Amy Szarkowski
University of Massachusetts, Boston, Institute for Community Inclusion, Department Member
- Boston Children's Hospital, Developmental Medicine, Department Memberadd
- Ethics, Public Health, Health Sciences, Bioethics, Developmental Psychology, Clinical Psychology, and 10 moreDeafness and Hearing Loss, Deaf Children and Education, Language and Deafness, Deaf studies, Deafblindness, Autism Spectrum Disorders, Qualitative methodology, Quality of life, Disability Studies, and The Rights of Persons With Disabilitiesedit
- Director of The Institute at the Children's Center for Communiction/Beverly School for the Deafedit
“Ubuntu” is illustrated by the story of an anthropologist who studied the customs of an African tribe.The anthropologist decided to play a game with the children of the tribe. He placed a basket of candies at the foot of a tree stating... more
“Ubuntu” is illustrated by the story of an anthropologist who studied the customs of an African tribe.The anthropologist decided to play a game with the children of the tribe. He placed a basket of candies at the foot of a tree stating that the first to reach the tree would receive all the candy. The children stood in a line waiting for the anthropologist to tell them it was time to run to the tree. When the anthropologist gave the signal to go, the children held hands and ran together toward the tree. The children all arrived together at the same time and shared the candy. The “children” in this story are the many, many experts from all over the globe who contributed to the production of this special edition of the Journal of Deaf Studies and Deaf Education (JDSDE). The “candy” is the series of 8 articles you are about to read.
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This Call to Action is the eighth and final article in this special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. Collectively, these articles... more
This Call to Action is the eighth and final article in this special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. Collectively, these articles highlight evidence-informed actions to enhance family well-being and to optimize developmental outcomes among children who are DHH. This Call to Action outlines actionable steps to advance FCEI-DHH supports provided to children who are DHH and their families. It also urges specific actions to strengthen FCEI-DHH programs/services and systems across the globe, whether newly emerging or long-established. Internationally, supports for children who are DHH are often siloed, provided within various independent sectors such as health/medicine, education, early childhood, and social and disability services. With this Call to Action, we urge invested parties from across relevant sectors to join together to implement and improve FCEI-DHH programs/services and systems, build the capacity of early intervention (EI) Providers and other professionals, extend research regarding FCEI-DHH, and fund EI supports, systems, and research, all with the aim of advancing outcomes for families and their children who are DHH.
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This article is the seventh in a series of eight articles that comprise a special issue on family-centered early intervention for children who are deaf or hard of hearing and their families, or FCEI-DHH. This article, Structure... more
This article is the seventh in a series of eight articles that comprise a special issue on family-centered early intervention for children who are deaf or hard of hearing and their families, or FCEI-DHH. This article, Structure Principles, is the third of three articles (preceded by Foundation Principles and Support Principles) that describe the 10 FCEI-DHH Principles. The Structure Principles include 4 Principles (Principle 7, Principle 8, Principle 9, and Principle 10) that highlight (a) the importance of trained and effective Early Intervention (EI) Providers, (b) the need for FCEI-DHH teams to work collaboratively to support families, (c) the considerations for tracking children's progress through developmental assessment, and (d) the essential role of progress monitoring to continuously improve systems.
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This article is the sixth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The Support Principles... more
This article is the sixth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The Support Principles article is the second of three articles that describe the 10 Principles of FCEI-DHH, preceded by the Foundation Principles, and followed by the Structure Principles, all in this special issue. The Support Principles are composed of four Principles (Principles 3, 4, 5, and 6) that highlight (a) the importance of a variety of supports for families raising children who are DHH; (b) the need to attend to and ensure the well-being of all children who are DHH; (c) the necessity of building the language and communication abilities of children who are DHH and their family members; and (d) the importance of considering the family's strengths, needs, and values in decision-making.
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This article is the fifth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The 10 FCEI-DHH... more
This article is the fifth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The 10 FCEI-DHH Principles are organized conceptually into three sections (a) Foundation Principles, (b) Support Principles, and (c) Structure Principles. Collectively, they describe the essential Principles that guide FCEI for children who are DHH and their families. This article describes the Foundation Principles (Principles 1 and Principle 2). The Foundation Principles emphasize the essential elements of ensuring that families with children who are DHH can access early intervention (EI) and other appropriate supports, as well as highlight the need for provision of EI that is family-centered. Implementation of these FCEI-DHH Principles is intended to improve the lives and the outcomes of children who are DHH and their families around the globe. The Foundation Principles of Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) highlight fundamental concepts upon which FCEI-DHH is built. The abbreviation, DHH, used throughout the Principles, is intended to be inclusive of all children who are deaf or hard of hearing, including children who are DHH with disabilities.
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This is the fourth article in a series of eight that comprise a special issue on family-centered early intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, FCEI-DHH. This article describes the... more
This is the fourth article in a series of eight that comprise a special issue on family-centered early intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, FCEI-DHH. This article describes the co-production team and the consensus review method used to direct the creation of the 10 Principles described in this special issue. Co-production is increasingly being used to produce evidence that is useful, usable, and used. A draft set of 10 Principles for FCEI-DHH and associated Tables of recommended behaviors were developed using the knowledge creation process. Principles were refined through two rounds of eDelphi review. Results for each round were analyzed using measures of overall group agreement and measures that indicated the extent to which the group members agreed with each other. After Round 2, with strong agreement and low to moderate variation in extent of agreement, consensus was obtained for the 10 Principles for FCEI-DHH presented in this special issue. This work can be used to enhance evolution of FCEI-DHH program/services and systems worldwide and adds to knowledge in improvement science.
