Michigan State University > College of Education : JDSDE-Author-Corner - all changes

effect_on_communication : re: Results - Dialogue ?

JesperDammeyer — Fri, 06 Nov 2009 09:44:06 GMT

Thanks for the response.

One explanation of why there was no effect is that the children were still not able to maintain an ongoing dialogue. Therefore, the effect of CI was not seen in the dialogue, but only in the social interaction.
But results vary among the children. Child #1, whose dialogue was much better when using CI, was about two years older than the other four children, and of average intelligence. Age and intellectual levels seem to be an important factor for CI outcome among the children in this study.

I do think a more enhanced interactional environment with focus on communication is very important. Experiences from the Scandinavian countries confirm this.
Longer use of CI is an important issue. We do experience benefits of CI - language development - more than ten years after implantation. Language development takes time among these students.

Jesper Dammeyer

effect_on_communication : Results - Dialogue ?

hjohnson — Wed, 04 Nov 2009 22:53:19 GMT

First, I would like to thank you for conducting and sharing this excellent study. You are indeed correct in your position that students who are deafblind are rarely studied, or given the opportunity to experience the benefits of CI.

In the "Results" section of your research summary, you stated that:

"There was no significant difference for the parameters concerning the Dialogue (Initiative, Answer and No-answer for the child or the adult)."

I wonder if you could comment further concerning the students level of pragmatic skills, i.e., their overall abilities to initiate,carry on, and end interactional exchanges.

I also wonder if you could speculate the impact of a more enhanced interactional environment, plus longer use of a CI upon the student's pragmatic competencies.

Harold Johnson

effect_on_communication

sherrye — Mon, 02 Nov 2009 21:31:39 GMT

Congenitally deafblind children and cochlear implant – effect on communication

Directions

Dr. Jesper Dammeyer, Department of Psychology, University of Copenhagen, is available from 11/2/09 until 11/22/09 to answer questions and share ideas concerning his research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of his work, Dr. Dammeyer has written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Dr. Dammeyer please:

1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.)
2. type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.
3. Dr. Dammeyer will then respond to your message in his post to the discussion board.

If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed, the research summary and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.

Abstract
There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on cochlear implantation in children who are both deaf and blind, however, is lacking.

Ratings of video observations were used to measure 5 children’s early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children’s cochlear implants. Benefits of cochlear implantation in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

Introduction
In the years since the advent of paediatric implantation, a positive effect of cochlear implantation for people with acquired deafblindness has been reported, both in auditory performance (Pennings et al., 2006; Saeed, Ramsden, & Axon, 1998), as well as in quality of life (Damen, Pennings, Snik, & Mylanus, 2006). Conversely, congenitally deafblind children, among other children with additional disabilities, had not been considered as cochlear implant candidates. One explanation was the huge medical and psychological problems congenitally deafblind children were forced to contend with: either the cochlear implantation was too risky a surgical procedure, or hearing loss was not the most important problem facing the child.

In Scandinavia there is a strong tradition of focusing upon social interactions and communication in the habilitation of congenitally deafblind children (Rødbroe & Souriau, 1999; Janssen & Rødbroe, 2007). To create and expand social interaction is fundamental for the development of communication and possible later signed or oral language. The emergence of communication takes place via the processes of social interaction during play activities and in natural settings. The partner responds to and expands upon the child’s expressions of emotions and desires by regulation of contact, joint attention, turn-taking, and rhythm and tempo using tactile stimulation etc. (Janssen & Rødbroe, 2007; Nafstad & Rødbroe, 1996).

Along this line experiences have been positive regarding the 20 congenitally deafblind children with CI in Scandinavia (January 2007): less isolation, less self-stimulation, more awareness of the surroundings, motivation to investigate the surroundings, understanding of emotional expressions, and, in a few cases, understanding of single words and sentences. The aim of this study is to test these positive experiences.

Method
Five congenitally deafblind children from different parts of Scandinavia participated. The children were between 5.0 and 8.0 years old at the time of testing ( M = 6.3). Range of age at implant surgery was 2.2 to 4.2 years ( M = 3.6). At the time of testing, all children had used the CI for at least 1.0 year ( M = 2.8 years).
The children were observed by video in free play with a known adult (parent or caretaker) in known and natural contexts (home or institution). The five children were videotaped for about 30 minutes with their cochlear implants switched on and for another 30 minutes with them switched off. From both of the 30-minute observations with and without CI, two episodes of two minutes’ duration each were selected. The episodes of two minutes each were rated using six variables for every turn. All variables were selected to represent relevant aspects of the early stages of communication development of deafblind children as described in the introduction.

Modality of Communication: Three categories were used: Linguistic signs : When the child or the adult communicates or tries to communicate by single signs or sign-language sentences. Linguistic speech : When the child or the adult communicates or tries to communicate by single words or spoken sentences. Non-linguistic communication : Communicational behaviour such as pulling, pointing, screaming, kissing, and twisting the body.

Dialogue : Three categories were used: Initiative: If the child or the adult tries to establish a new round of communication. Answer: If the child or the adult responds along the same lines. No answer: If the child or the adult does not understand their partner.

Quality of Communication : The quality of the communication was rated on a scale ranging from 1 to 5. A 1 rating was given if “the communicational act makes the communicational interaction much worse,” while a 5 was rated if “the communicational act makes the communicational interaction much better.”

Manipulation of Objects, attention and emotional response were also rated on a scale ranging from 1 to 5. A rating of 5 was given if the manipulation of objects, attention or emotional response was relevant, i.e. in line with and adequate to, the social interaction. A score of 1 was indicative that the manipulation of objects, attention or emotional response not at all was of relevance to the social interaction.

The parents were interviewed about central issues concerning the outcome of the cochlear implantation and its impact on everyday life. The questions went beyond the variables rated in the video observations. For example: Is it easier or more difficult to understand why the child is sad, happy or angry? Does the child find it easier or more difficult to move around and explore new environments?

Results
For all children together, the difference between episodes with CI and without CI was significant for the variables Speech-turn , Quality of Communication , Manipulation of Objects, Attention , and Emotional Response . Even for some of the children individually the difference between episodes with CI and without was significant for these variables. There was no significant difference for the parameters concerning the Dialogue (Initiative, Answer and No-answer for the child or the adult).

In the interviews, all parents report that they would recommend CI to other parents with congenitally deafblind children. None of the parents had any negative experiences related to CI. Before implantation, all parents had only limited expectations for the outcome of CI.

Discussion
Despite the small number of children (five) in this study, it was possible to find a significant effect of CI for congenitally deafblind children. Though the outcome of CI was not spoken language, the progress was remarkably related to communication and social interaction. Improved attention, emotional response and manipulation of objects are all important issues in the development of communication for congenitally deafblind children (Janssen & Rødbroe, 2007) The relative difference for a deafblind child in being able to hear just a little seems to have a huge effect for the ability of the child to engage in social interaction and develop communication. When the adult responds to the child’s expressions (for example, emotions, manipulation of objects) in natural situations, it encourages the child to act in a socially significant environment. These shared social activities lead the child toward shared social meanings and communication, and further along the way toward the use of language.

Lisa: “Now it is possible to call out to Lisa. It makes me and her much more safe and relaxed”
Lisa is 5 years old. She is deafblind, but is able to use her limited vision. After CI, Lisa started slowly to make sense of sounds. She drew attention to sounds in combination with play. She started to imitate sounds she found interesting, and she also imitated the pitch of voices and rhythms. However, her reaction to sound can be difficult to identify. Lisa has been more relaxed – that is the most important effect of CI. She uses the sounds around her to make certain that she is not alone and that other children and adults are where they ought to be. Now she also uses her vision much more. She does not need to use her limited vision to control her mom’s face; now she can hear the emotional expressions in the pitch of the voice. She can concentrate on signs and movements, and communicates with signs and gestures much better than before. Three years after the operation, she has started to react to sounds without any cues. She turns around when she hears a sound and when she hears her name.

Conclusion
This study finds an overall good effect of cochlear implant use among congenitally deafblind children. The outcome is not spoken language, but better social interaction and communication. CI can be very helpful for the communicative and social development of congenitally deafblind children. CI is a relevant aid in the habilitation of congenitally deafblind children as a support to sign-language, tactile sign-language, and other modes and kinds of communication

References
Damen, G. W. J. A., Pennings, R. J. E., Snik, A. F. M., & Mylanus, E. A. M. (2006). Quality of life and cochlear implantation in Usher syndrome type I. Laryngoscope, 116 (5), 723-728.

Janssen, M., & Rødbroe, I. (2007). Communication and Congenital Deafblindness II: Contact and Social interaction. DK: Materialecentret.

Nafstad, A., & Rødbroe, I. (1996). Congenitally Deafblindness, interaction and development towards a model of intervention. In M. Laurent (Ed.), Communication and congenital deafblindness. The development of communication. What is new? Paris: Centre National de Suresnes.

