This purpose of this study was to examine pragmatic differences in children with hearing loss compared to children without hearing loss by understanding use of communication repairs, self and peer attitudes and perceptions to suggest the most appropriate intervention approaches. Previous research has found use of communication repairs, self and peer perceptions and attitudes to be associated with pragmatic skills. Intervention approaches were suggested for remediating pragmatic differences in children with hearing loss. / text

Magister Artium (Social Work) - MA(SW) / Overwhelming evidence suggests that 90% of children with a hearing loss are born to hearing parents. Research indicates that often these hearing parents are ill-informed about the cause and type of hearing loss their child has, leading the hearing parents to feelings of grief and disempowerment. Many hearing parents at the time of the diagnosis experience emotional turmoil as the diagnosis is often unexpected, resulting in a plethora of questions asked. The research approach for the study was qualitative in nature as it set out to explore and describe the experiences of hearing parents of their child’s hearing loss. A phenomenological strategy of design was employed to capture the lived experience from the hearing parents. Data was collected by means of unstructured individual in-depth interviews with 11 hearing parents. Volunteer and snowball sampling were implemented so as to access hearing parents whose children had been diagnosed with hearing loss. Data was analysed according to Creswell (2007) and Klenke (2008) and the trustworthiness of the qualitative study was evaluated against the criteria that Guba described in Krefting (1991). Ethical considerations, such as voluntary participation, informed consent, confidentiality, anonymity, no harm done and debriefing, were adhered to. After the conclusion of the research analysis, the findings of the research were discussed and recommendations were made. The findings of the recommendations spoke to the better understanding of the emotions and challenges of hearing parents as well as putting forward suggestions for supportive coping mechanisms to be put in place to support hearing parents whose children have been diagnosed with a hearing loss.

When families use a listening and spoken language approach to communicate with their child, access to a rich linguistic environment through an intact auditory system is essential. In children with hearing loss, optimal auditory access is achieved through the consistent use of appropriately fitted hearing devices or other assistive hearing technology, allowing these children access to an ample language environment. Parents or caregivers of children with hearing loss or hearing concerns play a large role in facilitating their child’s use of hearing devices and supporting their child’s speech and language development, a potentially overwhelming experience for these families. The "Little Ears, Enormous Purpose" (LEEP) project was created three years ago to educate caregivers of children with hearing devices and build caregiver self-efficacy, i.e., their confidence to optimize their child’s amplification use and linguistic exposure, increase family knowledge on language outcomes, and increase consistent use of amplification. This was done through an online educational workshop to families with children identified with hearing loss and/or hearing concerns. The current study is a continuation of the LEEP project and provides data for the 2022-2023 cycle. Feedback from students, faculty, and families has been implemented to improve and create methods for the 2022-2023 cycle. In this study, three to four in-person individualized educational intervention meetings were held with the families and encompassed the impact of hearing loss and/or hearing concerns on language development, the importance of language exposure, the use and care of amplification/treatment options, and empowerment to establish consistent device use in families that utilize amplification or other technology. The families’ self-efficacy skills were assessed through a pre- and post-survey, the Scale of Parent Involvement and Self-Efficacy-Revised (SPISE-R). The SPISE-R questions caregivers about their child’s device use and their perceptions of their beliefs, knowledge, confidence, and actions to support their child’s auditory access and spoken language development. The assessment and workshop incorporated in this study were modeled after Ambrose et al. (J Early Hear Detect Interv, 2020), who developed the SPISE-R as a promising tool for use in early intervention to better understand and further support parent’s strengths and needs concerning their young child’s auditory access and spoken language development. We hypothesize a significant increase in parental understanding and confidence between the pre-survey and post-survey as a result of the series of intervention meetings. Participants were recruited through the ETSU Nave Center with the use of flyers. A total of two pre-surveys were completed. Two families attended all individualized sessions, with both families also completing the post-survey. Data analysis is in process using a paired samples T-test.

