive and expressive language scores. The quality of evidence was not assessed as excellent for any of the included studies. Conclusions This systematic review reveals low-level evidence from 8 studies that specific language inputs (amount and style) are optimal for oral language outcomes in children with HL. Limitations were identified as sample selection bias, lack of information on control of confounders and assessment protocols, and limited duration of observation/recordings. Future research should address these limitations.

Association between parental involvement and academic achievement of deaf children at Mulago school for the deaf, Kampala, Uganda

Background

Deaf children face many challenges in dealing with educational opportunities and ensuring attainment of academic skills. A parent's involvement in the child's education has the potential to enhance academic performance. We sought to study the association between parental involvement and academic achievement among deaf children in Uganda.

Methods

Using purposive consecutive sampling, one hundred and eight parents of deaf children (Primary 1 to 7) were recruited from Mulago School for the Deaf in Kampala, Uganda. The Parental Involvement Questionnaire was used to measure parents' involvement in school activities while the Wide Range Assessment Test, third edition, was used to measure academic achievement (reading, spelling and arithmetic). Linear regression was used to test the association between parental involvement and academic achievement.

Results

One hundred and five children with mean age 11.09 years (SD = 2.89) were enrolled of whom 56 (35.3%) were female. With a Beta coefficient of 0.07, a 7% unit increase of summed parental involvement showed no significant association between parental involvement and academic achievement (p = 0.46) of the deaf children.

Conclusion

Parental involvement was not associated with academic achievement among deaf children in Kampala. Other factors associated with academic achievement need to be identified to enhance deaf children's performance at school.

Predictors of Vocabulary Outcomes in Children Who Are Deaf or Hard of Hearing From Spanish-Speaking Families

Purpose

The goal of this study was to identify predictors of expressive vocabulary in young Spanish-speaking children who are deaf or hard of hearing living in the United States.

Method

This cross-sectional study considered 53 children with bilateral hearing loss between 8 and 34 months of age ( M = 24, SD = 6.9). Demographic variables, variables related to the hearing loss, and intervention variables were included in a hierarchical regression analysis to predict expressive vocabulary quotients from the MacArthur Inventario del Desarrollo de Habilidades Comunicativas (Communicative Development Inventories; Jackson-Maldonado et al., 2003 ).

Results

Chronological age, degree of hearing loss, functional hearing ability ratings, age of enrollment in early intervention, and the interaction between chronological age and age of intervention accounted for 61.5% of the vocabulary variance. Children who received intervention by 6 months of age achieved significantly higher vocabulary outcomes than children who started intervention later.

Conclusion

The children's mean vocabulary outcomes were below average when compared with hearing peers. This was especially true for older children, children with moderately-severe-to-profound hearing loss, and children who began intervention after 6 months of age. This delay in vocabulary outcomes has the potential to interfere with future reading and academic outcomes.

Maternal Perception of Self-Efficacy and Involvement in Young Children with Prelingual Hearing Loss

Appropriate intervention needs to support families and consider them as a part of rehabilitation program. Parents who have high self-efficacy are more likely to put their knowledge and skills into action and have positive interactions with their children. In addition, there has been a positive relation between parental involvement and child educational success. The aim of present study was evaluating maternal perception of both self-efficacy and involvement between mothers of children with hearing aid and cochlear implant via Scale of Parental Involvement and Self Efficacy (SPISE) and exploring relationship between maternal self-efficacy and parental involvement and child factors. 100 mothers of children with hearing loss were available. 49 mothers participated in study, filled SPISE, and return it on time. SPISE consisted of three sections (1) demographic information, (2) maternal self-efficacy, (3) parental involvement. All cases had received at least 6 months auditory training and speech therapy. Participants included 30 (61.2%) mothers of children with hearing aid, 19 (38.8%) mothers of children with cochlear implant. ANOVA analysis showed that there is no significant difference between hearing aid (HA) and cochlear implant (CI) groups in term of self-efficacy and parent-involvement except for question 21 (comfortable in participating in individualized program) that score in HA group was significantly higher than CI group. Results of present study has practical implications for early interventionists working with families. Every early intervention program should consider families to reach maximum outcome. Early interventionists can use SPISE to evaluate parental selfefficacy and involvement and work on parents with low score to achieve the best results.