Pennings, R. J. E., Damen, G. W. J. A., Snik, A. F. M., Hoefsloot, L., Cremers, C. W. R. J., & Mylanus, E. A. M. (2006). Audiological performance and benefit of cochlear implantation in Usher syndrome type I. Laryngoscope, 116 (5), 717-722.

Rødbroe, I., & Souriau, J. (1999). Communication. In J. M. McInnes (Ed.), A Guide to Planning and Support Individuals who are Deafblind. Toronto: University of Toronto Press.

Saeed, S. R., Ramsden, R. T., & Axon, P. R. (1998). Cochlear implantation in the deafblind. American Journal of Otology, 19 (6), 774-777.

JDSDE Reference

Dammyer, J. (2008). Congenitally deafblind children and cochlear implant – effect on communication The Journal of Deaf Studies and Deaf Education 14 (2), 278-288.

Future Topical Discussions

sherrye — Mon, 02 Nov 2009 21:31:21 GMT

Future Topical Discussions:

~~10/12/09 through 11/1/09:~~ Irene W. Leigh, Deborah Maxwell-McCaw, Yael Bat-Chava, and John B. Christiansen Correlates of Psychosocial Adjustment in Deaf Adolescents With and Without Cochlear Implants: A Preliminary Investigation ~~Journal of Deaf Studies and Deaf Education, Spring 2009; 14(2): 244-259.~~ ~~Abstract:~~ The number of children who have received cochlear implants (CIs) has increased dramatically in the past two decades. In view of potential concerns about their psychosocial adjustment, our aim was to assess the effect of implants on the adolescents’ psychosocial functioning among a group of 57 deaf adolescents with and without CIs, using published and validated measures completed by the adolescents themselves, their parents, and teachers. Adolescents with CI tended to be more hearing acculturated, whereas those without CI tended to be more Deaf acculturated. Despite some differences in background characteristics between the two groups, there were no differences between them on the psychosocial variables assessed in this study, regardless of the reporting sources. Rather than having a direct effect on the psychosocial outcomes assessed in this study, it is through the mediating effect of acculturation and school setting that CI status exerts an influence over many of this study's outcomes. Recommendations for future research are made in light of our findings.

11/23/09 through 12/13/2009:
- Nunes, T., Bryant, P., Burman, D., Bell, D., Evans, D., & Hallett, D. Deaf Children's Informal Knowledge of Multiplicative
  Reasoning. Journal of Deaf Studies and Deaf Education, Spring 2009; 14(2), 260-277.
  - Abstract:
    - Multiplicative reasoning is required in different contexts in mathematics: it is necessary to understand the concept of multipart units, involved in learning place value and measurement, and also to solve multiplication and division problems. Measures of hearing children's multiplicative reasoning at school entry are reliable and specific predictors of their mathematics achievement in school. An analysis of deaf children's informal multiplicative reasoning showed that deaf children under-perform in comparison to the hearing cohorts in their first two years of school. However, a brief training study, which significantly improved their success on these problems, suggested that this may be a performance, rather than a competence difference. Thus, it is possible and desirable to promote deaf children's multiplicative reasoning when they start school so that they are provided with a more solid basis for learning mathematics.

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sherrye — Mon, 02 Nov 2009 21:30:49 GMT

Home
Directions & Help Info.

Topical Discussions :

1. Past

2. Current

~~10/12~~ 11/2 to ~~11/1: Psychosocial Adjustment~~ 11/22: Effect on Communication

3. Future

~~11/2 to 11/22: TBD~~ 11/23 to 12/13: Multiplicative Reasoning

Past Topical Discussions

sherrye — Mon, 02 Nov 2009 21:29:50 GMT

Academic Status and Progress of Deaf and Hard-of-Hearing Students in General Education Classrooms
- Author facilitated discussion concerning this topic ended on 10/11/09
- To read the research summary and related discussion, "click" on the following link
  - Academic Status and Progress of Deaf and Hard-of-Hearing Students in General Education Classrooms

Academic Status of Deaf and Hard-of-Hearing Students in Public Schools: Student, Home, and Service Facilitators and Detractors
- Author facilitated discussion concerning this topic ended on 6/30/08
- To read the research summary and related discussion, "click" on the following link
  - Academic Status of Deaf and Hard-of-Hearing Students in Public Schools: Student, Home, and Service Facilitators and Detractors

Accommodations Used For Statewide Standardized Assessments: Prevalence and Recommendations For Students Who Are Deaf or Hard of Hearing
- Author facilitated discussion concerning this topic ended on 10/12/08
- To read the research summary and related discussion, "click" on the following link
  - Accommodations Used For Statewide Standardized Assessments: Prevalence and Recommendations For Students Who Are Deaf or Hard of Hearing

Alternate Assessment Use With Students Who Are Deaf or Hard of Hearing: An Analysis of Portfolio, Checklists, and Out-of-Level Formats
- Author facilitated discussion concerning this topic ended on 12/7/08
- To read the research summary and related discussion, "click" on the following link
  - Alternate Assessment Use with Students who are Deaf or Hard of Hearing: An Analysis of Portfolio, Checklists, and Out-of-Level Formats

An Investigation of Two-way Text Messaging Use With Deaf Students at the Secondary Level
- Author facilitated discussion concerning this topic ended on 7/20/08
- To read the research summary and related discussion, "click" on the following link
  - An Investigation of Two-way Text Messaging Use With Deaf Students at the Secondary Level

Computer-based Exercises For Learning to Read and Spell by Deaf Children
- Author facilitated discussion concerning this topic ended on 3/29/09
- To read the research summary and related discussion, "click" on the following link
  - Computer-based Exercises For Learning to Read and Spell by Deaf Children

Correlates of Psychosocial Adjustment among Deaf Adolescents with and without Cochlear Implants: A Preliminary Investigation

Author facilitated discussion concerning this topic ended on 11/1/09
To read the research summary and related discussion, "click" on the following link
- Correlates of Psychosocial Adjustment among Deaf Adolescents with and without Cochlear Implants: A Preliminary Investigation

Deaf College Students’ Perceptions of Their Social-Emotional Adjustment
- Author facilitated discussion concerning this topic ended on 3/16/08
- To read the research summary and related discussion, "click' on the following link
  - Deaf College Students’ Perceptions of Their Social-Emotional Adjustment

Evaluating Phonological Processing Skills in Children With Prelingual Deafness Who Use Cochlear Implants
- Author facilitated discussion concerning this topic ended on 2/1/09
- To read the research summary and related discussion, "click" on the following link
  - Evaluating Phonological Processing Skills in Children With Prelingual Deafness Who Use Cochlear Implants

Family Mediation of Mathematically Based Concepts While Engaged In A Problem-solving Activity With Their Young Deaf Children
- Author facilitated discussion concerning this topic ended on 9/21/08
- To read the research summary and related discussion, "click" on the following link
  - Family Mediation of Mathematically Based Concepts While Engaged In A Problem-solving Activity With Their Young Deaf Children

Literacy Skills In Children With Cochlear Implants: The Importance of Early Oral Language and Joint Storybook Reading
- Author facilitated discussion concerning this topic ended on 8/31/08
- To read the research summary and related discussion, "click" on the following link
  - Literacy Skills In Children With Cochlear Implants: The Importance of Early Oral Language and Joint Storybook Reading

Math Problem Solving: Abstract of Research Currently Under Discussion
- Author facilitated discussion concerning this topic ended on 2/13/08
- To read the research summary and related discussion, "click' on the following link
  - The Relative Difficulty of Signed Arithmetic Story Problems for Primary Level Deaf and Hard-of-Hearing Students

Modeling Reading Vocabulary Learning In Deaf Children In Bilingual Education Programs
- Author facilitated discussion concerning this topic ended on 8/11/08
- To read the research summary and related discussion, "click" on the following link
  - Modeling Reading Vocabulary Learning In Deaf Children In Bilingual Education Programs

Parents' Views on Changing Communication After Cochlear Implantation
- Author facilitated discussion concerning this topic ended on 6/8/08
- To read the research summary and related discussion, "click" on the following link
  - Parents' Views on Changing Communication After Cochlear Implantation

The Relationship Between the Reading and Signing Skills of Deaf Children In Bilingual Education Programs
- Author facilitated discussion concerning this topic ended on 11/02/08
- To read the research summary and related discussion, "click" on the following link
  - The Relationship Between the Reading and Signing Skills of Deaf Children In Bilingual Education Programs

The Signed Reading Fluency of Students Who Are Deaf/Hard of Hearing
- Author facilitated discussion concerning this topic ended on 2/25/08
- To read the research summary and related discussion, "click' on the following link
  - The Signed Reading Fluency of Students Who are Deaf - Hard of Hearing

Social Integration of Deaf Children In Inclusive Settings
- Author facilitated discussion concerning this topic ended on 4/6/08
- To read the research summary and related discussion, "click" on the following link
  - Social Integration of Deaf Children In Inclusive Settings

Spoken Language Development In Oral Preschool Children With Permanent Childhood Deafness
- Author facilitated discussion concerning this topic ended on 11/23/08
- To read the research summary and related discussion, "click" on the following link
  - Spoken Language Development In Oral Preschool Children With Permanent Childhood Deafness

Spoken Language Scores of Children Using Cochlear Implants Compared to Hearing Age-Mates at School Entry
- Author facilitated discussion concerning this topic ended on 4/12/09
- To read the research summary and related discussion, "click" on the following link
  - Spoken Language Scores of Children Using Cochlear Implants Compared to Hearing Age-Mates at School Entry

Theory of Mind and Language In Children With Cochlear Implants
- Author facilitated discussion concerning this topic ended on 2/22/09
- To read the research summary and related discussion, "click" on the following link
  - Theory of Mind and Language In Children With Cochlear Implants

What Really Matters In the Early Literacy Development of Deaf Children?
- Author facilitated discussion concerning this topic ended on 4/27/08
- To read the research summary and related discussion, "click" on the following link
  - What Really Matters In the Early Literacy Development of Deaf Children?

