Journal of Communication Disorders, Deaf Studies & Hearing Aids
Open Access

Strategies Parents Use to Support Communication of their Children Who are Deaf or Hard of Hearing

Carolina Lebene Kudesey^{* *}Correspondence: Carolina Lebene Kudesey, Department of Special Education and Multiple Abilities, The University of Alabama, Alabama, United States of America, Email:

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Introduction

Usually, parents of young children who are deaf or hard of hearing make decisions about which communication mode their children and family will use. It appears that in most cases hearing parents of children who are deaf face challenges in providing language input to their children. It also appears that some families lack good interpersonal communication with their children who are deaf or hard of hearing because of language barriers. Lack of good interpersonal communication can pose some challenges for children, such as low self-esteem, delayed language acquisition and development, prolonged victimization of bullying, and children refusing to use sign language [1].

It is important for parents to be able to communicate effectively with their children who are deaf or hard of hearing. Additionally, when there is effective communication, all members of the family benefit. According to Allen et al., for some parents, their deaf child is the first deaf person they might have seen or have communicated with. Parents who are not familiar with raising children who are deaf and who do not know appropriate resources to support their children might face challenges with communicating with their children. These communication barriers create problems of parents not being able to meet the social-emotional, personal and academic needs of their children [2].

Furthermore, the first teacher of a child is the parents. A child’s communication starts with parents’ efforts at home. Parents need to support their children who are deaf to communicate effectively as they would for their hearing children. In the early stages of life, it is important for parents to decide which communication mode they want for their child. According to Vaccari and Marschark, over 90% of deaf children have hearing parents who might not be familiar with sign language.

Literature Review

Making a communication choice

Kluwin and Gaustad conducted a study to examine why families of 192 children who are deaf developed one pattern of communication rather than another. The study revealed that mothers decide on the family's preferred method of communication. Findings also indicated that the single largest influence on the mother's mode of communication was the child's degree of hearing loss and the mother's educational background [3].

Often, a specialist in hearing loss will describe five communication methods: Auditory-verbal, auditory-oral, ASLEnglish bilingual, cued speech and total communication, before guiding parents through their choice of communication mode for a child who is deaf or hard of hearing. Similarly, Porter et al. are of the view that parents of a child who is deaf or hard of hearing will have to make numerous choices. The way they want their child to interact with others will be one of these choices. However, it's crucial for parents to remember that whichever decision they make, they always have the option of changing their mind throughout this crucial stage in their child's development [4].

Likewise, Young et al. state that parents frequently feel pressure when making decisions about their children's communication and language preferences. This is true for both medical and nonmedical choices, such as the incorporation of sign language, as in the case of cochlear implantation. This choice is typically made within the first several months following the diagnosis. Also, several people, including medical professionals, linguists, teachers of the deaf and hard of hearing, early intervention specialists and deaf or hard of hearing people have strong beliefs regarding the best way for children who are deaf or hard of hearing to learn language and communicate. Parents can get assistance from other parents who have gone through the same process, as well as from individuals with hearing loss, parent support groups and other parents, in exploring communication options. Knoors argues that the idea that parents can incorporate both spoken and signed languages, some form of bilingualism into a child's development rather than having to choose between them has gained support in recent years, according to experts' evolving perspectives [5].

Theoretical framework

The current study used the symbolic inter-subjectivity theory by George Herbert Mead and Max Weber. The symbolic intersubjectivity theory describes how human beings understand their social world through communication and meaning through visual language such as signs and symbols. Language is made up of shared symbols, so we can communicate.

Gillespie agrees with Mead and Weber that inter-subjectivity exists in symbols. Different but complementary perspectives existing in social interaction are bound together through symbols and signs. The relationship between the sign and the thing it stands for and the notion that signs "stand for" particular, indicated meanings are both true [6].

Empirical background

Hadadian and Rose conducted a study to investigate the relationship between parental attitudes toward deafness and the communication skills of their children with hearing loss. The study found a statistically significant correlation between fathers' scores on the attitude to deafness scale and the language comprehension scores of their children who are deaf. No significant differences in attitudes were found between mothers and fathers. Similarly, no differences were found between the parents of boys and the parents of girls.

