UNASSIGNED: Communication breakdowns and their repair by deaf and hard-of-hearing (DHH) and hearing adolescents were examined in conversation with an unfamiliar communication partner.
UNASSIGNED: This study compared the number and type of clarification requests and responses to those requests of 16 DHH and 16 normal-hearing adolescents aged 11-16 years, in a 10-minute conversation with an unfamiliar adult. It also analyzed the relationship between speech intelligibility, communication breakdowns, and clarification requests by an unfamiliar adult. the Children\'s Communication Checklist (CCC) was completed by parents.
UNASSIGNED: DHH adolescents demonstrated significantly higher usage of nonverbal clarification requests and verbal and nonverbal responses to clarification requests compared to normal-hearing adolescents in conversations with an unfamiliar adult. Furthermore, the subscale scores of the CCC and the speech intelligibility of DHH adolescents were significantly lower than those of normal-hearing adolescents. There were correlations between speech intelligibility and the speech subscale score of the CCC, as well as correlations between the pragmatic composite score of the CCC, the number of communication breakdowns, and the number of clarification requests by an unfamiliar adult.
UNASSIGNED: The adolescents with DHH experienced more communication breakdowns in conversation with an unfamiliar adult and the number of clarification requests made by adults was higher.

BACKGROUND: Deaf and hard-of-hearing (DHH) people are at higher risk than their non-DHH counterparts of experiencing adverse birth outcomes. There is a lack of research focusing on social, linguistic, and medical factors related to being DHH which may identify groups of DHH people who experience more inequity.
OBJECTIVE: Examine difference in prevalence of cesarean and adverse birth outcomes among diverse sub-groups of DHH people.
METHODS: We conducted a cross-sectional survey of DHH birthing people in the U.S. who gave birth within the past 10 years. The sample was predominantly white, college educated, and married. We assessed cesarean birth and three adverse birth outcomes: preterm birth, low birthweight, and NICU admission post-delivery. DHH-specific variables were genetic etiology of hearing loss, preferred language (i.e., American Sign Language, English, or bilingual), severity of hearing loss, age of onset of hearing loss, and self-reported quality of perinatal care communication. We estimated prevalence, 95 % confidence intervals, and unadjusted prevalence ratios.
RESULTS: Thirty-one percent of our sample reported a cesarean birth. Overall, there were no significant differences in prevalence across the outcome variables with respect to preferred language, genetic etiology, severity, and age of onset. Poorer perinatal care communication quality was associated with higher prevalence of preterm birth (PR = 2.37) and NICU admission (PR = 1.91).
CONCLUSIONS: Our study found no evidence supporting differences in obstetric outcomes among DHH birthing people across medical factors related to deafness. Findings support the important role of communication access for DHH people in healthcare environments.

BACKGROUND: Pandemic public health measures, such as masks and social distancing, present unique challenges for people who are hard-of-hearing. This study sought to understand how adolescents with varying levels of hearing loss would describe their experiences communicating in a classroom environment during a pandemic and its associated public health measures.
METHODS: Qualitative study utilizing one-on-one semi-structured interviews conducted from July 2021 to April 2022. Interviews were transcribed and analyzed using a reflexive thematic analysis to conceptualize the main themes from the data. Adolescents ages 12-17 who attended school in person during the COVID-19 pandemic with either normal hearing or; bilateral cochlear implants or; bone-anchored hearing aids or; unilateral moderate to severe (40-70 dB) conductive hearing loss secondary to mastoidectomy, were interviewed. Participants were recruited from BC Children\'s Hospital Otolaryngology clinic via a convenience sample.
RESULTS: Fourteen adolescents were interviewed with a median age of 15, 9 with hearing loss and 5 with normal hearing. Pandemic associated challenges such as masks muffling speech, protocol fatigue, and missing pre-pandemic life were present in both the hearing loss and normal hearing groups. Classroom communication for adolescents with hearing loss was disproportionately affected by pandemic measures, leading to challenges making friends, feeling behind their peers in learning, and listening fatigue. Resilience was noted among adolescents with hearing loss in their ability to adapt to pandemic measures and changing classroom dynamics. For adolescents with unilateral hearing loss, the pandemic provided an improved listening environment via a reduction in background noise.
CONCLUSIONS: Pre-existing classroom communication challenges for adolescents with hearing loss were amplified under pandemic public health measures and shared, in part, by those with normal hearing. These findings can be used to further inform classroom design to the optimize learning environment for deaf and hard of hearing students.