Word-learning Abilities In Deaf and Hard of Hearing Preschoolers: Effect of Lexicon Size and Language Modality
- Author facilitated discussion concerning this topic ended on 3/08/09
- To read the research summary and related discussion, "click" on the following link
  - Word-learning Abilities In Deaf and Hard of Hearing Preschoolers: Effect of Lexicon Size and Language Modality

Visual-Spatial Representation In Mathematical Problem Solving by Deaf and Hearing Students
- Author facilitated discussion concerning this topic ended on 5/18/08
- To read the research summary and related discussion, "click" on the following link
  - Visual-Spatial Representation In Mathematical Problem Solving by Deaf and Hearing Students

Psychosocial_Adjustment

sherrye — Mon, 02 Nov 2009 21:25:26 GMT

Correlates of Psychosocial Adjustment among Deaf Adolescents with and without Cochlear Implants: A Preliminary Investigation

Directions

Drs. Deborah McCaw and Irene W. Leigh ~~are~~ were available from 10/12/09 until 11/1/09 to answer questions and share ideas concerning their research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of their work, the authors have written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Drs. McCaw and Leigh please: 1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.) 2. ~~type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.~~ 3. ~~Drs. McCaw and Leigh will then respond to your message in their post to the discussion board.~~ If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed,

You are encouraged to read the research summary ~~and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.~~ below and review the attached discussion.

Abstract

The number of children who have received cochlear implants has increased dramatically in the past two decades. In view of publicized concerns about their psychosocial adjustment, our aim was to assess the effect of implants on the adolescents’ psychosocial functioning among a group of 57 deaf adolescents with and without cochlear implants (CI), using published and validated measures completed by the adolescents themselves, their parents and teachers. Adolescents with CI tended to be more hearing acculturated, whereas those without CI tended to be more Deaf acculturated. Despite some differences in background characteristics between the two groups, there were no differences between them on the psychosocial variables assessed in this study, regardless of the reporting sources. Rather than having a direct effect on the psychosocial outcomes assessed in this study, it is through the mediating effect of acculturation and school setting that CI status exerts an influence over many of this study’s outcomes. Recommendations for future research are made in light of our findings.

Introduction and Purpose

Today’s adolescents continue to experience rapid physiological, psychological, and social development. They are also experiencing a world that is rapidly changing in terms of technological advances and their access to that technology is sometimes limited. CIs represent a technology that has increasingly become the standard of care for young children who are identified as deaf.

Currently, there are approximately 160,000 who have obtained CIs worldwide (Nussbaum, 2009). We now have a significant cohort of children and adolescents with CIs. In industrialized countries, between 50% and 80% of children have CIs (Hyde & Power, 2006). Approximately 7,000 have bilateral implants, many under age 18 (Nussbaum, 2009). Increasing numbers are mainstreamed nowadays (Gallaudet Research Institute, 2008), approximately 80% depending on the source.

Deaf culture advocates have questioned the effectiveness of CIs for deaf children, and have expressed concerns regarding their psychosocial functioning with CIs. (e.g., Ladd, 2007). They express concerns about identity evolution as Deaf persons versus academic achievement. They view the efforts to create “hearing” deaf children as misguided considering that many enter the Deaf community and find a home there.

Regarding academics and quality of life, research results indicate increased auditory perception, speech, and spoken language development (e.g. Geers, 2004; Waltzman, 2006). Without a doubt, this necessitates intensive communication therapy utilizing listening and speaking. The expectation is that better academics will result. Thus far, research has supported this expectation in that children with CIs generally do better than those with hearing aids, but do not equal hearing peers academically (for reviews, see Fagan, Pisoni, Horn, & Dillon, 2007; Geers, 2006; Marschark, Rhoten, & Fabich, 2007). It is important to keep in mind that results have been quite varied, depending on sample characteristics.

Moving on to psychosocial aspects, research covering parent perspectives indicate that they perceive their children with CIs to have improved quality of life, greater self-esteem/confidence, and higher levels of outgoing behavior post-implantation (Bat-Chava & Deignan, 2001; Bat-Chava, Martin, & Kosciw, 2005; Chmiel, Sutton, & Jenkins, 2000; Christiansen & Leigh, 2005; Kluwin & Stewart, 2000; Nicholas & Geers, 2003). However, observational findings indicate that integration in social situations continue to be less than ideal (Boyd, Knutson, & Dahlstrom, 2000; Preisler, Tvingstedt, & Ahlstrom, 2005). Self-perceptions tended to be positive (Nicholas & Geers, 2003).

Regarding deaf identity development, the general trend is toward categorization as hearing acculturated, Deaf acculturated, Bicultural, or Marginal (not belonging to either) (Glickman, 1996; Maxwell-McCaw, 2001). Bat-Chava (1993) found that deaf adults with stronger culturally Deaf identities had higher self-esteem. How cultural identity impacts on those with CIs has received limited attention in the literature. In two studies that have been conducted, adolescents with CIs indicated they were socially flexible and wanted contact with both hearing and deaf peers. (Christiansen & Leigh, 2005; Wheeler, Archbold, Gregory, & Skipp, 2007).

The purpose of this study was to further explore the psychosocial effects of CIs on deaf adolescents and compare these with adolescents who did not have CIs, incorporating self-reports from the adolescents themselves in addition to reports from their parents and teachers. The focus was on exploring factors that contribute to psychosocial well-being for deaf youth with and without CIs.

Method

Participants included 57 deaf high school students; 28 were CI-users and 29 were non-users. In terms of ethnicity, 84% were White, 26% other. Most (96%) had parents who were well-educated with 45% having 2-4 years of college and 42% had graduate degrees). For CI-users, the average age of implantation was 7 (quite late by today’s standards, but keep in mind the adolescents are an earlier cohort in terms of cochlear implant technology), and the average length of use was 8 years. The two groups were not significantly different in terms of age, ethnicity, gender, age of identification, parental SES, or reading ability.

Outcomes assessed utilized measures specifically covering acculturation (Deaf Acculturation Scale), self-esteem (Self-Perception Profile for Adolescents), satisfaction with life (Satisfaction with Life Scale), loneliness (Revised UCLA Loneliness Scale), and overall psychosocial functioning (ASEBA) (this one was filled out by parents and teachers as well).

We did group comparisons (CI-users and non-CI-users) and looked at the effects of school setting and degree of hearing loss because both groups differed on these variables. We also examined findings from the overall sample related to predictors of acculturation, self-esteem, satisfaction with life, negative behavioral outcomes, and positive behavioral outcomes. We also looked at findings related to CI users only.

Results

Group comparisons between CI users and non-users (controlling for school environment and age of detection): The only finding was: that CI users showed higher hearing acculturation & non-users showed higher Deaf acculturation. All other factors were found not to be significant.

Effects of school setting and degree of hearing loss: Mainstreamed students showed lower
Deaf acculturation, higher hearing acculturation, and slightly higher self-esteem in the scholastic, friendship, and global areas. They demonstrated higher parent-reported social competence compared to those in schools for the deaf. Greater levels of hearing loss resulted in lower hearing acculturation, fewer attention problems/rule-breaking behaviors, and marginally significant higher Deaf acculturation.

Overall sample results for predictors of acculturation: Higher levels of satisfaction with home communication resulted in higher levels of hearing acculturation and lower levels of Deaf acculturation. Higher numbers of deaf peers resulted in higher levels of Deaf acculturation and lower levels of hearing acculturation. Higher grade levels were associated with higher levels of Deaf acculturation and lower levels of hearing acculturation.

Overall sample results for predictors of self-esteem & satisfaction with life: Higher satisfaction with home communication resulted in higher scholastic self-esteem and social competence self-esteem. The earlier the hearing loss was identified, the higher the scholastic self-esteem. As for satisfaction with life, higher levels of satisfaction with home communication resulted in higher levels of satisfaction with life.

Overall sample results for predictors of behavioral outcomes

Positive behavioral outcomes: Satisfaction with home communication is associated with parent-rated higher social competence. Earlier identification of hearing loss is associated with higher scholastic competence (parent-rated).

