There has been a major growth in global health networks in recent decades to address health issues including tobacco use, alcohol abuse, and maternal mortality. Most conditions that incur high costs have provoked networks of advocates working to mitigate the impact, increase investment in research, and establish campaigns. Global health networks often work simultaneously across policy, knowledge creation, and advocacy. Until recently there has been limited activity in global health networks and advocacy addressing hearing loss and deafness which has contributed to its relatively low visibility with policymakers compared to other health conditions. This discussion paper reports on a global consultation that explored the views of advocacy groups and individuals on advocacy for the management of hearing loss, and cochlear implantation (CI). It focussed on stakeholders\' views of current advocacy endeavours, opportunities and barriers, and the possible development of a global advocacy network to improve access to cochlear implantation and the supporting services. The subsequent development of a global health network, the Cochlear Implant International Community of Action (CIICA) is discussed and the conditions necessary for the successful development of health networks are explored. This paper will be of interest to those wishing to understand the factors influencing the development of health networks and advocacy.

Here, a moral case is presented as to why sign languages such as Auslan should be made compulsory in general school curricula. Firstly, there are significant benefits that accrue to individuals from learning sign language. Secondly, sign language education is a matter of justice; the normalisation of sign language education and use would particularly benefit marginalised groups, such as those living with a communication disability. Finally, the integration of sign languages into the curricula would enable the flourishing of Deaf culture and go some way to resolving the tensions that have arisen from the promotion of oralist education facilitated by technologies such as cochlear implants. There are important reasons to further pursue policy proposals regarding the prioritisation of sign language in school curricula.

A systematic review explored the evidence base of literacy intervention studies that examined the early years of schooling (preschool through first grade) of participants who were d/Deaf or hard of hearing (d/Dhh). Specific inclusion criteria were used to select single-case design (SCD) studies published in peer-reviewed journals between 2004 and 2017. Fourteen studies met the criteria. Studies were evaluated according to the quality indicators for evidence-based research, individually and across studies (Horner et al., 2005; Institute for Educational Sciences, 2017; Kratochwill et al., 2013). Five of the 14 studies were categorized as \"Meets Standards Without Reservations\"; 7 as \"Meets Standards With Reservations\"; and 2 as \"Does Not Meet Standards.\" None met the established criteria for an evidence base. Recommendations for future research are provided, with specific studies highlighted for replication to build evidence-based practices using SCD in the field of educating students who are d/Dhh.

Deaf and hard of hearing (d/Dhh) children frequently have delayed language; yet limited research exists on interventions to facilitate linguistic development in the classroom (Fung, Chow, & McBride-Chang, 2005). Dialogic reading is an evidence-based practice that has resulted in significantly improved language skills (Towson, Fettig, Fleury, & Abarca, 2017; Whitehurst, Arnold, et al., 1994). The present study used case study and design research methods with three elementary school teachers to identify challenges to implementing dialogic reading and necessary adaptations for d/Dhh students. Primary data sources were collaborative meetings with teachers and these meetings\' transcripts. Additional sources were video-recordings of dialogic reading. Teachers were found to be hindered by insufficient knowledge about language delays and elements of implementation; specifically, adaptations for d/Dhh students competed with curricular responsibilities. It is concluded that teachers should receive better preparation and support for the complex, multifaceted task of instruction.

Limited evidence exists about how to design interventions to improve access to health care for people with disabilities in low and middle-income countries (LMICs). This paper documents the development of two behaviour change interventions. Case study one outlines the design of an intervention to improve uptake of referral for ear and hearing services for children in Malawi. Case study two describes the design of an intervention to improve menstrual hygiene management for people with intellectual impairments in Nepal. Both followed existing approaches-Medical Research Council Guidance for developing and evaluating complex interventions and Behaviour Centred Design. The purpose is to demonstrate how these frameworks can be applied, to document the interventions developed, and encourage further initiatives to advance health services targeting people with disabilities. Important components of the intervention design process were: (1) systematic reviews and formative research ensure that interventions designed are relevant to current discourse, practice and context; (2) people with disabilities and their family/carers must be at the heart of the process; (3) applying the theory of change approach and testing it helps understand links between inputs and required behaviour change, as well as ensuring that the interventions are relevant to local contexts; (4) involving creative experts may lead to the development of more engaging and appealing interventions. Further evidence is needed on the effectiveness of these types of interventions for people with disabilities to ensure that no one is left behind.