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This article is the third in a series of eight articles that comprise this special issue on family-centered early intervention for children who are deaf or hard of hearing and their families (FCEI-DHH). It highlights the origins of... more
This article is the third in a series of eight articles that comprise this special issue on family-centered early intervention for children who are deaf or hard of hearing and their families (FCEI-DHH). It highlights the origins of FCEI-DHH in Western contexts and well-resourced locations and emphasizes the role of culture(s) in shaping FCEI-DHH. This article also cautions against the direct application of the 10 FCEI-DHH Principles presented in this issue across the globe without consideration of cultural implications. Cultural perceptions of decision-making processes and persons who can be decision-makers in FCEI-DHH are explored. Deaf culture(s) and the benefits of exposure to DHH adults with diverse backgrounds are introduced. Structural inequities that impact families' access to FCEI-DHH programs/services and systems, within and among nations and regions, are noted. The need to consider the cultural inf luences on families is emphasized; this applies to all levels of FCEI, including the development of systems through implementation of supports.
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This article is the second of eight articles in this special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. Five foundational values that guide... more
This article is the second of eight articles in this special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. Five foundational values that guide FCEI-DHH are described, providing an evidence-informed, conceptual context for the 10 FCEI-DHH Principles and other articles presented in this issue. These values are applicable for Early Intervention (EI) Providers and other professionals on FCEI teams, as well as for FCEI-DHH programs/services and systems. The five key values include (1) being family-centered, (2) responding to diversity, (3) involving invested parties, especially families and individuals who are DHH, (4) supporting holistic child development, and (5) ensuring fundamental human rights. These evidence-informed values are considered essential to the effective provision of FCEI-DHH supports.
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The authors performed a scoping review using a five-stage methodological framework (Arksey & O’Malley, 2005; Levac et al., 2010) to map the nature and extent of the literature regarding universal design for learning (UDL) in deaf... more
The authors performed a scoping review using a five-stage methodological framework (Arksey & O’Malley, 2005; Levac et al., 2010) to map the nature and extent of the literature regarding universal design for learning (UDL) in deaf education contexts. UDL is a well-established framework that provides actionable recommendations for developing instruction. The review revealed that high-quality investigations of UDL in deaf education are limited; only three articles met criteria for inclusion, though excluded articles were also examined for themes. The analysis showed that despite global interest in studying UDL through a variety of methods, more research is needed that applies this framework explicitly throughout study design, analysis, and discussion rather than just within the framing. Given its inclusion in federal educational policy, it is critical that scholars and educators examine how UDL can support educators in the design and implementation of impactful instruction for deaf learners.
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Deaf and hard-of-hearing (DHH) children who use spoken language face unique challenges when communicating with others who have typical hearing, particularly their peers. In such contexts, the social use of language has been recognized as... more
Deaf and hard-of-hearing (DHH) children who use spoken language face unique challenges when communicating with others who have typical hearing, particularly their peers. In such contexts, the social use of language has been recognized as an area of vulnerability among individuals in this population and has become a focus for research and intervention. The development of pragmatic skills intersects with many aspects of child development, including emotional intelligence and executive function, as well as social and emotional development. While all these areas are important, they are beyond the scope of this chapter, which highlights the impact of pragmatics on the specific area of cognition. Cognitive pragmatics is broadly defined as the study of the mental processes involved in the understanding of meaning in the context of a cooperative interaction. This chapter explores how DHH children and young people construe meaning in the context of conversations and expository interactions w...
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In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant... more
In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant interactions with caregivers and others, supporting development of theory of mind through play and use of mental state language (ie, describing one’s own or others’ thoughts, feelings, and beliefs), and providing accessible opportunities for social interaction. On the basis of a review of the literature and clinical experience, we offer prescriptive strategies for supporting DHH children’s development in these areas. To improve outcomes for DHH children, medical care providers and allied health professionals have a responsibility to support the development of young DHH children’s pragmatic abilities by understanding these variables, coaching caregivers regarding their importance, and facilitating referrals for support when necessary.
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Cochlear implants are uncontroversially helpful in restoring hearing to native spoken language users with later or progressive hearing loss. This chapter focuses on the more difficult issues in the cochlear implantation of children born... more
Cochlear implants are uncontroversially helpful in restoring hearing to native spoken language users with later or progressive hearing loss. This chapter focuses on the more difficult issues in the cochlear implantation of children born deaf or with significant loss of hearing before fully acquiring their first language. It emphasizes the language fluency in young deaf and hard of hearing children and makes suggestions for the various professionals who work with children who receive cochlear implants and their families to foster linguistic competence. The chapter also emphasizes that "language fluency" is independent of modality, and thus includes both signed and spoken language. While deaf children differ and no one strategy works for all deaf children, the inclusion of rich sign language exposure is far more likely to help than to hurt. Medical professionals point to the rapid development of the brain and argue that earlier implantation is better in order to increase the likelihood that a child can receive auditory benefit.
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Much of the literature exploring the role of parents of children who are deaf or hard of hearing (DHH) has focused on mothers; yet, the involvement and perspectives of fathers is valuable and warrants attention. Following the PRISMA... more
Much of the literature exploring the role of parents of children who are deaf or hard of hearing (DHH) has focused on mothers; yet, the involvement and perspectives of fathers is valuable and warrants attention. Following the PRISMA guidelines, this systematic literature review examined the peer-reviewed research that has differentially explored the experiences of fathers and mothers of young DHH children. Utilizing three databases (Web of Science, PsychINFO, Scopus) and spanning 50 years (1969–2019), 457 non-duplicated articles were identified that included the fathers of DHH children, birth to six years. Independent review of the titles, abstracts, and keywords by the authors limited these to 119. Full manuscripts were assessed for eligibility; 37 were deemed appropriate for inclusion in this systematic review. The papers included have been organized into the following themes: perspectives on parenting, parental stress and coping, parent-child interaction, involvement in early int...
