Research. Emergent Literacy Skills During Early

Transcription

1 Volume 108, Number 2 ISSN The Volta Review Alexander Graham Bell Association for the Deaf and Hard of Hearing The Research Emergent Literacy Skills During Early Volta Childhood in Children With Hearing Loss: Strengths and Weaknesses 91 Susan R. Easterbrooks, Ed.D.; Amy R. Lederberg, Ph.D.; Elizabeth M. Miller, M. Ed.; Jessica P. Bergeron, M. Ed.; and Carol McDonald Connor, Ph.D. Prelinguistic Vocal Development in Infants withtypical Hearing and Infants with Severe-to-Profound Hearing Loss 115 Suneeti Nathani Iyer, Ph.D., CCC-SLP; and D. Kimbrough Oller, Ph.D. Measuring Metacognition: A Prospect for Objective Assessment 139 Yasser A. Al-Hilawani, Ed.D.; Fatimah Review A. Dashti, Ph.D.; and Ahmad A. Abdullah, Ph.D.

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3 The Volta Review Volume 108, Number 2 ISSN Fall 2008 Organized in 1890 to encourage the teaching of speech, speechreading and the use of residual hearing to people who are deaf or hard of hearing, the Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) welcomes to its membership all who are interested in improving educational, professional and vocational opportunities for people who are deaf or hard of hearing. Affiliated with AG Bell are the Parent Section, the Deaf and Hard of Hearing Section and the International Professional Section. 89 Editors Preface Joseph Smaldino, Ph.D., and Kathryn L. Schmitz, Ph.D. Research 91 Emergent Literacy Skills During Early Childhood in Children With Hearing Loss: Strengths and Weaknesses Susan R. Easterbrooks, Ed.D.; Amy R. Lederberg, Ph.D.; Elizabeth M. Miller, M. Ed.; Jessica P. Bergeron, M. Ed.; and Carol McDonald Connor, Ph.D. 115 Prelinguistic Vocal Development in Infants with Typical Hearing and Infants with Severe-to-Profound Hearing Loss Suneeti Nathani Iyer, Ph.D., CCC-SLP; and D. Kimbrough Oller, Ph.D. 139 Measuring Metacognition: A Prospect for Objective Assessment Yasser A. Al-Hilawani, Ed.D.; Fatimah A. Dashti, Ph.D.; and Ahmad A. Abdullah, Ph.D. Regular Features 155 Information for Contributors to The Volta Review Permission to Copy: The Alexander Graham Bell Association for the Deaf and Hard of Hearing, as copyright owner of this journal, allows single copies of an article to be made for personal use. This consent does not extend to posting on Web sites or other kinds of copying, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works of any type, or for resale without the express written permission of the publisher. For more information, contact AG Bell at 3417 Volta Place, NW, Washington, DC 20007, [email protected], or call 202/ (voice) or 202/ (TTY).

4 The Alexander Graham Bell Association for the Deaf and Hard of Hearing Officers of the Association: President, John R. Jay Wyant (MN); President-Elect, Kathleen S. Treni (NJ); Secretary-Treasurer, Christine Anthony, M.B.A., M.E.M. (IL); Immediate Past President, Karen Youdelman, Ed.D. (OH); Executive Director, Alexander T. Graham. Board of Directors: Donald M. Goldberg, Ph.D. (OH); Irene W. Leigh, Ph.D. (MD); Michael A. Novak, M.D. (IL); Dan Salvucci, M.Ed, Ed.M, CCC-A (MA); J. Paul Sommer, M.B.A. (MA); Peter S. Steyger, Ph.D. (OR); Joanne Travers (MA) The Volta Review Editor: Joseph Smaldino, Ph.D. Senior Associate Editor: Kathryn L. Schmitz, Ph.D. Associate Editors: Alice Eriks-Brophy, Ph.D.; Carolyn J. Brown, Ph.D., M.S.P.A.; Paula Brown, Ph.D., CCC-SLP; Connie Mayer, Ed.D.; Jan Moore, Ph.D.; Michael Seidman, M.D., F.A.C.S. The Volta Review Staff: Managing Editor, Melody Felzien; Director of Professional Programs, Judy Harrison; Director of Communications, Catherine Murphy General Information: The Volta Review (ISSN ) is published two times annually: spring and fall. Copyright 2008 by Alexander Graham Bell Association for the Deaf and Hard of Hearing, 3417 Volta Place, NW, Washington, DC Postmaster: Send address changes to Alexander Graham Bell Association for the Deaf and Hard of Hearing, Attn: Membership Department, 3417 Volta Place, NW, Washington, DC Telephone 202/ (voice); 202/ (TTY). Claims for undelivered journal issues must be made within four months of publication. The Volta Review is sent to all premium, student, senior, household and lifetime members of the association. Yearly individual membership dues: Premium, $60; Household, $75, Senior, $40; Student, $30; Lifetime, $1,000. Yearly dues for residents of other countries: add $15 U.S. The Volta Review comprises $18 of membership dues. Subscriptions for schools, libraries and institutions are $79.95 (domestic) and $99.95 (international). Back issues, when available, are $10 each plus $3 shipping and handling, except for monograph issues, which are $24.95 plus $4 shipping and handling. PUBLICATIONS MAIL AGREEMENT NO Return undeliverable Canadian addresses to P.O. Box 503, RPO West Beaver Creek, Richmond Hill, ON L4B 4R6. The Volta Review is abstracted and indexed in Applied Social Science Index and Abstracts, Chicorel Abstracts to Reading and Learning Disabilities, Cumulative Index to Nursing & Health Literature, Current Index to Journals in Education, Educational Resources Information Center (ERIC), Elsevier s Bibliographic Databases, Exceptional Child Education Resources, Language Behavior Abstracts, Mental Health Abstracts, Psychological Abstracts, and Rehabilitation Literature. It is abstracted in PsycINFO and indexed in Educational Index. The Volta Review is devoted to reporting scholarly findings in areas related to the development of listening and spoken language by individuals who are deaf or hard of hearing. The Volta Review is the peer-reviewed scholarly research journal, published two times per year, of the Alexander Graham Bell Association for the Deaf and Hard of Hearing, a not-for-profit organization. Annual membership dues are $60 for individuals and $79.95 (domestic) for institutional subscriptions. The publishing office of The Volta Review is located at 3417 Volta Place, NW, Washington, DC

5 Editors Preface Joseph Smaldino, Ph.D., Editor Kathryn L. Schmitz, Ph.D., Senior Associate Editor Change has been a word that has been used frequently during this election season. Most of us, even politicians, understand the definition of change to be to undergo transformation or transition (Merriam-Webster Online Dictionary. Retrieved November 12, 2008). The Volta Review recently underwent such a transition when I became the new Editor this past fall. I am an audiologist and have professionally served individuals who are deaf and hard of hearing for over 35 years. My background as an author, review panelist, and associate editor of various journals has prepared me well for the position. I will do my best to maintain The Volta Review as a high quality source of information regarding the educational, spoken language, and auditory development of children who are deaf or hard of hearing, a role it has maintained for over a hundred years. I also intend to transform the journal by bringing some exciting innovations. To this end, I have assembled a diverse group of stakeholders from among the readers of the journal. Based on discussions with this group and other reader input, the editorial board of The Volta Review hopes to transform the journal so that it better meets the needs of the readership in terms of content as well as accessibility of that content. Over the next few months you will read about some of these transformations.stay tuned. Another important transition has been the creation of a new position, the Senior Associate Editor. We are extremely fortunate to have Dr. Kathryn Schmitz serving in this position. She is very familiar with the academic publication process and managing publications and multiple projects, having served as editor of NTID s FOCUS magazine for four years. Her nearly 20 years of employment at the National Technical Institute for the Deaf has given her the opportunity to interact and work with a wide range of parents, students, academics, and professionals in the field of deaf education, both nationally and internationally. Her role will be to manage the solicitation and review of manuscripts as well as to be a major force in the journal s transformational process.

6 We are very excited about the future of The Volta Review, to build on its greatness and continue its revered position as a first-rate publication. Just as the African proverb proclaims, it takes a village to raise a child, it takes the AG Bell membership to keep The Volta Review at the forefront of research and scholarship related to children who are deaf and hard of hearing. This work involves the parent members, the professional members, and the members who are deaf and hard of hearing. Katie and I welcome your comments, your suggestions, your ideas, and most importantly any manuscripts that you feel address the concerns of the membership. With your help, The Volta Review will grow and prosper as it undergoes transition and transformation in maintaining its premier role in the field of research related to deafness. Sincerely, Joseph Smaldino, Ph.D. Professor and Chair, Department of Communication Sciences Illinois State University [email protected] Kathryn L. Schmitz, Ph.D. Assistant Professor and Interim Chair, Liberal Studies Department National Technical Institute for the Deaf, Rochester Institute of Technology [email protected] 90

7 The Volta Review, Volume 108(2), Emergent Literacy Skills During Early Childhood in Children With Hearing Loss: Strengths and Weaknesses Susan R. Easterbrooks, Ed.D. ; Amy R. Lederberg, Ph.D. ; Elizabeth M. Miller, M. Ed. ; Jessica P. Bergeron, M. Ed. ; and Carol McDonald Connor, Ph.D. The difficulties for students with hearing loss in gaining proficient literacy skills are well documented. However, studies describing the nature and variability of emergent literacy skills for students with hearing loss or the rate at which progress occurs at young ages are limited. We assessed emergent literacy skills and outcomes at the beginning and end of a school year for 44 young children (mean age = 5.2 years) who are deaf and hard of hearing and who had some speech perception skills. These children generally showed gains similar to their peers with typical hearing in knowledge of letter names and common written words, but lagged in phonological awareness skills. Correlational analyses suggest that these skills were systematically related to the children s literacy development, similar to what has been found in children with typical hearing. The results show that children participating in this study progressed on some phonological awareness skills (alliteration, blending, and elision) but not on others (rhyming, syllable segmentation). This article discusses the relevance of the findings for an emergent literacy curriculum. Susan R. Easterbrooks, Ed.D., is a Professor in the Department of Educational Psychology and Special Education at Georgia State University; Amy R. Lederberg, Ph.D., is a Professor in the Department of Educational Psychology and Special Education at Georgia State University; Elizabeth M. Miller, M. Ed., is a Cognitive Development Specialist in the Department of Educational Psychology and Special Education at Georgia State University; Jessica P. Bergeron, M. Ed., is a Cognitive Development Specialist in the Department of Educational Psychology and Special Education at Georgia State University; and Carol McDonald Connor, Ph.D., is an Associate Professor at Florida State University and the Florida Center for Reading Research. Correspondence concerning this article should be addressed to Dr. Easterbrooks, Educational Psychology and Special Education, P.O. Box 3979, Georgia State University, Atlanta, GA , or by at [email protected]. Emergent Literacy and Hearing Loss 91

