Search Results (26)

Globally, many countries have promulgated extensive, contextually relevant disability legislative policies for children with hearing impairment/d/Deafness (HI/d/D). The alignment of policies with their implementation, with robust monitoring, is essential for effective early intervention (EI) and early education (EE) outcomes. The study’s purpose was to review current South African EI and EE regulations, acts, and policies in relation to children with HI/d/D from birth to age six. An adapted Arksey and O’Malley framework with inductive thematic analysis was applied to synthesise and evaluate relevant information. Documentation was sourced between 1993 and 2023 from the official South African government portal and Google online searches using keywords. While 7976 documents were initially identified with the broad search and 1249 with a refined category search, only 17 met the specific inclusion criteria for policies referencing hearing impairment in early intervention and education. Seventeen documents were selected for study inclusion, with sixteen mentioning HI/d/D and multi-disciplinary, multi-sectoral, family-centred, culturally sensitive considerations superficially. One document from the Department of Health (DoH) specifically addressed early hearing detection and intervention (EHDI). Three main themes emerged, including Partnerships, Participation and Integration, Screening, Identification and/or Intervention, and Education/Special Education. Greater engagement with South African EI and education policies is essential to strengthen implementation, especially across sectors and at the community level. Mandating EHDI guidelines is critical to improving service delivery and ensuring smoother transitions between health, education, and social services for children with hearing impairment. Full article

Background: Early Hearing Detection and Intervention (EHDI) is essential for minimising the negative impact of childhood hearing loss on speech, language, and cognitive development. However, in low- and middle-income countries such as South Africa, various challenges hinder the implementation of EHDI services, leading to delayed diagnosis and intervention. Aim: This study explores caregivers’ experiences with EHDI services, identifying key challenges and facilitators affecting access and timely intervention. Methods: A narrative inquiry approach was used as part of a broader research initiative on family-centred EHDI. Nine caregivers of children who are deaf or hard of hearing (DHH) were purposively sampled, and data were collected through semi-structured interviews. Results: Thematic analysis revealed systemic and structural challenges, logistical and financial constraints, and caregiver-related factors that hindered access to EHDI services. Key facilitators included caregiver knowledge and advocacy, family support services such as counselling and South African Sign Language training, and high-quality audiological and educational services. Conclusions: Findings emphasise the need for policy-driven reforms, including expanding newborn hearing screening programmes, improving financial assistance mechanisms, and increasing public awareness. Addressing these challenges and leveraging facilitators can help South Africa align with global EHDI benchmarks and improve outcomes for DHH children. Full article

Background/Objectives: Globally, many countries have endorsed the World Health Organisation’s (WHO) early intervention (EI) guidelines through their legislation with contextual variations. Sensitive evaluation of gaps within EI-recommended systems is essential, especially in the translation of policy into practice across high-income and low- to middle-income country (LMIC) contexts, including South Africa. The main objective was to explore and identify the current evidence reflecting the application of hearing-specific government policy regarding EI and early education (EE) for hearing-impaired/d/Deaf/hard-of-hearing (HI/D/HH) children aged six and below. Method: An integrative review was conducted on peer-reviewed articles that examined policy in practice regarding EI for HI/D/HH children aged six and below. Studies were accessed via four databases (Ebscohost, Sabinet, Scopus, and ScienceDirect) and one search engine (Google Scholar) between 2014 and 2024. Qualitative evaluation ensued of themes identified deductively. Results: Twenty-six peer-reviewed studies were included. Deductive thematic analysis revealed six derived themes: EI timing, early hearing detection and intervention (EHDI)/EI mechanisms; EI services, EE, family considerations, and policy. Five of the 26 directly scrutinised government policy in its EI/EE practical application. Articles reflected the need for consideration of the complex processes that allow for policy actualisation, such as adequate infrastructure and family considerations. Conclusions: A bottom-up approach to policy actualisation, with grass-roots contextual considerations such as EI access and caregiver concerns, may improve policy application. Current findings have implications, particularly for LMIC contexts including South Africa, where EI and EE policy scrutiny regarding hearing impairment/deafness specificity is imperative for understanding its application alignment. Full article

