Olga María Alegre de la Rosa




Allen,T.E., & Anderson,M.L.(2010).Deaf Students and Their Classroom Communication: An Evaluation of Higher Order Categorical Interactions Among School and Background Characteristics.J Deaf Stud. Deaf Educ.,15(4):334-347.

This article investigated to what extent age, use of a cochlear implant, parental hearing status, and use of sign in the home determine language of instruction for profoundly deaf chil- dren. Categorical data from 8,325 profoundly deaf students from the 2008 Annual Survey of Deaf and Hard-of-Hearing Children and Youth were analyzed using chi-square auto- mated interaction detector, a stepwise analytic procedure that allows the assessment of higher order interactions among categorical variables. Results indicated that all char- acteristics were significantly related to classroom communi- cation modality. Although younger and older students demonstrated a different distribution of communication mo- dality, for both younger and older students, cochlear implan- tation had the greatest effect on differentiating students into communication modalities, yielding greater gains in the speech-only category for implanted students. For all sub- groups defined by age and implantation status, the use of sign at home further segregated the sample into communi- cation modality subgroups, reducing the likelihood of speech only and increasing the placement of students into signing classroom settings. Implications for future research in the field of deaf education are discussed.

Connor,C.M.(2006).Examining the Communication Skills of a Young Cochlear Implant Pioneer.J.Deaf Stud. Deaf Educ.11(4):449-460.

The purpose of this longitudinal case study was to closely examine one deaf child’s experience with a cochlear implant and his speech, language, and communication skills from kindergarten through middle and high school using both developmental and sociocultural frameworks. The target child was one of the first children to receive a cochlear im- plant in the United States in 1988, when he was 5 years of age. The developmental analysis revealed that prior to re- ceiving a cochlear implant the child demonstrated profound delays in speech and language skill development. His speech and language skills grew slowly during the first 3–4 years following implantation, very rapidly from about 5 through 7 years postimplantation, then slowed to rates that were highly similar to same-age peers with normal hearing. The socio- cultural analysis revealed that the child’s communicative competence improved; that he used sign language but use of sign language decreased as his oral communication skills improved; that as his oral communication skills improved, the adults talked and directed the topic of conversation less frequently; and that topics became less concrete and more personal over time. The results of this study indicate that we may learn more about how to support children who use co- chlear implants by examining what they are saying as well as how they are saying it.

Dammeyer,J.(2010).Psychosocial Development in a Danish Population of Children With Cochlear Implants and Deaf and Hard-of-Hearing Children.J.Deaf Stud. Deaf Educ.,15(1):50-58.

Research has shown a prevalence of psychosocial difficulties ranging from about 20% to 50% among children with hear- ing loss. This study evaluates the prevalence of psychosocial difficulties in a Danish population in relation to different explanatory variables. Five scales and questionnaires measur- ing sign language, spoken language, hearing abilities, and psychosocial difficulties were given to 334 children with hearing loss. Results show that the prevalence of psychoso- cial difficulties was 3.7 times greater compared with a group of hearing children. In the group of children with additional disabilities, the prevalence was 3 times greater compared with children without additional disabilities. If sign language and/or oral language abilities are good, the children do not have a substantially higher level of psychosocial difficulties than do hearing children. This study documents the impor- tance of communication—no matter the modality or degree of hearing loss—for the psychosocial well-being of hearing- impaired children.

DesJardin,J.L., Ambrose,S.E., & Eisenberg,L.S.(2009).Literacy Skills in Children With Cochlear Implants: The Importance of Early Oral Language and Joint Storybook Reading.J.Deaf Stud. Deaf Educ.14(1):22-43.