UNASSIGNED: Child abuse and neglect have several short- and long-term consequences for the victim. Though Deaf and Hard-of-Hearing children are at higher risk of being maltreated as compared to hearing children, little research in Saudi Arabia has focused on this population. To determine the prevalence of child maltreatment and to examine its association with depression and anxiety among a sample of Deaf and Hard-of-Hearing students in Saudi Arabia, recruited from secondary schools in southern Saudi Arabia.
UNASSIGNED: The sample included 186 Deaf and Hard-of-Hearing students aged 14-17 years (M = 15.7 years; SD = 3.41 years). Data were collected using the Child Abuse Self-Report Scale, Center for Epidemiological Studies Depression Scale for Children, and Generalized Anxiety Disorder Questionnaire. Bivariate and Linear regression analyses were conducted using SPSS 20.
UNASSIGNED: About 47.3% of the students were exposed severe to very severe child maltreatment. The severity of maltreatment varied based on parents\' educational and income level, number of children in the family, the Deaf and Hard-of-Hearing student\'s gender, and parents\' hearing status. Linear regression analysis indicated that child maltreatment was a significant predictor of depression and anxiety in this sample.
UNASSIGNED: Considering the socio-demographic factors influencing the prevalence of maltreatment in the present study, it seems important to work with parents of Deaf and Hard-of-Hearing children to improve their skills in rearing a child with special needs. Addressing the social stigma and social barriers experienced by DHH individuals through familial, institutional, and community interventions may be a first step toward long-term prevention of maltreatment among DHH children.

Deaf and hard-of-hearing (DHH) people report ineffective healthcare communication. Limited research has been conducted on healthcare communication during pregnancy. This study\'s aim was to assess communication accommodations and experiences during pregnancy for DHH people.
An accessible web-based survey was administered to a non-probability sample of DHH people through national organizations, social media, and snowball sampling. Eligibility criteria included being 21 years or older; given birth in the U.S. within the past 10 years, report hearing loss prior to the most recent birth. Questions focused on healthcare experiences and information access during their last pregnancy. The sample included 583 respondents for the present analysis. We describe the communication accommodations requested and received during pregnancy, segmented by preferred language.
Most DHH participants reported communication with prenatal clinicians as \"good\" or \"very good\". On-site interpreter services were most commonly requested by American Sign Language (ASL) only and bilingual DHH people. Interpersonal communication modification requests (e.g., speaking louder) were rarely obliged.
This study is the first national examination of requested and received communication accommodations for DHH patients during the perinatal period.
Healthcare providers should work closely with patients to ensure effective communication access is provided.

School-based programs are an important tobacco prevention tool. Yet, existing programs are not suitable for Deaf and Hard-of-Hearing (DHH) youth. Moreover, little research has examined the use of the full range of tobacco products and related knowledge in this group. To address this gap and inform development of a school-based tobacco prevention program for this population, we conducted a pilot study among DHH middle school (MS) and high school (HS) students attending Schools for the Deaf and mainstream schools in California (n = 114). American Sign Language (ASL) administered surveys, before and after receipt of a draft curriculum delivered by health or physical education teachers, assessed product use and tobacco knowledge. Thirty-five percent of students reported exposure to tobacco products at home, including cigarettes (19%) and e-cigarettes (15%). Tobacco knowledge at baseline was limited; 35% of students knew e-cigarettes contain nicotine, and 56% were aware vaping is prohibited on school grounds. Current product use was reported by 16% of students, most commonly e-cigarettes (12%) and cigarettes (10%); overall, 7% of students reported dual use. Use was greater among HS versus MS students. Changes in student knowledge following program delivery included increased understanding of harmful chemicals in tobacco products, including nicotine in e-cigarettes. Post-program debriefings with teachers yielded specific recommendations for modifications to better meet the educational needs of DHH students. Findings based on student and teacher feedback will guide curriculum development and inform next steps in our program of research aimed to prevent tobacco use in this vulnerable and heretofore understudied population group.