Satisfaction with Life among Mothers of Pediatric Cochlear Implant Candidates: The Impact of Implant Operation and Sociodemographic Factors

OBJECTIVES

To evaluate the satisfaction with life among mothers of pediatric cochlear implant candidates regarding implant surgery and sociodemographic factors.

MATERIALS AND METHODS

Mothers of 160 pediatric patients with profound sensorineural hearing loss who underwent unilateral cochlear implant surgery were included. A questionnaire form with items on sociodemographic-familial characteristics and Satisfaction with Life Scale (SWLS) was employed via face-to-face interview method before and 12 months after the implant surgery.

RESULTS

The SWLS scores significantly improved after the implant surgery [from 19.1 (7.0) to 28.9 (4.0), p<0.000]. Being unemployed vs. employed [17.9 (6.9) vs. 24.0 (5.3), p=0.000], having another child with hearing disability [13.5 (5.7) vs. 19.7 (6.9), p=0.001], younger (12-24 months) vs. older (>24 months) age of the child at the time of implant surgery [7.1 (0.4) vs. 19.7 (6.6), p=0.001], absence vs. presence of regular follow-up visits [13.0 (0.0) vs. 19.4 (7.1), p=0.002], and presence vs. absence of change in social life after the diagnosis of disease [17.3 (6.5) vs. 20.9 (7.1), p=0.001] were associated with significantly lower SWLS scores among mothers. SWLS scores were positively correlated with patient's age at the time of implant surgery (r=0.206, p=0.009), whereas negatively correlated with the number of household members (r=-0.406, p=0.000) and number of children (r=-0.310, p=0.000).

CONCLUSION

In conclusion, our findings revealed the association of cochlear implantation with a significant increase in mother's life satisfaction, despite the unemployment, presence of another child with hearing disability, and crowded household. Our findings emphasize on the consideration of family systems with special attention to mother's emotional experiences and occupational competence in the intervention programs.

Inequalities in socio-emotional development and positive parenting during childhood: Evidence from China 2010-2014

Socio-emotional development (SED) is a critical dimension of early childhood development (ECD). However, little research has been conducted thus far regarding inequalities across family income status in children's SED and positive parenting scores in China, which has the second largest population of children in the world. Using nationally representative data from the China Family Panel Survey (CFPS), we addressed this knowledge gap by assessing the levels and trends of inequalities in children's SED scores and positive parenting scores across wealth quintiles between 2010 and 2014. Positive parenting was measured for (1) children aged two and younger (PP_younger) and (2) children between the ages of three and five (PP_older). We adopted five inequality measures, including both absolute and relative measures. We found that, between 2010 and 2014, SED scores significantly increased for all five wealth quintiles, with the first quintile (Q1, the lowest income) growing the fastest. Consequently, observed inequalities in SED scores between Q1 and the fifth wealth quintile (Q5, the highest income) no longer existed in 2014. For the two parenting scores, we observed a significant reduction in inequality between Q1 and Q5, from 1.03 (95% CI: 0.71-1.35) in 2010 to 0.51 (95% CI: 0.27-0.74) in 2014 for PP_younger and from 1.28 (95% CI: 1.09-1.47) in 2010 to 0.53 (95% CI: 0.37-0.70) in 2014 for PP_older. These changes are due to larger increases in scores for children in Q1 compared to Q5 during this time period. These results are highly consistent over different inequality measurements and indicate that both the absolute level and the equality status of young children's SED score and parenting score experienced improvement during the study period. This suggests that China's large investments since 2010 in pre-primary education may have yielded their desired results. Future research should further investigate the association between positive parenting and SED.