The goal of this study was to longitudinally examine rela- tionships between early factors (child and mother) that may influence children’s phonological awareness and reading skills 3 years later in a group of young children with cochlear implants (N 5 16). Mothers and children were videotaped during two storybook interactions, and children’s oral lan- guage skills were assessed using the ‘‘Reynell Developmental Language Scales, third edition.’’ Three years later, phono- logical awareness, reading skills, and language skills were assessed using the ‘‘Phonological Awareness Test,’’ the ‘‘Woodcock–Johnson-III Diagnostic Reading Battery,’’ and the ‘‘Oral Written Language Scales.’’ Variables included in the data analyses were child (age, age at implant, and lan- guage skills) and mother factors (facilitative language tech- niques) and children’s phonological awareness and reading standard scores. Results indicate that children’s early expres- sive oral language skills and mothers’ use of a higher level facilitative language technique (open-ended question) during storybook reading, although related, each contributed uniquely to children’s literacy skills. Individual analyses revealed that the children with expressive standard scores below 70 at Time 1 also performed below average (<85) on phonological awareness and total reading tasks 3 years later. Guidelines for professionals are provided to support literacy skills in young children with cochlear implants.

Dillon,C.M., de Jong,K., & Pisoni,D.B.(2012) Phonological Awareness, Reading Skills, and Vocabulary Knowledge in Children Who Use Cochlear Implants.J.Deaf Stud.Deaf Educ.,17(2):205-226.

In hearing children, reading skills have been found to be closely related to phonological awareness. We used several standardized tests to investigate the reading and phonological awareness skills of 27 deaf school-age children who were ex- perienced cochlear implant users. Approximately two-thirds of the children performed at or above the level of their hearing peers on the phonological awareness and reading tasks. Read- ing scores were found to be strongly correlated with measures of phonological awareness. These correlations remained the same when we statistically controlled for potentially con- founding demographic variables such as age at testing and speech perception skills. However, these correlations de- creased even after we statistically controlled for vocabulary size. This finding suggests that lexicon size is a mediating factor in the relationship between the children’s phonological awareness and reading skills, a finding that has also been reported for typically developing hearing children.

Edwards,L.C.(2007). Children With Cochlear Implants and Complex Needs: A Review of Outcome Research and Psychological Practice.J.Deaf Stud. Deaf Educ.,12(3):258-268.

In recent years, the number of children receiving cochlear implants who have significant disabilities in addition to their deafness has increased substantially. However, in comparison with the extensive literature on speech, language, and com- munication outcomes following pediatric implantation in children without complex needs, the available literature for this special group of children is relatively sparse. This article reviews the available research on outcomes, grouping studies according to the nature of the additional disabilities and specific etiologies of deafness. The methodological problems relating to outcome research in this field are outlined, followed by some tentative conclusions drawn from the literature base while bearing these problems in mind. The remainder of the article focuses on the challenges for clinical practice, from a psychological perspective, of implanting deaf children with complex needs. Two groups of children are considered, those whose additional disabilities have been identified prior to implantation and those whose difficulties become apparent at some point afterward, sometimes many years later. A case example describing the psychological as- sessment of a deaf–blind child being considered for implan- tation is presented.

Fagan,M.K., & Pisoni,D.B.(2010).Hearing Experience and Receptive Vocabulary Development in Deaf Children With Cochlear Implants.J.Deaf Stud. Deaf Educ.15(2):149-161.

This study investigated receptive vocabulary delay in deaf children with cochlear implants. Participants were 23 chil- dren with profound hearing loss, ages 6–14 years, who re- ceived a cochlear implant between ages 1.4 and 6 years. Duration of cochlear implant use ranged from 3.7 to 11.8 years. Peabody Picture Vocabulary Test, Third Edition (PPVT- III) data were analyzed first by examining children’s errors for evidence of difficulty in specific lexical content areas, and second by calculating standard scores with reference to hear- ing age (HA) (i.e., chronological age [CA] 2 age at implan- tation) rather than CA. Participants showed evidence of vocabulary understanding across all PPVT-III content cat- egories with no strong evidence of disproportionate numbers of errors in any specific content area despite below-average mean standard scores. However, whereas mean standard scores were below the test mean established for hearing children when based on CA, they were within the average range for hearing children when calculated based on HA. Thus, children’s vocabulary knowledge was commensurate with years of cochlear implant experience, providing support for the role of spoken language experience in vocabulary acquisition.

Gale,E.(2011).Exploring Perspectives on Cochlear Implants and Language Acquisition Within the Deaf Community.J.Deaf Stud. Deaf Educ.,16(1):121-139.

