A Steep Hill to Climb: Identifying the Literacy Crisis for Deaf and Hard of Hearing Students Christine YoshinagaItano, Ph.D.
Download ReportTranscript A Steep Hill to Climb: Identifying the Literacy Crisis for Deaf and Hard of Hearing Students Christine YoshinagaItano, Ph.D.
A Steep Hill to Climb: Identifying the Literacy Crisis for Deaf and Hard of Hearing Students Christine Yoshinaga Itano, Ph.D. Professor University of Colorado, Boulder
THE TIME IS NOW
NO CHILD LEFT BEHIND: INCLUDING THOSE WHO ARE DEAF OR HARD OF HEARING
Early Hearing Detection and Intervention Sensitive Periods of Brain Development An opportunity to develop language in the typical time frame, achieving milestones at the same time as children with normal hearing.
Critical Milestones with the goal of age appropriate language
Screening before 1 month Identification before 3 months Amplification within 1 month from identification Intervention before 6 months
What needs to happen to meet these goals
?
COLLABORATION AND COORDINATION
INTER-AGENCY: BREAKING DOWN THE BARRIERS
INTER-DISCIPLINARY, MULTI-DISCIPLINARY, TRANS-DISCIPLINARY INTERACTION
ACCOUNTABILITY AND DATA MANAGEMENT
FIDELITY OF THE SERVICES PROVIDED
HIGHLY QUALIFIED PROVIDERS
THE OUTCOME OF MEETING EHDI MILESTONES
OPTIMAL OUTCOMES ARE POSSIBLE
AT ALL AGES FROM BIRTH FOR CHILDREN OF FAMILIES WHO HAVE CHOSEN SIGN LANGUAGE AS THEIR PRIMARY MODE OF COMMUNICATION FOR CHILDREN OF FAMILIES WHO HAVE CHOSEN SPOKEN LANGUAGE AS THEIR PRIMARY MODE OF COMMUNICATION FOR CHILDREN IN FAMILIES FROM ETHNIC MAJORITY CULTURE FOR CHILDREN IN FAMILIES FROM ETHNIC MINORITY CULTURES FOR FEMALES AND FOR MALES
OPTIMAL OUTCOMES
FOR ALL CHILDREN WHO ARE DEAF OR HARD OF HEARING – MILD, MODERATE, SEVERE, PROFOUND FOR CHILDREN IN FAMILIES WHOSE MOTHERS HAVE A HIGH SCHOOL EDUCATION OR LESS FOR CHILDREN IN FAMILIES WHOSE MOTHERS HAVE GREATER THAN A HIGH SCHOOL EDUCATION FOR CHILDREN IN FAMILIES ON MEDICAID FOR CHILDREN IN FAMILIES WHO DO NOT RECEIVE MEDICAID FOR CHILDREN WITH HEARING LOSS ONLY FOR CHILDREN WITH HEARING LOSS AND ADDITIONAL DISABILITIES
FAILURE IS NOT AN OPTION IF APPROPRIATE SERVICES ARE NOT PROVIDED, THE LACK OF APPROPRIATE SERVICES CREATES AN ENVIRONMENTALLY -CAUSED DISABILITY AS SERIOUS AS A COGNITIVE DEVELOPMENTAL DELAY
How lasting is the effect?
Longitudinal study of children birth through 84 months (7 years)
Age appropriate vocabulary skills Age appropriate receptive syntax skills
Primary predictors: account for 72% of the variance of the language outcome at 84 months of age. Non-verbal cognitive development Amount of language the child is exposed to in the home Language development at 3 years of age Degree of hearing loss Age of identification and initiation of early intervention Maternal level of education
MCDI-EL and TACL-3 (Baca, 2009)
Some delays still exist
Articulation
Pragmatic language development – the socially appropriate use of language
Expressive syntax
ASSURING QUALITY
ADOPT BEST PRACTICE STANDARDS OF CARE AND IMPLEMENT AN ACCOUNTABILITY SYSTEM
DEVELOP A DATA MANAGEMENT SYSTEM: FOLLOW FROM AGE OF IDENTIFICATION – EHDI DATA BASE HAS THAT POTENTIAL AGE OF IDENTIFICATION, THE AGE OF ACCESS TO LANGUAGE/ INTERVENTION START IS CRITICAL LONGITUDINAL DEVELOPMENT ONLY WAY TO GUARANTEE THAT ALL CHILDREN WHO ARE DEAF OR HARD OF HEARING ARE INCLUDED
ASSURING QUALITY
QUALIFICATIONS OF THE EARLY INTERVENTION PROVIDER WITH ADDITIONAL QUALIFICATIONS FOR BOTH LISTENING AND SPOKEN LANGUAGE AND FOR SIGN LANGUAGE DEVELOP AND IMPLEMENT A MECHANISM FOR PROVIDERS TO IMPROVE THEIR SKILLS AND KNOWLEDGE
DOCUMENT DEVELOPMENTAL PROGRESS, PROVIDE FEEDBACK TO FAMILIES AND PROVIDERS IMPLEMENT A STATEWIDE PROTOCOL, COMMON ASSESSMENT TOOLS THAT WILL BE USED WITH ALL CHILDREN AND FAMILIES
ASSURING QUALITY
ASSURE MEANINGFUL INVOLVEMENT OF PARENTS OF CHILDREN WHO ARE DEAF OR HARD OF HEARING AT ALL LEVELS OF THE SYSTEM
ASSURE MEANINGFUL INVOLVEMENT OF DEAF AND HARD OF HEARING ADULTS AT ALL LEVELS OF THE SYSTEM DEVELOP AND IMPLEMENT LEADERSHIP TRAINING DESIGN AND IMPLEMENT A SYSTEM OF SERVICES
ASSURING QUALITY