In South Africa, the current movement towards the inclusion of children with disabilities, including children with hearing loss, is likely to have far-reaching consequences for both teachers and learners. Undoubtedly, needs will arise from teachers during the transition, especially in the areas pertaining to the audiological and educational management of children with hearing loss. A hearing loss often negatively impacts on the development of the child’s auditory, language, speech, communication, literacy, academic, and psychosocial skills. The educational audiologist is uniquely skilled in managing the effects of hearing loss on the child’s educational development, and is a crucial member on the educational team. The educational audiologist as specialist in the management of children with hearing loss, is able to offer a wide range of support and assistance to teachers as well as children with hearing loss in the inclusive educational system. When teachers receive appropriate educational audiology services, they are enabled to provide quality education that strives to reach the full potential of every child with hearing loss. Therefore, an urgent need existed to determine the needs of teachers of children with hearing loss regarding an educational audiology service delivery model for use within the inclusive educational system. In order to comply with this need, a descriptive research design was developed comprising of a questionnaire survey followed by focus group interviews. The questionnaire survey explored the needs of 664 teachers of children with hearing loss. Focus group interviews were conducted with 19 teachers of children with hearing loss and these results were used to substantiate findings from the questionnaire survey. The results of the study indicated that the needs of teachers differ according to the sub-groups found among teachers, namely those teachers who mainly promote the use of spoken language and those who mainly promote Sign Language. Findings revealed that, although participants realised the importance of various aspects of development of the child with hearing loss, they generally did not realise the importance of receiving support from an educational audiologist. With respect to specifics in term of support, participants strongly recommended that teachers receive support in the acquisition of knowledge re the trouble-shooting of hearing aids, advocacy for the implementation of FM systems in inclusive classrooms and the development of speech production skills of the child with hearing loss in the inclusive environment. In addition, various suggestions were made regarding the structure of services rendered within the educational context. These findings were utilised in order to propose an educational audiology service delivery model for South Africa in the current timeframe. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2005. / Speech-Language Pathology and Audiology / unrestricted

Background: Many hearing impaired children present with one or more health-related conditions, in addition to hearing loss. Families and professionals are therefore faced with numerous challenges when a child presents with co-morbidities of hearing loss. The implications for assessment, management and educational placement of these children are numerous. Appropriate plans for holistic intervention and education are essential for the development of the child as well as improved life quality. This study therefore aimed to describe the co-morbidities that pre-school children with hearing loss present with at the Centre for Language and Hearing Impaired Children (CLAHIC), and its implications for management. Method: A descriptive, retrospective research design was employed for the purpose of this study. A non-probability, purposive sampling strategy was implemented to select the records of children diagnosed with a hearing loss, and who have attended CLAHIC from 1999 to 2010. The records of 62 children were reviewed. Results: The more prevalent co-morbidities identified in this study were fine motor delay, gross motor delay, visual motor integration disorder, bilateral integration disorder , apraxia of speech and attention deficit hyperactivity disorder. Further findings of the study indicated that the co-morbidities of hearing loss are independent of the degree of the hearing loss. It was however found that there is an increased risk for fine-motor difficulties across the sample. Implications: The findings of this research suggest that pre-school children with hearing loss, irrespective of degree of hearing loss, should be screened and or monitored for the risk of prevalent co-morbidities, such as fine and gross motor difficulties. A collaborative, holistic and multi-disciplinary team approach should be implemented to ensure that services are provided to improve the life quality and development of the hearing impaired child.

