deaf and hard of hearing students' through'the'air

Bennett, J. G., Gardner III, R., & Rizzi, G. L. (2014). Deaf and hard of hearing students' through-the-air English skills: A review of formal assessments. American Annals of the Deaf 158(5), 506-521.

DEAF AND HARD OF HEARING STUDENTS' THROUGH'THE'AIR ENGLISH SKILLS: A REVIEW OF FORMAL ASSESSMENTS

TRONG CORRELATIONS exist between signed and/or spoken English and the literacy skills of deaf and hard of hearing students. Assessments that are both valid and reliable are key for researchers and practitioners investigating the signed and/or spoken English skills of signing populations. The authors conducted a literature review to explore which tests researchers are currently using, how they administer the tests, and how reliability and validity are maintained. It was found that, overall, researchers working with this population use the same tests of English employed by practitioners working with hearing students (i.e., the Peabody Picture Vocabulary Test, Expressive One-Word Picture Vocabulary Test, and Clinical Evaluation of Language Fundamentals). There is a disconnect between what is being used in research with deaf and hard of hearing students and what is being used in practice with them. Implications for practice are discussed. JESSICA G . BENNETT, RALPH GARDNER III, AND

GLEIDES LOPES RIZZI

BENNETT IS A DOCTORAL CANDIDATE, GARDNER AN ASSOCIATE PROFESSOR, AND RIZZI A DOCTORAL STUDENT IN THE SPECIAL EDUCATION PROGRAM, DEPARTMENT OF EDUCATIONAL STUDIES, OHIO STATE UNIVERSITY, COLUMBUS.

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Literacy outcomes for students who are deaf or hard of hearing have been consistently poor (S. Qi & Mitchell, 2012; Traxler, 2000). One cause of poor literacy outcomes is delays in the development of language, whether signed or spoken (P Spencer & Marschark, 2010). The fact is that proficient through-theair^ English skills are a predictor of proficient print literacy skills for learners who are deaf or hard of hearing (Geers & Moog, 1989; Geers, Tobey, Moog, & Brenner, 2008; Goldin-Meadow & Mayberry, 2001; Mayer, 2007,2009; Mayer & Akamatsu, 2000; Mayer & Leigh, 2010; Mayer & Trezek, 2011; Mayer & Wells, 1996; Moores & Sweet, 1990; Nielsen, Luetke, & Stryker, 2011; Paul, 2003; Per-

fetti & Sandak, 2000). Even children with mild hearing loss struggle to develop language (Marschark et al., 2009). Having limited vocabularies compared to their hearing peers (Connor, Heiber, Arts, & Zwolan, 2000), deaf and hard of hearing students whose first language is American Sign Language (ASL) often struggle with language development. For deaf and hard of hearing students, underdeveloped language skills can be an immense obstacle to acquiring English literacy skills. ASL does not have a written form, and for such students who do not benefit from amplification, access to spoken English is often limited. As a result, these students are essentially required to learn how to

AMERICAN ANNALS OF THE DEAF

read and write in English as they learn the language (Marschark & Harris, 1996; Mayer & Trezek, 2011; Paul, 2003; Perfetti & Sandak, 2000). Not having a printed form of ASL, and/or not having full face-to-face access to the phonemes, morphemes, semantics, syntax, and pragmatics of English, inevitably delays the acquisition of print literacy and consequently creates a gap in academic achievement (Marschark & Harris, 1996; Marschark, Spencer, Adams, & Sapere, 2011; McGuiness, 2004,2005; Perfetti & Sandak, 2000). In other words, academic achievement gaps are cyclically and simultaneously created by delay of a first language, delay of acquisition of print literacy, and an overall lack of proficiency in English skills at the conversational and academic levels (Luckner & Handley, 2008; Mayer, 2009; Mayer & Leigh, 2010). Therefore, finding reliable tools to measure the progress of the throughthe-air English language development of deaf and hard of hearing students should be a priority for teachers, clinicians, and researchers (Schick, 1997). Although dozens of assessments are available (see Easterbrooks & Baker, 2002), there is little clarity as to how these assessments are being administered to deaf and hard of hearing students who require access to a visual-manual language (i.e., children placed in Total Communication or bilingual/bicultural programs). Moreover, most of these assessments have been normed on typically developing hearing children using spoken English. If these assessments are being administered by means of some sort of English-based sign, there may be an important yet unknown impact on the validity and reliability of these assessments (Moores, 2006/2007). Researchers have found that to become fiuent readers and writers, students who are deaf or hard of hear-