Italian Sign Language (LIS) is the primary form of communication for many members of the Italian deaf community. Despite being recognized as a fully fledged language with its own grammar and syntax, LIS still faces challenges in gaining widespread recognition and integration into public services, education, and media. In recent years, advancements in technology, including artificial intelligence and machine learning, have opened up new opportunities to bridge communication gaps between the deaf and hearing communities. This paper presents a novel educational tool designed to teach LIS through SIGNIFY, a Machine Learning-based interactive serious game. The game incorporates a tutorial section, guiding users to learn the sign alphabet, and a classic hangman game that reinforces learning through practice. The developed system employs advanced hand gesture recognition techniques for learning and perfecting sign language gestures. The proposed solution detects and overlays 21 hand landmarks and a bounding box on live camera feeds, making use of an open-source framework to provide real-time visual feedback. Moreover, the study compares the effectiveness of two camera systems: the Azure Kinect, which provides RGB-D information, and a standard RGB laptop camera. Results highlight both systems’ feasibility and educational potential, showcasing their respective advantages and limitations. Evaluations with primary school children demonstrate the tool’s ability to make sign language education more accessible and engaging. This article emphasizes the work’s contribution to inclusive education, highlighting the integration of technology to enhance learning experiences for deaf and hard-of-hearing individuals. Full article

During the COVID-19 pandemic, many DeafBlind children were left without access to educational services when schools went remote. This article presents findings from a project that brought DeafBlind adults into the homes of DeafBlind children during a historically unprecedented time, when a new language was emerging among DeafBlind people who call themselves “Protactile”. In analyzing interactions between the DeafBlind adults and children, we have gained new insights into how novel communication channels are forged intersubjectively. We focus our analysis on Jelica, a DeafBlind member of the research team and experienced Protactile educator, and her interactions with two DeafBlind children. Grounding her extensive field notes in an anthropological theory on intersubjectivity, her insights show how they gradually became attuned to each other and their environment, thereby laying the foundation for intention attribution and joint attention. Jelica does this, in part, via frequent use of “Protactile taps”, which have attention-modulating and demonstrative functions among adults. Jelica’s taps perform a “meta-channel” function to direct the child to use particular parts of their bodies for communication and exploration. This study shows how Jelica establishes an operable environment, within which the vocabulary and grammar she exposes them to will take on situated meaning. This research builds on previous work on language emergence by showing that both children and adults contribute to language emergence as they adjust to one another in the unfolding of interaction. Finally, this research calls attention to the need for DeafBlind adults to have institutional authority to shape communication practices for DeafBlind children. Full article

The international recognition of the critical importance of the early childhood phase has been firmly established through decades of rigorous research, evidence-based practices, and undeniable evidence of the returns on investment made during this formative period. Consequently, early childhood development has emerged as a top priority on both national and international agendas. This momentum reached a pinnacle in 2015 with the unanimous adoption of the 17 Sustainable Development Goals (SDGs) by the United Nations, which placed a particular emphasis on children under the age of five within the education-focused SDG 4, notably target 4.2, centered on ensuring that all girls and boys are ready for primary education through the provision of accessible “quality early childhood development, care and pre-primary education”. However, the Global South reflects the glaring omission of addressing the needs of children at risk of poor development due to disabilities. This paper underscores the imperative for specialized early childhood intervention tailored to young children with disabilities and their families, commencing as early as possible following birth. It advocates for Early Childhood Intervention (ECI) as a service distinct from general Early Childhood Development (ECD), emphasizing the crucial role of families as active partners from the outset. Furthermore, the paper strengthens the case for Family-Centered Early Childhood Intervention (Fc-ECI) through the integration of evidence-based practices and an in-depth description of one such program in South Africa with specific reference to deaf and hard-of-hearing infants and their families. This model will be guided by core concepts outlined in WHO and UNICEF Early Childhood Intervention frameworks. Through this exploration, the paper aims to shed light on the urgent need for inclusive approaches to early childhood development, particularly for children with disabilities, and to advocate for the adoption of Family-Centered Early Childhood Intervention as a cornerstone of global efforts to ensure the holistic well-being and development of all children. Full article

Research in the field of human–robot interactions (HRIs) has advanced significantly in recent years. Social humanoid robots have undergone severe testing and have been implemented in a variety of settings, for example, in educational institutions, healthcare facilities, and senior care centers. Humanoid robots have also been assessed across different population groups. However, research on various children groups is still scarce, especially among deaf children. This feasibility study explores the ability of both hearing and deaf children to interact with and recognize emotions expressed by NAO, the humanoid robot, without relying on sounds or speech. Initially, the children watched three video clips portraying emotions of happiness, sadness, and anger. Depending on the experimental condition, the children observed the humanoid robot respond to the emotions in the video clips in a congruent or incongruent manner before they were asked to recall which emotion the robot exhibited. The influence of empathy on the ability to recognize emotions was also investigated. The results revealed that there was no difference in the ability to recognize emotions between the two conditions (i.e., congruent and incongruent). Indeed, NAO responding with congruent emotions to video clips did not contribute to the children recognizing the emotion in NAO. Specifically, the ability to predict emotions in the video clips and gender (females) were identified as significant predictors to identify emotions in NAO. While no significant difference was identified between hearing and deaf children, this feasibility study aims to establish a foundation for future research on this important topic. Full article