The entire context of South African education is undergoing a slow, yet definite metamorphosis, and inclusion is now nationally both a constitutional imperative and an unequivocal reality. Teachers are the key role-players in determining the quality of implementation of this new policy. They are expected to embrace the new philosophy, to think and to work in a new frame of reference. Unfortunately, too often change in education has failed because insufficient attention has been paid to the challenges posed to those who are expected to put the change into effect. Against this background the aim of this study is to determine the challenges posed to the teacher of the child with a hearing loss in inclusive education. In order to attain this aim, the study was divided into two sections: a literature study and an empirical study. The literature study offers a review of the development of the inclusive philosophy, with specific reference to the educational inclusion of the child with a hearing loss. The knowledge and attitude of teachers towards inclusive education as well the responsibilities of the teachers of a child with a hearing loss within the South African education system are critically discussed. During the empirical research a descriptive design was followed comprising of questionnaire surveys followed by focus group discussions. The questionnaire surveys explored the knowledge, attitudes and training needs of 220 teachers and 81 student teachers. Focus group discussions were conducted with four parents, five speech therapist/audiologist and four teachers (all actively involved in inclusion programmes) and these results were used to substantiate findings from the questionnaire survey. The results of this study indicate that the teachers in regular education as well as the student teachers had sufficient knowledge about the theoretical aspects of inclusion but they lack knowledge regarding the child with a hearing loss. Aspects that were significantly related to the teachers’ lack of knowledge were their unwillingness to include a child with hearing loss and to a lesser extent their years of teaching experience. It was clear that both the teachers and student teachers appear to have negative attitudes towards the inclusion of children with hearing loss. The negative attitudes of the teachers were, as in the case of knowledge, significantly related to their unwillingness to include a child with a hearing loss and their years of teaching experience, but also to their personal experience with hearing loss. The teachers and student teachers indicated specific needs in terms of further training and the content of training. A wide variety of demands that are posed to teachers with regard to the unique South African context were identified, for example lack of support, lack of training, high teacher/child ratios etc. The implications of this study, which amongst other factors include the motivation for the promotion of educational audiology in order to support and train the teachers of children with a hearing loss in inclusive education, are discussed. The education system is challenged to address the needs of teachers in order to ensure the successful implementation of inclusive education for children with hearing loss. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2004. / Speech-Language Pathology and Audiology / unrestricted

Many positive outcomes have been documented for children with hearing loss utilizing current treatment approaches such as early identification and intervention, including appropriately fit sensory devices and communication modes that focus on listening and spoken language. However, challenges related to social-emotional development have been widely observed. The development of communication skills in children with hearing loss is impacted by many factors, including the degree of hearing loss, the child's age at onset and identification, the presence of other disabilities, and when the child receives intervention. While there are a variety of therapeutic options available for children with hearing loss to develop communication skills, listening and spoken language is of particular interest to parents with normal hearing. In addition to affecting social competence and participation, problems with social-emotional development are linked to poor academic performance. This study examined the social-emotional development of a small group of young children who communicated using listening and spoken language as measured by parent and caregiver report. Three psychosocial scales were used to evaluate the children's social-emotional development in comparison to peers. These results were analyzed within the context of other demographic variables. One of the five children was identified as facing problems with social-emotional development.

This phenomenological study investigated the nature and extent of the support parents received during IEP development. The study was informed by Bronfenbrenner's ecological systems theory. Participants, located in a Northeastern state, were 10 hearing parents of children who had been diagnosed with hearing loss at birth and were between ages 5 and 12. Data were in-depth interviews that were analyzed, coded, and organized into themes using an inductive approach to analysis informed by Hatch. Results indicated that parents believed they needed more guidance on what to expect during the first IEP meeting, that advocating for appropriate accommodations for their child was important, and that education professionals communicate in a more compassionate and less business-like manner when speaking with parents. Parents also indicated increased anxiety due to their perceptions that education professionals have inadequate knowledge about issues relating to hearing loss and hearing amplification technology. Based on these results, special education professionals and policy makers can focus on increased understanding of hearing loss and amplification use in order to help children with hearing loss achieve more positive educational outcomes effecting positive social change.