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ing need to become fiuent users of English (Mayer 2007, 2009; Mayer & Leigh, 2010). Teaching and providing through-the-air opportunities for students to become users of English overtly may have the potential to enable students to "think" in English covertly as a more efficacious bridge to learning how to read and write English (Mayer & Wells, 1996). Consequently, regardless of program type (i.e., aural/oral. Total Communication, bilingual/bicultural) or communication history and/or preference (e.g., spoken, sign-supported speech, ASL), programming considerations should include teaching deaf and hard of hearing students to communicate in English through the air (Mayer, 2007; Mayer & Akamatsu, 2000). Under current bilingual-bicultural practices in deaf education, students learn to read and write English by attempting to make direct connections between ASL and printed English (Mayer & Wells, 1996; P Spencer & Marschark, 2010). Skipping the step of actually learning English through the air is a method that is not based on scientific evidence pertaining to bilingual education models such as the language acquisition research of Cummings (1989; cited in Mayer & Wells, 1996); nor does this method necessarily produce better deaf readers (Luetke-Stahlman & Nielsen, 2003; Paul, 2011; P Spencer & Marschark, 2010). Mayer and Trezek (2011) recommend that teachers sequentially teach the form of the language in which students are expected to read and write, and provide them with opportunities to generalize these skills in natural settings. English-based sign language is one means by which deaf and hard of hearing students may be able to do just that (Akamatsu & Stewart, 1998; Convertino, Marschark, Sapere, Sarchet, & Zupan, 2009; Goldin-Meadow & Mayberry, 2001;

Hyde & Power, 1991; Luetke-Stahlman & Nielsen, 2003; Mayer 2009; Mayer & Akamatsu, 2000; Mayer & Leigh, 2010; Paul, 2011; Perfetti & Sandak, 2000; Power, Hyde, & Leigh, 2008; Schick & Moeller, 1992; Wilson & Hyde, 1997). In order to identify student language needs and measure effectiveness of language instruction, practitioners need the ability to formally assess the through-the-air English skills of students, as we will discuss further in the present article. Speech-language pathologists (SLPs) typically conduct formal measures of language and communication skills of students who are deaf or hard of hearing (Luckner & Bowen, 2006). However, teachers also need to understand the language achievement levels of their students and should be more involved in the assessment process so that language goals can be developed, instruction can be designed and implemented, and progress can be frequently monitored (Easterbrooks & Baker, 2002; Luckner & Bowen, 2006). Because of the significance of through-the-air English skills to language development and subsequent literacy achievement, teachers need to fully understand the available assessments for measuring the throughthe-air English skills of deaf and hard of hearing students who sign, how to administer those assessments, and how these assessments can be used to guide instruction (Easterbrooks & Baker, 2002; Luckner & Bowen, 2006). The literature review we conducted for the present article was directed toward determining which English-language assessment tools researchers have most commonly used to measure through-the-air English skills of deaf and hard of hearing students who sign. For the subsequent study, we posed three specific research questions: 1. How were the assessments adapted and administered to


REVIEW OF FORMAL ASSESSMENTS

provide access to students who need a visual-manual mode of communication? 2. How were reliability and validity preserved? 3. How can the assessments be used to guide both language and literacy interventions in the classroom? In the closing sections of the article, we make recommendations for future research and discuss the practical implications of using formal Englishlanguage assessments to guide classroom language and literacy instruction of students who are deaf or hard of hearing. Overview of Assessments for the Literature Review In 'Assessment of Language," a chapter in their book Language Learning in Children Who Are Deaf and Hard of Hearing, Easterbrooks and Baker (2002) identified four features of English-language assessments: tests of English grammar, tests of English word meaning, tests of spoken English versus signed English, and tests of English pragmatic skills. Easterbrooks and Baker reviewed a total of 43 assessments (see Table 1). We used the 15 examples provided by Easterbrooks and Baker (2002) in "Assessment of Language" as a starting point to determine which assessments are currently being used to assess through-the-air English skills of deaf and hard of hearing students who use sign language (i.e., ASL or Englishbased sign). In addition, two surveys (Caesar & Köhler, 2009; Luckner & Bowen, 2006) each verified that approximately half of the assessments highlighted by Easterbrooks and Baker (2002) are used by SLPs in practice (see Table 1). The two surveys also provided additional insight into tests

