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CSD 5400
REHABILITATION
PROCEDURES FOR THE
HARD OF HEARING
Language and Speech of Deaf and
Hard-of-Hearing
Characteristics and Concerns
Language Acquisition and Development
The Components of
Language
• Form
• The structure of language
• Content
• The meaning of language
• Use
• The goal or purpose of language
The Five Rule Systems of
Language
Form
Syntax
Rules for combining words into sentences
Morphology
Rules for combining speech sounds into meaningful units
Phonology
Rules for combining speech sounds to make words
Content
Semantics
Rules for combining words and meaning of words
Use
Pragmatics
Rules for conversation
Some Characteristics of
Normal Language
Acquisition
 A process that occurs in




natural contexts
Only requirement is
repeated opportunities for
meaningful conversation
with adults
Children are cognitively
programmed to learn
language
No one language is
universal
No one language is easier or
harder to learn
When Things Interfere with
Acquisition…
Problems arise
when..
 Language is used
inconsistently by
adults
 Obstacles prevent
full access to the
language
Factors Affecting the Degree
of Language Difficulties
Language learning difficulties vary
depending on:
1. The degree of hearing loss
2. Intelligence
3. Family communication styles
4. Intervention programs the child
ultimately is exposed to
Effect on the
Mother-Child Bond
Deafness has the potential to impair
the communication between a child
and his hearing parents
This has become a recent “hot topic” in
the literature regarding psychosocial
effects of deafness
Early Bonds
Understanding the effect of deafness on the
early bonds between mother and child is
important because:
1. Communication is integral to the
emotional bond between parents and
their children
2. It is only through the conversations
between children and their parents that
the rules of language are acquired
The First Six Months
“Motherese”
The way parents
interact in a
meaningful way with
their young babies
Motherese
Some characteristics of the linguistic
forms used by mothers with their
young babies:
1. Simple, well-formed, clear
linguistic forms
2. High pitch
3. Exaggerated stress and intonation
Interactions Between Hearing
Parents and Their Deaf Babies
A study by Meadow-Orlans & Steinber
(1993) concluded:
 Hearing mothers were less likely to use
frequent and positive touch with their
deaf infants
 Hearing mothers were less sensitive,
more intrusive, less flexible, and less
consistent in their responses to their
deaf infants compared to mothers who
were deaf
The Second Six Months
Evidence of
intentional
communication
The use of gestures
and nonverbal
communication
Parent-Child Interactions
During this Period
Parents of hard-of-hearing
children have interactions with
their children that are more
directive than interactive
Conversations are rather onesided
 Failure to respond to the child’s
communication behavior

Spencer (1993)
Compared differences and similarities of
various communication behaviors between
normally hearing moms and their normally
hearing 1-1.5 year olds and normally
hearing moms and their deaf 1-1.5 year
olds
The deaf children in this study were
identified early and were receiving
intervention (amplification and language
intervention) before 12 months
Spencer (1993)
Spencer found no significant
differences between the two groups in
terms of the quantity of
communication behaviors, gestures
and vocalizations, but did find
significant differences between the
two groups in terms of the kinds of
vocalizations and verbal productions
Preschool Language
Knowledge of schema
Facilitates language
development
Hearing Impairment
Limits schema
 Limited access to
family’s use of
language
 Reduces
opportunity for
incidental learning
Relationship Between
Hearing Loss and Language
Deficit
Linguistic skills vary
tremendously due to:
1.
2.
3.
4.
5.
Speech understanding
Benefit from amplification
Individual learning
characteristics
Intelligence
Family communication
styles
Common Trends
1. Language delay
2. Language skill plateau
3. Deaf children show evidence of
deviant linguistic forms
Phonology
Normal but delayed
Deaf children show deviant
development
Syntax
Normal but delayed
 Restricted
knowledge of word class
 Restricted knowledge of different
syntactic forms
Deaf children show evidence of deviant
syntax
Morphology and Vocabulary
A study by Moeller (1986):
Peabody Picture Vocabulary Test (PPVT) and
Boehme Test of Basic Concepts
Deaf children in a residential program 4-20 years
old
PPVT score means were equivalent to normally
hearing 6-8 year olds; little improvement after
age 12
Boehme scores of 16-18 year olds equivalent to
normally hearing 6-8 year olds
Expressive vocabulary of deaf 4 year olds
averaged 150 words
Morphology and Vocabulary
A study by Davis (1986):
Mild-to-moderate hearing impaired first, second,
and third graders (Iowa) mainstreamed in
regular classrooms
Boehme scores and PPVT scores
PPVT delay of 1-3 years
75% of the sample scored below the 10th percentile
on the Boehme
Another Case for Early
Identification
Children with hearing
loss identified before 6
months show
significantly higher
vocabulary and
language acquisition
skills even three years
later, compared to
children identified
after 6 months
Semantics and Pragmatics
Semantics

Delay
Pragmatics

Turn-taking, topic initiation and
maintenance
Language Assessment and
Hard-of-Hearing/Deaf Kids
Language assessment
can be accomplished
by:
Communication
checklists
Formal language tests
Language sample
analysis
Language Assessment Tests
Developed Especially for Hearing
Impaired Children
Test of Syntactic Ability (TSA)
Grammatical Analysis of Elicited
Language (GAEL)
Spontaneous Language Analysis
Procedure (SLAP)
Carolina Picture Vocabulary Test
Rhode Island Test of Language Structure
Scales of Early Communication Skills
SKI-HI Language Development Scale
Cautions Using Other
Assessment Measures
Remember to:
1. Avoid IQ/mental age
scores and
interpretations
2. Think about the
response required from
the child and additional
bias
3. Maximize acoustic and
visual cues during the
assessment
4. The assessment must
be given by someone
proficient in the child’s
first language, whatever
it is
A Few Words About
Treatment Goals…
Treatment goals for your hard-of-hearing
child should include:
Enhanced parent-child communication in the
chosen communication modality/language
Understanding of increasingly complex concepts
and discourse
Acquisition of lexical and world knowledge
Development of verbal reasoning skills to foster
literacy
Enhanced self-expression and acquisition of
pragmatic, syntactic, and semantic rules
Development of spoken, written, and/or signed
narrative skills