8 Introduction Children who are deaf and hard of hearing are at risk for serious reading deficiencies (Carney & Moeller, 1998). Indeed, the median reading level for high school graduates with hearing loss falls between fourth and fifth grades (Allen, 1986; Traxler, 2000). Recent reports suggest that a newer generation of children who are deaf and hard of hearing (DHH) may have a better longterm prognosis. For many of these children, this may be related to improved speech perception skills resulting from universal newborn screening and advances in technology, such as cochlear implants (Spencer & Oleson, 2008). Research has established key skills, such as phonological awareness, knowledge of the alphabetic principle (e.g., that letters represent phonemes, which can be blended to form words), and vocabulary as integral to successful literacy development among children with typical hearing (Ehri et al., 2001; Rayner, Foorman, Perfetti, Pesetsky, & Seidenberg, 2001). Recent research for elementary-age school children who are DHH suggests that many of these same skills are important for children with hearing loss who have at least some access to spoken language (e.g., through hearing aids or cochlear implants) (Colin, Magnan, Ecalle, & Leybaert, 2007; Spencer & Oleson, 2008). However, there is little research on these foundational skills for younger children who are DHH. The purpose of this study is to learn more about the early development of literacy skills by examining changes over a typical school year for young children with hearing loss. We were especially interested in three skills that are foundational for emergent literacy development in children with typical hearing and may also be critical for children who are DHH and who have access to spoken language: phonological awareness, alphabetics, and vocabulary. These skills form the foundation to read words and passages meaningfully (National Reading Panel, 2002). Phonological Awareness Phonological awareness refers to the broad class of skills that involve attending to, thinking about, and intentionally manipulating the phonological aspects of spoken language, especially the internal phonological structure of words (Scarborough & Brady, 2002, p. 312). These skills include blending, segmenting, elision, and rhyming. Among hearing children, phonological awareness skills are relatively stable from the late-preschool period forward, although there are important individual differences (Burgess & Lonigan, 1998; Lonigan, Burgess, & Anthony, 2000; Wagner et al., 1997). These skills represent strong independent predictors of beginning reading and spelling abilities (Lonigan et al., 2000; MacLean, Bryant, & Bradley, 1987). Phonological awareness develops from larger to smaller units, from implicit to explicit knowledge. For example, rhyming and syllable segmentation skills develop between 3 and 4 years of age, while elision and blending develop later (Lee 92 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

9 Webb, Schwanenflugel, & Kim, 2004). Although developmentally sequenced, these skills seem to relate to a single phonological ability (Anthony & Lonigan, 2004). For children who are DHH, research is inconsistent and pertains for the most part to school-age children (Dyer, Szczerbinski, MacSweeney, & Campbell, 2003; Harris & Beech, 1998; Harris & Moreno, 2004, 2006; Izzo, 2002; James, Rajput, Brinton, & Goswami, 2008; James et al., 2005). Some research has shown that the reading abilities of children who are DHH are related to phonological awareness abilities (e.g., Colin et al., 2007; Most, Aram, & Andorn, 2006; Spencer & Oleson, 2008), while other studies have not made this correlation (Goldin-Meadow & Mayberry, 2001; Kyle & Harris, 2006; McQuarrie & Parrila, 2008). This inconsistency in research may arise from differences in the samples ages, reading and speech perception, and production abilities as well as the different phonological skills measured. This inconsistency may also be attributed to the role that phonological awareness plays in the reading development of children with hearing loss who have acquired at least some spoken language skills when compared to its role for those who have not developed spoken language (Harris & Beech, 1998). There is simply no sufficient evidence yet to answer these questions. Several recent studies suggest that young children who are DHH and acquire spoken language skills develop phonological awareness, although at a lower level than children with typical hearing. James et al. (2005) compared the phonological awareness abilities of children with hearing loss ages 5 to 10 years old, with and without cochlear implants, and found that children with cochlear implants performed syllable awareness tasks commensurate with children with severe hearing loss who used hearing aids. The children with cochlear implants also performed commensurate with hearing aid users who were profoundly deaf on rhyming and phoneme awareness tasks, suggesting these latter skills were more difficult for children with cochlear implants. A year later, the children with cochlear implants made progress in rhyming but not phoneme awareness. James et al. (2008) found that children who were 6- to 7-years old who received cochlear implants during preschool showed better syllabic, phonemic, and rhyme awareness than children who received cochlear implants after preschool. However, both groups performed significantly more poorly than children with typical hearing, especially on rhyme and phoneme awareness. Over the course of a year, the children who received cochlear implants later showed no growth on any of the phonological awareness skills, while the children who received cochlear implants early progressed only in their ability to detect rhyme. Colin et al. (2007) found that the rhyming abilities of oral kindergarteners with cochlear implants (5- to 7-years old) who were exposed to cued speech generally predicted later word recognition scores, but not rhyming or explicit phonological sensitivity skills (all measured in first grade). Most et al. (2006) found that kindergarteners with hearing loss who were integrated into mainstream classrooms Emergent Literacy and Hearing Loss 93

10 performed above chance on tasks of phonological awareness (as measured by identification of words with similar initial or final phonemes or syllables), but their performance was poorer than children with typical hearing. Furthermore, phonological awareness correlated with the ability to identify written words. Alphabetic Principle One key element of emergent literacy development is knowledge of the alphabetic principle, defined as the knowledge that written graphemes correspond to the phonemes of spoken words (Scarborough & Brady, 2002, p. 322). In alphabetic writing systems, teaching children with typical hearing how to decode text involves teaching them that written letters (graphemes) relate to specific speech sounds (phonemes) and that phonemes are blended to create words, which have meaning (Morrison, Bachman, & Connor, 2005). Children who begin school knowing their letters are more likely to become successful readers (Adams, 1990; Stevenson & Newman, 1986). In addition to its direct role in facilitating text decoding, letter knowledge plays a role in the development of phonological awareness, both prior to and after the initiation of formal reading instruction. Higher levels of letter knowledge are associated with a child s abilities to detect and manipulate phonemes (Bowey, 1994; Stahl & Murray, 1994). The letter knowledge of children with typical hearing in preschool (Burgess & Lonigan, 1998), kindergarten, and first grade (Wagner, Torgesen, & Raschotte, 1994; Wagner et al., 1997) is predictive of their growth in phonological awareness over a 1- to 2-year period. Combined training in phonological awareness and letter knowledge is more powerful than phonological awareness or letter training alone (Bradley & Bryant, 1985). While there is little comparable research with children who are DHH, several recent studies have found that teaching phonics (i.e., grapheme-phoneme correspondence and grapheme-lexicalized fingerspelling) to students with hearing loss (kindergarteners through middle schoolers) is associated with improved word identification skills (Aghababian, Nazir, Lancon, & Tardy, 2001; Haptonstall-Nykaza & Schick, 2007; Trezek & Malmgren, 2005; Trezek & Wang, 2006; Trezek, Wang, Woods, Gampp, & Paul, 2007). Vocabulary Vocabulary is another influential component in literacy development (Dickinson, McCabe, Anastasopoulos, Peisner-Feinberg, & Poe, 2003). Basic vocabulary knowledge plays a key role in print word and passage comprehension. In children with typical hearing, improvements in sophistication of vocabulary beyond that found in traditional basal texts appear to have a positive influence on reading outcomes for struggling readers (Duff et al., 2008). Similarly, research consistently demonstrates that vocabulary ability plays an 94 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

11 important role in reading for children who are DHH (Geers & Moog, 1989; LaSasso & Davey, 1987; Paul, 1996). Research shows that the productive vocabulary of children with hearing loss is a strong predictor of their reading achievement (Connor & Zwolan, 2004; Kyle & Harris, 2006). For example, Connor and Zwolan (2004) used structural equation modeling of early predictors of reading comprehension skills to demonstrate that vocabulary skills acquired prior to receiving a cochlear implant predicted post-implant vocabulary skills, which in turn predicted reading comprehension skills. Many children with hearing loss start preschool with significant gaps and fewer words in their lexicons when compared to children with typical hearing (Lederberg, 2003). Thus, limited vocabulary abilities may be another cause of reading challenges. In summary, the goal of the current study was to examine select skills that are foundational for early literacy development among children with typical hearing and may have implications for a new generation of children who are DHH and have improved access to spoken language. The current study examines the development of a broad range of phonological awareness skills, including rhyming, alliteration, syllable segmentation, blending, and elision, in children 3 to 6 years old who are DHH and who have some speech perception abilities, as well as the development of vocabulary skills and an emerging grasp of the alphabetic principle (specifically letter-sound correspondence). We examine the relationships among these skills and whether they predict early reading development in children (i.e., print word and passage comprehension). We also examine growth and stability of these skills over the course of a school year. We asked the following research questions: 1. What proportion of children attending self-contained preschool classrooms for children with hearing loss have sufficient access to sound to develop speech perception skills? This would have implications for the numbers who might be able to develop auditory-based phonological and alphabetic skills. Because we expect these children s skills to differ in fundamental ways from those who have no speech perception skills, our other research questions addressed the abilities of children with hearing loss who have developed speech perception skills. 2. What are the strengths and weaknesses of emergent literacy skills in children who are DHH? Specifically, we examined phonological awareness skills (i.e., rhyming, blending, segmenting, elision, alliteration), emerging alphabetic knowledge (letter-sound correspondences), vocabulary, and beginning reading ability (letter-word identification and passage comprehension) of children. 3. What is the nature and variability in growth of these skills over 1 school year? 4. How do these skills relate to each other? 5. What skills present in the fall will predict successful development of these skills in the spring? Emergent Literacy and Hearing Loss 95