It Takes Two to Read: Interactive Reading with Young Deaf and Hard-of-Hearing Children

Interactive storybook reading is an important activity to enhance the emergent literacy skills of young deaf and hard-of-hearing (DHH) children. Parents have a crucial role to play in promoting their children's literacy development. However, parents often do not read in an interactive way; therefore guidance is recommended in applying these interactive reading strategies. In the present study we examined how parent reading behavior was affected by implementing an interactive reading training program for parents of young DHH children. Parents of 18 DHH toddlers in the Netherlands participated in a series of group training sessions and their interactive reading behavior was compared to that of 10 parents who did not participate. The results showed that parents' interactive reading behavior tended to increase after they participated in the interactive reading program. After the program, they applied the interactive reading strategies more often than parents who had not participated in the program. The findings suggest that interactive reading programs should be incorporated into early intervention programs for DHH children.

Parent Couples' Coping Resources and Involvement in their Children's Intervention Program

Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers' and fathers' coping resources and their involvement in their child's intervention program. In addition, the moderating roles of parent's gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child's intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor-partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers' child acceptance and social support were negatively associated with mothers' involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent's needs.

Psychosocial Development in 5-Year-Old Children With Hearing Loss Using Hearing Aids or Cochlear Implants

This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study-a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire ( n = 333), the Social Skills subscale from the Child Development Inventory ( n = 317), and questionnaires on functional auditory behavior (Parents' Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss.

Language and reading comprehension in middle childhood predicts emotional and behaviour difficulties in adolescence for those with permanent childhood hearing loss

BACKGROUND

Permanent childhood hearing loss (PCHL) is associated with an elevated level of emotional and behaviour difficulties (EBD). In children and adolescents with PCHL, EBD has been found to be linked to language ability in children with PCHL. The present study was designed to test whether childhood language and/or reading comprehension abilities of children with PCHL predict subsequent EBD in adolescence.

METHODS

Language comprehension (LC) and reading comprehension (RC) were measured at ages 6-10 years (Time 1) and 13-20 years (Time 2) in participants with PCHL who preferred to communicate using spoken language (n = 57) and a hearing comparison group (n = 38). EBD was measured at both time points by parent and by teacher ratings on the Strengths and Difficulties Questionnaire.

RESULTS

Within the PCHL group there were negative correlations between EBD scores and concurrent LC and RC scores at Time 1 and at Time 2. Cross-lagged latent variable models fitted to the longitudinal data indicated that the associations between LC, RC and teacher-rated EBD were more likely to arise from the impact of LC and RC on behaviour rather than the other way around.

CONCLUSIONS

In those with PCHL, poor language and reading comprehension in middle childhood increased the risk of emotional and behaviour difficulties at school in the teenage years. The results suggest that effective language and literacy interventions for children with hearing loss may also bring benefits to their mental health.

What You Don't Know Can Hurt You: The Risk of Language Deprivation by Impairing Sign Language Development in Deaf Children

A long-standing belief is that sign language interferes with spoken language development in deaf children, despite a chronic lack of evidence supporting this belief. This deserves discussion as poor life outcomes continue to be seen in the deaf population. This commentary synthesizes research outcomes with signing and non-signing children and highlights fully accessible language as a protective factor for healthy development. Brain changes associated with language deprivation may be misrepresented as sign language interfering with spoken language outcomes of cochlear implants. This may lead to professionals and organizations advocating for preventing sign language exposure before implantation and spreading misinformation. The existence of one-time-sensitive-language acquisition window means a strong possibility of permanent brain changes when spoken language is not fully accessible to the deaf child and sign language exposure is delayed, as is often standard practice. There is no empirical evidence for the harm of sign language exposure but there is some evidence for its benefits, and there is growing evidence that lack of language access has negative implications. This includes cognitive delays, mental health difficulties, lower quality of life, higher trauma, and limited health literacy. Claims of cochlear implant- and spoken language-only approaches being more effective than sign language-inclusive approaches are not empirically supported. Cochlear implants are an unreliable standalone first-language intervention for deaf children. Priorities of deaf child development should focus on healthy growth of all developmental domains through a fully-accessible first language foundation such as sign language, rather than auditory deprivation and speech skills.