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that were not highlighted by Easterbrooks and Baker. Eor example, Luckner and Bowen (2006) conducted an online survey to better understand current assessment practices for students who are deaf or hard of hearing. They found that these students' language skills are most frequently assessed by SLPs. In addition, through the responses on the survey, Luckner and Bowen were able to identify and rank the eight most common measures of language being used in practice. Easterbrooks and Baker also identified six of these language assessments (see Table 1). When adjusting the rank order to include only formal assessments (i.e., language samples were the second most used assessment overall), Luckner and Bowen found that the Stanford Achievement Test series, which measures written language, was the third most frequently used formal assessment, and that the Clinical Evaluation of Language Eundamentals (CELE) was the sixth most frequently used formal assessment. Further, Caesar and Köhler (2009) conducted a survey of language assessment procedures used by schoolbased SLPs who did not specifically serve deaf and hard of hearing students. These authors also identified a total of 15 assessments currently being used by SLPs. Seven of these assessments were highlighted by Easterbrooks and Baker (2002; see Table 1). Particularly noteworthy is the finding that the CELF-3 (Semel, Wiig, & Secord, 1995) was the most commonly used tool among school-based SLPs (Caesar & Köhler, 2009). Considering that the CELF appeared in both surveys and is a comprehensive formal assessment of spoken English, the CELF was included in the literature search for the present study along with the 15 assessments highlighted by Easterbrooks and Baker.

Method Database Procedures To determine which formal assessments of language are being used to measure the through-the-air English skills of deaf and hard of hearing students who sign, we conducted a literature search for each of the 15 assessments highlighted by Easterbrooks and Baker (2002; see Table 1), as well as a general search for the CELF. An accompanying descriptor was used to capture deaf and hard of hearing students. The exact name of the assessment was individually cross-referenced with the following terms: deaf, deafness, hard of hearing, hearing impairment, hearing loss, spoken English, signed English, and Englishbased sign. Each of the 16 test names and descriptors was searched for in ERIC and PsycINFO, and was also entered in a digital library network that searched seven databases including Academic OneFile, Academic Search Complete, and WoridCat (OCLC). In addition, four journals that publish articles on sign communication were separately searched: American Annals of the Deaf, Communication Disorders Quarterly, Journal of Deaf Studies and Deaf Education, and Journal of Speech, Language, and Hearing Research. These journals were chosen because the American Annals of the Deaf and Journal of Deaf Studies and Deaf Education are the two leading journals in deaf education, and Communication Disorders Quarterly and the Journal of Speech, Language, and Hearing Research also frequently include studies with deaf and hard of hearing participants. For the American Annals of the Deaf, the first author looked through each past year's index by subject. The years 1991-2012 were available. The first author read the titles of the articles grouped under the following subjects in the index: assessments, bilingual


Table 1 Assessments Identified by Easterbrooks and Baker (2002) Number of articles reporting on research Features I of English

P^sts of E I granni

Assessments identified by Easterbrooks and Baker (2002)

witti signing participants (present review), exciuding the Clinicai Evaiuation of Language Fundamentals

Rhode Island Test of Lan. (E. Engen & T. Engen, 1 Grammatical Analysis of Elicifed Language (Moog& Geers, 1979) Teacher Assessment of Grammatical Structures (Moog&Kozak, 1983) Teacher Assessment of Spoken Language (Moog & Biedenstein, 1998) Kendalf Conversational Proficiency Levels French. 1999) Test of Auditory Comprehension of Language-Revised (Carrow-Wooifoik, 1985)^ Test of Language Development (Newcomer & Hammill. 1988)« í

word meaning

Receptive One-Word Picture Vocabulary Test (Gardner, 1985)-wa/ of Deaf Studies and Deaf Education, 17(1), 39-60. doi:10.1093/deafed/enr030 Caesar, L. G., & Kohler, E D. (2009). Tools clinicians use: A survey of language assessment procedures used by school-based speechlanguage pathologists. Communication Disorders Quarterly, 30(4), 226-236. *Ching, T. Y C, Crowe, K., Martin, V, Day, J., Mahler, N., Youn, S., et al. (2008). Language development and everyday functioning of children with hearing loss assessed at 3 years

