1. Communication Decisions and Services
Online Presentation for
Deaf Education - Parent Infant
Michigan State University
Marilyn Sass-Lehrer, Ph.D.
Gallaudet University

2. Goals What Decisions? Roles and Responsibilities
Identify the decisions families face; Understand the challenges
Roles and Responsibilities
Understand the professional’s role using “Informed Choice”
Understand how child and family characteristics influence decisions
ASL and English Bilingual Approach
Describe what it is
Identify features of an Effective Program
Identify FAQs about a Bilingual Approach
Information and Resources
Identify strategies for promoting decision making
Identify the “evidence base” and resources

3. Decisions, Decisions, Decisions
Technology
Services
Communication
Hearing Aids

4. Decision Making: A Difficult Process
Perceived Urgency
Strong Opinions
Professional Bias
Not all Options Presented
Resources Not Available
Insufficient Information

5. Misinformation All children with hearing loss should sign
If children sign then they won’t talk
Children who are deaf cannot learn to talk
You have to choose signing or talking
Depends on the extent of the hearing loss
All children should try speech first
ASL is not a “real” language
Children who speak don’t need signs
Children with cochlear implants should not sign

6. Questions to Consider:
What is bias?
Should professionals be “neutral”?
What does informed choice mean?
Can/Should families make decisions?
What do families need to make decisions?
Do all families want to decide for themselves?
How can professionals be most helpful?

7. What is Bias?
A bias is a prejudice in a general or specific sense, usually in the sense for having a preference to one particular point of view or ideological perspective. However, one is generally only said to be biased if one's powers of judgment are influenced by the biases one holds, to the extent that one's views could not be taken as being neutral or objective, but instead as subjective.
wikipedia.org/wiki/Bias

8. In the Words of the 14th Dalai Lama
A biased mind never sees the complete picture, and any action that results will not be in tune with reality…I often say that while one can adhere to the principle of “one truth, one religion” at the level of one’s personal faith, we should embrace at the same time the principle of “many truths, many religions” in the context of wider society. (The Washington Post, Oct. 21, 2007).

9. What is the Evidence?

10. Is one Technology, Communication Approach, or Program More Effective than Another?
Research Methodology Difficulties:
Quality and quantity of studies;
Size of samples,
Generalizability;
Diversity of population;
Lack of long term outcomes;
Lack of studies with children who were identified early

11. What is the research suggesting on CI?
Younger is better for ease in typical progression of spoken language development
No age limit for “some” benefit (older children, teens, senior citizens)
Children with implants have diverse spoken language outcomes related to a variety of factors.
Children with additional special needs can benefit
Importance of early language in any modality for improved spoken language outcomes with implant
Sub dividing 2 and under
Cochlear Implant Education Center, Gallaudet University

12. What is the Research Suggesting about Communication Approaches?
No evidence that one communication approach is best for all
Language growth is the critical measure of effectiveness
Services must support Communication Approach
Exposure to dual communication modes does not impede progress across developmental domains
Individual child characteristics and overall development inform decisions
Multi-sensory communication options should be based on individual characteristics and environmental conditions
Bilingualism (ASL and English) does not impede language growth and may provide a supportive benefit to both languages

13. What is the research suggesting regarding Programming?
Programs should be comprehensive
Family-Centered
Relationship-Based
Emphasizing Family Involvement/Parent-Child Communication
How much, when, where has little impact on outcomes
hours per week
public vs private
home vs center
Evidence suggests that “specialists” make a difference

14. Receptive Communication Continuum
Fully
Visual
Communicator
Mostly
Auditory V VA Av A
Continuum concept: Bettie Waddy-Smith
Laurent Clerc National Deaf Education Center

15. Receptive Communication
V Depends on visual information ASL/Signs
VA Depends on ASL/signs; obtains some benefit from auditory information
VA Equally depends on and able to use ASL/signs and auditory information via Spoken English
Av Depends on Spoken English, sometimes needs Sign to clarify Spoken English
A Depends on auditory information via Spoken English

16. Expressive Communication Continuum
Fully
Sign
Communicator
Mostly
Oral S SO Os O
Continuum concept: Bettie Waddy-Smith
Laurent Clerc National Deaf Education Center

17. Expressive Communication
S Uses Signs/ASL Only
So Uses Signs/ASL; some oral communication
SO Equally able to use sign and oral communication
Os Uses oral communication; signs for clarification
O Uses oral communication only