Negative behavioral outcomes: Later identification of hearing loss is associated with greater attention difficulties, rule-breaking behaviors, and aggression.

For CI-users only, factors contributing to psychosocial functioning as reported by adolescents: Having deaf peers resulted in greater Deaf acculturation, and having hearing peers resulted in greater hearing acculturation. Having more deaf peers resulted in lower levels of scholastic self-esteem. The greater the perceived teacher support, the lower the satisfaction with life was. Having more hearing peers was related to higher levels of loneliness.

For CI-users only, factors contributing to psychosocial functioning as reported by parents: There were no significant findings for negative psychosocial functioning. For positive psychosocial functioning, higher scholastic competence was related to socialization/acceptance with hearing peers.

For CI-users only, factors contributing to psychosocial functioning as reported by teachers: Withdrawn behaviors were related to higher levels of teacher support and higher levels of socialization with/acceptance by hearing peers.

Conclusions/Discussion

It is not the CI or lack of that matters, but rather environmental factors, most notably home communication, early identification of hearing loss, school setting (though not conclusive), relationship between hearing status and environmental response, and the importance of peer groups. The findings generally bring up questions for discussion and we look forward to dialogue on this forum.

References based on above citations

Bat-Chava, Y. (1993). Antecedents of self-esteem in deaf people: A meta-analytic review. Rehabilitation Psychology, 38 (4), 221-234.

Bat-Chava, Y. & Deignan, E. (2001). Peer relationships of children with cochlear implants. Journal of Deaf Studies and Deaf Education , 6, 186-199.

Bat-Chava, Y., Martin, D., & Kosciw, J.G. (2005). Longitudinal improvements in communication and socialization of deaf children with cochlear implants and hearing aids: Evidence from parental reports. Journal of Child Psychology and Psychiatry, 46(12), 1287-1296.

Boyd, R., Knutson, J., & Dahlstrom, A. (2000). Social interaction of pediatric cochlear implant recipients with age-matched peers. Annals of Otology, Rhinology & Laryngology (Supp.. 185), 12(2), 105-109.

Chmiel, R., Sutton, L., & Jenkins, H. (2000). Quality of life in children with cochlear implants. Annals of Otology, Rhinology & Laryngology (Supp.. 185), 12(2), 103-105.

Christiansen, J.B. & Leigh, I.W. (2005). Cochlear implants in children: Ethics and
choices . Washington, D.C.: Gallaudet University Press.

Fagan, M., Pisoni,D., Horn, D., & Dillon, C. (2007). Neuropsychological correlates of
vocabulary, reading, and working memory in deaf children with cochlear
implants. Journal of Deaf Studies and Deaf Education, 12, 461-471.

Gallaudet Research Institute (November 2008). Regional and national summary report of
data from the 2007-2008 annual survey of deaf and hard of hearing children and
youth. Washington, DC: GRI, Gallaudet University.

Geers, A. E. (2004). Speech, language, and reading skills after early cochlear implantation. Archives of Otolaryngology -- Head & Neck Surgery, 130 (5), 634-638.

Geers, A. (2006). Spoken language in children with cochlear implants. In P. Spencer & M. Marschark (Eds.). Advances in the spoken language development of deaf and hard-of-hearing children (pp. 244-270). New York: Oxford.

Glickman, N. (1996). The development of culturally deaf identities. In N. Glickman & M. Harvey (Eds.). Culturally affirmative psychotherapy with deaf persons (pp.115-153). Mahwah, N.J.: Lawrence Erlbaum.

Hyde, M. & Power, D. (2006). Some ethical dimensions of cochlear implantation for deaf
children and their families. Journal of Deaf Studies and Deaf Education, 11(1), 103-111.

Ladd, P. (2007). Cochlear implantation, colonialism, and Deaf rights. In L. Komesaroff
(Ed.). Surgical consent (pp. 1-29). Washington, DC: Gallaudet University Press.

Kluwin, T. & Stewart, D. (2000). Cochlear implants for younger children: A preliminary
description of the parental decision process and outcomes . American Annals of the Deaf, 145, 26-32.

Marschark, M., Rhoten, C., & Fabich, M. (2007). Effects of cochlear implants on children’s reading and academic achievement. Journal of Deaf Studies and Deaf Education, 12(3), 269-282.

Maxwell-McCaw, D. (2001). Acculturation and psychological well-being in deaf and hard-of-hearing people. Unpublished doctoral dissertation, The George Washington University, Washington, D.C.

Nicholas, J. & Geers, A. (2003). Personal, social, and family adjustment in school-aged
children with a cochlear implant. Ear & Hearing, 24, 69S-80S.

Nussbaum, D. (2009). Evolving trends and practices. Presentation, Cochlear Implants and Sign Language Conference, Clerc Center, Washington, D.C.

Preisler, G., Tvingstedt, A, & Ahlstrom, M. (2005). Interviews with deaf children about their experiences using cochlear implants. American Annals of the Deaf, 150, 260-267.

Waltzman, S.B. (2006). Cochlear Implants: Current status. Expert Review of Medical
Devices, 3 (5), 647-55.

Wheeler, A., Archbold, S., Gregory, S., & Skipp, A. (2007). Cochlear implants: The young people’s perspective. Journal of Deaf Studies and Deaf Education, 12(3), 303-316.

JDSDE Reference

Leigh, I.W., Maxwell-McCaw, D., Bat-Chava, Y., & Christiansen, J. (2009). Correlates of Psychosocial Adjustment among Deaf Adolescents with and without Cochlear Implants: A Preliminary Investigation. Journal of Deaf Studies & Deaf Education, 14(2), 244-259.

Past Topical Discussions

sherrye — Mon, 02 Nov 2009 21:24:12 GMT

Academic Status and Progress of Deaf and Hard-of-Hearing Students in General Education Classrooms
- Author facilitated discussion concerning this topic ended on ~~10/11/00~~ 10/11/09
- To read the research summary and related discussion, "click" on the following link
  - Academic Status and Progress of Deaf and Hard-of-Hearing Students in General Education Classrooms

Academic Status of Deaf and Hard-of-Hearing Students in Public Schools: Student, Home, and Service Facilitators and Detractors
- Author facilitated discussion concerning this topic ended on 6/30/08
- To read the research summary and related discussion, "click" on the following link
  - Academic Status of Deaf and Hard-of-Hearing Students in Public Schools: Student, Home, and Service Facilitators and Detractors

Accommodations Used For Statewide Standardized Assessments: Prevalence and Recommendations For Students Who Are Deaf or Hard of Hearing
- Author facilitated discussion concerning this topic ended on 10/12/08
- To read the research summary and related discussion, "click" on the following link
  - Accommodations Used For Statewide Standardized Assessments: Prevalence and Recommendations For Students Who Are Deaf or Hard of Hearing

Alternate Assessment Use With Students Who Are Deaf or Hard of Hearing: An Analysis of Portfolio, Checklists, and Out-of-Level Formats
- Author facilitated discussion concerning this topic ended on 12/7/08
- To read the research summary and related discussion, "click" on the following link
  - Alternate Assessment Use with Students who are Deaf or Hard of Hearing: An Analysis of Portfolio, Checklists, and Out-of-Level Formats

An Investigation of Two-way Text Messaging Use With Deaf Students at the Secondary Level
- Author facilitated discussion concerning this topic ended on 7/20/08
- To read the research summary and related discussion, "click" on the following link
  - An Investigation of Two-way Text Messaging Use With Deaf Students at the Secondary Level

Computer-based Exercises For Learning to Read and Spell by Deaf Children
- Author facilitated discussion concerning this topic ended on 3/29/09
- To read the research summary and related discussion, "click" on the following link
  - Computer-based Exercises For Learning to Read and Spell by Deaf Children

Deaf College Students’ Perceptions of Their Social-Emotional Adjustment
- Author facilitated discussion concerning this topic ended on 3/16/08
- To read the research summary and related discussion, "click' on the following link
  - Deaf College Students’ Perceptions of Their Social-Emotional Adjustment

Evaluating Phonological Processing Skills in Children With Prelingual Deafness Who Use Cochlear Implants
- Author facilitated discussion concerning this topic ended on 2/1/09
- To read the research summary and related discussion, "click" on the following link
  - Evaluating Phonological Processing Skills in Children With Prelingual Deafness Who Use Cochlear Implants

Family Mediation of Mathematically Based Concepts While Engaged In A Problem-solving Activity With Their Young Deaf Children
- Author facilitated discussion concerning this topic ended on 9/21/08
- To read the research summary and related discussion, "click" on the following link
  - Family Mediation of Mathematically Based Concepts While Engaged In A Problem-solving Activity With Their Young Deaf Children

Literacy Skills In Children With Cochlear Implants: The Importance of Early Oral Language and Joint Storybook Reading
- Author facilitated discussion concerning this topic ended on 8/31/08
- To read the research summary and related discussion, "click" on the following link
  - Literacy Skills In Children With Cochlear Implants: The Importance of Early Oral Language and Joint Storybook Reading