The Relationship Between Language and Culture: Evidence From the Deaf Bi-Bi Community

Language helps establish cultural identification and social ties within a community. Like most cultural groups, language and culture are tightly interwoven in the Deaf 1 bilingual-bicultural (Bi-Bi) community. The social intimacy resulting from the shared use of American Sign Language (ASL) makes the Deaf Bi-Bi community unique from the mainstream hearing world. As our society grows increasingly diverse, it is very important to understand the intricate relationship between language and and how it supports identity formation and enhances social participation among a particular group of people. Specifically, this article will focus on cases illustrating potential consequences of a language loss. The social and cultural experiences of two Cantonese-ASL-English-speaking adolescent siblings will be discussed and understood through an in-depth interview. Finally, clinical implications for the role of clinicians in supporting Deaf families in the healthcare system will be discussed.

Parental involvement in the care and intervention of children with hearing loss

OBJECTIVE

The present study aimed to explore the nature of parental involvement in the intervention of children with hearing loss, as experienced by parents.

DESIGN

A qualitative descriptive methodology was adopted to conduct semi-structured in-depth interviews with a purposive sample of parents who have a child with hearing loss.

STUDY SAMPLE

Seventeen parents of 11 children aged 6-9 years participated in this study.

RESULTS

The overarching theme of parents taking the central role was identified using thematic analysis. This overarching theme connected five themes which described the nature of parental involvement: (1) parents work behind the scenes; (2) parents act as 'case managers'; (3) parents always have their child's language development in mind; (4) parents' role extends to advocacy for all children with hearing loss; and (5) parents serve a number of roles, but at the end of the day, they are parents.

CONCLUSIONS

The results indicate that parental involvement in the intervention of children with hearing loss is multifaceted in nature and incorporates a broad range of behaviours and practices. These findings have important implications for the provision of family-centred practices.

Tele-intervention for children with hearing loss: A comparative pilot study

Introduction This pilot study compared tele-intervention to conventional intervention for children with hearing loss in terms of communication performance, parental perceptions and clinician perceptions. Methods A within-subject design was employed, including 10 children with hearing loss and their parents who each received a structurally similar tele-intervention and conventional intervention session in a counterbalanced manner. Quality of communication performance was analysed using a modified Tait video analysis method. Parent and clinician perceptions were collected through rating-scale surveys and thematic analysis of qualitative responses. Results No significant difference ( p > 0.05) was found between tele-intervention and conventional intervention in terms of communication performance of children. Parent perceptions were not significantly different ( p > 0.05) between conventional and tele-intervention in terms of facilitating meaningful communication interaction. Significant differences were evident for parents' comfort level during the session, whether they found it to be a beneficial experience and whether they would like to continue receiving intervention through this method.  Clinician perceptions of conventional and tele-intervention were not significantly different ( p > 0.05) and tele-intervention was deemed a valuable method of service delivery for clients. Discussion This study provides preliminary evidence that tele-intervention is effective for communication intervention and can be a valuable solution to typical barriers such as distance and the shortage of trained interventionists.

The Impact of Childhood Hearing Loss on the Family: Mothers' and Fathers' Stress and Coping Resources

Parenting children who are deaf or hard of hearing (D/HH) presents unique long-term challenges that can place the parents at a greater risk for elevated levels of parenting stress. Adaptation of families to the various challenges presented by childhood hearing loss is influenced by their personal and social coping resources available for managing these stressors and challenges. The current study examined differences in parenting stress and personal (i.e., acceptance of the child who is D/HH and parents' sense of parenting self-efficacy) and social (i.e., formal and informal social support) coping resources between mothers and fathers of children who are D/HH in the Arab sector in Israel. Further, the study examined the relations between coping resources and parenting stress among these parents. Participants included 30 Israeli Arab mother-father couples (n = 60) having a child who is D/HH aged 3-8 years. Findings revealed no significant differences between mothers and fathers regarding parenting stress, child acceptance, or parental support systems. However, mothers reported significantly higher self-efficacy. In addition, correlation analysis indicated that higher coping resources decreased parenting stress levels. Theoretical and practical implications of parental gender in the context of cultural background are discussed regarding parent intervention programs.