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We introduce this supplement and highlight the importance of the development of pragmatic skills in children who are DHH.
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As an audiologist, you know how to fit a hearing aid on even the most uncooperative patient. You can skillfully communicate audiological assessment results to parents and caregivers. You have extensive knowledge about the etiologies of... more
As an audiologist, you know how to fit a hearing aid on even the most uncooperative patient. You can skillfully communicate audiological assessment results to parents and caregivers. You have extensive knowledge about the etiologies of hearing loss. You eagerly digest, and perhaps contribute to, the most recent audiological research. And then you treat a child who may have autism spectrum disorder (ASD), and you are not sure what to do next. Yet in reality, this combination is not unusual: Estimates of the prevalence rates of ASD in the general population are 1 in 68, whereas prevalence of ASD in children who are deaf or hard of hearing is 1 in 59 (see sources). Drawing on the literature, as well as our clinical experience with this population, we share strategies audiologists can use when confronting the possibility of ASD—to help these children receive needed comprehensive care.
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ABSTRACT
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We examined the relationship between parenting practices and behavior problems among deaf children. Parents of 39 deaf and 37 hearing children (ages 3–8) completed the Alabama Parenting Questionnaire (APQ; Shelton, Frick, &... more
We examined the relationship between parenting practices and behavior problems among deaf children. Parents of 39 deaf and 37 hearing children (ages 3–8) completed the Alabama Parenting Questionnaire (APQ; Shelton, Frick, & Wootten, 1996) and the Eyberg Child Behavior Inventory (ECBI; Eyberg & Ross, 1978). For both groups, inconsistent discipline was positively correlated with behavior problems. There were no differences
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The emergence of positive psychology as an approach to studying what makes life worth living has inspired a new wave of research. Studies have focused on the prevalence and degree of positive attributes, attitudes, and characteristics in... more
The emergence of positive psychology as an approach to studying what makes life worth living has inspired a new wave of research. Studies have focused on the prevalence and degree of positive attributes, attitudes, and characteristics in the wider population. Increasingly, lessons learned from positive psychology have been applied to understanding the more diverse experiences of individuals belonging to various groups. Only recently, however, has positive psychology research incorporated a disability perspective, and very little research from a positive psychology stance has been conducted with deaf people. This article addresses the application of positive psychology constructs in the context of deaf communities and individuals who are deaf or hard of hearing. We argue that utilization of a positive psychology paradigm can broaden and enrich a collective understanding of deaf people, and suggest a different set of research questions. A positive psychology mindset encourages scholar...
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Abstract: (1) Background: Studies related to family-centered early intervention (FCEI) for children who are deaf or hard of hearing (DHH) have largely focused on mothers, at the exclusion of fathers. Yet, understanding fathers’... more
Abstract: (1) Background: Studies related to family-centered early intervention (FCEI) for children who are deaf or hard of hearing (DHH) have largely focused on mothers, at the exclusion of fathers. Yet, understanding fathers’ experiences with FCEI is also important and may inform service delivery. The present study explores self-efficacy and involvement with FCEI in both fathers and mothers. (2) Methods: Dutch fathers and mothers completed questionnaires about their parental self-efficacy, involvement in FCEI, perceived support from their primary EI provider, and the impact of raising a child who is DHH on parenting. (3) Results: Both fathers and mothers reported relatively high
levels of self-efficacy. Mothers reported higher levels than fathers on some domains of self-efficacy and tended to be more involved in their child’s FCEI than fathers. In fathers, but not mothers, higher levels of self-efficacy were related to higher levels of involvement and higher levels of perceived support. (4) Conclusions: Similarities and differences were found between fathers and mothers in their perspectives on self-efficacy and involvement. This points to potential differences related to their FCEI needs. EI providers need to address both the needs of fathers and mothers to promote optimal development among child who are DHH.
levels of self-efficacy. Mothers reported higher levels than fathers on some domains of self-efficacy and tended to be more involved in their child’s FCEI than fathers. In fathers, but not mothers, higher levels of self-efficacy were related to higher levels of involvement and higher levels of perceived support. (4) Conclusions: Similarities and differences were found between fathers and mothers in their perspectives on self-efficacy and involvement. This points to potential differences related to their FCEI needs. EI providers need to address both the needs of fathers and mothers to promote optimal development among child who are DHH.
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Much of the literature exploring the role of parents of children who are deaf or hard of hearing (DHH) has focused on mothers; yet, the involvement and perspectives of fathers is valuable and warrants attention. Following the PRISMA... more
Much of the literature exploring the role of parents of children who are deaf or hard of hearing (DHH) has focused on mothers; yet, the involvement and perspectives of fathers is valuable and warrants attention. Following the PRISMA guidelines, this systematic literature review examined the peer-reviewed research that has differentially explored the experiences of fathers and mothers of young DHH children. Utilizing three databases (Web of Science, PsychINFO, Scopus) and spanning 50 years (1969-2019), 457 non-duplicated articles were identified that included the fathers of DHH children, birth to six years. Independent review of the titles, abstracts, and keywords by the authors limited these to 119. Full manuscripts were assessed for eligibility; 37 were deemed appropriate for inclusion in this systematic review. The papers included have been organized into the following themes: perspectives on parenting, parental stress and coping, parent-child interaction, involvement in early intervention, parental self-efficacy, and benefits of fathers' inclusion. Recommendations for future research include: (a) actively recruiting fathers in research, (b) differentially analyzing fathers' and mothers' experiences in research studies, (c) using information gleaned from research regarding father-child and mother-child interactions to guide interventions/programming, (d) recognizing the bidirectional inf luences of fathers and their DHH children, (e) moving beyond descriptive studies to explore fathers' inf luences on child outcomes, and (f) recognizing diverse family constellations.