oí age. International Journal of Speech-Language Pathology', 12(2), 124-131. *Connor, C. M., Hieber, S., Arts, H. A., & Zwolan, T A. (2000). Speech, vocabulary, and the education of children using cochlear implants: Oral or Total Communication? Journal of Speech, Language, and Hearing Research, 43, 1185-1204. Convertino, C. M., Marschark, M., Sapere, R, Sarchet, T, & Zupan, M. (2009). Predicting academic success among deaf college students. Journal of Deaf Studies and Deaf Education, 14(5), 324-343. *Dodd, B., Woodhouse, L, & Mclntosh, B. (1992). The linguistic abilities of young children with hearing impairment: Eirst report of a longitudinal study. Australia and New Zealand Journal of Developmental Disabilities, 18(1), 17-34. Easterbrooks, S. R., & Baker, S. (2002). Language learning in children who are deaf and hard of hearing: Multiple pathways. Boston, MA: Allyn & Bacon. Geers, A. E., & Moog, J. (1989). Eactors predictive of the development of literacy in profoundly hearing-impaired adolescents. Volta Review, 91, 69-86. *Geers, A. E., Moog, J., & Schick, B. (1984). Acquisition of spoken and signed English by profoundly deaf children./owm«/ of Speech and Hearing Disorders, 49(4), 378-388. »Geers, A. E., Nicholas, J. G., & Sedey, A. L. (2003). Language skills of children with early cochlear imphntaiion. Ear and Hearing 24, 46S-58S. doi: 10.1097/01.AUD.0000051689.57380.1B *Geers, A. E., & Schick, B. (1988). Acquisition of spoken and signed English by hearingimpaired children of hearing-impaired or hearing parents. Journal of Speech and Hearing Disorders, 53(2), 136-143. *Geers, A. E., Tobey, E., Moog, J., & Brenner, C (2008). Long-term outcomes of cochlear implantation in the preschool years: Erom elementary grades to high school. International Journal of Audiology, 47(2), 21-30. doi: 10.1080/14992020802339167 *Gioia, B. (2001). The emergent language and literacy experiences of three deaf preschoolers. International Journal of Disability, Development, and Education, 48(4), 411-428. doi: 10.1080/10349120120094293 Goldin-Meadow, S., &Mayberry, R., (2001). How do profoundly deaf children learn to read? Learning Disabilities Research and Practice, 16, 222-229. Goldstein, G., & Bebko,J. M. (2003). The profile of multiple language proficiencies: A measure for evaluating language samples of deaf chüdrea. Journal of Deaf Studies and Deaf Education, 8(4), 452-463. doi: 10.1093/ deafed/engO27 *Guo, L Y, Spencer, L J., & Tomblin,J. B. (2013). Acquisition of tense marking in Englishspeaking children with cochlear implants: A longitudinal study. Journal of Deaf Stud-

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REVIEW OF FORMAL ASSESSMENTS ies and Deaf Education, 18(2), 187-205. doi: 10.1093/deafed/ens069 *Hay-McCutcheon, M. J., Kirk, K. I., Henning, S. C, Gao, S., & Qi, R. (2008). Using early language outcomes to predict later language ability in children with cochlear implants. Audiotogy Neurototogy, 13, 370-378. doi: 10.1159/000148200 Hyde, M. B., & Power, D. J. (1991). Teachers' use of Simultaneous Communication: Effects on the signed and spoken components. American Annats of the Deaf 136(5), 381-387. Konstantareas, M., Oxman, J., & Webster, C. (1978). Iconicity: Effects on the acquisition of sign language by autistic and other severely dysfunctional children. In E Siple (Ed.), Understanding language through sign language research (pp. 213-237). New York, NY: Academic Press. *Krinsky, S. G. (1990). The feeling of knowing in deaf adolescents. American Annats of the Deaf 135(5), 389-395. *Lederberg, A. R., & Spencer, E E. (2008). Wordlearning abilities in deaf and hard-of-hearing preschoolers: Effect of lexicon size and language modality. Joumat of Deaf Studies and Deaf Education, 14(1), 44-62. doi:10.1093/ deafed/ennO21 Luckner, J., & Bowen, S. (2006). Asse.s.sment practices of professionals serving students who are deaf or hard of hearing: An initial investigation. American Annals of the Deaf 757(4), 410-417. Luckner, J., & Handley C. M. (2008). A summary of the reading comprehension research undertaken with students who are deaf or hard of hearing. American Annals of the Deaf 153(1), 6-36. ''Luetke-Stahlman, B., & Nielsen, D. C. (2003). The contribution of phonological awareness and receptive and expressive English to the reading ability of deaf students with varying degrees of exposure to accurate English. Journal of Deaf Studies and Deaf Education, 8(4), 464-484. doi: 10.1093/deafed/ engO28 Marschark, M., & Harris, M. (1996). Success and failure in learning to read: The special (?) case of deaf children. In C. Cornolodi & J. Oakhill (Eds.), Reading comprehension difficulties: Processes and intervention (pp. 279-300). Hillsdale, NJ: Erlbaum. Marschark, M., Sapere, E, Convertino, C. M., Mayer, C, Wauters, L, & Sarchet, T (2009). Are deaf students' reading challenges really about reading? American Annats of the Deaf 154(4), 357-370. Marschark, M., Spencer, E, Adams, J., & Sapere, E (2011). Evidence-based practice in educating deaf and hard-of-hearing children: Teaching to their cognitive strengths and needs. European Journal of Special Needs Education, 26(1), 3-ld. Martin, L., & Bench, J. (1997). Some observations on the use of conjunctions when using

