Janet R. Jamieson Susan Lane Assessing Communication and Social/Emotional Development in Children Who Are Deaf and Hard of Hearing: Infancy to Early School Age Janet R. Jamieson Susan Lane Educational & 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