12 Methods Participants Consent forms were sent to parents of children attending self-contained preschool, kindergarten, and first-grade classrooms for children with hearing loss in one large metropolitan area. Classes were held in three countywide public school districts, an oral private school, and a state (day) school for the deaf. Only children who met the following criteria were selected for the study: (1) a Pure Tone Average (PTA) of more than 50 db, (2) 3 to 6 years of age, (3) not severely handicapped by multiple disabilities (i.e., intellectual disability, autistic, severe medical involvement), and (4) demonstrated access to sound by showing at least the ability to detect patterns for spoken words (i.e., a score of 2, 3, or 4 on the Early Speech Perception Test; Moog & Geers, 1990). (See Instruments for explanation of assessment.) Fifty-eight children formed the available pool after all possible consent forms were gathered. Twelve children met the first two criteria but not the third criterion. Two children were lost to attrition. Forty-four children met all four criteria and completed the study. The participant pool of 44 included 32 children in oral-only classes, 7 children in total communication classes, and 5 in bilingual/total communication classes. The average age was 61 months (standard deviation [SD] = 13 months; minimum = 36 months; maximum = 83 months). Seven were 3-year-olds, 11 were 4-year-olds, 15 were 5-year-olds, and 11 were 6-year-olds. Eighteen different teachers served these children across 9 different school buildings. Twenty-eight of the participants had at least one cochlear implant; several used both a cochlear implant and a hearing aid. Because most of the children with cochlear implants entered their programs after receiving the implant, pre-implant hearing loss levels were not available in the school records. For this reason, the researchers arbitrarily assigned a 110 db PTA to all cochlear implant recipients, even though this would artificially inflate the overall average (mean = 94.3 db PTA, SD = 21.5). Disaggregating those with hearing aids from those with cochlear implants, the hearing aid users ranged from 58 to 78 db PTA with a mean of Limited information was available on the presence or absence of additional disabilities as it is customary not to identify children at young ages unless the secondary disability is visibly apparent (e.g., cerebral palsy). For this reason, the data provided may overestimate the absence of additional learning challenges, resulting in some children with additional disabilities entering the participant pool. Table 1 provides student demographics and includes available data for home language and etiology. A research assistant gathered demographic data from school records and sent them home for verification by the parents. It is interesting to note that many parents verified that their children received amplification immediately upon identification. 96 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

13 Instruments Screening Instrumentation The Early Speech Perception (ESP) test is designed to examine speech perception in young children with profound hearing loss (Moog & Geers, 1990). The ESP test consists of a series of subtests that assess pattern and word discrimination in a closed-set format. A child is first asked to identify items presented with both visual and auditory cues. This ensures that the child has comprehension of the vocabulary. The child is then asked to identify the items with auditory input only. Although an audiotape is available, we chose to use a live voice because the children were so young and inexperienced in processing auditory cues. The standard version uses plates with 12 pictures. Children who do not show comprehension of the pictures on the standard version are given the low verbal version, which uses a smaller closed set of four toys for each subtest. According to their performance, children are placed into one of four speech perception categories: 1 = no pattern perception, 2 = pattern perception, 3 = some word identification, and 4 = consistent word identification. Those children with hearing loss who did not have amplification or did not show any evidence of sound detection during testing were considered unable to test. We used ESP as a screening tool to identify children who have access to sound and for whom phonological development through the auditory pathway is a realistic goal. Instrumentation for Phonological Awareness Individual Growth and Development Indicators (IGDI) Rhyming (McConnell, 2003). Children must select the picture of the word (out of a choice of three possible answers) that rhymes with the target word (and picture). The task starts with six training trials. The examiner models two trials, presents the next two trials with feedback, and then presents the final two trials with no feedback. Only students who correctly answer two of the final four trials can proceed to the 10-test trials. Children in our study who were unable to proceed received a score of 0 for this test. IGDI Alliteration (McConnell, 2003). Children select the picture of the word (out of a choice of three possibilities) that starts with the same sound as the target. Procedures follow the same pattern as IGDI Rhyming, with 6 training trials and 10 test trials. Syllable-Segmentation Task. This task was developed by study personnel to assess children s ability to discriminate the number of syllables in words. Children were asked to point to a dot on a strip of paper for each syllable for words spoken by the examiner. Two demonstration items were presented followed by two practice items with feedback. There were a total of 8 test Emergent Literacy and Hearing Loss 97

14 Table 1. Participant Demographics Participants Fall Age in Months PTA School Type Age of Identification Age of Amplification Etiology HA or CI Diagnosed Secondary Disability Home Language State School Birth 22 CMV CI English State School 36 CI Spanish State School 48 Heredity HA Other State School Heredity HA Spanish State School Heredity HA ASL Local School Oral Birth 4 Unknown CI none English Local School Oral Other CI motor/ physical English Local School Oral Heredity HA English Local School Oral Birth 27 Other Both none English Local School Oral Heredity HA none English Local School Oral Unknown HA none English Local School TC 1 2 CMV Both none English Local School TC Unknown HA none Spanish Local School TC Unknown CI none English Local School Oral Birth CMV HA Local School Oral Birth 2 Other HA none English Local School TC Local School TC Heredity CI Local School TC Local School TC CI Local School Oral Birth 12 Unknown CI Spanish 98 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

15 Local School Oral Birth Unknown CI English Local School Oral Other CI none English Local School Oral Other CI other English Local School Oral 5 24 Unknown HA Spanish Local School TC Unknown Both attention English Private School Oral Unknown CI Other Private School Oral Birth Birth Connexin CI none English Private School Oral Unknown CI none Spanish Private School Oral Unknown CI Spanish Private School Oral Connexin HA none English Private School Oral CI English Private School Oral Other CI none English Private School Oral Other CI none English Private School Oral 2 5 Unknown CI English Private School Oral Unknown HA none English Private School Oral Unknown HA Private School Oral Connexin HA none English Private School Oral Heredity CI none English Private School Oral CI Private School Oral 2 2 Unknown CI Private School Oral Unknown Both none Other Private School Oral CMV CI none English Private School Oral CI Indicates no data available on student s record. Emergent Literacy and Hearing Loss 99

16 items: 3 one-syllable (e.g., top), 2 two-syllable (e.g., cookie), and 3 threesyllable words (e.g., banana). Preschool Comprehensive Test of Phonological Processing (P-CTOPP)- Phonological Awareness Subtest (Lonigan, Wagner, Torgesen, & Rashotte, 2003). This instrument contains blending and elision subtasks. In P-CTOPP Elision, children must identify what word remains when a portion of the word has been deleted. Half the items have picture support. The 18 items are divided between elision of words (e.g., rainbow without rain), of syllables (e.g., catcher without -er), and of phonemes (e.g., meat without -t). P-CTOPP Blending has 18 items requiring children to blend words into compound words (cow-boy), syllables into words (ba-by), and phonemes into words (c-a-t). Because this test is designed to be used with young children, the P-CTOPP Blending test is administered using live voice. Earlier items for both the elision and blending tasks have picture support. Cronbach s alpha for the P-CTOPP: Phonological Awareness subtest (Elision + Blending) is 0.87, demonstrating high internal consistency. The P-CTOPP was the beta version of the now-published Test of Preschool Early Literacy (TOPEL)(Lonigan, Wagner, & Torgeson, 2007). Criterion-prediction validity between the TOPEL (Lonigan et al., 2007) and Comprehensive Test of Phonological Processing (CTOPP), a test for school-age children (Wagner, Torgesen, & Raschotte, 1999), yielded a correlation of 0.59 for Elision and 0.65 for Blending. In the current study, standard scores for the Elision and Blending subtests were calculated using norms from the TOPEL. For those children who were older than the norms for the test (i.e., 6-year-olds), standard scores were calculated using those for children age 5 years 11 months. Therefore, the standard scores are inflated for the older children. Alphabetics Letter-Sound Identification Task. In this task developed by study personnel, children were asked to identify the sound(s) associated with the graphemes for 18 consonants, 3 diagraphs, and 5 vowels (both long and short) for a total of 31 test items. A 19th consonant was used as a trial item with feedback. Content validity of this measure is high in that it measures the extant content under consideration rather than representative samples of the content. Instrumentation for Vocabulary Woodcock Johnson Achievement Test-III (WJ-III) Picture Vocabulary (Mather & Woodcock, 2001). In this test of expressive vocabulary, children must provide the word or sign for a picture that the examiner presents. Splithalf reliability coefficients of 0.84, 0.81, 0.76, and 0.70 were reported for 3-, 4-, 5-, and 6-year-olds, respectively. 100 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

17 Instrumentation for Early Reading Skills WJ-III Letter-Word Identification Test (Mather & Woodcock, 2001). Children are asked to name letters in large type in early items. The remaining items require the child to read words. Split-half reliability coefficients of 0.97, 0.98, 0.99, and 0.87 were reported for 3-, 4-, 5-, and 6-year-olds, respectively. The WJ-III demonstrates content validity broadly in that an overall correlation of 0.65 and 0.79 are reported relative to the Wechsler Individual Achievement Test and the Kaufman Test of Educational Achievement, respectively. WJ-III Passage Comprehension Subtest. Children must match pictures with ideograms in early items and then match words with pictures in later items. Split-half reliability coefficient scores of 0.95, 0.94, 0.96, and 0.96 were reported for 3-, 4-, 5-, and 6-year-olds with typical hearing, respectively. Passage comprehension correlations for the 4- and 5-year-olds correlate weakly with most WJ-III measures (r < 0.37), which is predictable given its instability at this age. Procedures Trained examiners assessed participants in the fall and spring of the school year. Examiners included three teachers with 5 to more than 20 years of experience teaching children with hearing loss, and a professor of deaf education. Examiners escorted children to different locations suitable for assessment depending on which of the seven school buildings housed the program. All examiners had experience working with children with hearing loss and were able to establish rapport necessary for testing. For children who were in environments that included sign language, examiners administered the directions for all tasks using simultaneous communication. Actual test stimuli requiring manipulation of an auditory stimulus (e.g., blending) were administered with an auditory stimulus only. Tasks not requiring manipulation of a signal (e.g., vocabulary) were presented in sign language to those who used it. The first step was to screen the available pool based on the four criteria for participation. All children were first administered the ESP in the fall. Children who met participant criteria (i.e., received scores of 2 or above on the ESP) were further assessed with IGDI Rhyming, IGDI Alliteration, syllable segmentation, letter-sound knowledge, WJ-III Picture Vocabulary, WJ-III Letter-Word Identification, and WJ-III Passage Comprehension. Because of time constraints, examiners did not administer the P-CTOPP Blending and Elision subtests to children in the county school systems. This contributes to the variability of Ns reported in the data tables. Testing required approximately 2 hours per student and transpired over several sessions. These students were assessed again in the spring. For most of the children, the examiner who collected data at a school in Emergent Literacy and Hearing Loss 101

