CSD 5400 REHABILITATION PROCEDURES FOR THE HARD OF HEARING

1. CSD 5400REHABILITATION PROCEDURES FOR THE HARD OF HEARING Language and Speech of Deaf and Hard-of-Hearing Characteristics and Concerns Language Acquisition and Development

2. The Components of Language • Form • The structure of language • Content • The meaning of language • Use • The goal or purpose of language

3. The Five Rule Systems of Language Form Syntax Rules for combining words into sentences Morphology Rules for combining speech sounds into meaningful units Phonology Rules for combining speech sounds to make words Content Semantics Rules for combining words and meaning of words Use Pragmatics Rules for conversation

4. Some Characteristics of Normal Language Acquisition • A process that occurs in natural contexts • Only requirement is repeated opportunities for meaningful conversation with adults • Children are cognitively programmed to learn language • No one language is universal • No one language is easier or harder to learn

5. When Things Interfere with Acquisition… Problems arise when.. • Language is used inconsistently by adults • Obstacles prevent full access to the language

6. Factors Affecting the Degree of Language Difficulties Language learning difficulties vary depending on: • The degree of hearing loss • Intelligence • Family communication styles • Intervention programs the child ultimately is exposed to

7. Effect on theMother-Child Bond Deafness has the potential to impair the communication between a child and his hearing parents This has become a recent “hot topic” in the literature regarding psychosocial effects of deafness

8. Early Bonds Understanding the effect of deafness on the early bonds between mother and child is important because: • Communication is integral to the emotional bond between parents and their children • It is only through the conversations between children and their parents that the rules of language are acquired

9. The First Six Months “Motherese” The way parents interact in a meaningful way with their young babies

10. Motherese Some characteristics of the linguistic forms used by mothers with their young babies: • Simple, well-formed, clear linguistic forms • High pitch • Exaggerated stress and intonation

11. Interactions Between Hearing Parents and Their Deaf Babies A study by Meadow-Orlans & Steinber (1993) concluded: • Hearing mothers were less likely to use frequent and positive touch with their deaf infants • Hearing mothers were less sensitive, more intrusive, less flexible, and less consistent in their responses to their deaf infants compared to mothers who were deaf

12. The Second Six Months Evidence of intentional communication The use of gestures and nonverbal communication

13. Parent-Child Interactions During this Period Parents of hard-of-hearing children have interactions with their children that are more directive than interactive • Conversations are rather one-sided • Failure to respond to the child’s communication behavior

14. Spencer (1993) Compared differences and similarities of various communication behaviors between normally hearing moms and their normally hearing 1-1.5 year olds and normally hearing moms and their deaf 1-1.5 year olds The deaf children in this study were identified early and were receiving intervention (amplification and language intervention) before 12 months

15. Spencer (1993) Spencer found no significant differences between the two groups in terms of the quantity of communication behaviors, gestures and vocalizations, but did find significant differences between the two groups in terms of the kinds of vocalizations and verbal productions

16. Preschool Language Knowledge of schema Facilitates language development

17. Hearing Impairment Limits schema • Limited access to family’s use of language • Reduces opportunity for incidental learning

18. Relationship Between Hearing Loss and Language Deficit Linguistic skills vary tremendously due to: • Speech understanding • Benefit from amplification • Individual learning characteristics • Intelligence • Family communication styles

19. Common Trends • Language delay • Language skill plateau • Deaf children show evidence of deviant linguistic forms

20. Phonology Normal but delayed Deaf children show deviant development

21. Syntax Normal but delayed • Restricted knowledge of word class • Restricted knowledge of different syntactic forms Deaf children show evidence of deviant syntax

22. Morphology and Vocabulary A study by Moeller (1986): Peabody Picture Vocabulary Test (PPVT) and Boehme Test of Basic Concepts Deaf children in a residential program 4-20 years old PPVT score means were equivalent to normally hearing 6-8 year olds; little improvement after age 12 Boehme scores of 16-18 year olds equivalent to normally hearing 6-8 year olds Expressive vocabulary of deaf 4 year olds averaged 150 words

23. Morphology and Vocabulary A study by Davis (1986): Mild-to-moderate hearing impaired first, second, and third graders (Iowa) mainstreamed in regular classrooms Boehme scores and PPVT scores PPVT delay of 1-3 years 75% of the sample scored below the 10th percentile on the Boehme

24. Another Case for Early Identification Children with hearing loss identified before 6 months show significantly higher vocabulary and language acquisition skills even three years later, compared to children identified after 6 months

25. Semantics and Pragmatics Semantics • Delay Pragmatics • Turn-taking, topic initiation and maintenance

26. Language Assessment and Hard-of-Hearing/Deaf Kids Language assessment can be accomplished by: Communication checklists Formal language tests Language sample analysis

27. Language Assessment Tests Developed Especially for Hearing Impaired Children Test of Syntactic Ability (TSA) Grammatical Analysis of Elicited Language (GAEL) Spontaneous Language Analysis Procedure (SLAP) Carolina Picture Vocabulary Test Rhode Island Test of Language Structure Scales of Early Communication Skills SKI-HI Language Development Scale

28. Cautions Using Other Assessment Measures Remember to: • Avoid IQ/mental age scores and interpretations • Think about the response required from the child and additional bias • Maximize acoustic and visual cues during the assessment • The assessment must be given by someone proficient in the child’s first language, whatever it is

29. A Few Words About Treatment Goals… Treatment goals for your hard-of-hearing child should include: Enhanced parent-child communication in the chosen communication modality/language Understanding of increasingly complex concepts and discourse Acquisition of lexical and world knowledge Development of verbal reasoning skills to foster literacy Enhanced self-expression and acquisition of pragmatic, syntactic, and semantic rules Development of spoken, written, and/or signed narrative skills