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PubMed2005

Mental distress and quality of life in a deaf population.

BACKGROUND: High risks of mental illness within the deaf community are reported. The assessment of the level of mental distress and quality of life in the deaf community is difficult due to communication problems in spoken and written language. The deaf community is characterized by the use of sign language. METHODS: A new measure of acceptable reliability using sign language is described. The interactive computerised package including special versions of the World Health Organisation's Brief Quality of Life questionnaire (WHOQOL-BREF), the 12-Item General Health Questionnaire (GHQ-12) and five subscales of the Brief Symptom Inventory (BSI) was administered to a large community sample of deaf people (n = 236), and results were compared with normative data for German-speaking hearing people. RESULTS: The deaf sample has a significantly poorer quality of life than the general population for the physical and psychological domains (p < 0.01) as measured by the WHOQOL-BREF. However, in the domain of social relationships, no significant difference (p = 0.19) was demonstrated. All findings with the GHQ-12 and the BSI show much higher levels (p = 0.01) of emotional distress among the deaf. CONCLUSION: Although a poorer quality of life and a higher level of mental distress are demonstrated, the similarity to the general population in the domain social relationships shows that this does not affect all domains. These findings show the need for easily accessible health services for the deaf which offer sensitive communication with them.

Deafness↗

PubMed1991

Pragmatic and linguistic constraints on message formulation: a cross-linguistic study of English and ASL.

This study provides a cross-linguistic replication, using American Sign Language (ASL), of the Brown and Dell (1987) finding that when relaying an action involving an instrument, English speakers are more likely to explicitly mention the instrument if it is atypically, rather than typically, used to accomplish that action. Subjects were 20 hearing-impaired users of English and 20 hearing-impaired users of ASL. Each subject read and retold, in either English or ASL, 20 short stories. Analyses of the stories revealed production decision differences between ASL and English, but no differences related to hearing status. In ASL, there is more explicitness, and importance seems to play a more pivotal role in instrument specification. The results are related to differences in the typology of English and ASL and are discussed with regard to second-language learning and translation.

Hearing Disorders↗

PubMed2004

Vocabulary Use by Low, Moderate, and High ASL-Proficient Writers Compared to Hearing ESL and Monolingual Speakers.

The written English vocabulary of 72 deaf elementary school students of various proficiency levels in American Sign Language (ASL) was compared with the performance of 60 hearing English-as-a-second-language (ESL) speakers and 61 hearing monolingual speakers of English, all of similar age. Students were asked to retell "The Tortoise and the Hare" story (previously viewed on video) in a writing activity. Writing samples were later scored for total number of words, use of words known to be highly frequent in children's writing, redundancy in writing, and use of English function words. All deaf writers showed significantly lower use of function words as compared to their hearing peers. Low-ASL-proficient students demonstrated a highly formulaic writing style, drawing mostly on high-frequency words and repetitive use of a limited range of function words. The moderate- and high-ASL-proficient deaf students' writing was not formulaic and incorporated novel, low-frequency vocabulary to communicate their thoughts. The moderate- and high-ASL students' performance revealed a departure from findings one might expect based on previous studies with deaf writers and their vocabulary use. The writing of the deaf writers also differed from the writing of hearing ESL speakers. Implications for deaf education and literacy instruction are discussed, with special attention to the fact that ASL-proficient, deaf second-language learners of English may be approaching English vocabulary acquisition in ways that are different from hearing ESL learners.

Deafness↗

PubMed2004

Literacy development in deaf students: case studies in bilingual teaching and learning.

A bilingual model has been applied to educating deaf students who are learning American Sign Language (ASL) as their first language and written English as a second. Although Cummins's (1984) theory of second-language learning articulates how learners draw on one language to acquire another, implementing teaching practices based on this theory, particularly with deaf students, is a complex, confusing process. The purposes of the present study were to narrow the gap between theory and practice and to describe the teaching and learning strategies used by the teachers and parents of three elementary school children within a bilingual/bicultural learning environment for deaf students. The findings suggest that strategies such as using ASL as the language of instruction and making translation conceptual rather than literal contribute to literacy learning. Findings further indicate that some inconsistencies persist in applying a bilingual approach with deaf students.