Parental comparison of the prosodic and paralinguistic ability of children with cochlear implants and their normal hearing siblings

The everyday communication of children is commonly observed by their parents. This paper examines the responses of parents (n=18) who had both a Cochlear Implant (CI) and a Normal Hearing (NH) child. Through an online questionnaire, parents rated the ability of their children on a gamut of speech communication competencies encountered in everyday settings. Comparative parental ratings of the CI children were significantly poorer than those of their NH siblings in speaker recognition, happy and sad emotion, and question versus statement identification. Parents also reported that they changed the vocal effort and the enunciation of their speech when they addressed their CI child and that their CI child consistently responded when their name was called in normal, but not in noisy backgrounds. Demographic factors were not found to be linked to the parental impressions.

Does the introduction of newborn hearing screening improve vocabulary development in hearing-impaired children? A population-based study in Japan

OBJECTIVE

Permanent hearing impairment has a life-long impact on children and its early identification is important for language development. A newborn hearing screening (NHS) program has started in Okayama Prefecture, Japan, in 1999 to detect hearing impairment immediately after birth. We aim to examine the effect of this screening program on vocabulary development in pre-school children in a before and after comparative study design.

METHODS

A total of 107 5-year-old children who graduated from Okayama Kanariya Gakuen (an auditory center for hearing-impaired children) between 1998 and 2011 were enrolled in this study. The pre-NHS group (n=40) was defined as those who graduated between 1998 and 2003, while the post-NHS group (n=67) was defined as those who graduated between 2004 and 2011. The primary outcome was receptive vocabulary, which was assessed by the Picture Vocabulary Test [score <18 (low) vs. score ≥18 (high)]. The secondary outcome was productive vocabulary, or the number of productive words, which was assessed by an original checklist [<1773 words (low) vs. ≥1773 (high)]. We calculated odds ratios and 95% confidence intervals for vocabulary development and compared both groups.

RESULTS

The adjusted Picture Vocabulary Test score and number of productive words were significantly higher (p<0.01) in the post-NHS group than the pre-NHS group. Odds ratios were 2.63 (95% confidence interval: 1.17-5.89) for receptive vocabulary and 4.17 (95% confidence interval: 1.69-10.29) for productive vocabulary.

CONCLUSIONS

The introduction of NHS in Okayama Prefecture significantly improved both receptive and productive vocabulary development in hearing-impaired children.

Principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing

This document is a supplement to the year 2007 position statement of the Joint Committee on Infant Hearing and provides comprehensive guidelines for establishing strong early intervention (EI) systems with appropriate expertise to meet the needs of children who are deaf or hard of hearing (D/HH). Optimal outcomes can only be achieved when there is high quality to the universal newborn hearing screening programs, the audiologic diagnostic process of confirmation that a child is D/HH and fitting of amplification, and the provision of appropriate, individualized, targeted, and high-quality EI services. There are 12 best practice guidelines for EI programs that include the provision of timely referral to EI services with providers who have knowledge and skills in early childhood deafness and hearing loss, infusion within the system of partnerships with parents as well as professionals who are D/HH, longitudinal developmental assessments for monitoring the child's development, data management systems that include developmental outcomes, a process to monitor the fidelity of the intervention, and appropriate services for children with additional disabilities, those from non-English speaking families, and those from special populations, including unilateral hearing loss and auditory neuropathy/dyssynchrony.

Parent influences on physical activity participation and physical fitness of deaf children

Research has consistently demonstrated that parents' values toward physical activity and fitness have strongly influenced the physical activity habits of hearing children (Welk, G. J., Wood, K., & Morss, G. [2003]. Parental influences on physical activity in children: An exploration of potential mechanisms. Pediatric Exercise Science, 15, 19-33). The primary purpose of this study was to determine whether similar findings are obtained for deaf (1) children. The influence of parents' hearing status and parents' involvement in Deaf sport (2) was assessed in addition to their values toward sports participation and physical fitness for their deaf children. Deaf children's physical activity habits were determined by the number of activities participated per week, and fitness levels by the number of scores within the Healthy Fitness Zone from the Fitnessgram test. Parents demonstrated positive values toward physical fitness regardless of hearing status; this finding was strongest among deaf parents of deaf children. Significant positive relationships were found among parents' values toward physical fitness and sport participation and children's physical activity and fitness levels, as well as between Deaf sport involvement by deaf parents and children's physical activity levels.