In the history of deaf education, questions attending communication, language, and modality have generated much discussion, and even heated debate. This should not be surprising as these questions touch on a fundamental issue that is central to policy and practice in the field—how to provide early, ready, and meaningful linguistic access. While one point of agreement is that such access is vital for age-appropriate language and literacy development, there is less consensus on how this access should be realized. This focus has heightened consequences and significance in the current context in which auditory access to spoken language is possible for the majority of deaf children. With a goal of reframing the conversation, the focus of this article will be on making the critical distinctions between language and modality that can inform understandings as to how access can be best achieved for an increasingly diverse population of deaf children and their families. Full article

The present narrative synthesis summarizes perspectives on the development of identity, or a sense of self, and the intersectionality of salient factors related to individuals who are d/Deaf and hard of hearing. Prior research indicates that identity encompasses the stories of an individual’s experiences and relationships; identity development may not be static but rather dynamic and ongoing throughout an individual’s lifetime. After this general background, the article focuses on identity and deafness, particularly for children in K-12 educational settings. There are a multitude of factors—physiological (e.g., hearing acuity, appearance, gender), psychological (e.g., memory, intelligence, affective behaviors), and social (e.g., education, home or immigrated environment, ethnicity, group membership)—that contribute to the development of identity. This discussion is based on a synthesis of a variety of published sources; however, as much as possible, the focus is on empirical research conducted with children and young adults who are d/Deaf and hard of hearing. Results of the narrative synthesis suggest several topics around which the extant research coalesce: traditional and evolving views of d/Dhh identity, d/Dhh identity as fluid, identity development through relationships, identity and children with cochlear implants and those who are hard of hearing, the role of educational experiences, and intersectional identity development. The article concludes with a summary and recommendations for further investigation. Full article

Background and objectives: More and more children with severe-to-profound hearing loss are receiving cochlear implants (CIs) at an early age to improve their hearing and listening abilities, speech recognition, speech intelligibility, and other aspects of spoken language development. Despite this, the rehabilitation outcomes can be very heterogeneous in this population, not only because of issues related to surgery and fitting or the specific characteristics of the child with his/her additional disabilities but also because of huge differences in the quality of the support and rehabilitation offered by the therapist and the family. These quality standards for the rehabilitation of young deaf children receiving CIs are developed within the European KA202 Erasmus+ project “VOICE”—vocational education and training for speech and language therapists and parents for the rehabilitation of children with CIs, Ref. No.: 2020-1-RO01-KA202-080059. Material and methods: To develop these quality standards, we used the input from the face-to-face interviews of 11 local rehabilitation experts in CIs from the four partner countries of the project and the outcomes of the bibliographic analysis of 848 publications retrieved from six databases: Pub Med, Psych Info, CINAHL, Scopus, Eric, and Cochrane. Based on all this information, we created a first set of 32 quality standards over four domains: general, fitting, rehabilitation, and for professionals. Further on, the Delphi method was used by 18 international rehabilitation experts to discuss and agree on these standards. Results: The results from the literature analysis and the interviews show us that more than 90% of the consulted international experts agreed on 29 quality standards. They focus on different aspects of rehabilitation: the multidisciplinary team, their expertise and knowledge, important rehabilitation topics to focus on, and programming issues related to rehabilitation. Conclusions: These quality standards aim to optimize the activity of speech rehabilitation specialists so that they reach the optimal level of expertise. Also presented is the necessary equipment for the IC team to carry out the rehabilitation sessions in good conditions. This set of quality standards can be useful to ensure the appropriate postoperative care of these children. As a result, the rehabilitation process will be more relaxed, and therapists will have the opportunity to focus more on the specific needs of each child, with the provision of quality services, which will result in better results. This theme is particularly complex and dependent on multifactorial aspects of medicine, education, speech therapy, social work, and psychology that are very intricate and interdependent. Full article

The population of students who are d/Deaf or hard of hearing (d/Dhh) with a disability have unique educational needs. Various terms have been used to describe this population, including “deaf plus”, “deaf with additional disabilities”, and most recently, “deaf with disabilities (DWD)”. Currently, there is no agreement on the percentage of DWD students in PreK-21 settings but is considered to comprise at least 40–50%. An individual who is DWD has a hearing loss and one or more disabilities, including (but not limited to) visual impairment or blindness, autism spectrum disorder, intellectual or developmental disabilities, specific learning disabilities, health impairments, etc. The critical consideration is that the interaction between hearing loss and the disability(ies) is not simply additive but rather multiplicative, impacting communication, cognition, social development, and behavior. Furthermore, the presence of hearing loss may decrease accurate identification of other disabilities and vice versa. Although the incidence of students who are DWD is quite high, there is inadequate research as these students are often excluded from studies focused on children who are d/Dhh. This article explores what we currently know about DWD students, and the knowledge and skills needed by teachers in the 21st century to meet the needs of these students and their families. Full article