Child↗

PubMedDate not supplied

Assessment of depressive symptoms in deaf persons.

BACKGROUND: Evidence suggests that Deaf people may have a greater prevalence of depressive symptoms. However, it is unclear whether commonly used written screening instruments are accurate with this population because of their unique cultural and linguistic factors. SETTING: Deaf persons (n = 71) residing in southeastern Michigan. METHODS: Subjects completed the Zung Self-Rated Depression Scale in both the written (ZSDS-W) and American Sign Language (ZSDS-S) formats and the Hamilton Depression Scale (HAM-D) in American Sign Language in counterbalanced order, followed by a Test Of Reading Comprehension (TORC). They also provided extensive data on demographic, hearing loss, language use, social and health care use variables. RESULTS: Mean subject age was 52 years, 63% of subjects were women, 95% were Caucasian, and 47% were married (87% to another deaf/hard of hearing person). Thirty percent had a college degree and 20% had less than a 10th grade education. The ZSDS-W and ZSDS-S scores were highly correlated (r = +0.79), although the mean ZSDS-W score was 2.8 points higher (P = .001). The ZSDS-S correlated more highly (r = 0.80) with the HAM-D than the ZSDS-W (r = 0.71). There was a significant interaction effect (P < .001) such that the ZSDS-W and HAM-D were significantly associated among higher literacy subjects (beta = 0.80, P < .001) but not lower literacy subjects (beta = 0.20, P = .183). There were no other significant associations between depression scores and numerous demographic, educational, hearing loss, social or language variables. CONCLUSIONS: Compared with the conventional ZSDS-W, the ZSDS-S more accurately assesses depression severity among deaf persons with lower English literacy. However, given the greater sensitivity of the ZSDS-W and the practical barriers to ZSDS-S in physician practices, further research should determine which modality is best for routine depression screening.

Adult↗

PubMed2004

Communicating about health care: observations from persons who are deaf or hard of hearing.

BACKGROUND: Achieving patient-centered care requires effective communication between physicians and patients. Persons who are deaf or hard of hearing face considerable barriers to communicating with physicians. OBJECTIVE: To understand perceptions of health care experiences and suggestions for improving care among deaf or hard-of-hearing individuals. DESIGN: 4 semistructured group interviews, 2 conducted in American Sign Language (for deaf individuals) and 2 using Communication Access Realtime Translation (for hard-of-hearing individuals). Men and women were interviewed separately. Tapes of interviews were transcribed verbatim for analysis. SETTING: Greater Boston, Massachusetts, and Washington, DC, in 2001. PARTICIPANTS: 14 deaf adults (23 to 51 years of age) and 12 hard-of-hearing adults (30 to 74 years of age). MEASUREMENTS: Commonly expressed themes or views organized around dimensions of communication. RESULTS: Concerns coalesced around 6 broad themes: conflicting views between physicians and patients about being deaf or hard of hearing; different perceptions about what constitutes effective communication (such as lip reading, writing notes, and sign language interpreter); medication safety and other risks posed by inadequate communication; communication problems during physical examinations and procedures; difficulties interacting with office staff, including in waiting rooms; and problems with telephone communication, such as lengthy message menus. Participants offered extensive suggestions for improvements, starting with clinicians' asking patients about their preferred communication approach. Having patients repeat critical health information (such as medication instructions) can identify potentially dangerous miscommunication. CONCLUSIONS: As the population ages, physicians will encounter many more persons with hearing limitations. Physicians are not reimbursed for making some accommodations, such as hiring sign language interpreters. However, ensuring effective communication is essential to safe, timely, efficient, and patient-centered care.

Adult↗

PubMed2004

The role of video technology in on-line lectures for the deaf.