The importance of language in the home for school-age children with permanent hearing loss

AIM

To determine the characteristics of the natural spoken language environment associated with better language skills at school age of children with permanent hearing loss (HL) screened in a newborn hearing screen programme.

METHODS

A language processor recorded language environment including child vocalisations (CVs), conversational turns (CTs), adult word count (AWC), percentage of language and percentage of silence in 23 children with HL and 41 hearing controls. Relationships of language environment scores with Reynell language scores were analysed.

RESULTS

Children with HL had significantly lower Reynell comprehension scores (15-25 points; p = 0.0001) and expressive scores (7-12 points; NS) than hearing children. In regression analyses for the children with HL, after adjusting for age of entry to early intervention and stay in a NICU, every increase in ten percentage points of language in the home was associated with 7.2 points higher comprehension score (p = 0.027) and 9.99 points higher expressive score (p = 0.006). After adjusting for nonverbal intelligence, similar independent effects of the language environment on both comprehension (p = 0.027) and expressive scores (p = 0.006) were identified.

CONCLUSION

A rich language environment in the home is associated with better language abilities, which are necessary for academic success for children with permanent HL at school age.

Muenster Parental Programme empowers parents in communicating with their infant with hearing loss

OBJECTIVE

With the implementation of the Universal Newborn Hearing Screening (UNHS), the age of diagnosis of children with hearing loss (HL) has been steadily declining in the past years. Consequently, there is a need for early educational intervention methods that are suitable for infants at the preverbal level. To meet this need we have developed and evaluated the Muenster Parental Programme (MPP), a responsive parenting programme for parents of children with HL aged 3-18 months. It aims at enhancing the parents' communicative skills towards their child.

METHODS

The MPP is introduced following confirmation of a HL. Flanked by two individual counselling sessions, the programme comprises six group sessions and two single training sessions with video feedback. The focus of the programme lies in enhancing parents' responsive behaviour and in reducing inappropriate initiative behaviour. The present study involved 29 parents of 24 children aged 6.6 (mean, range: 3-12) months at the outset of the MPP. The children's degree of HL ranged from moderate to profound. Parents of children with unilateral HL and/or risk for an additional developmental delay were included. The prospective study compared parent communication skills of a trained (N = 15) versus a control group (N = 14) before and after the MPP. For this purpose, instances of responsive behaviour to the signals of the child and total time of initiative behaviour within a 4-min video-sample were measured before and after completion of the study in both groups.

RESULTS

Trained parents could enhance their responsiveness to vocal and preverbal signals of the child (Wilcoxon test, p = .002) and also their responsiveness to non-verbal signals (Wilcoxon test, p < .001). Moreover, parents reduced their inappropriate initiative behaviour (related t-test, p < .001). Pre-post comparisons in the control group were non-significant.

CONCLUSIONS

The increased parental responsiveness to infants with HL is of great importance as these early behaviours underlie later acquisition of speech, language, hearing and social communication skills. The MPP constitutes the first evaluated group concept for parents of infants with HL in the German-speaking countries and equally meets the needs of parents and professionals.

Narrative spoken language skills in severely hearing impaired school-aged children with cochlear implants

Cochlear implants have a significant positive effect on spoken language development in severely hearing impaired children. Previous work in this population has focused mostly on the emergence of early-developing language skills, such as vocabulary. The current study aims at comparing narratives, which are more complex and later-developing spoken language skills, of a contemporary group of profoundly deaf school-aged children using cochlear implants (n=66, median age=8 years 3 months) with matched normal hearing peers. Results show that children with cochlear implants demonstrate good results on quantity and coherence of the utterances, but problematic outcomes on quality, content and efficiency of retold stories. However, for a subgroup (n=20, median age=8 years 1 month) of deaf children without additional disabilities who receive cochlear implantation before the age of 2 years, use two implants, and are raised with one spoken language, age-adequate spoken narrative skills at school-age are feasible. This is the first study to set the goals regarding spoken narrative skills for deaf children using cochlear implants.