La présente recherche explore les conséquences d’une perte auditive périphérique sur le traitement de l’information auditive. Des études ont montré que les enfants malentendants ont de la difficulté à effectuer des tâches d’écoute complexes. De plus, des études menées auprès d’adultes malentendants montrent que l’activité corticale associée à l’écoute de stimuli auditifs est différente de celle d’adultes entendants. Cependant, les résultats de ces études ne mettent pas en lumière la nature des difficultés de traitement de l’information auditive des enfants malentendants. Cette recherche examine donc cet aspect en ayant recours à des mesures comportementales et neurophysiologiques. Les données ont été recueillies auprès de 40 enfants âgés de 9 à 12 ans : 12 enfants ayant une surdité neurosensorielle, 12 enfants ayant trouble de traitement auditif et 16 enfants normo-entendants. Les enfants ont reproduit dans l’ordre des séquences de deux, trois et cinq stimuli verbaux ou non verbaux avec un intervalle interstimuli de 425 ms. Les enfants ont également reproduit des séquences de deux stimuli avec un intervalle interstimuli de 20 et 1000 ms. Enfin, les enfants ont été soumis à des mesures neurophysiologiques à partir de potentiels évoqués auditifs de latence longue et de négativité de discordance avec des paires de stimuli verbaux et non verbaux. Les résultats obtenus permettent d’avancer que les participants du groupe d’enfants malentendants ont un trouble spécifique de traitement auditif. En effet, les résultats de la tâche comportementale montrent que les enfants malentendants ont de la difficulté à traiter des séquences de stimuli lorsque ceux-ci sont verbaux et acoustiquement similaires. Quant aux données neurophysiologiques, les résultats ont démontré que l’amplitude de l’onde tardive N2 était réduite chez les enfants malentendants comparativement à celle de l’onde N2 des deux autres groupes d’enfants. Cette onde pourrait être considérée comme étant un marqueur neurophysiologique reflétant l’influence d’une perte auditive sur le traitement auditif central. De plus, l’amplitude de l’onde de négativité de discordance pourrait être aussi un marqueur pour distinguer les enfants malentendants de ceux ayant un trouble de traitement auditif.Mots-clés : organisation séquentielle auditive, potentiels évoqués auditifs de latence longue, négativité de discordance, enfants malentendants d’âge scolaire / The present research explores the effects of peripheral hearing loss on central auditory processing. Previous studies showed that children with hearing loss have significant difficulties in performing complex listening tasks. Moreover, studies of adults with hearing loss revealed that cortical activity related to listening to acoustic stimuli differed from that of adults without hearing loss. However, results of these studies do not clarify the nature of the difficulties in processing auditory information among children with hearing loss. The present research examines this issue using behavioural and neurophysiological measures. Behavioural and neurophysiological data were collected with forty 9- to 12-year-old children: 12 with hearing loss, 12 with central auditory processing disorder (CAPD) and 16 with normal hearing. Children repeated, in order, two, three, and five verbal and nonverbal stimuli with an interstimulus interval of 425 ms. They also repeated sequences of two stimuli with an interstimulus interval of 20 or 1000 ms. Finally, late-latency auditory evoked potentials and mismatch responses were recorded in the participants using pairs of verbal and nonverbal stimuli. Results suggest that children with hearing loss have a specific central auditory processing disorder. Results of the behavioural task showed that children with hearing loss had difficulty processing sequences of stimuli when the stimuli were verbal as well as similar and complex acoustically. As for the neurophysiological data, results indicated that the amplitude of late N2 waveform was smaller in children with hearing loss than in the other two groups of children. The N2 waveform has the potential to be a neurophysiological marker revealing the influence of hearing loss on central auditory processing. Moreover, the amplitude of the mismatch response could be another marker to distinguish the children with hearing loss from those with central auditory processing disorder. Keywords : Auditory sequential organization, late-latency auditory evoked potentials, mismatch responses, school-aged children with hearing loss