PURPOSE: The purpose of this paper is to determine the effectiveness of web-based video lectures on demand for the deaf in comparison to the traditional method of teaching using a sign language interpreter. The web-based lectures presented are specifically designed for the deaf in education and in rehabilitation. METHOD: Sixty-three deaf students and adults were divided into four groups. All of the groups were made up of users who shared similar knowledge in the field of computers, but with different abilities in using computers, from beginners to advanced users. All of the groups were of mixed gender. The first two groups (consisting of 23 test users) graded the usability of the user interface for web-based lecture on demand with the help of the standardized SUMI questionnaire. After that, two groups (20 students from high school and 20 adults) joined in a 45-min informational program on the history of the deaf. Both groups were then divided into two smaller subgroups of 10 participants. The first subgroup in the first part of the learning program followed a traditional teaching style with the help of a teacher and an interpreter for Slovenian sign language. Meanwhile, the second group observed a 12-min web-based video lecture on demand and still had available an additional 18 min for a more detailed observation of the video. At the end of the lecture, the teacher used the questionnaire to review the participants' understanding of the content of the lecture in both of the groups. During the entire testing period, the interpreter used Slovenian sign language. RESULTS: By using the SUMI questionnaire, we determined the usability of the user interface for comprehension and gathering of knowledge. We discovered that the system was usable according to the standards. The global Median results (Global Median=51) were in the range of 50. In the second part of testing, we determined the level of significance between the traditional and web-based lectures. The results were statistically evaluated using the t-tests and the ANOVA test. From the t-tests we established the hypothesis that the number of correct answers for both groups (group 1: web-based, group 2: traditional) differed. The t-test used for the age groups rejected the hypothesis that the number of correct answers for both groups differed, where group 1 was comprised of adults and group 2 was comprised of students. Additionally, the ANOVA test showed that the number of correct answers for adults using traditional lectures differed significantly from the number of correct answers for both adult and student web-based users. The ANOVA test showed no differences between any of the remaining groups. CONCLUSIONS: We can conclude that for deaf people it is extremely important to introduce the use of information and communications technology on all levels of education and rehabilitation. This increases their ability to learn and improves their understanding of learning materials, especially if the applications are designed specifically for their needs. Through daily exposure to a larger number of such materials, we can positively influence the literacy (reading and writing skills) of the deaf. With increased literacy, the deaf would be able to read literature, and subtitles, enabling them to receive information through written sources. Therefore, we can expect them to have a higher self-esteem, more easily integrate into society and have more opportunities for employment.

Adolescent↗

PubMed1986

Development of creative language devices in signed and oral production.

The development of linguistic and cognitive flexibility was examined by evaluating nonliteral language use by 20 deaf and 20 hearing children aged 7;11 to 15;0 years. Each subject was videotaped telling stories on two experimenter-supplied themes. Deaf subjects' stories were translated and transcripts for both samples were scored for gesture, pantomime, linguistic modifications, and inventions as well as novel and frozen trope. Results indicated deaf children produced just as much figurative language in sign language as their matched hearing age-mates did in English. Deaf subjects exceeded their hearing peers in other types of creative productions. They also evidenced a "literal period" in language development, comparable to hearing children but delayed approximately 4 years. Findings are discussed in terms of their implications for understanding both language and cognitive flexibilities of deaf children.

Adolescent↗

PubMed1984

Comparison between the motoric constraints for Amer-Ind and ASL sign formation.

Previous research has shown that Amer -Ind signals are more easily learned and remembered than their synonyms in American Sign Language. One possible reason is a difference in motoric complexity between the two systems. To test the hypothesis that such a difference exists, the positions and movements that constitute the 236 signals of Amer -Ind Code were compared with those of their synonyms in American Sign Language. It was found that the ASL signs were indeed more complex in terms of changes of hand orientation during production, the use of two hands rather than one, the number of different handshapes used, and the total amount of movement required. When the two systems were compared in terms of the normal development of finger, hand, and arm movements, it was found that more Amer -Ind signals than ASL signs are within the competence of infants at both the 6-month and 12-month levels. Relative to the motor coordination required to execute both systems, it was concluded that the Amer -Ind corpus is less complex than a matched group of ASL signs.

Deafness↗

PubMed1994

Self-esteem, family climate, and communication patterns in relation to deafness.