This study mainly explored psychological stress due to coronavirus disease 2019 (COVID-19) among parents of deaf and hard-of-hearing children and how it related to parents\' views of school success in mainland China. The Psychological Stress Questionnaire and Views of Social and Academic Success were administered to 213 parents of deaf and hard-of-hearing children. Results showed that parents\' and children\'s characteristics were related to psychological stress due to COVID-19, which significantly negatively predicted parents\' views of school success. The contributions, limitations, and implications of the present research are discussed.

This study aimed to identify the most common thinking styles of deaf/hard-of-hearing (DHH) and hearing adolescent students, and to examine the extent to which thinking styles predict self-efficacy. It also explored gender-based differences in the thinking styles and self-efficacy of DHH students. Data were collected from 145 DHH and 160 hearing adolescent students in Saudi Arabia (Mage = 17.8 years; SDage = 3.57 years) using the Thinking Styles Inventory-Revised II (TSI-R2) and Self-Efficacy Questionnaire for Children (SEQ-C). Findings revealed that the executive, local, conservative, and chaotic thinking styles were more prevalent among DHH students, while the legislative, universal, liberal, and critical thinking styles were more prevalent among hearing students. Those with Type I thinking styles had higher levels of self-efficacy, while those with Type II thinking styles had lower levels of self-efficacy. There were gender-based differences in the self-efficacy of DHH and hearing students, with higher scores observed among females. Further, for DHH students, the Legislative, Liberal, and Internal thinking styles were more prevalent among males rather than females, while the Executive, Hierarchical, Conservative, External, Judicial, and Local thinking styles were more prevalent among females rather than males. For hearing students, males were more likely to exhibit the Liberal, External, and Oligarchic styles, while females were more likely to exhibit the Global, Executive, Conservative, Local, and Hierarchical styles. Together, these findings suggest the need to train DHH students to use positive thinking styles by implementing courses in their school curricula that enable them to reflect on their self-efficacy.

Deaf and hard-of-hearing (DHH) patients are understudied in emergency medicine health services research. Theory and limited evidence suggest that DHH patients are at higher risk of emergency department (ED) utilization and poorer quality of care. This study assessed ED condition acuity, length of stay (LOS), and acute ED revisits among DHH patients. We hypothesized that DHH patients would experience poorer ED care outcomes.
We conducted a retrospective chart review of a single health care system using data from a large academic medical center in the southeast United States. Data were received from the medical center\'s data office, and we sampled patients and encounters from between June 2011 and April 2020. We compared DHH American Sign Language (ASL) users (n = 108), DHH English speakers (n = 358), and non-DHH English speakers (n = 302). We used multilevel modeling to assess the differences among patient segments in outcomes related to ED use and care.
As hypothesized, DHH ASL users had longer ED LOS than non-DHH English speakers, on average 30 min longer. Differences in ED condition acuity, measured through Emergency Severity Index and triage pain scale, were not statistically significant. DHH English speakers represented a majority (61%) of acute ED revisit encounters.
Our study identified that DHH ASL users have longer ED LOS than non-DHH English speakers. Additional research is needed to further explain the association between DHH status and ED care outcomes (including ED LOS and acute revisit), which may be used to identify intervention targets to improve health equity.

Theory of Mind (ToM) is related to reading comprehension in hearing children. In the present study, we investigated progression in ToM in Swedish deaf and hard-of-hearing (DHH) signing children who were learning to read, as well as the association of ToM with reading comprehension. Thirteen children at Swedish state primary schools for DHH children performed a Swedish Sign Language (SSL) version of the Wellman and Liu (2004) ToM scale, along with tests of reading comprehension, SSL comprehension, and working memory. Results indicated that ToM progression did not differ from that reported in previous studies, although ToM development was delayed despite age-appropriate sign language skills. Correlation analysis revealed that ToM was associated with reading comprehension and working memory, but not sign language comprehension. We propose that some factor not investigated in the present study, possibly represented by inference making constrained by working memory capacity, supports both ToM and reading comprehension and may thus explain the results observed in the present study.