18 the fall did so at the same school in the spring. However, one new examiner was added in spring in order to complete testing before the end of the school year. Throughout the process, examiners kept field notes describing factors that may have contributed to test performance (e.g., a tornado drill). Field notes also contributed to an examination of baseline data collection procedures from the fall, allowing the spring test administration to run more smoothly. Due to the nature of the test format, examiners scored several of the tests on site (i.e., IGDI, WJ-III, P-CTOPP) while graduate assistants scored others in the lab (i.e., TOPEL, letter-sound assessment). Graduate research assistants examined all protocols for scoring accuracy, and senior research personnel reexamined every test and then rescored if necessary. Results Early Speech Perception Test Figure 1 shows the percentage of children at the four levels of ESP, as well as those who showed no access to speech (categorized as unable to test). A total of 73% of children enrolled in self-contained classes had some or consistent spoken-word identification skills on the ESP (levels 3 and 4). Thus, a large Figure 1. Early Speech Perception Results of 58 Participants 102 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

19 majority of children in the population examined, who attended classes for children with hearing loss, had speech perception skills. Standard Scores Table 2 lists the standard scores for emergent literacy tests in the fall and spring. Note that the variability in N is a result of not testing the county students on the TOPEL as well as child absences and examiner error. Computergenerated standard scores (using the WJ-III NU Compuscore program) for fall and spring demonstrated that, on average, children performed within 1 SD of the mean on the WJ-III Letter-Word Identification, Passage Comprehension, and Picture Vocabulary subtests. These tests have a mean of 100 and SD of 15. Our participants scores fell on average within the traditional +/ 1 SD of the norming sample, with the exception of Letter-Word Identification. Performance varied somewhat more than the SD of the test, indicating that although within normal limits, the children in this sample varied more in their performance than did children with typical hearing. On the Vocabulary subtest, means of 90 (fall) and 87 (spring) placed the average score low in the normal range. With group SDs of 15 in the fall and 17 in the spring, a large portion of the children scored below the normal range on the Vocabulary subtest. On the TOPEL Blending and Elision subtests, students scored, on average, lower than 1 SD than the norming sample, indicating that the majority of children s phonological awareness skills did not fall within normal limits when compared to those of children with typical hearing. Note that TOPEL scores were used to determine standard scores for P-CTOPP results, as the P-CTOPP was the beta version of the TOPEL. Table 2. Standard Scores for Phonological Awareness, Vocabulary, and Literacy Assessments Fall Mean (Standard Deviation) Spring Mean (Standard Deviation) TOPEL (Blending and Elision) (21.87) (22.89) 20 WJ-III Letter-Word Identification (20.97) (18.70) 40 WJ-III Passage Comprehension (17.97) (18.88) 37 WJ-III Picture Vocabulary (15.25) (16.96) 44 Note: The standard scores for the TOPEL may be an overestimation because standard scores were available only up to age 5 years, 11 months. N Change Over the School Year Table 3 lists means and SDs of raw scores on all tests, and the results of paired t-tests. Scores significantly increased across the year on all tasks except for the Emergent Literacy and Hearing Loss 103

20 Table 3. Changes Across a School Year in Raw Scores for Components of Emergent Literacy Fall Mean (Standard Deviation) Spring Mean (Standard Deviation) N t value p value Phonological Awareness Skills IGDI - Alliteration 2.21 (3.19) 4.66 (4.02) IGDI - Rhyming 2.24 (3.58) 3.18 (3.89) Syllable Segmentation 3.56 (2.89) 4.87 (2.70) P-CTOPPP Blending 8.16 (7.21) (7.19) P-CTOPPP Elision 2.48 (4.03) 5.65 (5.76) Alphabetic Principle Skill Letter-Sound (9.69) (9.98) Identification Vocabulary Skill WJ-III Picture (4.04) (4.49) Vocabulary Early Reading (7.84) (9.42) WJ-III Letter-Word Identification WJ-III Passage Comprehension 5.91 (3.02) 7.57 (3.98) Note: Number of test items for each task: Alliteration, 10; Rhyming, 10; Letter-Sound, 31; Syllable Segmentation, 8; Blending, 21; Elision, 18; Letter-Word, 25; Passage Comprehension, 16; Vocabulary, 18. Vocabulary and Rhyming tests. Not only did the children fail to improve on rhyming, many demonstrated no rhyming knowledge. For example, on the pretest, 67% of the children were not able to pass the criteria during training. At post-test, 45% of the children continued to score 0. Alliteration appeared to be easier for the children. Whereas 54% of the children could not demonstrate alliteration on the pretest, only 29% still scored 0 on the post-test. Note that children made generally modest gains in letter-sound knowledge with a mean increase of four sounds across all age groups. Next, using the cross-sectional nature of our sample, we correlated children s chronological age in months with fall test scores to confirm that these skills develop with age. Chronological age was significantly (p < 0.05) correlated with raw scores for all tests: Rhyming (r = 0.30), Alliteration (0.43), Blending (0.52), Elision (0.55), segmentation (0.36), Letter-Word Identification (0.61), Passage Comprehension (0.51), and Vocabulary (0.30). Note that rhyming and vocabulary, the two subskills that did not show significant growth over the school year, also showed the lowest correlation with age. Interestingly, standard scores for the three WJ-III subtests showed a significant negative correlation 104 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

21 with age: Passage Comprehension ( 0.67), Letter-Word Identification ( 0.58), and Vocabulary ( 0.30). This suggests that an increased gap between children with hearing loss and children with typical hearing develops with age. Hearing loss (as defined by PTA) was significantly correlated only with Elision ( 0.51), Vocabulary ( 0.34), and Passage Comprehension ( 0.29). Relations Among Phonological, Alphabetic, Vocabulary, and Literacy Skills To examine relations among tests, we conducted partial correlations controlling for chronological age. Because of the restricted sample, results of the P-CTOPP Elision and Blending tests were not included. Table 4 displays relations between scores in the fall. Table 5 displays correlations between scores in the spring. Table 6 displays correlations across time. In the fall, all measures were significantly and at least moderately correlated with one another except syllable segmentation, which was not correlated with Vocabulary or Rhyming ( Table 4 ). In the spring, all measures continued to be significantly correlated with one another, with the exception of syllable segmentation, which was significantly correlated only with Rhyming ( Table 5 ). Correlations between fall and spring assessments are displayed in Table 6. With the exception of syllable segmentation, all tests showed significant stability across time (noted in bold in Table 6 ). Letter-Word Identification, letter-sound knowledge, Rhyming, and Vocabulary showed extremely high stability. The low correlation of fall to spring for syllable segmentation suggests that the research-created test may not be a valid indicator of this skill. Table 4. Partial Correlations (and Significance) Among Fall Assessments for Children Who Are Deaf and Hard of Hearing Assessments WJ-III 0.69** 0.57** 0.36* 0.47** 0.35* 0.63** Ltr-Wd Id 2. WJ-III 0.36* 0.51** 0.36* 0.42** 0.44** Pass Comp 3. WJ-III 0.32* 0.33* * Pic Voc 4. IGDI 0.57** 0.52** 0.58** Allit 5. IGDI ** Rhyming 6. Syllable 0.36* Seg 7. Ltr-Snd Id *p < 0.05 **p < 0.01 Emergent Literacy and Hearing Loss 105

22 Table 5. Partial Correlations (and Significance) Among Spring Assessments for Children Who Are Deaf and Hard of Hearing Assessments WJ-III 0.80** 0.52** 0.49** 0.47** ** Ltr-Wd Id 2. WJ-III 0.53** 0.47** 0.52** ** Psg Comp 3. WJ-III 0.50** 0.63** ** PicVoc 4. IGDI 0.62** ** Allit 5. IGDI 0.32* 0.57** Rhyming 6. Syllable 0.11 Seg 7. Ltr-Snd Id *p < 0.05 **p < 0.01 Table 6. Across-Time Correlations (and Significance) for Fall and Spring Assessments for Children Who Are Deaf and Hard of Hearing Spring (Posttest) Assessments Fall (Pretest) 1. WJ-III 0.81** 0.59** 0.44** 0.38* 0.32* * Ltr-Wd Id 2. WJ-III 0.52** 0.44** Psg Comp 3. WJ-III 0.52** 0.44** 0.84** 0.46** 0.52** ** Pic Voc 4. IGDI 0.34* 0.39** 0.37* 0.44** 0.34* ** Allit 5. IGDI 0.47** 0.40** 0.36* 0.54** 0.64** ** Rhyming 6. Syllable 0.38* 0.41** * Seg 7. Ltr-Snd Id 0.63** 0.59** 0.35* 0.75** 0.61** 0.37** 0.78** *p < 0.05 **p < 0.01 Correlations in bold represent across-time stability of each test. Fall scores correlated with spring scores on the vast majority of tests. Fall letter-sound knowledge scores had the highest correlation with spring scores for most tests, including Rhyming, Alliteration, Letter-Word Identification, and Passage Comprehension. 106 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