Expressive vocabulary, morphology, syntax and narrative skills in profoundly deaf children after early cochlear implantation

Practical experience and research reveal generic spoken language benefits after cochlear implantation. However, systematic research on specific language domains and error analyses are required to probe sub-skills. Moreover, the effect of predictive factors on distinct language domains is unknown. In this study, outcomes of 70 school-aged children with cochlear implants were compared with hearing peers. Approximately half of the children with cochlear implants achieved age-adequate language levels. Results did not reveal systematic strong or weak language domains. Error analyses showed difficulties with morphological and syntactic rules and inefficient narrative skills. Children without additional disabilities who received early intervention were raised with one spoken language, and used a second cochlear implant or contralateral hearing aid were more likely to present good language skills.

Assessing language and language environment of high-risk infants and children: a new approach

Language delays are common among premature infants and children with hearing loss. There are multiple tools and reports for assessing language in young children. Assessing early language and providing intervention is key to improving outcomes.

CONCLUSION

We conclude that utilization of a new tool, Language Environment Analysis digital language processor (LENA™), to assess the natural language environment of high-risk infants and children in a variety of settings including the neonatal intensive care unit and home, provides the opportunity to access and identify key features of the early language environment.

Identification of effective strategies to promote language in deaf children with cochlear implants

Parental involvement and communication are essential for language development in young children. However, hearing parents of deaf children face challenges in providing language input to their children. This study utilized the largest national sample of deaf children receiving cochlear implants, with the aim of identifying effective facilitative language techniques. Ninety-three deaf children (≤ 2 years) were assessed at 6 implant centers prior to and for 3 years following implantation. All parent-child interactions were videotaped, transcribed, and coded at each assessment. Analyses using bivariate latent difference score modeling indicated that higher versus lower level strategies predicted growth in expressive language and word types predicted growth in receptive language over time. These effective, higher level strategies could be used in early intervention programs.

Language outcomes and service provision of preschool children with congenital hearing loss

BACKGROUND

Children with congenital hearing loss (HL) are at increased risk of speech and language delays and require increased resource needs.

METHODS

Assessments of language, adaptive behavior, and resource needs at mean age of 60±5 months. Effects of age of enrollment in Early Intervention (EI) and degree of HL were evaluated.

RESULTS

Children with HL had lower Reynell verbal comprehension scores (77.6±18 versus 94.8±15; p=0.0001) and expressive language scores (85.9±19 versus 97.4±15; p=0.0051) than hearing children. Children with HL enrolled in EI ≤3 months versus >3 months had higher verbal comprehension (86.6±21 versus 70.3±12; p=0.0143) and expressive language scores (92.1±12 versus 80.5±21; p=0.0601), respectively. Children with bilateral moderate to profound HL and children with unilateral or bilateral mild HL were more likely to have low verbal comprehension scores versus children with hearing (75.8±17 and 81.0±22 versus 94.8±15; p=0.001), and receive more special educational services (100% and 100% versus 42%) respectively. After adjusting for degree of HL and Vineland adaptive scores <70, entry to EI ≤3 months was associated with a 13.8 point higher verbal comprehension score (p=0.047) for children with HL. The model accounted for 26% of variance.

CONCLUSIONS

Persistent beneficial effects of early age of entry to EI on verbal comprehension scores are observed for children with congenital HL at preschool age. Children with HL continue to need comprehensive education services.

Perceptions of parents and speech and language therapists on the effects of paediatric cochlear implantation and habilitation and education following it

BACKGROUND

During the process of implantation, parents may have rather heterogeneous expectations and concerns about their child's development and the functioning of habilitation and education services. Their views on habilitation and education are important for building family-centred practices.

AIMS

We explored the perceptions of parents and speech and language therapists (SLTs) on the effects of implantation on the child and the family and on the quality of services provided. Their views were also compared.