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The current qualitative study explored the positive, internal, and growth-enhancing experiences hearing parents derived from raising achild who isdeaf or hardofhearing. Based on characteristics of parents’ processand outcomesof the... more
The current qualitative study explored the positive, internal, and growth-enhancing experiences hearing parents derived from raising achild who isdeaf or hardofhearing. Based on characteristics of parents’ processand outcomesof the parenting experiences, three distinct parent patterns were identified. Reflective PositiveParentsreflected deeply about their experiences, quickly and easily identified positive experiences, and were open to making adjustments to meet their child’s needs. Engaged Parentscontemplated their experiences,yet decisions about how to best support their children in many remainedunresolved; this groupidentified both positive and negative aspects of parenting and attempted to align their decisions with both the needs of the child and the recommendations of professionals. The third group, Compliant Parents, described positive experiences yet struggled to provide examples; data from observations were typically not consistent with their description. These parents typically followed the advice of professionals and showed less reflection about the decisions they had made. In the current project, employing a positive psychology lens led to a new and potentially beneficial way of thinking of differences among parents. These differences focus on pathways to personal growth and happiness, pathways that may well lead people to flourish.
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Although major strides have been made in supporting the linguistic development of deaf and hard of hearing (DHH) children, a high risk of pragmatic delay persists and often goes unrecognized. Pragmatic development (the growing sensitivity... more
Although major strides have been made in supporting the linguistic development of deaf and hard of hearing (DHH) children, a high risk of pragmatic delay persists and often goes unrecognized. Pragmatic development (the growing sensitivity to one’s communication partner when producing and comprehending language in context) is fundamental to children’s social-cognitive development and to their well-being. We review the reasons why DHH children are vulnerable to pragmatic developmental challenges and the potential to create positive change. In this call to action, we then urge (1) medical providers to recognize the need to monitor for risk of pragmatic difficulty and to refer for timely intervention (beginning in infancy), (2) allied health professionals involved in supporting DHH children to incorporate development of pragmatic abilities into their work and to foster awareness among caregivers, and (3) the research community to deepen our understanding of pragmatics in DHH children with investigations that include pragmatics and with longitudinal studies that chart the paths to positive outcomes while respecting the diversity of this population. By working together, there is substantial potential to make rapid progress in lifting developmental outcomes for DHH children.
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In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant... more
In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant interactions with caregivers and others, supporting development of theory of mind through play and use of mental state language (ie, describing one’s own or others’ thoughts, feelings, and beliefs), and providing accessible opportunities for social interaction. On the basis of a review of the literature and clinical experience, we offer prescriptive strategies for supporting DHH children’s development in these areas. To improve outcomes for DHH children, medical care providers and allied health professionals have a responsibility to support the development of young DHH children’s pragmatic abilities by understanding these variables, coaching caregivers regarding their importance, and facilitating referrals for support when necessary.
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The purpose of this supplement is to highlight the importance of attending to the development of pragmatic skills in children who are deaf and hard of hearing (DHH) for health care professionals, allied health professionals, and... more
The purpose of this supplement is to highlight the importance of attending to the development of pragmatic skills in children who are deaf and hard of hearing (DHH) for health care professionals, allied health professionals, and researchers. Through increased awareness of the need to identify congenital hearing loss as early as possible, the medical field has been instrumental in fostering substantial improvements in the early detection of hearing loss and widespread implementation of early intervention to support children who have been identified with hearing loss.1,2 Benefitting from this earlier diagnosis, many DHH children are showing improved language abilities, relative to previous generations of young DHH children.3,4 Yet pragmatic abilities remain an area of concern for many DHH children.5,6 We believe that attending to the pragmatic development needs of DHH children is the “next frontier” in improving the quality and type of care needed to optimize development for DHH children.
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In this article, we discuss deaf and hard of hearing (DHH) children’s pragmatic difficulties and strengths from within the lived experiences of 5 hearing parents of DHH children and 5 DHH adults (one of whom is also a parent of a deaf... more
In this article, we discuss deaf and hard of hearing (DHH) children’s pragmatic difficulties and strengths from within the lived experiences of 5 hearing parents of DHH children and 5 DHH adults (one of whom is also a parent of a deaf child). We define lived experience as both a specific form of knowledge (first-hand stories from everyday life) and a unique way of knowing (reflecting and telling from insider perspectives). The parents and DHH adults involved coauthored the article alongside 2 experienced researcher-practitioners. Key themes include what pragmatic challenges feel like for a DHH person, why they arise, how they might result in longer-term consequences (such as implications for well-being) that can continue into adulthood, what might be pragmatic strengths in this population, and what might be done to ameliorate pragmatic difficulties. We end the article with reflections on the significance of individual parents and DHH adults in the coproduction and execution of research on this topic and make suggestions for future directions of inquiry.
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This paper investigates the use of checklists to assess pragmatics in children and adolescents who are deaf and hard of hearing. A systematic literature review was undertaken to identify all of the published research articles between 1979... more
This paper investigates the use of checklists to assess pragmatics in children and adolescents who are deaf and hard of hearing. A systematic literature review was undertaken to identify all of the published research articles between 1979 and 2018 on the topic of the assessment of pragmatics for this population of children and adolescents. The 67 papers identified in this review were analyzed and all papers that utilized a checklist to assess pragmatic skills were identified. Across the 18 different published papers on the use of pragmatic skills among children who are deaf and hard of hearing, nine checklists were identified. These nine checklists were then compared and contrasted on six key features including identification of a theoretical framework or model; the type of pragmatic skills measured; the age range of the child assessed; the information/ outputs generated; the primary informant for the assessment; and reliability, validity, and normative data. The resulting analysis provides a comprehensive guide to aid clinicians, educators, and researchers in selecting an appropriate checklist to assess pragmatic skills for children and adolescentswho are deaf and hard of hearing.