Cochlear implants generated intense debate almost immedi- ately following their introduction in the 1980s. Today, with a vast number of deaf individuals with cochlear implants, the debate about the cochlear implant device and mode of com- munication continues. Q-methodology was used in this study to explore cochlear implants and language acquisition perspectives within the deaf community. Thirty respondents sorted 33 statements, which were collected from professional literature and mainstream media, into a forced-choice, quasi- normal template. A by-person factor analysis of the Q-sorts revealed 5 model viewpoints: (a) American Sign Language advocate, (b) bilingual advocate, (c) cochlear implant advo- cate, (d) diverse options advocate, and (e) English visually advocate. Even though the results indicate 5 distinct per- spectives, the Q-method also revealed similarities among them. The results also show that there seems to be some agreement on using a bilingual approach, although the per- spectives seem to disagree on which language should be acquired first.

Gheysen,F., Loots,G., & Van Waelvelde,H.(2008).Motor Development of Deaf Children With and Without Cochlear Implants.J.Deaf Stud. Deaf Educ.,13(2):215-224.

The purpose of this study was to investigate the impact of a cochlear implant (CI) on the motor development of deaf children. The study involved 36 mainstreamed deaf children (15 boys, 21 girls; 4- to 12-years old) without any develop- mental problems. Of these children, 20 had been implanted. Forty-three hearing children constituted a comparison group. Motor development was assessed by three standardized tests: the Movement Assessment Battery for Children, the Ko ̈rperkoordinationstest fu ̈r Kinder, and the One-leg standing test. Results showed that the hearing children performed on average significantly better than the deaf children (whether or not using a CI). Regarding the use of a CI, there was only a significant difference on one subtest between both groups, although there was a nonsignificant trend for the deaf 1CI group to score somewhat worse on average than the deaf –CI group. This led to some significant differences between the hearing group and the deaf 1CI group on measures requiring balance that did not hold for the hearing/deaf –CI comparison. Although this study could demonstrate neither a positive nor a negative impact of CI on balance and motor skills, the data raise the need for further, preferably longitudinal, research.

Harris,M., & Terlektsi,E.(2011).Reading and Spelling Abilities of Deaf Adolescents With Cochlear Implants and Hearing Aids.J.Deaf Stud. Deaf Educ.,16(1):24-34.

A total of 86 deaf children aged between 12 and 16 years were recruited from schools for the deaf, specialist units attached to a school, and mainstream schools. Approximately one-third used hearing aids, one-third had received a co- chlear implant before 42 months, and one-third had been implanted later. The 3 subgroups were matched for age and nonverbal IQ , and all had an unaided hearing loss of at least 85 dB. Assessments revealed mean reading ages that were several years below chronological age for all 3 groups. How- ever, participants in the hearing aid group performed best. Reading levels were not predicted by age of diagnosis or degree of hearing loss, but there was a relationship between reading level and presence of phonetic errors in spelling. There were also differences in educational setting, with the great majority of children in the hearing aid group in a school for the deaf and relatively more of the children with cochlear implants being educated in a unit or mainstream setting.

James,D., Rajput,K., Brinton,J., & Goswami,U.(2008).Phonological Awareness, Vocabulary, and Word Reading in Children Who Use Cochlear Implants: Does Age of Implantation Explain Individual Variability in Performance Outcomes and Growth?.J.Deaf Stud. Deaf Educ.,13(1):117-137.

The phonological awareness (PA), vocabulary, and word reading abilities of 19 children with cochlear implants (CI) were assessed. Nine children had an implant early (between 2 and 3.6 years) and 10 had an implant later (between 5 and 7 years). Participants were tested twice over a 12-month period on syllable, rhyme, and phoneme awareness (see James et al., 2005). Performance of CI users was compared against younger hearing children matched for reading level. Two standardized assessments of vocabulary and single word reading were administered. As a group, the children fitted early had better performance outcomes on PA, vocabulary, and reading compared to hearing benchmark groups. The early group had significant growth on rhyme awareness, whereas the late group showed no significant gains in PA over time. There was wide individual variation in perfor- mance and growth in the CI users. Two participants with the best overall development were both fitted with an im- plant late in childhood.

