Assessing Communication and Social/Emotional Development

in Children Who Are Deaf and Hard of Hearing: Infancy to Early School Age

Janet R. Jamieson Susan LaneEducational & Counselling BC Family Hearing

Psychology, & Special Ed. Resource Centre

UBC

How Does Hearing Loss Impact Development?

Early infancy– mother-infant “courtship dance”– synchronous vs. asynchronous communication– hearing loss affects every aspects of

psychological development in a bidirectional way:

• social-emotional• language• cognitive

How Does Hearing Loss Impact Social-emotional

Development? From the Parent’s Perspective:

– parental grieving (anger and denial)– parents may not make necessary

adjustments to communication– increased control

• in communication• in behaviour• what is the impact of this increased control on

the child?

How Does Hearing Loss Impact Social-emotional

Development? From the Child’s Perspective:

– inability to predict what will happen next– resulting frustration– fear of taking risks (e.g., new settings, new

experiences)– increased dependence on others– sense of isolation and loneliness– preference for peers with same hearing status

How Does Hearing Loss Impact Language Development?

From the Parent’s Perspective:

– lack of expected response– spirals of increasing control– difficulty with turn-taking– increased use of directions, 2-choice

questions, “air time”

How Does Hearing Loss Impact Language Development?

From the Child’s Perspective:– may be delayed, but not deviant– approx. 1/3 of deaf children have other

disabilities (leading to possible language disorder)

– inability to divide attention between visual and auditory cues

– strong reliance on visual cues

Overall, then... Language development includes:

– phonology– semantics / morphology– syntax

Neurologically, there are many paths to language development

Focus on the process; don’t worry if a path is unique

How Does Hearing Loss Impact Cognitive Development?

A learning cycle has been created:

– the child does not respond as expected

– the parent reacts by taking control

– the child has less room to take risks, unless she does so quickly

We assess young children to...

determine if child needs help

design an appropriate plan

monitor change in child and family to determine if intervention is resulting in positive outcomes

What we look at when we assess...

child-caregiver interactions listening play vocalizations / speech gestures vocabulary development combining of words / signs pragmatics

What assessment tools do you use?

1. 2. 3. 4 5. etc…..

Special Considerations when Assessing a Child

with a Hearing Loss What language systems surround the child? What is the child’s preferred modality (vision

or hearing)? Are there idiosyncracies in the child’s use of

the language system?

Special Considerations when Assessing a Child

with a Hearing Loss

Bottom line #1: During assessments, use the child’s preferred language, and receive input from informants across contexts.

Bottom line #2: For non-English-speaking hearing parents, use culturally sensitive interpreters and and at least one parent report instrument that is valid for the home.

Special Considerations in Test Selection

and Interpretation of Results Both formal and informal assessments are needed. Most formal tests are normed on hearing children

– some tests unfairly penalize deaf children and make their language appear more delayed than it is

– procedures may differ from standardized test– question the value of comparing the performance of

younger hearing children with older deaf children– make sure some part of assessment occurs in

relevant communication context

Other Professionals Who May Be Involved in the Assessment of a

Child with a Hearing Loss Medical

– Family Physician– Ear, Nose, & Throat Physician (ENT)– Audiologist

Habilitation– Teacher of the Deaf and Hard of Hearing– Speech-Language Pathologist (SLP)– Occupational Therapist– Physical Therapist– Aural Rehabilitationists

Family Support– Social Worker

Videos: Communicators in Action!

E.L.R

Joshua

Sam

Your (Very Important) Role in the Assessment of

Deaf and Hard of Hearing Children You are a key team member -- each

member holds a piece of the puzzle

The overall goal of intervention is to impact the communication system

Select assessment tools carefully and interpret the results with caution