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This article proposes modifications to current rehabilitation methods for infants and children who are deaf or have reduced hearing. The widespread implementation of newborn hearing screening has resulted in numerous benefits to infants... more
This article proposes modifications to current rehabilitation methods for infants and children who are deaf or have reduced hearing. The widespread implementation of newborn hearing screening has resulted in numerous benefits to infants with reduced hearing and their families. Collectively, despite the enormous audiologic benefit that many children receive from both hearing assistive technologies and the provision of direct services aimed to support their development, numerous children with reduced hearing continue to perform below the levels of their counterparts with typical hearing in their ability to demonstrate age-appropriate functional use of language skills.
Research Interests: Speech-Language Pathology/ Communication Disorders, Audiology, Pediatric Audiology, Speech Communication, Multisensory perception, and 6 moreMultisensory Integration, Aural Training, Education of the Deaf and hard of Hearing, Speech Language Pathology and Audiology, Rehabilitative Audiology, and Aural Habilitation
As an audiologist, you know how to fit a hearing aid on even the most uncooperative patient. You can skillfully communicate audiological assessment results to parents and caregivers. You have extensive knowledge about the etiologies of... more
As an audiologist, you know how to fit a hearing aid on even the most uncooperative patient. You can skillfully communicate audiological assessment results to parents and caregivers. You have extensive knowledge about the etiologies of hearing loss. You eagerly digest, and perhaps contribute to, the most recent audiological research.
And then you treat a child who may have autism spectrum disorder (ASD), and you are not sure what to do next. Yet in reality, this combination is not unusual: Estimates of the prevalence rates of ASD in the general population are 1 in 68, whereas prevalence of ASD in children who are deaf or hard of hearing is 1 in 59 (see sources).
Drawing on the literature, as well as our clinical experience with this population, we share strategies audiologists can use when confronting the possibility of ASD—to help these children receive needed comprehensive care.
And then you treat a child who may have autism spectrum disorder (ASD), and you are not sure what to do next. Yet in reality, this combination is not unusual: Estimates of the prevalence rates of ASD in the general population are 1 in 68, whereas prevalence of ASD in children who are deaf or hard of hearing is 1 in 59 (see sources).
Drawing on the literature, as well as our clinical experience with this population, we share strategies audiologists can use when confronting the possibility of ASD—to help these children receive needed comprehensive care.
Research Interests:
The emergence of positive psychology as an approach to studying what makes life worth living has inspired a new wave of research. Studies have focused on the prevalence and degree of positive attributes, attitudes, and characteristics in... more
The emergence of positive psychology as an approach to studying what makes life worth living has inspired a new wave of research. Studies have focused on the prevalence and degree of positive attributes, attitudes, and characteristics in the wider population. Increasingly, lessons learned from positive psychology have been applied to understanding the more diverse experiences of individuals belonging to various groups. Only recently, however, has positive psychology research incorporated a disability perspective, and very little research from a positive psychology stance has been conducted with deaf people. This article addresses the application of positive psychology constructs in the context of deaf communities and individuals who are deaf or hard of hearing. We argue that utilization of a positive psychology paradigm can broaden and enrich a collective understanding of deaf people, and suggest a different set of research questions. A positive psychology mindset encourages scholars to learn how people who are deaf or hard of hearing, and those within the larger deaf community, may define and attain "the good life."
Research Interests: Positive Psychology, Social Research Methods and Methodology, Parenting, Qualitative Research, Research, and 6 moreDeafness and Hearing Loss, Disability Research, Positive psychology and its application to health, well-being, recovery from illness, and optimal functioning., Applied Positive Psychology, Deaf Children and Education, and Positive Psychology and Disability
Hearing parents of deaf and hard-of-hearing children face unique challenges and stressors, the understanding of which has been the focus of numerous studies; yet, relatively little is known about their positive experiences. Using a... more
Hearing parents of deaf and hard-of-hearing children face unique challenges and stressors, the understanding of which has been the focus of numerous studies; yet, relatively little is known about their positive experiences. Using a qualitative purposive sampling design, interviews were conducted with 11 hearing parents (8 mothers, 3 fathers) exploring parents’ positive appraisals of their experiences in raising a child who is deaf or hard of hearing (D/HH). Interviews were transcribed and a thematic analysis was conducted, which allowed the researchers to identify themes and patterns in the parents’ appraisals. Nine key themes emerged, which characterized parents’ positive perceptions of raising a child who is D/HH: knowing the child, appreciating everyday positives, increasing involvement with the child, relishing the highs, taking less for granted, letting go, learning, advocating, and experiencing personal growth. A positive psychology framework was employed to foster understanding of the interview findings and their implications. When asked about the positive aspects of raising a D/HH child, hearing parents were readily able to identify ways in which their parenting experience had been enhanced and their lives improved as a result of their unique situations. The implications of these findings are discussed.
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This article provides a consensus perspective based on the authors' expertise and the limited available literature regarding our understanding of children with an autism spectrum disorder (ASD) who are deaf or hard of hearing (D/HH).... more
This article provides a consensus perspective based on the authors' expertise and the limited available literature regarding our understanding of children with an autism spectrum disorder (ASD) who are deaf or hard of hearing (D/HH). The challenges in the accurate identification of an ASD in children who are D/HH, including red flags for a potential ASD and screening and assessment for ASD, are described in this article. Additionally, strategies to guide professionals in their communication about a possible ASD with families and to frame the need for expanding aspects of communication important for this group of children are suggested.