Math Problem Solving: Abstract of Research Currently Under Discussion
- Author facilitated discussion concerning this topic ended on 2/13/08
- To read the research summary and related discussion, "click' on the following link
  - The Relative Difficulty of Signed Arithmetic Story Problems for Primary Level Deaf and Hard-of-Hearing Students

Modeling Reading Vocabulary Learning In Deaf Children In Bilingual Education Programs
- Author facilitated discussion concerning this topic ended on 8/11/08
- To read the research summary and related discussion, "click" on the following link
  - Modeling Reading Vocabulary Learning In Deaf Children In Bilingual Education Programs

Parents' Views on Changing Communication After Cochlear Implantation
- Author facilitated discussion concerning this topic ended on 6/8/08
- To read the research summary and related discussion, "click" on the following link
  - Parents' Views on Changing Communication After Cochlear Implantation

The Relationship Between the Reading and Signing Skills of Deaf Children In Bilingual Education Programs
- Author facilitated discussion concerning this topic ended on 11/02/08
- To read the research summary and related discussion, "click" on the following link
  - The Relationship Between the Reading and Signing Skills of Deaf Children In Bilingual Education Programs

The Signed Reading Fluency of Students Who Are Deaf/Hard of Hearing
- Author facilitated discussion concerning this topic ended on 2/25/08
- To read the research summary and related discussion, "click' on the following link
  - The Signed Reading Fluency of Students Who are Deaf - Hard of Hearing

Social Integration of Deaf Children In Inclusive Settings
- Author facilitated discussion concerning this topic ended on 4/6/08
- To read the research summary and related discussion, "click" on the following link
  - Social Integration of Deaf Children In Inclusive Settings

Spoken Language Development In Oral Preschool Children With Permanent Childhood Deafness
- Author facilitated discussion concerning this topic ended on 11/23/08
- To read the research summary and related discussion, "click" on the following link
  - Spoken Language Development In Oral Preschool Children With Permanent Childhood Deafness

Spoken Language Scores of Children Using Cochlear Implants Compared to Hearing Age-Mates at School Entry
- Author facilitated discussion concerning this topic ended on 4/12/09
- To read the research summary and related discussion, "click" on the following link
  - Spoken Language Scores of Children Using Cochlear Implants Compared to Hearing Age-Mates at School Entry

Theory of Mind and Language In Children With Cochlear Implants
- Author facilitated discussion concerning this topic ended on 2/22/09
- To read the research summary and related discussion, "click" on the following link
  - Theory of Mind and Language In Children With Cochlear Implants

What Really Matters In the Early Literacy Development of Deaf Children?
- Author facilitated discussion concerning this topic ended on 4/27/08
- To read the research summary and related discussion, "click" on the following link
  - What Really Matters In the Early Literacy Development of Deaf Children?

Word-learning Abilities In Deaf and Hard of Hearing Preschoolers: Effect of Lexicon Size and Language Modality
- Author facilitated discussion concerning this topic ended on 3/08/09
- To read the research summary and related discussion, "click" on the following link
  - Word-learning Abilities In Deaf and Hard of Hearing Preschoolers: Effect of Lexicon Size and Language Modality

Visual-Spatial Representation In Mathematical Problem Solving by Deaf and Hearing Students
- Author facilitated discussion concerning this topic ended on 5/18/08
- To read the research summary and related discussion, "click" on the following link
  - Visual-Spatial Representation In Mathematical Problem Solving by Deaf and Hearing Students

effect_on_communication

sherrye — Mon, 02 Nov 2009 21:22:58 GMT

Congenitally deafblind children and cochlear implant – effect on communication
Directions
Dr. Jesper Dammeyer, Department of Psychology, University of Copenhagen, is available from 11/2/09 until 11/22/09 to answer questions and share ideas concerning his research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of his work, Dr. Dammeyer has written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Dr. Dammeyer please:

1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.)
2. type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.
3. Dr. Dammeyer will then respond to your message in his post to the discussion board.

If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed, the research summary and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.

effect_on_communication

sherrye — Mon, 02 Nov 2009 21:21:37 GMT

Congenitally deafblind children and cochlear implant – effect on communication
Directions
Dr. Jesper Dammeyer, Department of Psychology, University of Copenhagen, is available from 11/2/09 until 11/22/09 to answer questions and share ideas concerning his research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of his work, Dr. Dammeyer has written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Dr. Dammeyer please:

1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.)
2. type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.
3. Dr. Dammeyer will then respond to your message in his post to the discussion board.

If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed, the research summary and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.

Abstract
There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on cochlear implantation in children who are both deaf and blind, however, is lacking.

Ratings of video observations were used to measure 5 children’s early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children’s cochlear implants. Benefits of cochlear implantation in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

Introduction
In the years since the advent of paediatric implantation, a positive effect of cochlear implantation for people with acquired deafblindness has been reported, both in auditory performance (Pennings et al., 2006; Saeed, Ramsden, & Axon, 1998), as well as in quality of life (Damen, Pennings, Snik, & Mylanus, 2006). Conversely, congenitally deafblind children, among other children with additional disabilities, had not been considered as cochlear implant candidates. One explanation was the huge medical and psychological problems congenitally deafblind children were forced to contend with: either the cochlear implantation was too risky a surgical procedure, or hearing loss was not the most important problem facing the child.

In Scandinavia there is a strong tradition of focusing upon social interactions and communication in the habilitation of congenitally deafblind children (Rødbroe & Souriau, 1999; Janssen & Rødbroe, 2007). To create and expand social interaction is fundamental for the development of communication and possible later signed or oral language. The emergence of communication takes place via the processes of social interaction during play activities and in natural settings. The partner responds to and expands upon the child’s expressions of emotions and desires by regulation of contact, joint attention, turn-taking, and rhythm and tempo using tactile stimulation etc. (Janssen & Rødbroe, 2007; Nafstad & Rødbroe, 1996).

Along this line experiences have been positive regarding the 20 congenitally deafblind children with CI in Scandinavia (January 2007): less isolation, less self-stimulation, more awareness of the surroundings, motivation to investigate the surroundings, understanding of emotional expressions, and, in a few cases, understanding of single words and sentences. The aim of this study is to test these positive experiences.

Method
Five congenitally deafblind children from different parts of Scandinavia participated. The children were between 5.0 and 8.0 years old at the time of testing ( M = 6.3). Range of age at implant surgery was 2.2 to 4.2 years ( M = 3.6). At the time of testing, all children had used the CI for at least 1.0 year ( M = 2.8 years).
The children were observed by video in free play with a known adult (parent or caretaker) in known and natural contexts (home or institution). The five children were videotaped for about 30 minutes with their cochlear implants switched on and for another 30 minutes with them switched off. From both of the 30-minute observations with and without CI, two episodes of two minutes’ duration each were selected. The episodes of two minutes each were rated using six variables for every turn. All variables were selected to represent relevant aspects of the early stages of communication development of deafblind children as described in the introduction.

Modality of Communication: Three categories were used: Linguistic signs : When the child or the adult communicates or tries to communicate by single signs or sign-language sentences. Linguistic speech : When the child or the adult communicates or tries to communicate by single words or spoken sentences. Non-linguistic communication : Communicational behaviour such as pulling, pointing, screaming, kissing, and twisting the body.

Dialogue : Three categories were used: Initiative: If the child or the adult tries to establish a new round of communication. Answer: If the child or the adult responds along the same lines. No answer: If the child or the adult does not understand their partner.

Quality of Communication : The quality of the communication was rated on a scale ranging from 1 to 5. A 1 rating was given if “the communicational act makes the communicational interaction much worse,” while a 5 was rated if “the communicational act makes the communicational interaction much better.”
Manipulation of Objects, attention and emotional response were also rated on a scale ranging from 1 to 5. A rating of 5 was given if the manipulation of objects, attention or emotional response was relevant, i.e. in line with and adequate to, the social interaction. A score of 1 was indicative that the manipulation of objects, attention or emotional response not at all was of relevance to the social interaction.

The parents were interviewed about central issues concerning the outcome of the cochlear implantation and its impact on everyday life. The questions went beyond the variables rated in the video observations. For example: Is it easier or more difficult to understand why the child is sad, happy or angry? Does the child find it easier or more difficult to move around and explore new environments?

Results
For all children together, the difference between episodes with CI and without CI was significant for the variables Speech-turn , Quality of Communication , Manipulation of Objects, Attention , and Emotional Response . Even for some of the children individually the difference between episodes with CI and without was significant for these variables. There was no significant difference for the parameters concerning the Dialogue (Initiative, Answer and No-answer for the child or the adult).

In the interviews, all parents report that they would recommend CI to other parents with congenitally deafblind children. None of the parents had any negative experiences related to CI. Before implantation, all parents had only limited expectations for the outcome of CI.

