From “communication options” to global language proficiency

This work was posted as a Reader Comment in Pediatrics for the article, "Opportunities and Shared Decision-Making to Help Children Who Are Deaf to Communicate" Karl R. White, Louis Z. Cooper, Pediatrics Jun 2017, e20171287; DOI: 10.1542/peds.2017-1287

Operationalization and measurement of sign language

This piece will be included in a collection of commentaries that are being compiled as a Letter to the Editor

Considering Parental Hearing Status as a Social Determinant of Deaf Population Health: Insights from Experiences of the \ Dinner Table Syndrome\

The influence of early language and communication experiences on lifelong health outcomes is receiving increased public health attention. Most deaf children have non-signing hearing parents, and are at risk for not experiencing fully accessible language environments, a possible factor underlying known deaf population health disparities. Childhood indirect family communication-such as spontaneous conversations and listening in the routine family environment (e.g. family meals, recreation, car rides)-is an important source of health-related contextual learning opportunities. The goal of this study was to assess the influence of parental hearing status on deaf people\u27s recalled access to childhood indirect family communication. We analyzed data from the Rochester Deaf Health Survey-2013 (n = 211 deaf adults) for associations between sociodemographic factors including parental hearing status, and recalled access to childhood indirect family communication. Parental hearing status predicted deaf adults\u27 recalled access to childhood indirect family communication (χ2 = 31.939, p \u3c .001). The likelihood of deaf adults reporting sometimes to never for recalled comprehension of childhood family indirect communication increased by 17.6 times for those with hearing parents. No other sociodemographic or deaf-specific factors in this study predicted deaf adults\u27 access to childhood indirect family communication. This study finds that deaf people who have hearing parents were more likely to report limited access to contextual learning opportunities during childhood. Parental hearing status and early childhood language experiences, therefore, require further investigation as possible social determinants of health to develop interventions that improve lifelong health and social outcomes of the underserved deaf population

Signing While Driving: An Investigation of Divided Attention Resources Among Deaf Drivers

Safely operating vehicles require significant visual attention. While attention can be divided, cognitive resources are not limitless. Deaf and hearing participants engaged in a simulated driving task while simultaneously engaging in a conversation in their preferred language. Results indicated that hearing drivers may have a performance advantage over deaf drivers, though it is so minor that it will not likely be seen outside of the laboratory setting. The results also indicated differing cognitive processing among hearing and deaf drivers. The results may inform policy, reduce stigma, and serve as the base for future research on deaf-specific cognitive factors of driving

Language deprivation syndrome: a possible neurodevelopmental disorder with sociocultural origins

PURPOSE: There is a need to better understand the epidemiological relationship between language development and psychiatric symptomatology. Language development can be particularly impacted by social factors-as seen in the developmental choices made for deaf children, which can create language deprivation. A possible mental health syndrome may be present in deaf patients with severe language deprivation. METHODS: Electronic databases were searched to identify publications focusing on language development and mental health in the deaf population. Screening of relevant publications narrowed the search results to 35 publications. RESULTS: Although there is very limited empirical evidence, there appears to be suggestions of a mental health syndrome by clinicians working with deaf patients. Possible features include language dysfluency, fund of knowledge deficits, and disruptions in thinking, mood, and/or behavior. CONCLUSION: The clinical specialty of deaf mental health appears to be struggling with a clinically observed phenomenon that has yet to be empirically investigated and defined within the DSM. Descriptions of patients within the clinical setting suggest a language deprivation syndrome. Language development experiences have an epidemiological relationship with psychiatric outcomes in deaf people. This requires more empirical attention and has implications for other populations with behavioral health disparities as well

Associations of childhood hearing loss and adverse childhood experiences in deaf adults

Childhood trauma and adverse childhood experiences have a strong relationship with health disparities across the lifespan. Despite experiencing approximately doubled rates of trauma, Adverse Childhood Experiences (ACEs) are poorly characterized in deaf populations. We sought to characterize deaf-specific demographic factors and their association with multiple experiences of ACEs before the age of 18 years old. An analytical cross-sectional approach was used to ascertain associations of deaf-specific demographic factors and experiences with ACEs. The complete dataset included 520 participants for a total response rate of 56%. After adjusting for confounding effects, less severe hearing loss of 16–55 dB (2+ OR: 5.2, 4+ OR: 4.7), having a cochlear implant (2+ OR: 2.1, 4+ OR: 2.6), and not attending at least one school with signing access (2+ OR: 2.4, 4+ OR: 3.7) were significantly and independently associated with reported experiences of multiple ACEs. We conclude that factors associated with childhood hearing loss and language experiences increase risk of experiencing ACEs. Given the strong relationship between ACEs and poor social outcomes, early intervention clinical practice and health policies should consider interventions to support healthy home environments for deaf children

Education and health of children with hearing loss: the necessity of signed languages

Medical and educational interventions for children with hearing loss often adopt a single approach of spoken language acquisition through the use of technology, such as cochlear implants. These approaches generally ignore signed languages, despite no guarantees that the child will acquire fluency in a spoken language. Research with children who have a cochlear implant and do not use a signed language indicates that language outcomes are very variable and generally worse than their non-deaf peers. In contrast, signing children with cochlear implants have timely language development similar to their non-deaf peers that also exceeds their non-signing peers with cochlear implants. Natural signed languages have been shown to have the same neurocognitive benefits as natural spoken language while being fully accessible to deaf children. However, it is estimated less than 2% of the 34 million deaf children worldwide receive early childhood exposure to a signed language. Most deaf children are, therefore, at risk for language deprivation during the critical period of language acquisition in the first five years of life. Language deprivation has negative consequences for developmental domains, which rely on timely language acquisition. Beyond the adverse effects on a child’s education, language deprivation also affects deaf people’s mental and physical health and access to health care, among others. Therefore, policies in accordance with the United Nations Convention on the rights of persons with disabilities are needed. Such policies would ensure early intervention and education services include signed languages and bilingual programmes where the signed language is the language of instruction.</p

Bivariate associations of general and deaf-related variables with presence of 2+ and 4+ adverse childhood experiences.

Bivariate associations of general and deaf-related variables with presence of 2+ and 4+ adverse childhood experiences.</p

Multivariate forward stepwise logistic regression model of 2+ and 4+ adverse childhood experiences.

Multivariate forward stepwise logistic regression model of 2+ and 4+ adverse childhood experiences.</p

A Pilot Study of Deaf Trauma Survivors\u27 Experiences: Early Traumas Unique to Being Deaf in a Hearing World

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals\u27 trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and other very stressful events. Although some other events overlap with traumas in the general population, many are unique to Deaf people (e.g., corporal punishment at oral/aural school if caught using sign language, utter lack of communication with hearing parents). These findings suggest that Deaf individuals may experience developmental traumas distinct to being raised in a hearing world. Such traumas are not captured by available trauma assessments, nor are they considered in evidence-based trauma treatments