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Utilizing a retrospective chart review of 30 children who have been dually diagnosed with hearing loss and autism spectrum disorders (ASDs), this study explores the process of arriving at the diagnosis of ASD in this population. Factors... more
Utilizing a retrospective chart review of 30 children who have been dually diagnosed with hearing loss and autism spectrum disorders (ASDs), this study explores the process of arriving at the diagnosis of ASD in this population. Factors of interest include the age of ASD diagnosis in children who are deaf and hard of hearing, the types of professionals involved in making the diagnosis, and the measures used for assessment. Complications in the diagnostic process are highlighted.
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Working with Deaf clients in a mental health setting requires specific knowledge about issues related to deafness in order to provide effective and appropriate services. Understanding Deaf Culture, working effectively with interpreters,... more
Working with Deaf clients in a mental health setting requires specific knowledge about issues related to deafness in order to provide effective and appropriate services. Understanding Deaf Culture, working effectively with interpreters, communicating with someone who cannot hear your speech, and conceptualizing challenges that are unique to raising a deaf child are a few examples of what clinicians might encounter. This article highlights some of the important aspects of working with and for the deaf population. It provides a cursory review of the literature in this area, as well as personal experience from two clinicians with specialized training in the field of deafness.
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Abstract: With an increasing presence of distance education learners in postsecondary educational institutions, there is a pressing need for a different mode of student service delivery that can benefit both traditional as well as the... more
Abstract: With an increasing presence of distance education learners in postsecondary educational institutions, there is a pressing need for a different mode of student service delivery that can benefit both traditional as well as the distance learners. This paper ...
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The issue Relatively little is known about the needs of the families of children who are deaf or hard of hearing (DHH) and have a diagnosis of Autism Spectrum Disorder (ASD). Working with these families can pose unique challenges for... more
The issue
Relatively little is known about the needs of the families of children who are deaf or hard of hearing (DHH) and have a diagnosis of Autism Spectrum Disorder (ASD). Working with these families can pose unique challenges for professionals, as information about how best to engage and support these caregivers is limited.
Relatively little is known about the needs of the families of children who are deaf or hard of hearing (DHH) and have a diagnosis of Autism Spectrum Disorder (ASD). Working with these families can pose unique challenges for professionals, as information about how best to engage and support these caregivers is limited.
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Collaborative Project:
Gallaudet University Laurent Clerc National Deaf Education Center & Boston Children's Hospital Deaf and Hard of Hearing Program
Gallaudet University Laurent Clerc National Deaf Education Center & Boston Children's Hospital Deaf and Hard of Hearing Program
Research Interests:
Cochlear implants are uncontroversially helpful in restoring hearing to native spoken language users with later or progressive hearing loss. This chapter focuses on the more difficult issues in the cochlear implantation of children born... more
Cochlear implants are uncontroversially helpful in restoring hearing to native spoken language users with later or progressive hearing loss. This chapter focuses on the more difficult issues in the cochlear implantation of children born deaf or with significant loss of hearing before fully acquiring their first language. It emphasizes the language fluency in young deaf and hard of hearing children and makes suggestions for the various professionals who work with children who receive cochlear implants and their families to foster linguistic competence. The chapter also emphasizes that "language fluency" is independent of modality, and thus includes both signed and spoken language. While deaf children differ and no one strategy works for all deaf children, the inclusion of rich sign language exposure is far more likely to help than to hurt. Medical professionals point to the rapid development of the brain and argue that earlier implantation is better in order to increase the likelihood that a child can receive auditory benefit.
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Reduced hearing sensitivity cannot be perceived as a singular disorder. It does not result in a particular set of factors that impact functioning. Rather, the influence of reduced hearing sensitivity depends on its etiology,... more
Reduced hearing sensitivity cannot be perceived as a singular disorder. It does not result in a particular set of factors that impact functioning. Rather, the influence of reduced hearing sensitivity depends on its etiology, characteristics, timing, and the role that these all play in an individual's development. For example, a child with congenital profound deafness that limits access to spoken language will be largely shaped by the condition, with impact on educational, social, and familial functioning. An older adult with an age-related progressive hearing loss will not have been influenced by hearing status throughout development but may experience emotional, social and familial effects associated with limited ability to communicate.
In summary, physiological, developmental, and environmental factors are significantly shaped by a person's hearing status. Reduced hearing sensitivity along may, but not necessarily, impact intellectual, neuropsychological, emotional, social and behavioral functioning. Appropriate supports and accommodations that maximize access to language and communication can substantially mitigate the negative consequences that are sometimes associated with reduced hearing.
The role that hearing status plays for the patient, and understanding of that on the part of their health-care providers, will influence the interactions between them in significant ways.
In summary, physiological, developmental, and environmental factors are significantly shaped by a person's hearing status. Reduced hearing sensitivity along may, but not necessarily, impact intellectual, neuropsychological, emotional, social and behavioral functioning. Appropriate supports and accommodations that maximize access to language and communication can substantially mitigate the negative consequences that are sometimes associated with reduced hearing.
The role that hearing status plays for the patient, and understanding of that on the part of their health-care providers, will influence the interactions between them in significant ways.
Research Interests:
Synoposis of the Book: While addressing the implications of rising multilingualism in America, Learning the Language of Global Citizenship explores the link between the achievement gap and academic language proficiency, as well as civic... more
Synoposis of the Book:
While addressing the implications of rising multilingualism in America, Learning the Language of Global Citizenship explores the link between the achievement gap and academic language proficiency, as well as civic literacy and the individuals′ motivation for civic engagement. In this book, the authors show how service–learning enhances language learning, international understanding, and global civic participation skills. This is a topical book designed for practical use by service–learning and language educators in applied linguistics and related disciplines such as English, foreign languages, hearing and speech sciences, and TESOL. It introduces readers to current and unique approaches toward research on first– and second–language acquisition, language policy and planning, language testing and methodology, assessment, and bilingualism. The book also raises fundamental questions for undergraduate and graduate courses with social justice themes by considering educational, linguistic, and human rights issues. Learning the Language of Global Citizenship is divided into four parts: Theoretical framework for developing service–learning projects in applied linguistics Domestic service–learning efforts International service–learning efforts Service–learning research reports representing Spanish, TESOL, teacher education, and composition studies The authors make a convincing case for promoting and preparing learners for educated and engaged citizenship in both local and global arenas. Each of the projects and methods they describe emphasizes the importance of second language proficiency for establishing and sustaining academic community partnerships in today′s multilingual and multicultural societies.