Marschark,M., Rhoten,C., & Fabich,M.(2007). Effects of Cochlear Implants on Children’s Reading and Academic Achievement.J.Deaf Stud. Deaf Educ.12(3):269-282.

This article presents a critical analysis of empirical studies assessing literacy and other domains of academic achieve- ment among children with cochlear implants. A variety of recent studies have demonstrated benefits to hearing, lan- guage, and speech from implants, leading to assumptions that early implantation and longer periods of implant should be associated with higher reading and academic achieve- ment. This review, however, reveals that although there are clear benefits of cochlear implantation to achievement in young deaf children, empirical results have been somewhat variable. Examination of the literature with regard to reading achievement suggests that the lack of consistent findings might be the result of frequent failures to control potentially confounding variables such as age of implantation, language skills prior to implantation, reading ability prior to implan- tation, and consistency of implant use. Studies of academic achievement beyond reading are relatively rare, and the ex- tent to which performance in such domains is mediated by reading abilities or directly influenced by hearing, language, and speech remains unclear. Considerations of methodolog- ical shortcomings in existing research as well as theoretical and practical questions yet to be addressed provide direction for future research.

Martin,D., Bat-Chava,Y., Lalwani,A., & Waltzman,S.B.(2011).Peer Relationships of Deaf Children With Cochlear Implants: Predictors of Peer Entry and Peer Interaction Success.J.Deaf Stud. Deaf Educ.,16(1):108-120.

This study investigated factors that affect the development of positive peer relationships among deaf children with cochlear implants. Ten 5- to 6-year-old deaf children with implants were observed under conditions varying peer con- text difficulty in a Peer Entry task. Results revealed better outcomes for deaf children interacting in one-on-one sit- uations compared to interactions including two other hear- ing children and better performance among girls than boys. In addition, longer duration of implant use and higher self- esteem were associated with better performance on the Peer Task, which was in turn related to parental reports of children’s social functioning outside the experimental situation. These findings contribute to the growing litera- ture describing the benefits of cochlear implantation in the areas of communication and socialization, while pointing to interventions that may enhance deaf children’s social competence.

Maxwell-McCaw,D., & Zea,M.C.(2011).The Deaf Acculturation Scale (DAS): Development and Validation of a 58-Item Measure.J.Deaf Stud. Deaf Educ 16(3):325-342.

This study involved the development and validation of the Deaf Acculturation Scale (DAS), a new measure of cultural identity for Deaf and hard-of-hearing (hh) populations. Data for this study were collected online and involved a nation- wide sample of 3,070 deaf/hh individuals. Results indicated strong internal reliabilities for all the subscales, and con- struct validity was established by demonstrating that the DAS could discriminate groups based on parental hearing status, school background, and use of self-labels. Construct validity was further demonstrated through factorial analyses, and findings resulted in a final 58-item measure. Directions for future research are discussed.

Punch,R., & Hyde,M (2011).Social Participation of Children and Adolescents With Cochlear Implants: A Qualitative Analysis of Parent, Teacher, and Child Interviews.J.Deaf Stud. Deaf Educ.,16(4):474-493.

Psychosocial factors, including socioemotional well-being, peer relationships, and social inclusion with hearing and deaf peers, are increasingly becoming a focus of research investi- gating children with cochlear implants. The study reported here extends the largely quantitative findings of previous research through a qualitative analysis of interviews with parents, teachers, and pediatric cochlear implant users them- selves in three eastern states of Australia. We interviewed 24 parents, 15 teachers, and 11 children and adolescents. The findings displayed commonalities across the three groups of participants, indicating positive experiences around the children’s psychosocial development with their cochlear implants, but also ongoing difficulties communicating in groups of people and problems related to social skills. Some children had little contact with other deaf children (with or without cochlear implants) despite parents and teachers perceiving such contact beneficial. Children attending schools where there were other deaf children valued friend- ships with both deaf and hearing peers. Adolescence was a particularly difficult time for some as they struggled with feelings of self-consciousness about their deafness and external cochlear implant equipment and worries around friendships, dating, and their future place in the world. Rec- ommendations for practice and further research are made.