Discussion
Despite the small number of children (five) in this study, it was possible to find a significant effect of CI for congenitally deafblind children. Though the outcome of CI was not spoken language, the progress was remarkably related to communication and social interaction. Improved attention, emotional response and manipulation of objects are all important issues in the development of communication for congenitally deafblind children (Janssen & Rødbroe, 2007) The relative difference for a deafblind child in being able to hear just a little seems to have a huge effect for the ability of the child to engage in social interaction and develop communication. When the adult responds to the child’s expressions (for example, emotions, manipulation of objects) in natural situations, it encourages the child to act in a socially significant environment. These shared social activities lead the child toward shared social meanings and communication, and further along the way toward the use of language.

Lisa: “Now it is possible to call out to Lisa. It makes me and her much more safe and relaxed”
Lisa is 5 years old. She is deafblind, but is able to use her limited vision. After CI, Lisa started slowly to make sense of sounds. She drew attention to sounds in combination with play. She started to imitate sounds she found interesting, and she also imitated the pitch of voices and rhythms. However, her reaction to sound can be difficult to identify. Lisa has been more relaxed – that is the most important effect of CI. She uses the sounds around her to make certain that she is not alone and that other children and adults are where they ought to be. Now she also uses her vision much more. She does not need to use her limited vision to control her mom’s face; now she can hear the emotional expressions in the pitch of the voice. She can concentrate on signs and movements, and communicates with signs and gestures much better than before. Three years after the operation, she has started to react to sounds without any cues. She turns around when she hears a sound and when she hears her name.

Conclusion
This study finds an overall good effect of cochlear implant use among congenitally deafblind children. The outcome is not spoken language, but better social interaction and communication. CI can be very helpful for the communicative and social development of congenitally deafblind children. CI is a relevant aid in the habilitation of congenitally deafblind children as a support to sign-language, tactile sign-language, and other modes and kinds of communication

References
Damen, G. W. J. A., Pennings, R. J. E., Snik, A. F. M., & Mylanus, E. A. M. (2006). Quality of life and cochlear implantation in Usher syndrome type I. Laryngoscope, 116 (5), 723-728.

Janssen, M., & Rødbroe, I. (2007). Communication and Congenital Deafblindness II: Contact and Social interaction. DK: Materialecentret.

Nafstad, A., & Rødbroe, I. (1996). Congenitally Deafblindness, interaction and development towards a model of intervention. In M. Laurent (Ed.), Communication and congenital deafblindness. The development of communication. What is new? Paris: Centre National de Suresnes.

Pennings, R. J. E., Damen, G. W. J. A., Snik, A. F. M., Hoefsloot, L., Cremers, C. W. R. J., & Mylanus, E. A. M. (2006). Audiological performance and benefit of cochlear implantation in Usher syndrome type I. Laryngoscope, 116 (5), 717-722.

Rødbroe, I., & Souriau, J. (1999). Communication. In J. M. McInnes (Ed.), A Guide to Planning and Support Individuals who are Deafblind. Toronto: University of Toronto Press.

Saeed, S. R., Ramsden, R. T., & Axon, P. R. (1998). Cochlear implantation in the deafblind. American Journal of Otology, 19 (6), 774-777.

JDSDE Reference

Dammyer, J. (2008). Congenitally deafblind children and cochlear implant – effect on communication The Journal of Deaf Studies and Deaf Education 14 (2), 278-288.

effect_on_communication

sherrye — Mon, 02 Nov 2009 21:21:05 GMT

Congenitally deafblind children and cochlear implant – effect on communication
Directions
Dr. Jesper Dammeyer, Department of Psychology, University of Copenhagen, is available from 11/2/09 until 11/22/09 to answer questions and share ideas concerning his research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of his work, Dr. Dammeyer has written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Dr. Dammeyer please:

1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.)
2. type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.
3. Dr. Dammeyer will then respond to your message in his post to the discussion board.

If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed, the research summary and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.

Abstract
There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on cochlear implantation in children who are both deaf and blind, however, is lacking.
Ratings of video observations were used to measure 5 children’s early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children’s cochlear implants. Benefits of cochlear implantation in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

Introduction
In the years since the advent of paediatric implantation, a positive effect of cochlear implantation for people with acquired deafblindness has been reported, both in auditory performance (Pennings et al., 2006; Saeed, Ramsden, & Axon, 1998), as well as in quality of life (Damen, Pennings, Snik, & Mylanus, 2006). Conversely, congenitally deafblind children, among other children with additional disabilities, had not been considered as cochlear implant candidates. One explanation was the huge medical and psychological problems congenitally deafblind children were forced to contend with: either the cochlear implantation was too risky a surgical procedure, or hearing loss was not the most important problem facing the child.
In Scandinavia there is a strong tradition of focusing upon social interactions and communication in the habilitation of congenitally deafblind children (Rødbroe & Souriau, 1999; Janssen & Rødbroe, 2007). To create and expand social interaction is fundamental for the development of communication and possible later signed or oral language. The emergence of communication takes place via the processes of social interaction during play activities and in natural settings. The partner responds to and expands upon the child’s expressions of emotions and desires by regulation of contact, joint attention, turn-taking, and rhythm and tempo using tactile stimulation etc. (Janssen & Rødbroe, 2007; Nafstad & Rødbroe, 1996).
Along this line experiences have been positive regarding the 20 congenitally deafblind children with CI in Scandinavia (January 2007): less isolation, less self-stimulation, more awareness of the surroundings, motivation to investigate the surroundings, understanding of emotional expressions, and, in a few cases, understanding of single words and sentences. The aim of this study is to test these positive experiences.

Method
Five congenitally deafblind children from different parts of Scandinavia participated. The children were between 5.0 and 8.0 years old at the time of testing ( M = 6.3). Range of age at implant surgery was 2.2 to 4.2 years ( M = 3.6). At the time of testing, all children had used the CI for at least 1.0 year ( M = 2.8 years).
The children were observed by video in free play with a known adult (parent or caretaker) in known and natural contexts (home or institution). The five children were videotaped for about 30 minutes with their cochlear implants switched on and for another 30 minutes with them switched off. From both of the 30-minute observations with and without CI, two episodes of two minutes’ duration each were selected. The episodes of two minutes each were rated using six variables for every turn. All variables were selected to represent relevant aspects of the early stages of communication development of deafblind children as described in the introduction.

Modality of Communication: Three categories were used: Linguistic signs : When the child or the adult communicates or tries to communicate by single signs or sign-language sentences. Linguistic speech : When the child or the adult communicates or tries to communicate by single words or spoken sentences. Non-linguistic communication : Communicational behaviour such as pulling, pointing, screaming, kissing, and twisting the body.

Dialogue : Three categories were used: Initiative: If the child or the adult tries to establish a new round of communication. Answer: If the child or the adult responds along the same lines. No answer: If the child or the adult does not understand their partner.

Quality of Communication : The quality of the communication was rated on a scale ranging from 1 to 5. A 1 rating was given if “the communicational act makes the communicational interaction much worse,” while a 5 was rated if “the communicational act makes the communicational interaction much better.”
Manipulation of Objects, attention and emotional response were also rated on a scale ranging from 1 to 5. A rating of 5 was given if the manipulation of objects, attention or emotional response was relevant, i.e. in line with and adequate to, the social interaction. A score of 1 was indicative that the manipulation of objects, attention or emotional response not at all was of relevance to the social interaction.

The parents were interviewed about central issues concerning the outcome of the cochlear implantation and its impact on everyday life. The questions went beyond the variables rated in the video observations. For example: Is it easier or more difficult to understand why the child is sad, happy or angry? Does the child find it easier or more difficult to move around and explore new environments?

Results
For all children together, the difference between episodes with CI and without CI was significant for the variables Speech-turn , Quality of Communication , Manipulation of Objects, Attention , and Emotional Response . Even for some of the children individually the difference between episodes with CI and without was significant for these variables. There was no significant difference for the parameters concerning the Dialogue (Initiative, Answer and No-answer for the child or the adult).

In the interviews, all parents report that they would recommend CI to other parents with congenitally deafblind children. None of the parents had any negative experiences related to CI. Before implantation, all parents had only limited expectations for the outcome of CI.

Discussion
Despite the small number of children (five) in this study, it was possible to find a significant effect of CI for congenitally deafblind children. Though the outcome of CI was not spoken language, the progress was remarkably related to communication and social interaction. Improved attention, emotional response and manipulation of objects are all important issues in the development of communication for congenitally deafblind children (Janssen & Rødbroe, 2007) The relative difference for a deafblind child in being able to hear just a little seems to have a huge effect for the ability of the child to engage in social interaction and develop communication. When the adult responds to the child’s expressions (for example, emotions, manipulation of objects) in natural situations, it encourages the child to act in a socially significant environment. These shared social activities lead the child toward shared social meanings and communication, and further along the way toward the use of language.