23 Discussion The current study examined the development of emergent literacy skills of children with hearing loss ages 3 to 6 years old who had at least some speech perception abilities. In answer to Research Question 1, What proportion of children attending self-contained preschool classrooms for children with hearing loss have sufficient access to sound to develop speech perception skills?, we found that three-quarters of the children assessed had at least some spoken word identification perception skills. This supports our conjecture that today s children may have usable listening skills that might be nurtured for purposes of emergent literacy. While others have shown that cochlear implants have improved speech perception skills and phonological awareness skills (e.g., Colin et al., 2007; James et al., 2008; Spencer & Tomblin, 2008), the current study is one of the few that has examined these skills based on sampling children who are DHH, ages 3 to 6 years, attending specialized classes. Although not an epidemiological study, the results suggest that many of today s selfcontained early childhood classes successfully help children who are DHH to develop auditory-based phonological and phonics skills. With regard to Research Question 2, What are the strengths and weaknesses of emergent literacy skills in children who are DHH?, we found large variation in the relative performance across skills. On the one hand, standard scores on literacy tasks that involved recognition of letters, matching of pictures to rebus symbols, and recognition of common written words suggested that the performance of children who are DHH was similar to that of children with typical hearing. As both Mayer (2007) and Williams (2004) have observed, children with different hearing statuses go through similar development during the emergent literacy phase. This research also suggests that something in the early childhood environment was supporting the acquisition of these early literacy skills. However, standard scores on literacy tasks showed a negative correlation with age, indicating an increasing gap in literacy skills between children with and without hearing loss, which may develop as reading depends more on knowledge of the alphabetic principle. Because the current study incorporated participants from a cross-section of schools and some of the school districts mainstream higher functioning children after preschool, this conclusion must be considered tentative. However, it is consistent with other research of kindergarten and first-grade students with hearing loss (Trezek et al., 2007). It also would be predicted based on the children s performance on tasks that form the basis of literacy. In contrast, standard scores on the TOPEL, which assesses phonological awareness, indicate that the children s sensitivity to the phonological structure of spoken English lags far behind that of children with typical hearing. As to Research Question 3, What is the nature and variability in growth of these skills over 1 school year?, the children showed growth over the school year in blending, elision, alliteration, and learning letter-sound Emergent Literacy and Hearing Loss 107

24 correspondences. The development of phonological skills supports the hypothesis that, while delayed, these children have the potential to learn to appreciate the phonological structure of spoken English during preschool and kindergarten. However, the children did not make progress in vocabulary across the school year. This was surprising, given that the children in this study scored within the low average range on the WJ-III Vocabulary subtest. Thus, while the children in this study showed stronger vocabulary skills than children who are DHH have traditionally shown (Lederberg, 2003), they still seem to be developing their vocabulary more slowly. One possible explanation is that children with typical hearing usually learn a large part of their vocabularies incidentally (Nagy, McClure, & Mir, 1997; Saffran, Newport, Aslin, & Tunick, 1997). While children of parents who are DHH and use American Sign Language acquire signed language vocabulary incidentally (Brackenbury, Ryan, & Messenheimer, 2006), most children who are DHH require explicit instruction to improve their vocabulary performance (Lederberg & Spencer, 2008; Paatsch, Blamey, Sarant, & Bow, 2006). Hearing loss in and of itself does not preclude the development of vocabulary, but it does impose constraints that educators must help students overcome. In answer to Research Question 4, How do these skills relate to each other?, we found that the assessed early literacy skills were related to one another in ways that were similar to children with typical hearing. Additionally, we found that individual differences of these skills were stable across the year. Specifically, we found that most skills measured in the fall showed a moderate to strong correlation with spring scores. Answering Research Question 5, What skills present in the fall will predict successful development of these skills in the spring?, we found that, in general, fall phonological awareness and vocabulary predicted performance on our two measures of early literacy: Letter-Word Identification and Passage Comprehension. Notably, knowledge of letter-sound correspondences in the fall strongly correlated with the literacy skills and phonological awareness of the children who are DHH in the study. Alphabetic knowledge for children with typical hearing is also particularly predictive of later literacy skills (Rayner et al., 2001). Unfortunately, the children in our study gained knowledge, on average, of only four new spelling-sound correspondences per year. Although we found similarities between our sample of children who are DHH and children with typical hearing, in some ways the development of children who are DHH was not only delayed, but also different from that of children with typical hearing, particularly with regard to phonological awareness. The sensitivity of children with typical hearing to phonological structure generally proceeds from large (words, syllables, rhyming) to small units (phonemes), with rhyming recognition developing between 3 and 4 years of age (Lee Webb et al., 2004). In contrast, the majority of children in our study performed poorly, particularly on recognition of rhyming words. This seemed 108 Easterbrooks, Lederberg, Miller, Bergeron, & Connor

25 the most difficult of all the phonological sensitivity tasks. We offer a number of possible (and speculative) explanations for this. Research on children with typical hearing suggests rhyming may be more related to speech perception and production abilities than other phonological sensitivity skills (Mann & Foy, 2007), and thus may be more likely affected by hearing loss. In addition, our experience with deaf education suggests the environment for children who are DHH might be less than ideal for developing an awareness of rhyme. In speech therapy, children are taught that sounding the same refers to minimal pairs that share the same phonemes. This might result in confusion if children are told by adults that two words rhyme because they sound the same at the end. It also might be that instruction on rhyme may be less common in classrooms for children who are DHH than those of children with typical hearing. In discussing our findings with teachers, we have two opposite reactions. Some teachers have been surprised that their students did not know how to rhyme because they assumed they had implicitly taught rhyming by including nursery rhymes and rhyming books in their classrooms. Others were sensitive to this weakness in their students skills set but thought rhyming was too difficult to teach children who are DHH. Taken together, our findings suggest that the majority of young children who are DHH in self-contained early childhood classrooms may be capable of learning the skills that research suggests are foundational for literacy development. Our findings also support the importance of developing more effective emergent literacy instruction with these children. Data presented in this study were gathered in preparation for development of an emergent literacy curriculum for prekindergarteners with hearing loss based on three principles that arise out of recent research, including the current study. First, the similarities between children who are DHH with access to spoken language and children with typical hearing suggest that the rich body of research on effective reading instruction for children with typical hearing (National Reading Panel, 2000; Rayner et al., 2001; Schirmer & McGough, 2005) may form the basis for effective intervention for children who are DHH. Second, instructional strategies developed for children with typical hearing would need to be adapted to meet the specific needs of children who are DHH. These might include the use of instructional language that is more explicit for teaching, especially for skills such as rhyming and vocabulary; a slower, more repetitious pace of instruction because of the children s weaker phonological representation of spoken words; and the use of visual support to facilitate the development of sensitivity to phonological structure of words. Third, instruction has to be individualized to the language and phonological sensitivity skills of children who are DHH, given the wide range of these skills. Controversy over whether spoken phonological processing is the basis of literacy among children who are DHH has a long history in the field (Goldin- Meadow & Mayberry, 2001). This may be because the basic processes of literacy can be different depending on the phonological representations of words Emergent Literacy and Hearing Loss 109

26 for children who are DHH. Future research should explore whether processes that underlie literacy are different for children with hearing loss, depending on the nature of these representations. We also wish to open a dialogue to explore whether researchers should pursue two separate curricula based on these differences. While the current curriculum suggestions focus on children with access to sound, it is equally important to develop curricula that are effective for children with little access to sound. These children may constitute a majority of the older children who are DHH in self-contained classes and resource classes, as many of the children who are DHH with access to sound become mainstreamed. Approaches that have been researched in recent years include accompanying a curriculum for children with typical hearing (e.g., Reading Mastery) with visual phonics to develop phonological sensitivity (Trezek & Malmgren, 2005; Trezek & Wang, 2006; Trezek et al., 2007), using lexicalized fingerspelling to facilitate word knowledge (Haptonstall-Nykaza & Schick, 2007), developing orthographic-morphological sensitivity (Nunes, Burman, Evans, & Bell, in press, 2009), and developing signed reading fluency (Easterbrooks & Huston, 2008). Clearly, much work lies ahead to ensure that all young children with hearing loss have appropriate access to the kind of emergent literacy instruction that prepares them to make progress once they reach the school years. Acknowledgments This research was funded by grant #R324E060035, Improving Deaf Preschoolers Literacy Skills, from the U.S. Department of Education, Institute of Education Sciences. The opinions expressed are ours and do not represent the views of the funding agency. We also wish to thank the teachers and children for their cooperation. References Adams, M.J. (1990). Learning to read: Thinking and learning about print. Cambridge, MA: MIT Press. Aghababian, V., Nazir, T.A., Lancon, C., & Tardy, M. (2001). From logographic to normal reading: The case of a deaf beginning reader. Brain and Language, 78, Allen, T. (1986). Patterns of academic achievement among hearing impaired students: 1974 and In A. Schildroth & M. Karchmer (Eds.), Deaf children in America (pp ). San Diego: College-Hill Press. Anthony, J.L., & Lonigan, C.J. (2004). The nature of phonological awareness: Converging evidence from four studies of preschool and early grade school children. Journal of Educational Psychology, 96, Bowey, J.A. (1994). Phonological sensitivity in novice readers and nonreaders. Journal of Experimental Child Psychology, 58, Easterbrooks, Lederberg, Miller, Bergeron, & Connor

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30 Schirmer, B.R., & McGough, S.M. (2005). Teaching reading to children who are deaf: Do the conclusions of the National Reading Panel apply? Review of Educational Research, 75 (1), Spencer, L.J., & Oleson, J.J. (2008). Early listening and speaking skills predict later reading proficiency in pediatric cochlear implant users. Ear and Hearing, 29 (2), Spencer, L.J., & Tomblin, B. (in press, 2008). Evaluating phonological processing skills in children with prelingual deafness who use cochlear implants. Journal of Deaf Studies and Deaf Education. Stahl, S.A., & Murray, B.A. (1994). Defining phonological awareness and its relationship to early reading. Journal of Educational Psychology, 86, Stevenson, H.W., & Newman, R.S. (1986). Long-term prediction of achievement and attitudes in mathematics and reading. Child Development, 57, Traxler, C.B. (2000). The Stanford Achievement Test, 9th edition: National norming and performance standards for deaf and hard-of-hearing students. Journal of Deaf Studies and Deaf Education, 5 (4), Trezek, B.J., & Malmgren, K.W. (2005). The efficacy of utilizing a phonics treatment package with middle school deaf and hard-of-hearing students. Journal of Deaf Studies and Deaf Education, 10 (3), Trezek, B.J., & Wang, Y. (2006). Implications of utilizing a phonics-based reading curriculum with children who are deaf or hard of hearing. Journal of Deaf Studies and Deaf Education, 11 (2), Trezek, B.J., Wang, Y., Woods, D.G., Gampp, T.L., & Paul, P.V. (2007). Using visual phonics to supplement beginning reading instruction for students who are deaf or hard of hearing. Journal of Deaf Studies and Deaf Education, 12 (3), Wagner, R.K., Torgesen, J.K., & Raschotte, C.A. (1994). Development of reading-related phonological processing abilities: New evidence of bidirectional causality from a latent variable longitudinal study. Developmental Psychology, 30, Wagner, R.K., Torgesen, J.K., & Raschotte, C.A. (1999). Comprehensive test of phonological processes. Austin, TX: PRO-ED Publishing, Inc. Wagner, R.K., Torgesen, J.K., Raschotte, C.A., Hecht, S.A., Barker, T.A., Burgess, S.R., et al. (1997). Changing relations between phonological processing abilities and word-level reading as children develop from beginning to skilled readers: A 5-year longitudinal study. Developmental Psychology, 33, Williams, C. (2004). Emergent literacy of deaf children. Journal of Deaf Studies and Deaf Education, 9 (4), Easterbrooks, Lederberg, Miller, Bergeron, & Connor