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the CELF-R with hearing-impaired children. Child Language Teaching and Therapy, 13(1), 73-88. doi: 10.1177/02656590970 Mayer, C. (2007). What really matters in the early literacy development of deaf children./owrnat of Deaf Studies and Deaf Education, 72(4), 411-431. Mayer, C. (2009). Issues in second-language literacy education with learners who are deaf International Journal of Bilingual Education and Bilinguatism, 12(3), 325-334. Mayer, C, & Akamatsu, C. T (2000). Deaf children creating written texts: Contributions of American Sign Language and signed forms of English. American Annals of the Deaf 145(5), 394-403. Mayer, C, & Leigh, G. (2010). The changing context for sign bilingual education programs: Issues in language and the development of literacy. International Journal of Bilingual Education and Bilingualism, 13(2), 175-186. Mayer, C, & Trezek, B. J. (2011). New (?) answers to old questions: Literacy development in deaf and hard of hearing learners. In D. Moores (Ed.), Partners in education: Issues and trendsfrom the 21st International Congress on the Education of the Deaf (pp. 62-74). Washington, DC: Gallaudet University Press. Mayer, C, & Wells, G. (1996). Can the linguistic interdependence theory support a bilingualbicultural model of literacy education for Deaf students?yoíír«íí/ of Deaf Studies and Deaf Education, 7(2), 93-107. McGuinness, D. (2004). Early reading instruction: What science really tells us about how to teach reading. Cambridge, MA: MIT Press McGuinness, D. (2005). Language development and learning to read: The scientific study of how language development affects reading skill. Cambridge, MA: MIT Press. »Miller, E. M., Lederberg, A. R., & Easterbrooks, S. R. (2013). Phonological awareness: Explicit instruction for young deaf and hard-of-hearing children./owrK«/ of Deaf Studies and Deaf Education, 75(2), 206-227 doi: 10.1093/ deafed/ensO67 Miller, M. (2008). Sign iconicity and receptive vocabulary testing. American Annals of the Deaf 152(5), 441-449. *Moeller, M. P (2000). Early intei-vention and language development in children who are deaf and hard of hearing. Pediatrics, 106(3), 1-9. doi: 10.1542/peds.l06.3.e43 Moores, D. (2006/2007). Educational practices and assessment. American Annals of the Deaf 151(5), 461^63. Moores, D., c& Sweet, C. (1990). Relationships of English grammar and communicative fluency to reading in deaf adolescents. Exceptionality, 1(2), 97-106. *Murphy, J., & Dodd, B. (2010). A diagnostic challenge: Language difficulties and hearing impairment in a secondary school student