Lisa: “Now it is possible to call out to Lisa. It makes me and her much more safe and relaxed”
Lisa is 5 years old. She is deafblind, but is able to use her limited vision. After CI, Lisa started slowly to make sense of sounds. She drew attention to sounds in combination with play. She started to imitate sounds she found interesting, and she also imitated the pitch of voices and rhythms. However, her reaction to sound can be difficult to identify. Lisa has been more relaxed – that is the most important effect of CI. She uses the sounds around her to make certain that she is not alone and that other children and adults are where they ought to be. Now she also uses her vision much more. She does not need to use her limited vision to control her mom’s face; now she can hear the emotional expressions in the pitch of the voice. She can concentrate on signs and movements, and communicates with signs and gestures much better than before. Three years after the operation, she has started to react to sounds without any cues. She turns around when she hears a sound and when she hears her name.

Conclusion
This study finds an overall good effect of cochlear implant use among congenitally deafblind children. The outcome is not spoken language, but better social interaction and communication. CI can be very helpful for the communicative and social development of congenitally deafblind children. CI is a relevant aid in the habilitation of congenitally deafblind children as a support to sign-language, tactile sign-language, and other modes and kinds of communication

References
Damen, G. W. J. A., Pennings, R. J. E., Snik, A. F. M., & Mylanus, E. A. M. (2006). Quality of life and cochlear implantation in Usher syndrome type I. Laryngoscope, 116 (5), 723-728.

Janssen, M., & Rødbroe, I. (2007). Communication and Congenital Deafblindness II: Contact and Social interaction. DK: Materialecentret.

Nafstad, A., & Rødbroe, I. (1996). Congenitally Deafblindness, interaction and development towards a model of intervention. In M. Laurent (Ed.), Communication and congenital deafblindness. The development of communication. What is new? Paris: Centre National de Suresnes.

Pennings, R. J. E., Damen, G. W. J. A., Snik, A. F. M., Hoefsloot, L., Cremers, C. W. R. J., & Mylanus, E. A. M. (2006). Audiological performance and benefit of cochlear implantation in Usher syndrome type I. Laryngoscope, 116 (5), 717-722.

Rødbroe, I., & Souriau, J. (1999). Communication. In J. M. McInnes (Ed.), A Guide to Planning and Support Individuals who are Deafblind. Toronto: University of Toronto Press.

Saeed, S. R., Ramsden, R. T., & Axon, P. R. (1998). Cochlear implantation in the deafblind. American Journal of Otology, 19 (6), 774-777. .

JDSDE Reference

Dammyer, J. (2008). Congenitally deafblind children and cochlear implant – effect on communication The Journal of Deaf Studies and Deaf Education 14 (2), 278-288.

effect_on_communication

sherrye — Mon, 02 Nov 2009 21:18:56 GMT

Congenitally deafblind children and cochlear implant – effect on communication
Directions
Dr. Jesper Dammeyer, Department of Psychology, University of Copenhagen, is available from 11/2/09 until 11/22/09 to answer questions and share ideas concerning his research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of his work, Dr. Dammeyer has written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Dr. Dammeyer please:

1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.)
2. type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.
3. Dr. Dammeyer will then respond to your message in his post to the discussion board.

If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed, the research summary and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.

Psychosocial_Adjustment : re: Longitudinal?

adamstone — Thu, 15 Oct 2009 16:10:42 GMT

Yep - am a CI user but only got it when I was an undergraduate at RIT.

Psychosocial_Adjustment : re: Effect of earlier implantation

DeborahMcCaw — Wed, 14 Oct 2009 03:04:38 GMT

Yes, this is another excellent question. I suspect that there could be some real differences in today's children who are being implanted before age 2 and with the technology that is currently available, as opposed to what many of our participants had at the time of our study. Implant technology has come a long way and research on early implantation has reported significant gains in spoken language comprehension. Yet, even with these strides - we do need to remember that these children are still DEAF when their processors are off - for swimming, sleeping, when their batteries die, etc. They are not hearing like hearing people are. This has to still have a psychological impact in terms of their sense of self. So, personally - based on our current research findings - I strongly believe that bilingualism should still be promoted for these children until we know otherwise! Why not give them every tool possible to help navigate the world?

You pose an interesting question - "what do other people see as psychosocial factors influencing adolescents who recieved implants before age two?" It would be great to hear from parents, teachers, etc who are currently working with some of these kids!!

Psychosocial_Adjustment : re: conclusions resulting from this study - ?

DeborahMcCaw — Wed, 14 Oct 2009 02:53:30 GMT

Thank you for your kind comments on our study.

Your question is an excellent one (whether there were differences between the CI and non-CI group in terms of their satisfaction with their communication at home). We did not actually run this analysis in our study - as we were focused on psychosocial outcomes between the two groups and found that home communication was an important predictor regardless of implant status. In this case, we did find for both groups that higher levels of home satisfaction were related to higher self-esteem, greater satisfaction with life and higher levels of positive behavioral outcomes. Let me check our data to see if there were differences in the two groups though, in terms of satisfaction with home communication and get back to you on that...

Psychosocial_Adjustment : re: Longitudinal?

DeborahMcCaw — Wed, 14 Oct 2009 02:41:57 GMT

Adam -

Thank you for your posting! Unfortunately, we do not intend to follow up the adolescents in this study as it would be difficult to track them down at this point. But, your point is very well taken - and is an interesting line of thinking to guide future research. Certainly, more longitudinal studies are needed. Studies that track before/after changes in those who enter the deaf community later in life would definately increase our understanding of this impacts on the quality of life for deaf/hh individuals. Just curious - are you a CI-user yourself?

Psychosocial_Adjustment : conclusions resulting from this study - ?

hjohnson — Tue, 13 Oct 2009 16:17:43 GMT

First, I would like to thank you for carrying out this very well designed study.

Second, the conclusions you reached as a result of this study, i.e.,

"It is not the CI or lack of that matters, but rather environmental factors, most notably home communication, early identification of hearing loss, school setting (though not conclusive), relationship between hearing status and environmental response, and the importance of peer groups."

serve remind us all what is most essential in the education of students who are d/hh. Thank you

Third, could you please share a bit more about the impact, or lack of impact of a CI upon communications between students and their parents. That is, did the CI have an impact upon such communications, and if so what + what occurred (if anything) because of this impact?

thank you for your response to this question.

Harold Johnson

Psychosocial_Adjustment : Longitudinal?

adamstone — Mon, 12 Oct 2009 16:35:17 GMT

Drs. McCaw & Leigh--

Any plans to follow up with these adolescents in five or ten years? This is just a personal story, but if I had been given those surveys while I was the only deaf student in my high school, I would have probably scored more positively than I would now if reflecting back on my experience. I simply didn't know what else (e.g. the Deaf world) was out there until I entered college; once I gained full communication access, I started viewing my pre-college experience more negatively.

It'd be interesting to see where those adolescents end up when they become adults...

Adam

Psychosocial_Adjustment : Effect of earlier implantation

meccarius — Mon, 12 Oct 2009 16:26:36 GMT

I could not help wondering when I was reading the article what a replication of this study (done as today's children reach adolescence) will find. While the trends (mainstream more hearing oriented, residential school more deaf oriented, etc) might intensify for children receiving cochlear implants much earlier, I fully expect to see some surprises.
I have worked at a cochlear implant center where maintaining bi-modal communication post implant is encouraged. Even there, the medical team members often say that they are essentially removing the need for signed language, and Deaf Community affiliation. I suspect that they are missing the point--or even several points--made in this article.
What do other people see as psycho-social factors influencing adolescents who received cochlear implants before age two? We can't know, of course, but it is an interesting question.

Academic_Status_2009

sherrye — Mon, 12 Oct 2009 13:19:47 GMT

Academic status and progress of Deaf and Hard-of-Hearing students in general education classrooms.

~~Directions~~ Dr. Shirin Antia is was available from 9/21/09 until 10/11/09 to answer questions and share ideas concerning her research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them. In order to facilitate a discussion of her work, the author has written a brief summary (see below) of the longer article published in the Journal of Deaf Studies and Deaf Education. To discuss your questions, comments and suggestions with Dr. Antia please: 1. “click” on the “discussion” tab that is at the top of this page. (You must "Sign In" to see the "discussion" tab. If you do not have a username/password, please click on "Join" to establish them.) 2. ~~type your message, i.e., question, comment, suggestion, etc., then “click” on the “post” button that is at the bottom of the page.~~ 3. ~~Dr. Antia will then respond to your message in her post to the discussion board.~~ If you would like to receive a notification of new posts to this discussion board, please “click” on the “notify me” tab that is at the top of this page. (You must "Sign In" to see the "notify me" tab. If you do not have a username/password, please click on "Join" to establish them.) If you need assistance in using this wiki space, please “click” on the “Directions & Help” link that you will find at the top of the left hand menu bar. Once the designated time period for this research topic has been completed,

You are encouraged to read the research summary ~~and related discussion will be moved from the “Current” to the “Past” topical discussions, as noted on the left hand menu bar.~~ below and review the attached discussion.

Abstract

This study reports on the academic status and progress, over a five-year period, of deaf and hard-of-hearing (DHH) students attending general education classrooms in public schools. The study participants were 197 deaf or hard-of-hearing students with mild to profound hearing loss who attended general education classes for two or more hours per day. We obtained scores on standardized achievement tests of math, reading, and language/writing, and standardized teacher ratings of academic competence annually, for five years, together with other demographic and communication data.

