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

      1 , 2 , 3
      Bulletin of the World Health Organization
      WHO Press

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          Abstract

          Abstract 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.

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          Most cited references22

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          Spoken language development in children following cochlear implantation.

          Cochlear implantation is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe to profound sensorineural hearing loss (SNHL). To prospectively assess spoken language acquisition following cochlear implantation in young children. Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation before 5 years of age (n = 188) from 6 US centers and hearing children of similar ages (n = 97) from 2 preschools recruited between November 2002 and December 2004. Follow-up completed between November 2005 and May 2008. Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales). Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression. The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.
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            Language and theory of mind: a study of deaf children.

            Theory-of-mind (ToM) abilities were studied in 176 deaf children aged 3 years 11 months to 8 years 3 months who use either American Sign Language (ASL) or oral English, with hearing parents or deaf parents. A battery of tasks tapping understanding of false belief and knowledge state and language skills, ASL or English, was given to each child. There was a significant delay on ToM tasks in deaf children of hearing parents, who typically demonstrate language delays, regardless of whether they used spoken English or ASL. In contrast, deaf children from deaf families performed identically to same-aged hearing controls (N=42). Both vocabulary and understanding syntactic complements were significant independent predictors of success on verbal and low-verbal ToM tasks.
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              Spoken english language development among native signing children with cochlear implants.

              Bilingualism is common throughout the world, and bilingual children regularly develop into fluently bilingual adults. In contrast, children with cochlear implants (CIs) are frequently encouraged to focus on a spoken language to the exclusion of sign language. Here, we investigate the spoken English language skills of 5 children with CIs who also have deaf signing parents, and so receive exposure to a full natural sign language (American Sign Language, ASL) from birth, in addition to spoken English after implantation. We compare their language skills with hearing ASL/English bilingual children of deaf parents. Our results show comparable English scores for the CI and hearing groups on a variety of standardized language measures, exceeding previously reported scores for children with CIs with the same age of implantation and years of CI use. We conclude that natural sign language input does no harm and may mitigate negative effects of early auditory deprivation for spoken language development.
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                Author and article information

                Journal
                Bulletin of the World Health Organization
                Bull. World Health Organ.
                WHO Press
                0042-9686
                October 01 2019
                August 20 2019
                October 01 2019
                August 20 2019
                : 97
                : 10
                : 711-716
                Affiliations
                [1 ]Department of American Sign Language and Deaf Studies, Gallaudet University, 800 Florida Ave NE, Washington, DC, 20002, United States of America (USA).
                [2 ]Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, USA.
                [3 ]School of Early Childhood Studies, Ryerson University, Toronto, Canada.
                Article
                10.2471/BLT.19.229427
                5b00f7b2-03f5-4bfe-ae53-5326b5c2fd67
                © 2019
                History

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