The purpose of the study presented in this article was to determine the effect that family communication patterns have on the self-esteem of deaf children. Deaf students at a southern residential school, ranging in age from 13 to 19, were administered the Modified Self-Esteem Inventory (MSEI) and the Subject Communication Questionnaire. The subjects' parents answered 10 questions about their communication patterns with their deaf child. The parents were not deaf themselves. Analysis of the data revealed that there is a positive relationship between the family's communication method and the deaf child's self-esteem such that parents who use total communication (speech, fingerspelling, and sign) have children whose self-esteem scores are higher than those of children whose parents use an oral-only method of communication (speech). The parents who were best able to communicate by using sign language had children whose self-esteem scores were higher than those of children whose parents were less skilled in sign language. Also, a positive relationship was found between student self-esteem and reading level.

Adolescent↗

PubMed1997

[Competence in verbal communication of deaf adults in Austria. II: Vocabulary].

The understanding of isolated written words by deaf adults was checked using a basic list of 500 German words developed for this study. Even at this basic level about 7% of the words could not be identified by the deaf subjects. There were particular problems with words from colloquial German, function words, terms without mouthing in sign language and cover terms. Concerning rehabilitation the use of sign language vocabulary already known by the deaf for written language vocabulary training and a stronger orientation towards functional everyday communication is recommended.

Adolescent↗

PubMed1994

The role of adaptability and communication in fostering cohesion in families with deaf adolescents.

The families of 325 adolescents enrolled in local public high schools throughout the United States were surveyed to assess the relationship between the communication modes used by families and family cohesion. Cohesion is defined here as the degree of emotional bonding among family members. In a path analysis, family cohesion was predicted by the mother's use of sign language. In turn, the child's degree of hearing loss and the child's mode of communication predicted the mother's use of sign language. Based on the use of the FACES (family adaptability and cohesion evaluation) inventory and a parent communication questionnaire, the authors conclude that mothers who sign tend to be more family oriented.

Adaptation, Psychological↗

PubMed2003

Cognition in the hearing impaired and deaf as a bridge between signal and dialogue: a framework and a model.

This paper focuses on the role of cognition in visual language processing in the deaf and hard of hearing. Although there are modality-specific cognitive findings in the literature on comparisons across speech communication modes and language (sign and speech), there is an impressive bulk of evidence that supports the notion of general modality-free cognitive functions in speech and sign processing. A working-memory framework is proposed for the cognitive involvement in language understanding (sign and speech). On the basis of multiple sources of behavioural and neuroscience data, four important parameters for language understanding are described in some detail: quality and precision of phonology, long-term memory access speed, degree of explicit processing, and general processing and storage capacity. Their interaction forms an important parameter space, and general predictions and applications can be derived for both spoken and signed language conditions. The model is mathematically formulated at a general level, hypothetical ease-of-language-understanding (ELU) functions are presented, and similarities and differences from current working-memory and speech perception formulations are pointed out.

Cognition↗

PubMed2001

Hand preferences in sign-learning students with autistic disorder.

The purpose of the study was fourfold: (a) to document the hand preferences of nonspeaking individuals with autism as they produced signs and nonsign actions; (b) to find out if sign-language proficiency in such individuals is associated with directionality or consistency of signing hand preference; (c) to explore the link between hand preference for signing and standardised measures of cognitive and motor development; (d) to compare the hand preferences (sign and nonsign actions) of such individuals to sign-learning children with normal cognitive functioning. In this study, the hand preferences of 14 nonspeaking students with autistic disorder were determined from videotape records of their sign production and nonsign actions. In their sign production, four students strongly favoured their right hands, four had a distinct left-hand preference, and six did not significantly favour either hand. There was little evidence linking sign-language proficiency, cognitive maturity, or motor development to strongly lateralised signing or handedness in general in these students. Compared with the hand preferences of the children in the two comparison groups, the autistic students were markedly less lateralised with respect to signing, but not nonsign actions.

Journal Article↗

PubMed2002

Deaf women: experiences and perceptions of healthcare system access.