from a non-English-speaking background. Child Language Teaching and Therapy, 26(3), 207-220. doi: 10.1177/026565900 9349977 National Governors Association Center for Best Practices. (2010). Common Core state standards for English/language arts. Washington, DC: Council of Chief State School Officers. Nielsen, D. C, Luetke, B., & Stryker, D. S. (2011). The importance of morphemic awareness to reading achievement and the potential of signing morphemes to supporting reading development./oMrwa/ of Deaf Studies and Deaf Education, 16(3), 275-288. »Nielsen, D. C, & Luetke-Stahlman, B. (2002). The benefit of assessment-based language and reading instruction: Perspectives from a case study Journal of Deaf Studies and Deaf Education, 7(2), 149-186. »Orlando, A., & Shulman, B. (1989). Severeto-profound hearing-impaired children's comprehension of figurative language. Communication Disorders Quarterly, 12(2), 157-165. doi: 10.1177/1525740189 01200205 Easlawski, T (2005). The clinical evaluation of language fundamentals, 4th edition (CELE4): A review. Canadian Journal of School Psychology, 20, 129-134. Paul, E (2003). Processes and components of reading. In M. Marschark & E Spencer (Eds.), Oxford handbook of deaf studies, language, and education (Vol. 1, pp. 97-109). New York, NY: Oxford University Press. Paul, P (2011). The perils and benefits of assessment. American Annals of the Deaf 156(4), 339-341. Paul, P, & Lee, C. (2010). The qualitative similarity hypothesis. American Annals of the Deaf, 154(5), 456-462. Perfetti, C. A., & Sandak, R. (2000). Reading optimally builds on spoken language: Implications for deaf readers. Journal of Deaf Studies and Deaf Education, 5(1), 32-50. Power, D., Hyde, M., & Leigh, G. (2008). Learning English from Signed English: An impossible task? American Annals of the Deaf 153(1), 37-47. Prezbindowski, A. K., & Lederberg, A. R. (2003). Vocabulary assessment of deaf and hard-ofhearing children: From infancy through the preschool years. Journal of Deaf Studies and Deaf Education, 8(4), 383-400. Qi, S., & Mitchell, R. E. (2012). Large-scale academic achievement testing of deaf and hardof-hearing students: Past, present, and future. Journal of Deaf Studies and Deaf Education, 17(1), 1-18. *Rance, G., Barker, E. J., Sarant, J. Z., & Ching, T Y C. (2007). Receptive language and speech production in children with auditory neuropathy/dyssynchrony-type hearing loss. Ear and Hearing, 28, 694-702. Schick, B. (1997). The effects of discourse genre


on English-language complexity in schoolage deaf students. Journal of Deaf Studies and Deaf Education, 2(4), 234-251, *Schick, B., & Moeller, M. R (1992). What is learnable in manually coded English sign systems? Applied Psycholinguistics, 7J(3), 313-340. *Spencer, R (2004). Individual differences in language performance after cochlear implantation at 1 to 3 years of age: Child, family, and linguistic hctoK. foumal of Deaf Studies and Deaf Education, 9{A), 395-412. doi: 10.1093/deafed/enh033 »Spencer, R, Barker, B., & Tomblin, J, B. (2003). Exploring the language and literacy outcomes of pédiatrie cochlear implant users. Ear and Hearing, 24, lid-141. doi; 10.1097/ 01 .AUD.0000069231.72244.94 Spencer, P, & Marschark, M. (2010). Evidencebased practices in educating deaf and hard of hearing students. New York, NY: Oxford University Rress. •Tomblin, J. B., Spencer, I.., Flock, S., Tyler, R., & Gantz, B. (1999). A comparison of language

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achievement in children with cochlear implants and children using hearing aids. foumal of Speech, Language, and Hearing Research, 42, 497-511. Traxler, C. (2000). The Stanford Achievement Test, ninth edition: National norming and performance standards for deaf and hard-ofhearing students./oz^r««/ of Deaf Studies and Deaf Education. 5(1), 33-48. U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Rrograms. (2009). Tluenty-eighth annual report to Congress on the implementation of the Individuals With Disabilities Education Act, 2006 (Vol. 1). Washington, DC: Author. *Wake, M., Poulakis, Z., Hughes, E. K., CareySargeant, C, & Rickards, R W (2004). Hearing impairment: A population study of age of diagnosis, severity, and language outcomes at 7-8 years. Archives of Disease in Childhood, 90, 238-244. doi: 10.1136/adc.2003 .039354

White, A., & Tischler, S. (1999). Receptive sign vocabulary tests: Tests of single-word vocabulary or iconicity? American Annals of the Deaf 144(4), 33^^338. Wilson, T, & Hyde, M. (1997). The use of Signed English pictures to facilitate reading comprehension by deaf students. American Annals of the Deaf 142(4), 333-341. *Yim, D. (2011). Spanish- and English-language performance in bilingual children with cochlear implants. Otology and Neurotology. 33, 20-25. *Yoshinaga-Itano, C, Baca, R., & Sedey A. (2010). Describing the trajectory of language development in the presence of severe-to-profound hearing loss: A closer look at children with cochlear implants versus hearing aids. Otology and Neurotology, 31, 1268-1274. *Yoshinaga-Itano, C, & Downey, D. M. (1996). The psychoeducational characteristics of school-aged students in Colorado with educationally significant hearing losses. Volta Review, 98, 65-96.


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