While addressing the implications of rising multilingualism in America, Learning the Language of Global Citizenship explores the link between the achievement gap and academic language proficiency, as well as civic literacy and the individuals′ motivation for civic engagement. In this book, the authors show how service–learning enhances language learning, international understanding, and global civic participation skills. This is a topical book designed for practical use by service–learning and language educators in applied linguistics and related disciplines such as English, foreign languages, hearing and speech sciences, and TESOL. It introduces readers to current and unique approaches toward research on first– and second–language acquisition, language policy and planning, language testing and methodology, assessment, and bilingualism. The book also raises fundamental questions for undergraduate and graduate courses with social justice themes by considering educational, linguistic, and human rights issues. Learning the Language of Global Citizenship is divided into four parts: Theoretical framework for developing service–learning projects in applied linguistics Domestic service–learning efforts International service–learning efforts Service–learning research reports representing Spanish, TESOL, teacher education, and composition studies The authors make a convincing case for promoting and preparing learners for educated and engaged citizenship in both local and global arenas. Each of the projects and methods they describe emphasizes the importance of second language proficiency for establishing and sustaining academic community partnerships in today′s multilingual and multicultural societies.
Research Interests:
Synopsis of the book: Deafness may or may not be considered a 'disability' by those afflicted with auditory loss, but it is indeed a physical difference that has resulted in a language system. From language springs culture, and Deaf... more
Synopsis of the book:
Deafness may or may not be considered a 'disability' by those afflicted with auditory loss, but it is indeed a physical difference that has resulted in a language system. From language springs culture, and Deaf language is indeed a cultivation that celebrates such ethnology. As a result, most of the authors in this book recognize that discernment when referring to the 'Deaf' culture and their unique, pictorial, sign language. Sign language vibrates through space as a three-dimensional language system, which arcs in past, present, and future just by mere body positioning and facial expression. This enchanting language crosses culture and is indeed classified, codified, and uniquely its own system. Because of the complexity of this pictorial system, (from a developmental, cognitive, and emotional standpoint), invited contributions from some of the foremost authorities on Deafness pepper these readings. As many of the contributors note, there has been an antiquated prejudice against Deaf culture and a reluctance to treat those who are Deaf in an appropriate fashion. The authors in this volume have refuted the mistaken conviction that Deaf individuals lack creativity, intelligence or the insight to be helped through psychotherapy and/or mental health services. One of the most wonderful things about this book is that finally the Deaf are being recognized as the full human beings they have always been, who deserve full access to all of our resources. Celebrating the unique strengths of Deaf individuals while rejecting the focus on their weaknesses is sprinkled throughout the pages of this book. Indeed, this offers a vantage point that is both optimistic and realistic. And best of all, there are chapters, which will sensitize, inform, and inspire. Doctor Ellen G. Horovitz has done a service to anyone who offers art therapy to the Deaf. Through promoting healthier art therapy for the hearing impaired, those who are assisted will be able to live fuller, more rewarding, creative lifestyles.
Deafness may or may not be considered a 'disability' by those afflicted with auditory loss, but it is indeed a physical difference that has resulted in a language system. From language springs culture, and Deaf language is indeed a cultivation that celebrates such ethnology. As a result, most of the authors in this book recognize that discernment when referring to the 'Deaf' culture and their unique, pictorial, sign language. Sign language vibrates through space as a three-dimensional language system, which arcs in past, present, and future just by mere body positioning and facial expression. This enchanting language crosses culture and is indeed classified, codified, and uniquely its own system. Because of the complexity of this pictorial system, (from a developmental, cognitive, and emotional standpoint), invited contributions from some of the foremost authorities on Deafness pepper these readings. As many of the contributors note, there has been an antiquated prejudice against Deaf culture and a reluctance to treat those who are Deaf in an appropriate fashion. The authors in this volume have refuted the mistaken conviction that Deaf individuals lack creativity, intelligence or the insight to be helped through psychotherapy and/or mental health services. One of the most wonderful things about this book is that finally the Deaf are being recognized as the full human beings they have always been, who deserve full access to all of our resources. Celebrating the unique strengths of Deaf individuals while rejecting the focus on their weaknesses is sprinkled throughout the pages of this book. Indeed, this offers a vantage point that is both optimistic and realistic. And best of all, there are chapters, which will sensitize, inform, and inspire. Doctor Ellen G. Horovitz has done a service to anyone who offers art therapy to the Deaf. Through promoting healthier art therapy for the hearing impaired, those who are assisted will be able to live fuller, more rewarding, creative lifestyles.