La présente recherche explore les conséquences d’une perte auditive périphérique sur le traitement de l’information auditive. Des études ont montré que les enfants malentendants ont de la difficulté à effectuer des tâches d’écoute complexes. De plus, des études menées auprès d’adultes malentendants montrent que l’activité corticale associée à l’écoute de stimuli auditifs est différente de celle d’adultes entendants. Cependant, les résultats de ces études ne mettent pas en lumière la nature des difficultés de traitement de l’information auditive des enfants malentendants. Cette recherche examine donc cet aspect en ayant recours à des mesures comportementales et neurophysiologiques. Les données ont été recueillies auprès de 40 enfants âgés de 9 à 12 ans : 12 enfants ayant une surdité neurosensorielle, 12 enfants ayant trouble de traitement auditif et 16 enfants normo-entendants. Les enfants ont reproduit dans l’ordre des séquences de deux, trois et cinq stimuli verbaux ou non verbaux avec un intervalle interstimuli de 425 ms. Les enfants ont également reproduit des séquences de deux stimuli avec un intervalle interstimuli de 20 et 1000 ms. Enfin, les enfants ont été soumis à des mesures neurophysiologiques à partir de potentiels évoqués auditifs de latence longue et de négativité de discordance avec des paires de stimuli verbaux et non verbaux. Les résultats obtenus permettent d’avancer que les participants du groupe d’enfants malentendants ont un trouble spécifique de traitement auditif. En effet, les résultats de la tâche comportementale montrent que les enfants malentendants ont de la difficulté à traiter des séquences de stimuli lorsque ceux-ci sont verbaux et acoustiquement similaires. Quant aux données neurophysiologiques, les résultats ont démontré que l’amplitude de l’onde tardive N2 était réduite chez les enfants malentendants comparativement à celle de l’onde N2 des deux autres groupes d’enfants. Cette onde pourrait être considérée comme étant un marqueur neurophysiologique reflétant l’influence d’une perte auditive sur le traitement auditif central. De plus, l’amplitude de l’onde de négativité de discordance pourrait être aussi un marqueur pour distinguer les enfants malentendants de ceux ayant un trouble de traitement auditif.Mots-clés : organisation séquentielle auditive, potentiels évoqués auditifs de latence longue, négativité de discordance, enfants malentendants d’âge scolaire / The present research explores the effects of peripheral hearing loss on central auditory processing. Previous studies showed that children with hearing loss have significant difficulties in performing complex listening tasks. Moreover, studies of adults with hearing loss revealed that cortical activity related to listening to acoustic stimuli differed from that of adults without hearing loss. However, results of these studies do not clarify the nature of the difficulties in processing auditory information among children with hearing loss. The present research examines this issue using behavioural and neurophysiological measures. Behavioural and neurophysiological data were collected with forty 9- to 12-year-old children: 12 with hearing loss, 12 with central auditory processing disorder (CAPD) and 16 with normal hearing. Children repeated, in order, two, three, and five verbal and nonverbal stimuli with an interstimulus interval of 425 ms. They also repeated sequences of two stimuli with an interstimulus interval of 20 or 1000 ms. Finally, late-latency auditory evoked potentials and mismatch responses were recorded in the participants using pairs of verbal and nonverbal stimuli. Results suggest that children with hearing loss have a specific central auditory processing disorder. Results of the behavioural task showed that children with hearing loss had difficulty processing sequences of stimuli when the stimuli were verbal as well as similar and complex acoustically. As for the neurophysiological data, results indicated that the amplitude of late N2 waveform was smaller in children with hearing loss than in the other two groups of children. The N2 waveform has the potential to be a neurophysiological marker revealing the influence of hearing loss on central auditory processing. Moreover, the amplitude of the mismatch response could be another marker to distinguish the children with hearing loss from those with central auditory processing disorder. Keywords : Auditory sequential organization, late-latency auditory evoked potentials, mismatch responses, school-aged children with hearing loss