BACKGROUND: The authors investigated the knowledge, attitudes, and healthcare experiences of Deaf women. METHODS: Interviews with 45 deaf women who participated in focus groups in American Sign Language were translated, transcribed, and analyzed. Deaf women's understanding of women's health issues, knowledge of health vocabulary in both English and American Sign Language, common health concerns among Deaf women, and issues of access to information, including pathways and barriers, were examined. As a qualitative study, the results of this investigation are limited and should be viewed as exploratory. RESULTS: A lack of health knowledge was evident, including little understanding of the meaning or value of cancer screening, mammography, or Pap smears; purposes of prescribed medications, such as hormone replacement therapy (HRT); or necessity for other medical or surgical interventions. Negative experiences and avoidance or nonuse of health services were reported, largely due to the lack of a common language with healthcare providers. Insensitive behaviors were also described. Positive experiences and increased access to health information were reported with practitioners who used qualified interpreters. Providers who demonstrated minimal signing skills, a willingness to use paper and pen, and sensitivity to improving communication were appreciated. CONCLUSIONS: Deaf women have unique cultural and linguistic issues that affect healthcare experiences. Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must be trained to become more effective communicators with Deaf patients and to use qualified interpreters to assure access to healthcare for Deaf women.

Adolescent↗

PubMedDate not supplied

Neuropsychological studies of linguistic and affective facial expressions in deaf signers.

For deaf users of American Sign Language (ASL), facial behaviors function in two distinct ways: to convey affect (as with spoken languages) and to mark certain specific grammatical structures (e.g., relative clauses), thus subserving distinctly linguistic functions in ways that are unique to signed languages. The existence of two functionally different classes of facial behaviors raises questions concerning neural control of language and nonlanguage functions. Examining patterns of neural mediation for differential functions of facial expressions, linguistic versus affective, provides a unique perspective on the determinants of hemispheric specialization. This paper presents two studies which explore facial expression production in deaf signers. An experimental paradigm uses chimeric stimuli of ASL linguistic and affective facial expressions (photographs of right vs. left composites of posed expressions) to explore patterns of productive asymmetries in brain-intact signers. A second study examines facial expression production in left and right brain lesioned deaf signers, specifying unique patterns of spared and impaired functions. Both studies show striking differences between affective and linguistic facial expressions. The data indicate that for deaf signing individuals, affective expressions appear to be primarily mediated by the right-hemisphere. In contrast, these studies provide evidence that linguistic facial expressions involve left hemisphere mediation. This represents an important finding, since one and the same muscular system is involved in two functionally distinct types of facial expressions. For hearing persons, the right-hemisphere may be predominant in affective facial expression, but for deaf signers, hemispheric specialization for facial signals is influenced by the purposes those signals serve. Taken together, the data provide important new insights into the determinants of the specialization of the cerebral hemispheres in humans.

Affect↗

PubMed2004

Accessing university education: perceptions, preferences, and expectations for interpreting by deaf students.

This paper provides a brief review of the history of deaf education in Australia, Australian Sign Language (Auslan), and Auslan interpreting. A panel of Australian deaf university students from diverse linguistic and educational backgrounds provides insights into their perceptions of sign language interpreting provision in university lectures. They commented on their interpreting preferences after viewing two videotaped segments of university lecture interpretation, one demonstrating a predominantly free approach and the other a predominantly literal approach. Expectations of the deaf students were explored in relation to the educational backgrounds and qualifications of university interpreters; comprehension of interpreters is also discussed. Results suggest that the university students preferred interpreters to combine both interpretation styles, switching between literal and free approaches when appropriate. In doing so, students can access lecture content in Auslan while accessing subject-specific terminology or academic language in English. In terms of qualifications, the students advocated for interpreters to have a university qualification in general, especially if they are working in a university context. However, the students also acknowledged that interpreting did not provide them with full access in educational settings.

Australia↗

PubMed1996

Word recall in deaf students: the effects of different coding strategies.

This study examined whether instructions to use specific word coding strategies affected deaf students immediate and delayed final free recall of English word lists. Both the word-coding strategy and the visual imagery value of the words were important factors in word recall. 44 deaf students participated. Those who received instructions to produce the sign language equivalent of each stimulus word tended to recall more words over all than those students instructed to fingerspell each word or those instructed to form a sign language sentence that included the stimulus word. Stimulus words rated high in imagery value were recalled more frequently than words with low imagery values across coding strategies and in both immediate and delayed memory. In addition, analyses of serial position indicated pronounced primary and recency effects in immediate recall of words and a primacy effect in delayed final recall. These findings are discussed in relation to current conceptualizations of memory and language processing in deaf students.

Adolescent↗