31 The Volta Review, Volume 108(2), Prelinguistic Vocal Development in Infants with Typical Hearing and Infants with Severe-to- Profound Hearing Loss Suneeti Nathani Iyer, Ph.D. CCC-SLP, and D. Kimbrough Oller, Ph.D. Delays in the onset of canonical babbling with hearing loss are extensively documented. Relatively little is known about other aspects of prelinguistic vocal development and hearing loss. Eight infants with typical hearing and eight with severe-to-profound hearing loss were matched with regard to a significant vocal development milestone, the onset of canonical babbling, and were examined at three points in time: before, at, and after the onset of canonical babbling. No differences in volubility were noted between the two infant groups. Growth in canonical babbling appeared to be slower for infants with hearing loss than infants with typical hearing. Glottal and glide production was similar in both groups. The results add to a body of information delineating aspects of prelinguistic vocal development that seem to differ or to be similar in infants with hearing loss compared to infants with typical hearing. Introduction Hearing loss affects one in every 1,000 children in the United States (National Institutes of Health [NIH] Consensus Statement, 1993). Due to aggressive newborn hearing screening efforts (92% of infants in the United States are presently screened for hearing loss, according to the 2006 Centers for Disease Control Suneeti Nathani Iyer, Ph.D., CCC-SLP, is an Assistant Professor in the Department of Communication Sciences and Special Education at the University of Georgia. D. Kimbrough Oller, Ph.D., is a Professor and Plough Chair of Excellence in the School of Audiology and Speech Language Pathology at the University of Memphis. Correspondence concerning this article should be addressed to Dr. Iyer at 564 Aderhold Hall, The University of Georgia, Athens, GA 30602, or by at [email protected]. Prelinguistic Vocalizations 115

32 and Prevention [CDC] Early Hearing Detection and Intervention [EHDI] hearing screening and follow-up survey), the average age of hearing loss identification in the United States is now considerably lower than 30 months, the age indicated as typical for diagnosis in the 1993 NIH Consensus Statement. Results from a universal newborn hearing screening study indicated that the median age of hearing loss identification was 3 months and for hearing aid fitting was 7.5 months ( Dalzell et al., 2000 ). Programs that target and assess outcomes using prelinguistic vocal skills are, therefore, becoming increasingly crucial. An important first step in the development of these programs and outcome measures will be careful documentation of the course of prelinguistic vocal development in infants with severe-to-profound hearing loss. Studies of prelinguistic vocal development and hearing loss are also needed because they shed light on the mechanisms of speech and language acquisition. Aspects of vocalizations that are found to be similar in infants with typical hearing (ITH) and infants with hearing loss would suggest that these aspects are robust and perhaps part of our biological heritage, whereas features that are different between ITH and infants with hearing loss would suggest that auditory perception is crucial in the development of these features. Delays in the onset of canonical babbling in the presence of deafness (CB), consisting of well-formed syllables such as [ba] or [ni], are well-documented (see Oller, 2000, for a review). Other aspects of prelinguistic vocal development, e.g., volubility, have been the subject of widespread speculations but have not received as much empirical attention. The present study longitudinally investigates several aspects of prelinguistic vocal development in ITH and in infants with severe-to-profound hearing loss (IHL) in order to further characterize the nature of prelinguistic vocal development and to determine whether hearing loss affects this development. Volubility Early reports claimed that the number of vocalizations per minute, or volubility, of IHL diminishes after 6 months of age (e.g., Lach, Ling, Ling, & Ship, 1970 ; Lenneberg, Rebelsky, & Nichols, 1965 ; Maskarinec, Cairns, Butterfield, & Weamer, 1981 ; Mavilya, 1972 ). This reduction was presumed to occur due to impoverished auditory input or due to impoverished auditory self- feedback ( Fry, 1966 ; Whetnall & Fry, 1964 ). However, little empirical evidence was presented in support of the purported low volubility of IHL, and, therefore, the claim can be appropriately characterized as a speculation rather than as a finding. A few recently conducted empirical observations of volubility and deafness have not revealed lower volubility in IHL. Clement ( 2004 ) and van den Dikkenberg-Pot, Koopmans-van Beinum, and Clement ( 1998 ) found that six IHL vocalized either to the same extent or more frequently than six ITH, aged 2.5 to 18 months. Similarly, Moeller et al. ( 2007 ) did not note any reliable difference in volubility between ITH and infants with varying degrees of hearing 116 Iyer & Oller

33 loss at 8.5, 10, and 12 months of age. If these data are representative of the populations of IHL and ITH, then previous beliefs about reduced volubility in IHL may be merely myths. In addition, data from infants with lesser degrees of hearing loss (e.g., Nathani, Oller, & Neal, 2007 ; Petinou, Schwartz, Mody, & Gravel, 1999 ) have not demonstrated differences in volubility with ITH. Similarly, infants with cleft palate produced vocalizations as frequently as ITH at 9 months of age ( Chapman, Hardin-Jones, Schulte, & Halter, 2001 ). Thus, it appears that except for low socioeconomic status ( Oller, Eilers, Steffens, Lynch, & Urbano, 1994 ), volubility may be relatively unaffected by various conditions of risk for speech and language development. The present study attempts to provide additional data on volubility by matching ITH and IHL on the basis of a vocal developmental milestone rather than of age. The two common ways of matching groups in developmental research are matching by age or by a significant developmental milestone. Volubility and other prelinguistic comparisons for ITH and IHL have not yet been conducted by matching a vocal developmental milestone. The present study will provide one of the first developmental matching comparisons between ITH and IHL. One source of evidence hints that matching by vocal development might yield volubility differences between ITH and IHL. Ejiri (1998) found that audition is necessary to sustain certain rhythmic behaviors, e.g., rattle shaking. Because CB is also a rhythmic behavior, especially in reduplicated babbling, it is possible that reduction of volubility in IHL might become apparent only after the attainment of CB, when audition may play an important role in maintenance of CB. Delays in the onset of CB might also indirectly account for early, speculative claims of reduced volubility after 6 months of age in IHL. Because ITH usually begin CB around the middle of the first year of life, their speech-like vocalization rate may be interpreted as increasing at that point. Assuming that CB has a particularly strong impact on the impressionistic judgment of vocalization rate, IHL who experience delayed onset of CB would appear as if their vocalization rates begin to lag at the point when ITH begin to produce CB. The present study will attempt to evaluate these possibilities by comparing vocal characteristics after matching infants by the onset of CB. Growth in Canonical Babbling and Other Prelinguistic Syllable Types The onset of CB has been extensively researched for both ITH and IHL. Findings from this research have shown that deafness can significantly impact the onset of CB. ITH usually begin CB between 5 and 10 months of age, whereas the age of onset for CB in IHL, even with amplification, is usually well beyond 11 months of age (e.g., Eilers & Oller, 1994 ; Koopmans-van Beinum, Clement, & van den Dikkenberg-Pot, 2001 ; Oller & Eilers, 1988; Vinter, 1994 ). Hearing loss also delays the onset of CB even in the case of moderate-to-severe hearing loss, Prelinguistic Vocalizations 117

34 although to a lesser extent than profound hearing loss ( Nathani et al., 2007 ). 1 This delay is viewed as extremely significant because words are composed primarily of canonical syllables, thus it is essentially impossible to develop significant expressive vocabulary without canonical syllable control. Suggestive, although limited, evidence exists regarding differences in the pattern of CB production after its reported onset in ITH and IHL. ITH sometimes show a sudden onset of CB with stable production thereafter, but many infants show a fairly gradual onset with inconsistent CB during a period lasting at least a month ( Lewedag, 1995 ; Oller, 2000 ). On the other hand, the production of CB by IHL has been reported to be unstable for a considerable time after the onset of CB, as long as 5 to 6 months after the onset ( Steffens, Eilers, Fishman, Oller, & Urbano, 1994 ; Oller & Eilers, 1988). The overall number of canonical syllables produced by IHL has also been reported as less than that produced by ITH, at comparable ages ( Stoel-Gammon, 1988 ; Steffens et al., 1994 ; von Hapsburg & Davis, 2006 ). Data for IHL on the characteristics of many of the most common precanonical (i.e., before the onset of CB) vocalizations reported to occur in ITH are similarly scarce. The available data indicate that some of the most salient precanonical vocalizations are produced in relatively similar ways across ITH and IHL, e.g., raspberries and squeals ( Oller, Eilers, Bull, & Carney, 1985 ; Stoel-Gammon & Otomo, 1986 ). The development of other prelinguistic vocalization types may, however, be affected by the loss of audition. Lynch, Oller, & Steffens (1989) observed that prior to the emergence of CB, vocal productions of a child were dominated by primitive vowel-like sounds (termed quasi-resonant nuclei ; definition in Method section). Frequent production of other precanonical vocalizations seen in ITH, such as adult-like vowel sounds (termed fully resonant nuclei ; definition in Method section) and primitive consonant-vowel combinations (termed marginal syllables ; definition in Method section), did not occur in the child until after the emergence of CB. Whether the development of quasi-resonant nuclei, fully resonant nuclei, and marginal syllables in infants with less than complete absence of audition is similarly affected is not known. The growth (or lack thereof) of these syllable types after the onset of CB has also not been documented for IHL. In summary, limited data hint at differences between ITH and IHL in the development of canonical syllables following the onset of CB and in the development of other prelinguistic syllable types. The present work will provide additional relevant data on this issue through comparison of ITH and IHL before, at, and after the onset of CB. 1 It should be noted that more positive outcomes from those reported here have been noted for several aspects of prelinguistic vocal development for infants and toddlers fitted with cochlear implants (e.g., Colletti et al., 2005; Ertmer, Young, & Nathani, 2007; Schauwers, Gillis, Daemers, Beukelaer, & Govaerts, 2004). These outcomes are not discussed here because participants in this study were fitted with hearing and/or tactile aids, but not cochlear implants. 118 Iyer & Oller

