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
Psychology, & Special Ed.
UBC
BC Family Hearing
Resource Centre
How Does Hearing Loss
Impact Development?
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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?
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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?
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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
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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...
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determine if child needs help
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design an appropriate plan
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monitor change in child and family to
determine if intervention is resulting in
positive outcomes
What we look at when we assess...
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child-caregiver interactions
listening
play
vocalizations / speech
gestures
vocabulary development
combining of words / signs
pragmatics
What assessment tools do you use?
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etc…..
Special Considerations when
Assessing a Child
with a Hearing Loss
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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.
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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
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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
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Medical
– Family Physician
– Ear, Nose, & Throat Physician (ENT)
– Audiologist
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Habilitation
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–
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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!
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E.L.R
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Joshua
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Sam
Your (Very Important) Role
in the Assessment of
Deaf and Hard of Hearing Children
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You are a key team member -- each
member holds a piece of the puzzle
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The overall goal of intervention is to
impact the communication system
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Select assessment tools carefully and
interpret the results with caution