DEVELOP AND IMPLEMENT STRATEGIES FOR FAMILIES WHO DO NOT SPEAK ENGLISH IN THE HOME DEVELOP AND IMPLEMENT STRATEGIES FOR FAMILIES WHOSE CHILDREN HAVE ADDITIONAL DISABILITIES DEVELOP AND IMPLEMENT STRATEGIES FOR FAMILIES FOR DIVERSE CULTURES AND DIVERSE SOCIO-ECONOMIC BACKGROUNDS DEVELOP SYSTEMS THAT PROVIDE EQUITABLE CARE WHEREVER THE FAMILY AND CHILD LIVE IN THE STATE
PREDICTORS OF OPTIMAL LANGUAGE AND LITERACY
EMOTIONAL AVAILABILITY
MATERNAL/PATERNAL BONDING PARENTAL STRESS
RECIPROCAL EMOTIONAL AVAILABILITY IN THE COMMUNICATION BETWEEN PARENT AND CHILD SCAFFOLDING: KNOWING WHEN TO SUPPORT JUST ENOUGH FOR THE CHILD TO SUCCEED IN WHAT S/HE IS ATTEMPTING STRATEGIES FOR DEALING WITH FRUSTRATION AND ANGER
STRONG EMOTIONAL AVAILABILITY LEADS TO BETTER VOCABULARY DEVELOPMENT LOWER PARENTAL STRESS IS RELATED TO BETTER LANGUAGE
A POWERFUL PREDICTOR OF VOCABULARY DEVELOPMENT: AMOUNT OF PARENT TALK TO THE CHILD
Total Number of Parental Words
• Accounts for an
11.07% of the language outcome at 84 months and 14.04% of the rate of language development from 4 to 7 years
High Maternal Level of Education
• Number of Parent
Words not included
• High Maternal
level of Education accounts for 10.81% of the variance of the language outcome at 84 months and 7.48% of the variance of the rate of language development from 4 to 7 years
Maternal Level of Education + Number of Parental Words
• Accounts for
16.38% more variance of the language outcome at 84 months and 13.71% of the rate of language development from 4 to 7 years
Both Maternal level of education and Number of Parental Words are predictors of language at 84 months
• Maternal level of education emerges as a
significant predictor of language outcome between 48 and 84 months of age
• Number of parental utterances in the
birth through 48 month age group is a significant predictor of language outcome at 84 months of age and rate of language growth from 4 to 7 years of age
Relationship Maternal Level of Education and Number of Parental Words
• Amount of variance accounted for by
the variables High Maternal Level of Education and Number of Parental Words spoken to the Child appear to be accounting for overlapping variance
• Number of Parental Words accounts
for more variance
EOWPVT differences by Maternal Level of Educational Level (Baca, 2009)
– 35 month language age difference at
84 months of age between group with mean age level for mothers with educational level less than 12 years (HS grad) as compared to group for mothers with educational level 16 years or greater (college) 55.75 months versus 91.33 months
THE IMPACT OF MATERNAL LEVEL OF EDUCATION CAN BE OVERCOME WITH EXCELLENT INTERVENTION
• Colorado studies indicate that
Maternal level of education does not predict language outcomes of children with hearing loss – birth through 36 months
VOCABULARY DEVELOPMENT IS THE MOST SIGNIFICANT PREDICTOR OF LITERACY FOR CHILDREN WHO ARE DEAF OR HARD OF HEARING JUST AS IT IS FOR CHILDREN WITH NORMAL HEARING
EMERGENT LITERACY
Early sources: Emergent Literacy - Construction of knowledge about the uses and nature of written language Story telling Experiences with children’s books TV
NARRATIVE DEVELOPMENT
Literary devices Narrators Distinct voices of characters Setting Identities of characters Shifts in time or place Connectives (relationships between events in stories) (relationships between previous and upcoming events) cohesion
Storytelling is both social and cognitive Increasing sophistication in pragmatic uses, i.e. (because)
META-LINGUISTIC AWARENESS
Knowing what to do in failures of communication
Conscious awareness of adjustments Re-wording – vocabulary changes Changing syntax
WHY EMERGENT LITERACY, NARRATIVE DEVELOPMENT, METALINGUISTIC KNOWLEDGE ARE SO CRITICAL FOR CHILDREN WHO ARE DEAF OR HARD OF HEARING
Study Participants
Normal Hearing Group
N=109 Age Range: 2-7 years Normal hearing and cognition
Hearing Loss Group
N=126 Age Range: 3-7 years All Levels of hearing loss Normal cognition
Children with Normal Hearing
44% (20 of 45) of the items were mastered using complex language by 3 years of age 95.5% (43 of 45) of the items were mastered by 4 years of age 98% by 5 years 100% by 6 years
Final Items to Master for NH group
