CSD 5400REHABILITATION

PROCEDURES FOR THE HARD OF HEARING

Language and Speech of Deaf and Hard-of-Hearing

Characteristics and ConcernsLanguage Acquisition and

Development

The Components of Language

• Form• The structure of language

• Content• The meaning of language

• Use• The goal or purpose of language

The Five Rule Systems of Language

FormSyntax

Rules for combining words into sentencesMorphology

Rules for combining speech sounds into meaningful units

PhonologyRules for combining speech sounds to make words

ContentSemantics

Rules for combining words and meaning of words

UsePragmatics

Rules for conversation

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

When Things Interfere with Acquisition…

Problems arise when..

Language is used inconsistently by adults

Obstacles prevent full access to the language

Factors Affecting the Degree of Language

Difficulties

Language learning difficulties vary depending on:

1. The degree of hearing loss2. Intelligence3. Family communication styles4. Intervention programs the child

ultimately is exposed to

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

Early Bonds

Understanding the effect of deafness on the early bonds between mother and child is important because:

1. Communication is integral to the emotional bond between parents and their children

2. It is only through the conversations between children and their parents that the rules of language are acquired

The First Six Months

“Motherese”The way parents

interact in a meaningful way with their young babies

Motherese

Some characteristics of the linguistic forms used by mothers with their young babies:

1. Simple, well-formed, clear linguistic forms

2. High pitch3. Exaggerated stress and

intonation

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

The Second Six Months

Evidence of intentional communication

The use of gestures and nonverbal communication

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

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

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

Preschool Language

Knowledge of schema Facilitates language

development

Hearing Impairment

Limits schema Limited access to

family’s use of language

Reduces opportunity for incidental learning

Relationship Between Hearing Loss and Language

Deficit

Linguistic skills vary tremendously due to:

1. Speech understanding2. Benefit from amplification3. Individual learning

characteristics4. Intelligence5. Family communication

styles

Common Trends

1. Language delay2. Language skill plateau3. Deaf children show evidence of

deviant linguistic forms

Phonology

Normal but delayedDeaf children show deviant

development

Syntax

Normal but delayed Restricted knowledge of word class Restricted knowledge of different

syntactic forms

Deaf children show evidence of deviant syntax

Morphology and Vocabulary

A study by Moeller (1986):Peabody Picture Vocabulary Test (PPVT) and

Boehme Test of Basic ConceptsDeaf children in a residential program 4-20

years oldPPVT 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

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 scoresPPVT delay of 1-3 years75% of the sample scored below the 10th

percentile on the Boehme

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

Semantics and Pragmatics

Semantics Delay

Pragmatics Turn-taking, topic initiation and

maintenance

Language Assessment and Hard-of-Hearing/Deaf Kids

Language assessment can be accomplished by:Communication

checklistsFormal language testsLanguage sample

analysis

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 TestRhode Island Test of Language

StructureScales of Early Communication SkillsSKI-HI Language Development Scale

Cautions Using Other Assessment Measures

Remember to:1. Avoid IQ/mental age

scores and interpretations

2. Think about the response required from the child and additional bias

3. Maximize acoustic and visual cues during the assessment

4. The assessment must be given by someone proficient in the child’s first language, whatever it is

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/languageUnderstanding of increasingly complex concepts

and discourseAcquisition of lexical and world knowledgeDevelopment of verbal reasoning skills to foster

literacyEnhanced self-expression and acquisition of

pragmatic, syntactic, and semantic rulesDevelopment of spoken, written, and/or signed

narrative skills