Eleweke and Rodda, conducted a qualitative case study of two families with children who are deaf to examines factors contributing to parents' selection of a communication mode to use with their children with hearing loss. Their study found that more than 90% of children with prelingual hearing loss have normally hearing parents. Again, the study revealed that communication difficulties are among the obstacles facing parents in connection with their children’s communication and language development [7].

Moreover, based on the results of their study, the factors influencing parental choice were grouped under four themes:

• The influence of information provided to parents.

• Parents' perceptions of assistive technology.

• Attitudes of service professionals and educational authorities.

• Quality and availability of support services.

It will be interesting to know how the current study will correlate with Eleweke and Rodda’s study or how different it would be.

Vaccari and Marschark conducted a qualitative study to examine the role of effective parent-child communication in the social and emotional development of children who are deaf. Their study reviewed evidence concerning relations between early communication and social-emotional development of children who are deaf and superficial differences in the ways that parents interact with deaf versus hearing children are distinguished from differences that may have more significant and enduring effects. Results of the study revealed that hearing parents and their children who are deaf are found to develop alternative, often nonverbal, interaction strategies. The current will reveal strategies parents use to support communication of their children, Vaccari and Marschark’s study relates to the current study [8].

Majority of researchers in the field of deaf and hard of hearing studies have focused on how mothers support the children’s communication. A whole family involvement is very important in a child’s language and communication development. In this current study, both parents, were included in this investigation. The current study focused on how mothers and fathers support communication of their children. Also, the purpose of the study is to explore how parents support communication and language development of their children who are deaf or hard of hearing.

The study was guided by the following research questions:

• How do families of children with hearing loss support their children’s communication?

• What strategies do parents use to support communication of their children?

Design

The study used a descriptive phenomenology, research design. The researchers described how parents supported their children’s communication. Descriptive phenomenology research usually has approximately 10-15 participants. According to

Rodriguez and Smith, insights about people's actions and intentions can be gained through descriptive phenomenology, which breaks through long-held assumptions and which challenges conventional wisdom.

Moreover, descriptive phenomenology might help with the creation of fresh hypotheses, policy modifications or response adjustments. In the current study, we wanted to find out about parents’ interactions and actions with their children to support communication and language development.

Recruitment and selection

The web address for a Qualtrics survey was distributed to service coordinators who serve children birth to five years of age. We asked the service coordinators to disseminate the link to parents with children who are deaf or hard of hearing. Nine participants answered the survey. Participants were these nine parents who were all hearing and who had children who are deaf or hard of hearing ages 0-5 years. Six out of nine parents were first-time parents. All participants lived in Alabama and were working parents [9].

Instrumentation

The survey consisted of 21 questions in which respondents provided information related to demographics and communication support. We expected the survey to take 20 minutes to complete. We based questions on the literature. The survey was first drafted and later edited to reduce the number of questions, to reconstruct some sentences and to focus on communication support parents provide. The online survey was sent out in mid-April 2022 and closed on May 15, 2022. Data were collected and stored on the university of Alabama Qualtrics software and the University of Alabama (UA) Box. The survey data were downloaded anonymously and analyzed thematically.

Data analysis

The study used a narrative analysis to analyze date from the survey. We read through all responses to have an idea of what type of information was on the responses and organized responses by entering them in an excel spreadsheet. In one column, we copied and pasted the full unedited response. In the next column, we stated our impressions of the unedited response.

During the first stage of sorting, similar themes were assigned shorthand general codes and color coded and later resorted them into more specific codes. For example, one of the general codes was “activity” which was put into a more specific code “play”. All results having the same codes and colors were put into their own separate groups (i.e., themes) in one column. We noticed some connections in the themes. Connections between the themes were identified and grouped. We kept the data that answered the research questions. All data not answering the research questions were not included in the themes that supported the findings. Narrative analysis was used to track and reflect on the responses to get a better understanding of the entire data.