Provides information on request Name, date of birth, address (2 of 3 items) Makes promises
Children with Hearing Loss
6.6% (3 of 45) of the items were mastered with complex language by six years of age 69% (31 of 45) of the items were mastered by 7 years of age
Items not Mastered by 7yrs (HL Group)
Provides information on request Repairs incomplete sentences Ends conversations Interjects Apologies Request clarification Makes promises Ask questions to problem solve Asks questions to make predictions Retells a story Tells 4-6 picture story in right order Creates original story Explains relationships between objects-action-situations Compares and contrasts
Percentage of Items Mastered by Age for NH and HL groups
The proportion achieving 50% or more of the items with complex language
NECAP: NATIONAL EARLY CHILDHOOD ASSESSMENT PROJECT: DEAF AND HARD OF HEARING ASSOCIATION OF UNIVERSITY CENTERS ON DISABILITY: CENTERS FOR DISEASE CONTROL
STATE COMMITMENTS TO DEVELOP SYSTEMS TO COLLECT STANDARD ASSESSMENT DATA FROM ALL CHILDREN WHO ARE DEAF OR HARD OF HEARING
• • • • • •
Assessment Components Demographic form Release of audiologic information Minnesota Child Development Inventory MacArthur-Bates Communicative Development Inventories Additional assessments on request (e.g., play, listening skills, speech intelligibility, etc.)
Participating States
• • • • •
Arizona California Colorado Idaho Indiana
• • • • •
Texas Wisconsin Wyoming Nebraska Oregon
Assessments Completed
• • •
259 assessments completed (not including Colorado) 162 children assessed 1 to 4 times each Colorado: 225 assessments per year
Participant Characteristics (excluding Colorado)
• • • • •
Bilateral loss = 249; Unilateral loss = 10 Auditory Neuropathy = 7 English-speaking home = 239; Spanish-speaking home = 20 No additional disabilities = 229; Have additional disabilities = 30 Boys = 140; girls = 119
Degree of Hearing Loss
Participant Criteria for Language Outcomes Analysis
• • •
Bilateral hearing loss English-speaking home No other disabilities that would affect speech or language development
States Represented in Current Language Outcomes Analysis
• • • • • • • •
Arizona Colorado Idaho New Mexico (previous participant) Texas Utah (previous participant) Wisconsin Wyoming Note: CA and IN just initiated NECAP; no data yet
Language Outcomes Analysis: Participant Characteristics
• • • •
Chronological age Range = 6 to 40 months Mean = 21 months Boys = 130; Girls = 140
•
Number of assessments = 270
Assessment 1: Minnesota Child Development Inventory (1992)
• • • •
8 areas of development assessed Language, Motor, Social, Self Help, Pre-Literacy
•
Parent report Parents respond “yes” or “no” to a variety of statements about their child
•
Example: “Has a vocabulary of 20 or more words” Scales adapted to reflect abilities in both spoken and sign language
Assessment 2: MacArthur-Bates Communicative Dev. Inventories
• • • •
Assesses spoken and sign vocabulary Expressive and receptive for younger children Expressive vocabulary for older children Parent-report instrument
Determining Language Quotient
Language Age/Chronological Age x 100
If LQ = 100, Language Age = CA
If LQ < 100, Language Age < CA
If LQ > 100, Language Age > CA
LQs of 80+ are within the normal range compared to hearing children
Median Language Quotients
Percent of Scores in the Average Range (LQ = 80+)
Minnesota CDI: Median Language Quotients
MacArthur-Bates: Median Vocabulary Production Quotients
Conclusions
• •
Almost 80% of children scored within the average range on the Minnesota Expressive Language subtest On average, children in all states scored more poorly on cognitive-linguistic items (Minn Lang Comp) compared to more superficial language items (Minn Exp Lang)
Conclusions
• • •
Acquiring an age-appropriate lexicon is a challenge for many children with 43% demonstrating significant delays Differences in language outcomes are apparent between some states As more assessments are collected, factors predictive of better language outcomes will be identified
Colorado Individual Performance Profile: Criteria for Placement decisions
Describe the student's current service delivery system.