Research Interests:
The issue Relatively little is known about the needs of the families of children who are deaf or hard of hearing (DHH) and have a diagnosis of Autism Spectrum Disorder (ASD). Working with these families can pose unique challenges for... more
The issue
Relatively little is known about the needs of the families of children who are deaf or hard of hearing (DHH) and have a diagnosis of Autism Spectrum Disorder (ASD). Working with these families can pose unique challenges for professionals, as information about how best to engage and support these caregivers is limited. What we know Familial responses to a having a child who is DHH and has ASD are informed by a number of factors including, but not limited to: • Caregivers' experience with the diagnostic process • Personality attributes of the caregivers • Characteristics of the particular child (e.g., temperament, severity of ASD) • The amount and type of social support accessible to the caregivers • The extent to which family needs are understood and met by the professionals working with them • Caregivers' appraisals of their parenting experiences • Availability and quality of the early intervention and/or ASD-specific treatment (s) • Caregivers' perceived benefit from the supports/services they receive • Caregivers' sense of empowerment to make decisions Evidence suggests that early identification of and treatment for ASD are important in influencing outcomes. Yet, relative to children with typical hearing, the diagnosis of ASD in DHH children is often delayed. Family members report "having a sense" that the developmental trajectory of their DHH child is atypical, yet differences in development are more likely to be attributed to the child's hearing status. Difficulty finding effective resources to support the child and having to "fight for services" are common experiences for caregivers of children with this dual diagnosis. Research suggests that family members may be overwhelmed by the lack of information. While caregivers can and do report positive experiences in relationships with their DHH+ASD child and their parenting journeys, many also find the experience
Relatively little is known about the needs of the families of children who are deaf or hard of hearing (DHH) and have a diagnosis of Autism Spectrum Disorder (ASD). Working with these families can pose unique challenges for professionals, as information about how best to engage and support these caregivers is limited. What we know Familial responses to a having a child who is DHH and has ASD are informed by a number of factors including, but not limited to: • Caregivers' experience with the diagnostic process • Personality attributes of the caregivers • Characteristics of the particular child (e.g., temperament, severity of ASD) • The amount and type of social support accessible to the caregivers • The extent to which family needs are understood and met by the professionals working with them • Caregivers' appraisals of their parenting experiences • Availability and quality of the early intervention and/or ASD-specific treatment (s) • Caregivers' perceived benefit from the supports/services they receive • Caregivers' sense of empowerment to make decisions Evidence suggests that early identification of and treatment for ASD are important in influencing outcomes. Yet, relative to children with typical hearing, the diagnosis of ASD in DHH children is often delayed. Family members report "having a sense" that the developmental trajectory of their DHH child is atypical, yet differences in development are more likely to be attributed to the child's hearing status. Difficulty finding effective resources to support the child and having to "fight for services" are common experiences for caregivers of children with this dual diagnosis. Research suggests that family members may be overwhelmed by the lack of information. While caregivers can and do report positive experiences in relationships with their DHH+ASD child and their parenting journeys, many also find the experience
Research Interests:
September is National Deaf Awareness Month-a time to reflect both on how we monitor hearing and care for patients who are culturally Deaf. Permanent hearing loss occurs in 2-3 in 1000 young children. Reduced hearing can have significant... more
September is National Deaf Awareness Month-a time to reflect both on how we monitor hearing and care for patients who are culturally Deaf. Permanent hearing loss occurs in 2-3 in 1000 young children. Reduced hearing can have significant impacts on speech and language, social, and cognitive development, if left untreated (e.g., with hearing aids) or unmitigated (such as through the instruction of sign language). Even temporary hearing loss, secondary to fluid in the middle ear or infection, can impact a child's functioning. Hearing loss can be conductive, sensorineural, mixed, and central. It can also be static, fluctuating, or progressive.
Even mild hearing loss, which is sometimes dismissed as 'not significant,' results in the child missing out on sounds important for understanding and learning language.
Universal newborn hearing screening (UNHS) programs have resulted in earlier identification of hearing loss, yet it is imperative that pediatricians monitor the UNHS results and provide referrals to pediatric audiologists, especially in the presence of known risk factors for hearing loss, such as prematurity or congenital CMV. Physicians should NOT "wait and see" how a child's language develops to refer. Pediatric audiologists can test as early as the first days of life; if hearing is reduced, interventions-whether hearing aids or family instruction in sign language-can commence immediately. 1,2
Hearing aids, myringotomy tubes, and cochlear implants are all possible treatments for hearing loss depending on etiology and severity of hearing levels. 3 Some families may opt to forgo medical interventions and instead to use sign language for communication, while others use a combination of spoken and signed language approaches. Medical professionals need to be aware of Deaf Cultural perspectives; individuals may consider themselves members of a linguistic minority, rather than persons with a disability. Regardless of communication modality or use of technology to access auditory information, it is crucial that children receive appropriate specialty services to promote their development and that their parents receive support and education. Our key message to families should be to promote rich, fully-accessible communication with their children, including sign, pictures, and hugs! References: 1. American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.
Even mild hearing loss, which is sometimes dismissed as 'not significant,' results in the child missing out on sounds important for understanding and learning language.
Universal newborn hearing screening (UNHS) programs have resulted in earlier identification of hearing loss, yet it is imperative that pediatricians monitor the UNHS results and provide referrals to pediatric audiologists, especially in the presence of known risk factors for hearing loss, such as prematurity or congenital CMV. Physicians should NOT "wait and see" how a child's language develops to refer. Pediatric audiologists can test as early as the first days of life; if hearing is reduced, interventions-whether hearing aids or family instruction in sign language-can commence immediately. 1,2
Hearing aids, myringotomy tubes, and cochlear implants are all possible treatments for hearing loss depending on etiology and severity of hearing levels. 3 Some families may opt to forgo medical interventions and instead to use sign language for communication, while others use a combination of spoken and signed language approaches. Medical professionals need to be aware of Deaf Cultural perspectives; individuals may consider themselves members of a linguistic minority, rather than persons with a disability. Regardless of communication modality or use of technology to access auditory information, it is crucial that children receive appropriate specialty services to promote their development and that their parents receive support and education. Our key message to families should be to promote rich, fully-accessible communication with their children, including sign, pictures, and hugs! References: 1. American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.