Permanent childhood hearing impairment (PCHI) represents the most frequent sensory pathology at birth. PCHI has a relevant psychological impact on the life of both the affected children and their families. Thus, the aim of this work is to explore the degree of parental distress felt by mothers of a deaf or hard-of-hearing child, to determine if this stress is associated with variables related to the children’s health (e.g., the severity of hearing loss, presence of other conditions, difficulty with treatment options, difficulty with rehabilitation) or family characteristics such as socio-economic and educational status. The study used the Parenting Stress Index–Short Form (PSI-SF) questionnaire administered to mothers. The results were analyzed in relation to variables such as parents’ education level, number of children, severity of hearing loss, presence of other chronic conditions, presence of cognitive delay, familiarity with hearing loss, time of diagnosis, use of prosthetics, and start in a rehabilitation program. The data indicate a correlation between maternal stress levels and low-educational levels, as well as the presence of congenital infections and cognitive delay. These results highlight the need for a comprehensive physical and psychological approach for hearing-impaired children, as stress factors can affect the adherence to effective rehabilitation. Full article

This study aimed to evaluate the impact of oral health education (OHE), incorporating a novel pre-validated visual performance reinforcement (VPR) technique and sign language, on gingival health, plaque control, and oral hygiene knowledge and practices in 12 to 15-year-old hearing- and speech-impaired adolescents. A double-blinded randomized controlled trial was conducted in a government school for deaf children in Belagavi, Karnataka, India. A total of 80 adolescents, aged 12–15 years, were randomly assigned, using a computer-generated table of random numbers, into two groups: Group A receiving the VPR technique (n = 40), and Group B receiving sign language (n = 40). A specially designed pre-validated closed-ended questionnaire was administered to both groups, followed by clinical examination to obtain the gingival and plaque index, before intervention and at a 16-week follow-up period. Group A showed a significant increase in the knowledge gained when compared to Group B. Similarly, a significant improvement in oral hygiene practices was also observed in Group A. However, at the 16-week follow-up, there were no statistically significant differences in gingival and plaque scores between the groups. OHE using the VPR technique can be as effective and satisfactory as sign language in the reduction of gingival and plaque scores and in the improvement of knowledge and its application in oral hygiene maintenance among hearing- and speech-impaired adolescents. Full article

Implementing Collaborative Learning (CL) activities to support the education of children is something that must be carefully designed to achieve the desired goals since just having a group of children working on the same activity does not guarantee proper collaboration. It is something that goes from defining the profile of the students to structuring the collaboration according to the learning objectives, the number of children per group, roles defined, and shared resources among others. Designing Computer-Supported Collaborative Learning (CSCL) activities may be even harder to achieve when collaboration is trying to be accomplished by children with some kind of disability due to differences in the way they communicate or understand the world around them, which is why in this study we decided to focus on designing CSCL activities for deaf children. Since there is not a clear path in the literature to achieve effective collaboration among deaf learners, we propose four stages to be followed through a set of 27 cards that were designed to guide designers/developers and educators through the process of co-designing such activities. The cards were implemented in such a way that they were easy to follow along with, with templates that allowed designers of the CL activity to register all the information related to it. Digital and printed versions of the cards were evaluated by researchers and educators with satisfactory results and a prototype for mobile devices was developed and tested by children through individual and collaborative learning activities. Full article

The movement towards inclusive public education for deaf and hard of hearing children (DHH) has steadily gathered momentum during the last fifty years. Both within the United States and abroad, inclusive public education has been facilitated through legislative action with varied results. Varied interpretation of inclusion policy, notably the “Least Restrictive Environment” (LRE) clause of the Individuals with Disabilities Education Act in the United States, an emphasis on assimilation, and a default preference for auditory-oral communication have often resulted in isolating and inaccessible experiences for DHH students in the mainstream. The purpose of this article is to review theory and research on effective practices in inclusion for DHH students. The research is summarized with respect to accessibility, social-emotional considerations, and language policy. It is often asserted that communication access and cultural identity are major factors that impact the successful inclusion of these students with bicultural identity related to greater wellbeing. Deaf schools may be the LRE placement option for some students and source of resource and support for DHH students and educators in all settings. The authors suggest that a shift towards a more inclusive experience in mainstream settings is emerging through the use of Universal Design for Learning (UDL), classroom technology, and culturally responsive education that integrates sign language and Deaf culture to foster bicultural identities. Strategies for effective inclusion include co-enrollment, deaf awareness programming, and consistent policy that equalizes the status of sign languages. Future research is recommended in effective practices in auditory and visual accommodations, integration of technology in K-12 classrooms, and the relation of policy to practice in inclusive education for DHH students. Full article