METHODS & PROCEDURES

Parents and SLTs of 18 children filled out questionnaires containing open- and closed-ended questions at 6 months and annually 1-5 years after activation of the implant. Their responses were analysed mainly using data-based inductive content analysis.

OUTCOMES & RESULTS

Positive experiences outnumbered negative ones in the responses of both the parents and the SLTs surveyed. The parents were particularly satisfied with the improvement in communication and expanded social life in the family. These were the most prevalent themes also raised by the SLTs. The parents were also satisfied with the organization and content of habilitation. Most of the negative experiences were related to arrangement of hospital visits and the usability and maintenance of speech processor technology. Some children did not receive enough speech and language therapy, and some of the parents were dissatisfied with educational services. The habilitation process had generally required parental efforts at an expected level. However, parents with a child with at least one concomitant problem experienced habilitation as more stressful than did other parents.

CONCLUSIONS & IMPLICATIONS

Parents and SLTs had more positive than negative experiences with implantation. As the usability and maintenance of speech processor technology were often compromised, we urge implant centres to ensure sufficient personnel for technical maintenance. It is also important to promote services by providing enough information and parental support.

Effect of School-Initiated Parent Outreach Activities on Parent Involvement in School Events

Parent involvement is a cornerstone of special education policy and best practice. Parents of students with disabilities participate in school events in a manner similar to parents of students without disabilities, and the benefits of parent involvement are widely recognized for all students. Recent legislation and federal funding opportunities have targeted parent outreach programs as an area of improvement for schools. Using data from the Special Education Elementary Longitudinal Study, this study examined the effect of school-initiated parent outreach activities on parent involvement in school. Parents reported greater involvement in schools that offered a greater number of outreach activities. Parent involvement was lower for older students, non-Caucasian students, students from non-two-parent households, and students from lower income households, and these lower participation rates were not differentially higher in schools that offered a greater number of parent outreach activities. Patterns and trends of parent involvement and school-initiated outreach programs are discussed, with suggestions for practitioners and future research.

The effects of maternal stress and child language ability on behavioral outcomes of children with congenital hearing loss at 18-24months

BACKGROUND

Prior studies have shown that children with congenital hearing loss have increased rates of behavior disorders. Child hearing loss has also been reported to be associated with increased maternal stress. Little is known about the behavior or the predictors of behavioral outcomes of children with hearing loss identified early and receiving Early Intervention services.

AIM

The objective of this study was to identify the behavioral outcomes in early identified children with hearing loss and control hearing children at 18-24 months of age and to examine the impact of stress on early behavior development. It was hypothesized that children with hearing loss will have more behavior problems, and maternal stress will be associated with child behavior problems.

STUDY DESIGN

Prospective observational.

SUBJECTS

Children with and without congenital hearing loss and their mothers.

OUTCOME MEASURES

The Parenting Stress Index and the Child Behavior Checklist.

RESULTS

Children with hearing loss had increased scores for withdrawn and internalizing behavior. In multivariate analyses after adjusting for hearing loss, Neonatal Intensive Care Unit stay, and socioeconomic status, maternal stress independently contributed to higher scores for internalizing behavior, externalizing behavior, and total behavior problems.

CONCLUSION

Maternal stress is an important correlate of behavior problems for children with hearing loss and should be considered by Early Intervention providers.

Print exposure, reading habits, and reading achievement among deaf and hearing college students

This study explored relations of print exposure, academic achievement, and reading habits among 100 deaf and 100 hearing college students. As in earlier studies, recognition tests for book titles and magazine titles were used as measures of print exposure, college entrance test scores were used as measures of academic achievement, and students provided self-reports of reading habits. Deaf students recognized fewer magazine titles and fewer book titles appropriate for reading levels from kindergarten through Grade 12 while reporting more weekly hours of reading. As in previous studies with hearing college students, the title recognition test proved a better predictor of deaf and hearing students' English achievement than how many hours they reported reading. The finding that the recognition tests were relatively more potent predictors of achievement for deaf students than hearing students may reflect the fact that deaf students often obtain less information through incidental learning and classroom presentations.