This longitudinal study examined the phonological development of a bilingual Arabic-English-speaking child with bilateral cochlear implants (CIs). The focus of the study was to observe the interaction between her two languages and to observe the effect of CIs on the acquisition of two speech sound systems.
This study followed a 3;6-year-old (2;5 hearing age) bilingual Arabic-English-speaking child with bilateral CIs to age 4;4 (3;2 hearing age). Single-word samples were collected bimonthly in both languages. Phon software (Rose et al., 2006) was used to transcribe and analyze speech samples. Measures derived included Percent Consonants Correct-Revised (Shriberg & Kwiatkowski, 1994), percent vowels correct, phonetic inventory complexity, and common phonological patterns for both English and Arabic.
Our findings supported previous research on phonological development exhibited by children with CIs, with the gradual suppression of typical and atypical error patterns and gradual increase in segmental accuracy with maturation. In addition, language interaction and separation between English and Arabic were found, supporting previous cross-linguistic work on bilingual phonological acquisition (e.g., Fabiano-Smith & Goldstein, 2010b).
Bilingual children with CIs have the capability to learn both of their languages and perform similarly to, and even surpass in accuracy, monolingual children with CIs; however, it is also possible to exhibit a slower rate of acquisition of segmental accuracy as compared to their typically developing, hearing peers. Clinical implications of bilingual early intervention are discussed.

At a time when deaf education teacher preparation programs are declining in number, little is known about their actual effectiveness. A phenomenological case study of a graduate-level comprehensive deaf education teacher preparation program at a midwestern university explored empowered and enabled learning of teacher candidates using the Missouri Department of Elementary and Secondary Education educator pillars: (a) commitment to the profession, (b) proficiency in practice, and (c) learning impact, all deemed critical to developing quality teachers. A strong connection was found between the program\'s comprehensive philosophy and its practice. Embracing diversity of d/Deafness and differentiated instruction were the most prevalent themes expressed by participants. Teacher candidates displayed outstanding commitment to the profession and high proficiency in practice. The findings suggest that additional consideration should be given to classroom and behavior management, teacher candidate workload, teaching beyond academics, and preparation for navigating the public school system.

This article discusses the best practices for school psychological evaluation and reports for parents and professionals who work with deaf and hard of hearing children. Deaf and hard of hearing children present unique challenges and for parents to be strong advocates for their children, knowledge about the complexities of psychological assessments is important. Parents are also provided with best practices for psychological reports with descriptions for typical areas of reports and how each is different for deaf and hard of hearing children.

UNASSIGNED: Clinicians are regularly asked to make long-term prognoses. The aim of the current report was to present one systematic approach to doing so. A case example from a malpractice case involving a child fitted with a cochlear implant was presented. Implantation occurred at age 17 months (activation 1 month later), but due to a procedural error, the implant was not functional for 19 months. The problem was ultimately rectified, but the legal case hinged largely on whether the child would be able to make up for the lost time.
UNASSIGNED: A review of the literature on long-term outcomes in children with cochlear implants was conducted. Using 4 studies measuring outcomes 7-10 years later, outcomes were compared between children implanted at age 17-18 months and those implanted at age 36-37 months.
UNASSIGNED: Analysis suggested no potential impact on nonverbal cognitive skills. However, analysis in the areas of speech perception, word comprehension, speech intelligibility, and reading suggested that after 7-10 years, this child would potentially continue to be approximately 1-2 years behind where she might otherwise have been.
UNASSIGNED: This case illustrated the possibility of deriving a long-term prognosis using a systematic examination of the existing outcomes literature. Such an approach is consistent with our mandate to engage in evidence-based practice.

OBJECTIVE: Automatic acoustic measures of voice quality in people with Down syndrome (DS) do not reliably reflect perceived voice qualities. This study used acoustic data and visual spectral data to investigate the relationship between perceived voice qualities and acoustic measures.
METHODS: Participants were four young adults (two males, two females; mean age 23.8 years) with DS and severe learning disabilities, at least one of whom had a hearing impairment.
METHODS: Participants imitated sustained /i/, /u/, and /a/ vowels at predetermined target pitches within their vocal range. Medial portions of vowels were analyzed, using Praat, for fundamental frequency, harmonics-to-noise ratio, jitter, and shimmer. Spectrograms were used to identify the presence and the duration of subharmonics at onset and offset, and mid-vowel. The presence of diplophonia was assessed by auditory evaluation.
RESULTS: Perturbation data were highest for /a/ vowels and lowest for /u/ vowels. Intermittent productions of subharmonics were evident in spectrograms, some of which coincided with perceived diplophonia. The incidence, location, duration, and intensity of subharmonics differed between the four participants.
CONCLUSIONS: Although the acoustic data do not clearly indicate atypical phonation, diplophonia and subharmonics reflect nonmodal phonation. The findings suggest that these may contribute to different perceived voice qualities in the study group and that these qualities may result from intermittent involvement of supraglottal structures. Further research is required to confirm the findings in the wider DS population, and to assess the relationships between voice quality, vowel type, and physiological measures.