Vermeulen,A.M., van Bon,W., Schreuder,R., Knoors,H., & Snik,A.(2007).Reading Comprehension of Deaf Children With Cochlear Implants.J.Deaf Stud. Deaf Educ.,12(3):283-302.

The reading comprehension and visual word recognition in 50 deaf children and adolescents with at least 3 years of cochlear implant (CI) use were evaluated. Their skills were contrasted with reference data of 500 deaf children without CIs. The reading comprehension level in children with CIs was expected to surpass that in deaf children without implants, partly via improved visual word recognition. Read- ing comprehension scores of children with implants were significantly better than those of deaf children without im- plants, although the performance in implant users was sub- stantially lagging behind that in hearing children. Visual word recognition was better in children with CIs than in children without implants, in secondary education only. No difference in visual word recognition was found between the children with CIs and the hearing children, whereas the deaf children without implants showed a slightly poorer per- formance. The difference in reading comprehension perfor- mance of the deaf children with and without CIs remained present when visual word recognition was controlled for. This indicates that other reading-related skills were also contrib- uting to the improved reading comprehension skills of deaf children with CIs.

Wauters,L.N., & Knoors,H.(2008).Social Integration of Deaf Children in Inclusive Settings.J.Deaf Stud. Deaf Educ 13(1):21-36.

This article examines social integration of deaf children in inclusive settings in The Netherlands. Eighteen Grade 1–5 deaf children and their 344 hearing classmates completed 2 sociometric tasks, peer ratings and peer nomination, to mea- sure peer acceptance, social competence, and friendship rela- tions. Deaf and hearing children were found to be similar in their peer acceptance and friendship relations, but differ- ences occurred in social competence. Deaf children scored lower than hearing children on prosocial behavior and higher on socially withdrawn behavior. Structural equation model- ing showed peer acceptance, social competence, and friend- ship relations to be stable over time, and the structure of interrelations between variables at 2 measurements were found to be the same for deaf and hearing participants.

Wiefferink,C.H., Rieffe,C., Ketelaar,L., De Raeve,L., & Frijns,J.H.M.(2013).Emotion Understanding in Deaf Children with a Cochlear Implant.J.Deaf Stud. Deaf Educ.,18(2):175-186.

It is still largely unknown how receiving a cochlear implant affects the emotion understanding in deaf children. We exam- ined indices for emotion understanding and their associations with communication skills in children aged 2.5–5 years, both hearing children (n = 52) and deaf children with a cochlear implant (n = 57). 2 aspects of emotion understanding were examined: (a) emotion recognition in facial expressions and (b) emotion attribution in a situational context. On all emo- tion-understanding tasks, children with a cochlear implant were less proficient than children with normal hearing. In children with normal hearing, performance and language skills were positively associated. In children with cochlear implants, language was positively associated only with tasks in which a verbal demand was made on children. These find- ings indicate that hearing loss in children, despite a cochlear implant, affects all aspects of emotion understanding meas- ured in this study, including their nonverbal emotion-under- standing skills.

Ziv,M., Most,T., & Cohen,S.(2013).Understanding of Emotions and False Beliefs Among Hearing Children versus Deaf Children.J.Deaf Stud. Deaf Educ.,18(2):161-174.

Emotion understanding and theory of mind (ToM) are two major aspects of social cognition in which deaf children dem- onstrate developmental delays. The current study investi- gated these social cognition aspects in two subgroups of deaf children—those with cochlear implants who communicate orally (speakers) and those who communicate primarily using sign language (signers)—in comparison to hearing children. Participants were 53 Israeli kindergartners—20 speakers, 10 signers, and 23 hearing children. Tests included four emotion identification and understanding tasks and one false belief task (ToM). Results revealed similarities among all children’s emotion labeling and affective perspective taking abilities, similarities between speakers and hearing children in false beliefs and in understanding emotions in typical contexts, and lower performance of signers on the latter three tasks. Adapting educational experiences to the unique characteris- tics and needs of speakers and signers is recommended.






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