35 Other Aspects of Prelinguistic Vocalizations Two other aspects of prelinguistic vocalizations syllable shapes and proportions of true consonants, i.e., consonants other than glides and glottal stops have received some attention in the research literature. Production of complex syllable shapes and true consonants in typical infant vocalizations is associated with progress toward becoming efficient talkers ( Nathani, Ertmer, & Stark, 2006 ; Vihman & Greenlee, 1987 ). Delays in the production of these aspects have been associated with poor word production skills ( Moeller et al., 2007 ). Syllable shapes. In IHL, a limited variety of syllable shapes have been noted. An infant with hearing loss produced restricted syllable shapes, i.e., more open syllables and few closed syllable shapes, when compared to his twin who had typical hearing ( Kent, Osberger, Netsell, & Hustedde, 1987 ). More recent investigations have replicated some of these findings. Clement (2004) included IHL from 2.5 to 18 months of age and noted that IHL produced fewer closed syllables than ITH, but only at 9.5 and 10.5 months of age; few closed syllables were produced overall by either group of infants. Von Hapsburg and Davis (2006) observed that ITH used greater proportions of CV and CVC syllables than IHL, but IHL used greater proportions of VC syllables than ITH (C = consonant; V = vowel). Moeller et al. (2007) reported that children with varying degrees of hearing loss produced less complex syllable structures from 10 to 24 months of age than ITH. Glottal stops and glides. There have also been reports of reduced production of true consonants and increased production of glottal stops and glides by IHL. Inordinately frequent use of glottal stops (or glottal sequences ) was observed in multisyllabic utterances of IHL in the first year of life when compared with ITH ( Oller et al., 1985 ; Stark, 1972 ; Stoel-Gammon, 1988 ; Stoel-Gammon & Otomo, 1986 ). Glottal sequences are particularly interesting because they can show clear, well-timed syllabification without any supraglottal articulation, which is a requirement of canonical syllables. Von Hapsburg and Davis (2006) found that whereas an average of 23% of the consonants produced by five IHL at 18 months of age were glottal stops, only 3% of the consonants produced by four ITH at 12 months of age were glottal stops. Similar results for glottal stops were found by Clement (2004). With respect to glides, Stoel-Gammon and Otomo (1986) found greater production of glides by IHL, but these differences in glide production between ITH and IHL were not replicated by Clement (2004). In summary, the limited empirical data available suggest that complex syllable shapes and true consonants may not be produced as often by IHL and are, therefore, worthy of continued investigation. The present study matched infants on a vocal developmental variable to further delineate the effects of hearing loss on the production of these factors in prelinguistic vocalizations. Prelinguistic Vocalizations 119

36 Focus of the Present Study The present longitudinal investigation of vocal development compares eight IHL with eight ITH. In departure from most previous investigations, ITH and IHL were roughly matched on the basis of onset of CB (a vocal developmental variable) rather than age. This exploratory work constitutes one of the first comparisons of prelinguistic vocal characteristics in ITH and IHL based on developmental matching. Although Moeller et al. (2007) also matched ITH and IHL on the basis of CB ratios, they compared only consonant and vowel inventories of ITH and IHL. The present study evaluates several aspects of prelinguistic vocalizations using developmental matching. Both age matching and developmental matching have interpretive advantages and disadvantages. Children matched on age are expected to be alike in certain maturational ways, which suggests an advantage to age matching to keep general maturation constant while monitoring another variable, such as CB. However, if groups differ on a particularly influential variable (such as hearing), their maturational status can be uneven or globally delayed across various domains. One might also imagine that vocal environments of agematched children would be similar (again suggesting an advantage to age matching to keep vocal environments constant while monitoring another variable such as CB). But caretakers tend to adjust their input to children at a level of complexity near that of the children s communicative development levels (e.g., Guralnick, Neville, Hammond, & Connor, 2008 ), suggesting an advantage to developmental matching. Consequently, studies are needed using both kinds of matching and the present work can help fill this gap. This study examined four aspects of prelinguistic vocal development at three points in time: before the onset of CB (precanonical), at the onset of CB (canonical), and after the onset of CB (postcanonical). These four aspects included volubility; growth in various prelinguistic syllable types, including canonical syllables; production of varied syllable shapes; and glottal stop and glide production. For volubility, the expectation was neutral the most reliable empirical information to date suggests no volubility reduction in ITH, but there is a long tradition of expectation that volubility should be low in IHL. For growth in prelinguistic syllable types, it was expected that IHL would show slower growth in canonical syllable production across sessions and, thus, show persistence of other prelinguistic syllable types. IHL were also expected to produce a greater number of open syllables and a higher frequency of glottal stops and glides than ITH. Method Participants Eight full-term ITH and eight full-term IHL, matched for socioeconomic status and linguistic background, were longitudinally studied. Gender was balanced 120 Iyer & Oller

37 in IHL whereas there were seven males and one female in the ITH group. 2 Unaided better-ear pure tone averages for IHL were obtained using behavioral audiometry and revealed severe-to-profound or profound hearing losses for all eight infants. Severe hearing loss was defined by hearing thresholds in the range of db HL, and profound hearing loss was defined by hearing thresholds at 91 db HL or greater ( Goodman, 1965 ). The average age of identification of hearing loss was approximately 13 months (mean [M] = 12.88; standard deviation [SD] = 7.4), and the average age of amplification was approximately 1.5 months after identification of hearing loss (M = 14.25; SD = 8.4). Six of the eight infants were fitted with both hearing and tactile aids and the two remaining infants were fitted with only hearing aids. These six infants were also enrolled in a total communication program whereas the two remaining infants were enrolled in an oral communication program. One research paper has been published using this data set ( Nathani, Oller, & Cobo-Lewis, 2003 ). This previous study focused on syllable duration characteristics of ITH and IHL. An expanded description of the participants demographic characteristics can be found in the previous report. Recording Environment and Procedures Vocalizations of ITH were recorded in the company of either a parent, a staff member of the research project, or both. The parents and staff were encouraged to promote the production of vocalizations as much as possible during the recording sessions. Vocalizations of six IHL were recorded as they interacted with a speech-language pathologist during therapy sessions. The speech- language pathologist also attempted to promote vocalizations during the recording sessions. Vocalizations from the remaining two IHL were recorded under the same conditions and procedures as ITH. Criteria for Selection of Sessions A precanonical, a canonical, and a postcanonical session were selected for each infant. The first session was the canonical session, chosen based on the onset of CB. For ITH, CB ratios (the number of canonical syllables divided by the number of utterances) of 0.2, as determined by prior codings ( Oller et al., 1994 ), were used to select the canonical sessions. For IHL, the canonical sessions were not referenced to prior codings because these were not available. Instead, the first recording for six IHL available after the reported onset of CB by teachers or speech-language pathologists, who had closely worked 2 The gender mismatch was not expected to influence results because gender differences in the qualitative characteristics of prelinguistic vocal development have not been demonstrated in any previous work (e.g., Lynch, Oller, Steffens, & Buder, 1995; Camp, Burgess, Morgan, & Zerbe, 1987). Prelinguistic Vocalizations 121

38 with these infants, was designated the canonical session. The teachers and speech-language pathologists had been trained to identify the onset of CB by the second author of this manuscript. For the remaining two IHL (not in the same clinical program), the canonical sessions were the first recording session after the onset of CB as reported by the parents. Identification of the onset of CB by adults who have considerable contact with an infant has been shown to be remarkably reliable ( Oller, Eilers, & Basinger, 2001 ). For both groups, a session that was recorded approximately 3 months before the canonical session was designated the precanonical session, and a session that was recorded approximately 3 months after the canonical session was designated the postcanonical session. Ages corresponding to the precanonical, canonical, and postcanonical sessions for ITH were approximately 4 (SD = 1.1), 7 (SD = 0.79) and 10 (SD = 1.2) months; and for IHL were approximately 24 (SD = 11.04), 27 (SD = 11.13) and 30 (SD = 11.24) months, respectively. Data Coding Identification of utterances and syllables. Only vocalizations that were considered precursors to meaningful speech were categorized as utterances. These precursor vocalizations, termed protophones in the infraphonological model of vocal development and previously referred to as nonvegetative vocalizations, include vocalization types such as those traditionally called cooing and babbling. Vocalization types that have obvious biological functions (e.g., hiccup, sneeze) or obvious social functions (e.g., cry, laugh) were not categorized as utterances because they are presumed to have only indirect linkages to speech (Oller, 2000 ). Utterances were generally defined as a vocalization or group of vocalizations separated from all others by either audible ingressive breaths or by the primary judge s intuitions about utterance boundaries, which are often indicated by a silence of 1 second or longer ( Lynch et al., 1989 ; Stark, 1980 ). A second judge coded a randomly selected subset of vocalizations (10% from each infant group) to provide reliable data on the utterance determination by the primary reseacher. The two judges agreed on the occurrence of utterances 86% of the time. Cohen s kappa for utterance agreements was 0.66 ( Cohen, 1960, 1968 ). Kappa values of have been characterized as showing good agreement and those greater than 0.75 as showing excellent agreement ( Fleiss, 1981 ). Because analysis of a small number of utterances can result in underestimation of the developmental status of prelinguistic vocalizations ( Kent & Miolo, 1995 ), sessions had to contain at least 50 utterances. In cases where sessions yielded fewer than 50 utterances, additional recordings within a month of the session of interest, if available, were aggregated to yield 50 utterances ( Wachs, 1991 ). Even after this aggregation, data analyzed for three sessions (two for IHL and one for ITH) contained fewer than 50 utterances (22, 30, and 48 utterances, respectively). 122 Iyer & Oller