Results on standardized achievement tests indicated that, over the five-year period, 63-79% of students scored in the average or above-average range in math, 48-68% in reading, and 55-76% in language/writing. The standardized test scores for the group were, on average, half a standard deviation below hearing norms. Average student progress in each subject area was consistent with, or better than that made by the norm group of hearing students, and 79-81% of students made one or more year’s progress annually. Teachers rated 69%-81% of students as average or above-average in academic competence over the five years. The teacher ratings also indicated that 89% of students made average or above-average progress.

Introduction and Purpose

Approximately 48% of DHH students nationally spend more than 16 hours a week in classrooms with hearing students (Gallaudet Research Institute, November 2008). Early identification, early intervention, and the widespread use of cochlear implants is likely to increase this percentage in future decades. Although there is a concern that their academic and communication needs cannot be met in general education classrooms, comparatively little is known about the academic status of this population of students. Data on academic achievement of DHH students are traditionally obtained on national samples that include a large proportion of students with profound hearing loss in self-contained settings. However, a majority of DHH students in general education classrooms have less-than-severe hearing loss (Karchmer & Mitchell, 2003). The needs of these hard-of-hearing students are often overlooked because of the erroneous belief that they can function easily in oral environments and have less need for support services than students who are deaf (Marschark, Lang, & Albertini, 2002; Ross, Brackett, & Maxon, 1982) . Since hard-of-hearing students constitute 52% of students reported to the Annual Survey of Deaf and Hard of Hearing Children and Youth (Gallaudet Research Institute, November 2008) and 78% of DHH students in general education classrooms (Karchmer & Mitchell, 2003) it is important to obtain current data on the academic status and progress of both hard-of-hearing and deaf students, as was the focus of this study.

We examined academic status of the DHH students in three ways: normative academic status, classroom academic status and academic progress (Semmel & Frick, 1985). Normative academic status refers to students’ standing compared to hearing students on national or state achievement tests. Classroom academic status refers to students’ achievement in comparison with classmates and can be measured by obtaining teachers’ perceptions of students’ achievement and ability to learn expected academic content. Academic progress refers to the change in academic achievement from one year to the next and can be measured both by looking at gains on achievement tests and teacher perception of student change.

Participants

The participants were 197 DHH students who a) had an identified bi-lateral or unilateral hearing loss; b) did not have additional severe cognitive disabilities; c) received direct or consultative services from teachers of DHH or had an IEP; d) attended general education classrooms in public schools for two or more hours each day; and e) were in grades 2 - 8 at the beginning of the study. Once enrolled, students stayed in the study unless we were unable to locate them or obtain data on them in subsequent years. Over half the students had mild and moderate hearing losses; 85% spent three or more hours in the general education classroom. Spoken communication was the primary mode for most students, although 24% used at least some sign communication. Twenty-three percent of students had a home language that was not English, and 37% belonged to minority ethnic groups.

Data collection

We obtained demographic data, teacher ratings of students’ communication proficiency, students’ self-ratings of classroom participation, and preferred communication mode annually. Normative academic status was measured using standardized achievement tests normally administered as part of the state accountability system. Classroom academic status was measured through a teacher rating scale – the Academic Competence Scale of the Social Skills Rating System (SSRS) (Gresham & Elliott, 1990). Academic progress was examined on both normative and classroom academic data.

Results

Normative Academic Status and Progress.

We obtained student achievement on math, reading and writing annually. We converted the standardized academic achievement scores to Normal Curve Equivalents (NCE) where the average score for the population of all students is 50 and the standard deviation is 21; students scoring between 30 and 70 (within one standard deviation of the mean) are considered average; students scoring below 30 are below-average, while those scoring above 70 are above-average. In each content area (reading, writing, math) over 50% of the students scored within the average or above-average range. In Math over two-thirds of the students scored within this range. Average math achievement (NCE) scores over the 5 years ranged from 43 – 45; reading achievement ranged from 34 – 38, and writing achievement ranged from 35 – 42. Thus, one could characterize reading and writing achievement as being in the low average range, while math achievement was slightly below average. As a group, the DHH students averaged one year’s progress in one year’s time in math and reading, and significantly greater than one year’s annual progress in writing. Eighty-one percent of students averaged one year’s progress in one year’s time in math and writing, while 79% averaged one year’s progress in one year’s time in reading.

Classroom Academic Status and Progress.

The general education teachers rated each of the DHH students annually using the Academic Competence Scale. The scale includes items on reading, math, motivation, and overall academic competence in comparison to grade-level and classroom-level teacher expectations. The Academic Competence Scale has a mean of 100 and a standard deviation of 15. Students scoring between 85 and 115 are considered average, below 85 are below-average, and those scoring above 115 are above-average. Teachers rated between 70-80% of students in the average range during each of the five years. However, the percentage of students who were rated below average ranged from 19-27% (higher than the expected 16% for the general population). The teachers’ ratings showed that 70% of the DHH students made average progress annually, while 19% made above-average progress. Teachers rated only 11% of students as making below-average progress.

Conclusions

The good news is that the majority of these students are achieving within the normal range of hearing students on standardized tests of math, reading, and writing; and most are perceived by their teachers as performing academically within the range of their classmates. Most of the students are also making one year’s progress in one year’s time, and, in the area of writing, many are making more than one year’s progress in a year’s time. Previous researchers (Jensema, 1978; Wolk & Allen, 1984) have reported that the typical growth rate (at least in reading comprehension) is about one-third of a grade equivalent in one year’s time. The not-so-good news is that the group is in the low average range on standardized achievement tests in reading, and, despite making progress, may not be closing the performance gap between them and hearing students. However, the gap is much smaller than that reported by other researchers (Karchmer & Mitchell, 2003).

There are several reasons why the data from this sample may be different from other reported achievement data on DHH students. The sample in this study includes a large number of hard-of-hearing children who are often overlooked in other research because they are difficult to locate. Students are often placed in general education because it is the belief of their teachers and parents that they can thrive in these classrooms – in other words, these students are not randomly selected. It is quite likely that they are not representative of the general population of DHH students on hard-to-measure variables such as motivation to succeed. Another reason that these students may be performing academically higher than those in previous studies is because they might have more exposure to the general education curriculum than students educated in self-contained classrooms (Soukup, Wehmeyer, Bashinski, & Bovaird, 2007) . Other research with DHH students (Holt, 1994; Kluwin, 1993) has indicated that access to the general academic curriculum is associated with higher achievement and progress. Finally, it may be that these students are in an environment where they are encouraged by parents, teachers and peers to achieve.

References

Gallaudet Research Institute. (November 2008). Regional and National Summary Report of Data from the 2007-2008 Annual Survey of Deaf and Hard of Hearing Children and Youth. Washington DC: GRI, Gallaudet University.

Gresham, F. M., & Elliott, S. N. (1990). Social Skills Rating System. Circle Pines: American Guidance Service.

Holt, J. (1994). Classroom attributes and achievement test scores for deaf and hard of hearing students. American Annals of the Deaf , 139, 430-437.

Jensema, C. (1978). A comment on measurement error in achievement tests for the hearing impaired. American Annals of the Deaf , 123, 496-499.

Karchmer, M., & Mitchell, R. E. (2003). Demographic and achievement characteristics of deaf and hard-of-hearing students. In M. Marschark & P. E. Spencer (Eds.), Oxford handbook of deaf studies, language and education (pp. 21-37). New York: Oxford University Press.

Kluwin, T. N. (1993). Cumulative effects of mainstreaming on the achievement of deaf adolescents. Exceptional Children , 60, 73-81.

Marschark, M., Lang, H. G., & Albertini, J. A. (2002). Educating deaf students: From research to practice . New York: Oxford University Press.

Ross, M., Brackett, D., & Maxon, A. B. (1982). Hard of hearing children in regular schools. Englewood Cliffs: Prentice-Hall.

Semmel, M. I., & Frick, T. (1985). Learner competence in school. In M. Kaufman, J. A. Agard & M. I. Semmel (Eds.), Mainstreaming: Learners and their environment (pp. 99-150). Cambridge: Brookline Books.

Soukup, J. H., Wehmeyer, M. L., Bashinski, S. M., & Bovaird, J. A. (2007). Classroom variables and access to the general curriculum for students with disabilities. Exceptional Children , 74, 101-120.

Wolk, S., & Allen, T. E. (1984). A 5-year follow-up of reading-comprehension achievement of hearing-impaired students in special education programs. Journal of Special Education , 18(2), 161-176.

JDSDE Reference

Shirin D. Antia, Patricia B. Jones, Susanne Reed, and Kathryn H. Kreimeyer (2009). Academic status and progress of Deaf and Hard-of-Hearing students in general education classrooms. The Journal of Deaf Studies and Deaf Education 2009; Volume 14 (3) Summer 2009 pp 293-311.