Do NOT include the services of an educational interpreter when counting these hours to identify a category of services below.
__1_
Indirect Service: Monitor
(No IEP, 100% of time in general education); check here if student has a 504 Plan___.
__2_
Indirect Service: Consultation
(IEP, 100% of time in general education classroom) __3_
Direct Service: (>60% of time in general education classroom),
1-4 hours of instructional services per week from a licensed teacher of the Deaf/HH or combination of teacher of Deaf/HH or other special education team __4_
Direct Service: (21-60% of time in general education classroom),
1-2 hours instructional services daily from a licensed teacher of the Deaf/HH or combination of teacher of Deaf/HH & other special education team; may be team or co-taught __5_
Direct Service: (<21% of time in general education classroom)
, 3 or more hours per day of instructional services from a licensed teacher of the Deaf/HH or combination of teacher of Deaf/HH & other special education team; student is still receiving his/her academic instruction in the general classroom a portion of the school day; may be team or co-taught
__6_Direct Service: (Separate Facility),
all instruction from a licensed teacher of the Deaf/HH and other special education professionals in hearing services ___Other: Please explain___________________________________________________________ ___CSDB students only: ___day student ___residential
Comparison of CSAP Reading Score to Level of Service
650 600 550 500 450 400 IS: Monitor IS: Consult DS: >60% Gen Ed DS: 21 60% Gen Ed DS: <21% Gen Ed CSAP Reading Score
CSAP Reading Performance Growth 2004 vs 2005
Reading grades 3-10 N=751 students
Adequate Yearly Progress or 1 years growth in 1 year 40% made 1 years growth 40.8% made > 1 years growth 18.7% made < 1 years growth
Deaf Child’s
Bill of Rights
Deaf Child’s Bill of Rights
http://www.cde.state.co.us/cdesped/downlo ad/pdf/dhh-DeafChildBillRts.pdf
Deaf Child’s Bill of Rights that each child’s “unique communication mode is respected, utilized, and developed to an appropriate level of proficiency”, that teachers and other providers who work with children who are Deaf or Hard of Hearing are specifically trained for this population, including proficiency in the primary language mode of the children with whom they work, that an education with a sufficient number of language mode peers with whom direct communication is possible and who are of same age and ability level is available,
Deaf Child’s Bill of Rights
that each child’s “unique communication mode is respected, utilized, and developed to an appropriate level of proficiency”, that teachers and other providers who work with children who are Deaf or Hard of Hearing are specifically trained for this population, including proficiency in the primary language mode of the children with whom they work, that an education with a sufficient number of language mode peers with whom direct communication is possible and who are of same age and ability level is available,
Deaf Child’s Bill of Rights that parent involvement and, where appropriate, people who are Deaf and Hard of Hearing, determine the extent, content, and purpose of educational programs, that children who are Deaf and Hard of Hearing benefit from an education in which they are exposed to Deaf and Hard of Hearing role models, that programs provide direct and appropriate access to all components of the educational process, including but not limited to recess, lunch, and extra-curricular activities,
Deaf Child’s Bill of Rights
that parent involvement and, where appropriate, people who are Deaf and Hard of Hearing, determine the extent, content, and purpose of educational programs, that children who are Deaf and Hard of Hearing benefit from an education in which they are exposed to Deaf and Hard of Hearing role models, that programs provide direct and appropriate access to all components of the educational process, including but not limited to recess, lunch, and extra-curricular activities,
Deaf Child’s Bill of Rights that programs provide for the unique vocational needs, including appropriate research, curricula, programs, staff, and outreach, that the least restrictive environment for each child who is Deaf or Hard of Hearing takes into consideration the legislative findings and declarations of this law, and that due to the unique communication needs of children who are Deaf and Hard of Hearing, the development and implementation of state and regional programs would be beneficial.
SUMMARY Set a Goal Measure the Baseline Develop a Plan Institute the Plan Measure the progress
FOR THE SAKE OF OUR CHILDREN: WE CAN ACHIEVE OUR GOAL