18. Cochlear Implant Education Center, Gallaudet University
Where a child fits on the continuum depends on the coming together of many impacting factors
(and may change over time)
Cochlear Implant Education Center, Gallaudet University

19. ASL English Bilingual Approach
Philosophy:
Deaf and hard of hearing children should acquire, learn and use two languages (their native sign language and the spoken language(s) of their country)
Goal:
Children to become academically and linguistically competent in both ASL and English

20. Principles Based on principles of 2nd language acquisition
Supports language and literacy development as well as cognitive and social development
“Best of both worlds”
Language acquired through meaningful interactions with fluent users of the languages
ASL is foundation (and/or bridge) to English
Both languages continue to develop

21. Acquisition Watching/Attending Signing Fingerspelling Fingerreading
Writing/Typing
Lipreading
Speaking & Listening

22. Educational Implications
ASL and English are languages of instruction and interaction
Children have full access to both languages
Visually rich environment
Which language? Codeswitching
Rules for when and where to use which language
Communication and Language Plan
Bilingual Approach – ASL is dominant language with early exposure to English
English as 2nd Language – ASL first – then English

23. ASL Programs for Families
Sign Language Programs
Needs/Interests of Parents
Times, Places Convenient
Visual Communication Strategies (Mohay, 2000)
FAQs (See ASDC website)

24. Informed Choice and Information
Comprehensive, meaningful, relevant, un-biased
Accurate, up to date, evidence-based
Evaluative information is essential (risks and benefits)
Convey unpredictability or range of outcomes
Information should promote involvement
Promote knowledge and understanding
Young, Carr, Hunt, Skipp, Tattersall, 2006

25. Assessment-Based Process
F.A.M.I.L.Y. Assessment Approach
Auditory Skills
Language and Communication Skills
Play Skills
Motor Skills
Family Needs
Stredler-Brown (2003).
blocks.html

26. What Professionals Should Tell Families
Communication is not always “either/or”
Decisions take time and may change over time
No evidence that signs impede speech
Evidence that signs facilitate language acquisition
Better Language means better speech
Focus must be language access and use – not form
Language delays are difficult to overcome

27. Language is the “Holy Grail”

28. High Expectations: Benchmarks
EI by 6 months
Maintain language commensurate with hearing peers
One year’s growth in one year time
Adapted from Stredler-Brown, 2005

29. How Families Make Decisions
Families use a variety of strategies to gain information
Families give a lot of thought to decisions
Decisions made are frequently changed
Level of hearing loss influences approach selected
Deaf/HH adults and families influence decisions
Families want knoweldgable professionals
Perceptions of what professionals should do varies
Wainscott & Sass-Lehrer (In preparation)

30. Decision Making Model Professional Decision
Professional is responsible for making decisions for child
Guided Decision
Professional guides and directs families to the “right” decisions
Collaborative Decision
Professionals and family are partners in making decisions
Informed Decision
Families have the information they need to make the right decisions Wainscott, In Preparation

31. What Families Want: Advice for Professionals
Comprehensive, accurate, up to date, evidence-based Information
Honesty, Patience
Open-Minded Flexible
Cultural Sensitivity
Resources (Families/Deaf-HH Adults)
Monitoring Progress
Support Families’ decisions
Meadow-Orlans, Mertens& Sass-Lehrer, 2003; Wainscott, Croyle & Sass-Lehrer, 2006; Young, et al.; 2006

32. Additional References
McLaughlin, L., Small, A., Spink-Mitchell, C. Cripps, J. (2004). A Parent Guidebook: ASL and Early Literacy. Mississaugua, Ontrario: Ontario Society for the Deaf.
Meadow-Orlans, K.P., Mertens, D., Sass-Lehrer, M. (2003). Parents and their deaf children: The early years. Washington, DC: Gallaudet University Press.
Schwartz, S. (2007) Second Ed. Choices in Deafness. Bethesda, MD: Woodbine.
Young, A., Carr, G., Hunt, R., McCracken, W., Skipp, A., Tattersall, H. Informed choice and deaf children: Underpinnings, concepts and enduring challenges. Journal of Deaf Studies and Deaf Education 2006: 11:

33. So….. What did you learn or find interesting in this session?
How could you connect something you learned with your work with children and families