The study revealed that strategies parent reported they use to support their children’s communication are visual communication like American sign language and gestures. Some ways parents reported they use to promote visual communication include face-to-face communication, looking directly at the child, and facing them when communicating and not exaggerating their mouth. Parents reported using two types of visual communication strategies: Implicit and explicit strategies to gain attention. With implicit communication, parents explained that they use facial expressions, body language, and gestures to get a message across and seek the child’s attention. Parents stated that other ways they attract and keep children’s attention is being always clearly visible to the child and signing within the child’s space. Parents said they kneel to the child’s level so the child can see parent’s face clearly. Additionally, the study revealed that parents believed that facial expressions and body language are very important while using ASL.

With explicit communication, parents said they purposely seek the child’s attention or eye-gaze before they start communicating. Some explicit strategies parents and their children use to get attention include waving, gently tapping on the shoulder, and turning lights on and off for about two times. Some parents said they tap the child’s chin to get attention. Parents said they try to sit face-to-face or slightly sideways, so both parents and the child can see each other and touch if need be.

The study revealed that most parents who do not know sign language described how they communicate with their children by trying to find other ways to communicate. They said they never give up or say, “I will tell you later” or simply ignore their child. Parents said they try other ways of communicating; they draw a picture or act it out. All the parents who did not know sign language said they had enrolled in sign language class to be able to communicate with their children in ASL. Additionally, parents reported children did not have access to deaf role models.

Last, some parents said they believe hearing aids and speech therapy also support their children’s communication. Parents ensured their children wear their hearing aids and attend all speech therapy sessions.

Discussion

When a child who is deaf or hard of hearing is in a family, the family’s dynamic might change or be affected. People around the child need to be involved in the child’s growth and development: the child’s family, friends, and teachers are all essential team members. Parents, however, are the first to support the child’s communication and language, even before the child starts schooling.

Over the years, parents, professionals in deaf and hard of hearing education, speech therapists, audiologists, and early interventionists have debated about the best ways to develop communication skills and provide education for children who are deaf or hard of hearing. Each child is unique. It is important to understand the holistic nature and extent of a child’s hearing loss or deafness and which communication mode is best for the child and which strategies to use to support their communication.

Moreover, everyday activities are useful to practice communication, whether in American sign language, Sign Exact English, lip reading, cued speech, devices for communicating, tactile sign language or any other mode of communication. Therefore, the Routines-Based Model developed by Robin McWilliam, suggested everyday activities for children birth to five years should be used to promote communication. Moments such as feeding time, bathing time and play time are optimal moments to support the child’s communication.

Parents’ nomination of speech therapy as an aid to communication raise questions about dosage and effectiveness beyond the scope of this study. First, what was the frequency and intensity of the speech therapy? Most likely the frequency was once a week and the intensity was 30-60 minutes. Second, did parents believe in the power of this therapy because of cognitive dissonance, in which they felt compelled to trust the efficacy of the sessions because they were signed up for them? Third, what was the role of parents during speech therapy? Was their role simply to chauffeur their child to the sessions or were they the real recipients of the therapists’ expertise? Fourth, if the therapy was direct, hands-on, with minimal participation by the parents, how did anyone believe children this age would be able to transfer from the therapy session to everyday routines? Future research needs to delve into the efficacy of different models of service delivery and parents’ beliefs.

It was evident in this study that all the parents in the study used ASL and other visual communication, such as gestures, to support their children’s communication. Even the parents who did not know ASL had decided to invest in learning and using ASL to provide a solid foundation for their child to learn, thrive and succeed.

A limitation to the study is the small sample size. The sample size of nine participants could not give a full representation of various forms of communication modes among children who are deaf or hard of hearing other than ASL and how parents support communication. For example, there were no families using listening and spoken language, cued speech or total communication.

Parents reported using visual communication like ASL and gestures in supporting communication of their children. They also reported using two types of visual communication strategies: Implicit and explicit strategies to gain their children’s attention. Symbolic intersubjectivity theory posits that the self is created through social interactions and communication with others.

Conclusion

Through these interactions, individuals come to understand themselves and their own thoughts and actions by taking the perspective of others and internalizing the meanings and symbols used to communicate in their culture. Our findings could support this theory, as parents seek to promote their children’s communication. The visual strategies reported by parents in this study are a way to help create a comfortable, natural and confident environment for children who are deaf or hard of hearing to develop their communication skills.

Conflict of Interest

Nil.

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