39 The number of syllables within these utterances was then determined using the construct of countable beats (Nathani & Oller, 2001). The primary judge counted the number of beats they heard in each utterance to determine the number of syllables that would be coded for protophone types. A second judge coded a randomly selected subset of utterances (10% from each infant group) in order to verify the syllable counts of the primary judge. Cohen s kappa for interjudge agreement for syllable counts of all infants was 0.7. Determination of canonical babbling and other prelinguistic syllable types. Judges assigned syllables to one of five syllable types: canonical syllables, marginal syllables, fully resonant nuclei, quasi-resonant nuclei, and other, as recommended by the infraphonological model of prelinguistic vocal development ( Oller, 1980, 2000 ). Canonical syllables refer to consonant-vowel-like combinations with rapid (nominally <120 ms) adult-like transitions between the consonant and vowel. It is important to add that the definition of canonical syllable does not rule out VC shapes. Syllables such as [at] or [em], if well articulated according to the principles indicated above, are treated as canonical. Marginal syllables are similar to canonical syllables except that they are perceived to have slow transitions between closures and openings of the vocal tract (typically exceeding 120 ms, a fact that can often be verified by spectrographic inspection of formant and amplitude [RMS] changes), and often sound sloppy or slurred. Quasi-resonant and fully resonant nuclei designate vowel-like sounds that are produced without any adjacent consonantal elements. The distinction between fully resonant and quasi-resonant nuclei is based on whether the vowel-like sounds are perceived as having been produced with an open (fully resonant) or an at-rest (quasi-resonant) position of the supraglottal vocal tract. Because quasi-resonant nuclei are produced during an at-rest position, they are considered more primitive and less speech-like than fully resonant nuclei. Other refers to those protophones, e.g., raspberries, which cannot be coded using any of the four primary categories. The syllable types were coded using the Logical International Phonetics Programs (LIPP) ( Oller, 1991 ). An additional judge coded a randomly selected subset of vocal samples (10% from each infant group) in order to establish reliability for the primary judge s codes. Cohen s kappa for infraphonological coding of syllable types was Determination of syllable shape. Syllable shapes were classified as open or closed by the primary judge. Open syllable shapes contained a vowel-like element at the syllable offset, e.g., CV, whereas closed syllable shapes had a consonantlike element at the offset, e.g., VC. Only fully resonant nuclei and canonical syllables were included in this analysis because they bear the greatest resemblance to mature speech. All vocalizations classified as fully resonant nuclei were automatically classified as open syllables because each such vocalization consists of a vowel-like element alone. A second judge confirmed or rejected all the syllable shape determinations of the primary researcher. Only consensus agreements were used for these analyses. Prelinguistic Vocalizations 123

40 Determination of glottal stops and glides. The occurrence of glottal stops and glides was noted. Consensus agreements, as described for syllable shapes, were used in the analysis. Results Volubility The rate of utterance and syllable production, i.e., numbers of utterances and syllables per minute, were computed for each session to measure volubility. Table 1 shows syllables and utterances per minute, respectively, produced by ITH and IHL across the three sessions. There was considerable inter-infant variability in the volubility data. Volubility values (in syllables per minute) ranged from 2.38 to for ITH, and 1.13 to for IHL. There was also considerable intersession variability. Volubility values for one ITH across sessions ranged from 3.27 to 15.66, and for one IHL from 0.67 to A repeated measures mixed-model analysis of variance 3 was used to analyze the data for all dependent measures. The between- subjects variable was group (ITH, IHL) and the within-subjects variable was session (precanonical, canonical, and postcanonical). No main effect of group, session, or interaction was significant for syllables or utterances per minute. Thus, these results did not indicate statistically significant differences in volubility between the two groups or across sessions. Table 1. Average number (and standard error) of syllables and utterances per minute across three sessions for ITH and IHL Group and Session Syllables per Minute Utterances per Minute ITH Precanonical (2.32) 8.16 (2.21) Canonical 7.78 (0.96) 4.47 (0.54) Postcanonical 7.56 (2.02) 4.64 (1.07) IHL Precanonical (4.99) 5.41 (2.03) Canonical 8.93 (2.57) 5.82 (1.63) Postcanonical 8.91 (1.94) 5.09 (0.87) 3 Because of small sample sizes in the present study, statistical power to detect differences was limited. Statistical analyses were, therefore, applied throughout the study with caution and results are intended to be viewed as exploratory in nature. 124 Iyer & Oller

41 Although the differences were not statistically reliable, it is interesting that the trends were predominantly opposite of the traditional expectations of low volubility in IHL. First, volubility, as measured by utterances per minute, showed reduction across sessions for ITH but not for IHL. The traditional expectation was that IHL would show reduction in volubility across time, and ITH would show an increase. Similarly, contradicting the traditional expectation, the rate of utterance production was higher for ITH than for IHL only in precanonical sessions. That difference appeared to turn in favor of IHL in the later sessions. Growth in Canonical Babbling and Other Prelinguistic Syllable Types Syllable-type ratios were calculated by dividing the numbers of individual syllable types by the total number of syllables. For example, the CB ratio was the number of canonical syllables divided by the total number of syllables. Figures 1 and 2 show the mean proportions (and standard errors) of the four main syllable types across the three sessions for the two groups, ITH and IHL, respectively. Other syllable types occurred rarely for both groups: average of 2% and 6% for ITH and IHL, respectively. Canonical babbling. Figure 1 shows that CB ratios were higher in canonical than in precanonical sessions for ITH. The CB values went up further in the postcanonical sessions. Figure 2 shows a different picture for IHL. First, there was greater inter-infant variability during all sessions than that for ITH. Second, although there was a slight increase in production of CB from the precanonical to canonical session, CB appeared to reach substantial proportions only in postcanonical sessions. Statistical analysis revealed that there was a significant Group*Session interaction F (2, 27) = 4.85, p < 0.05, w 2 = indicating different developmental trajectories in the two groups. It should be noted that because different numbers of utterances were produced in different sessions, data were weighed differentially according to the number of utterances ( Verbeke & Molenberghs, 2000 ). Post hoc contrast tests using Tukey-adjusted p values revealed that CB significantly increased across the three sessions for ITH. CB ratios produced by ITH in canonical sessions were significantly greater than those produced by IHL in precanonical sessions. At the same time, CB produced by ITH in postcanonical sessions also occurred at significantly higher proportions than those produced by IHL in both precanonical and canonical sessions. IHL did not significantly increase their production of CB across the three sessions. One infant in the IHL group appeared to be an outlier because she had a 0.43 proportion of CB in her precanonical session; average of CB ratios across all other infants in the precanonical session was only When the data were reanalyzed without this infant s data, overall significance effects were identical to those based on the entire data set. There were, however, differences Prelinguistic Vocalizations 125

42 Figure 1. Mean proportions (and standard errors) of quasi-resonant nuclei (Q), fully resonant nuclei (F), marginal syllables (MS), and canonical syllables (CS) across sessions for ITH. Figure 2. Mean proportions (and standard errors) of quasi-resonant nuclei (Q), fully resonant nuclei (F), marginal syllables (MS), and canonical syllables (CS) across sessions for IHL. 126 Iyer & Oller

43 in the post hoc focus tests conducted using Tukey-adjusted values. ITH produced significantly more canonical syllables than IHL in canonical sessions when this infant was excluded, whereas this difference was not significant for the original data set. A more important and reliable contrast that did not change even with removal of the outlying infant s data was that IHL did not significantly produce more canonical syllables in postcanonical sessions than in precanonical sessions, while ITH showed a statistically reliable change in CB ratio from precanonical to postcanonical. Thus, the presence of this outlier did not affect the statistical reliability of differences in CB ratios for IHL between precanonical and postcanonical sessions despite her relatively stable, high CB ratios across all three sessions. The key point, consistent with prior claims of the literature, was that ITH appeared to show more rapid progress in their command of canonical syllables than IHL. Marginal syllables. Marginal syllables were not frequently produced by either group. They occurred at a rate between 0.1 and 0.2 in all sessions for ITH ( Figure 1 ) and lower than 0.2 in all sessions for IHL ( Figure 2 ). No statistically significant effects were obtained for marginal syllables. Quasi-resonant nuclei. Figure 1 shows that for ITH, the proportions of quasi-resonant nuclei sharply decreased in the canonical sessions and continued to decrease in postcanonical sessions. Quasi-resonant nuclei steadily decreased for IHL across the three sessions, with a ratio of less than 0.15 for the postcanonical sessions. Statistical analysis showed that Session had a significant effect on quasi-resonant nuclei for both ITH and IHL, F (2, 27) = 4.72, p < 0.05, w 2 = Post hoc focus tests using Tukeyadjusted p values revealed that quasi-resonant nuclei were significantly lower in post canonical sessions (M = 0.1, SD = 0.09) than in precanonical sessions (M = 0.26, SD = 0.19). No main effect of group or interaction effect was significant. Fully resonant nuclei. Fully resonant nuclei were the most frequently occurring syllable type in precanonical and canonical sessions for ITH ( Figure 1 ); canonical syllables were the most frequent syllable type in the postcanonical sessions. In contrast, fully resonant nuclei were the predominant protophone type across all three sessions for IHL, accounting for approximately half the syllables ( Figure 2 ). The interaction effect of Group*Session for fully resonant nuclei narrowly missed the 0.05 significance criterion, F (2, 27) = 3.15, p = , w 2 = Post hoc contrast tests using Tukey-adjusted p values did not reveal any significant differences. The main effect of either group or session was not significant. Thus, hearing status or level of vocal development did not strongly influence the production of fully resonant nuclei in most regards. However, the tendency of ITH toward a reduced rate of fully resonant nuclei production in comparison with CB production in the postcanonical session may deserve further attention. Prelinguistic Vocalizations 127

44 Other Aspects of Prelinguistic Vocal Development Syllable shapes. Neither group produced many closed syllable shapes. Even in postcanonical sessions, ITH had a median of 2% closed syllables and IHL had a median of 3%. Thus, only open syllables were considered for further analysis. The shift to open syllables left just two types for analysis, CV and V (fully resonant nuclei). Entropy analysis for open syllables revealed a significant interaction effect for Group*Session, F (1.8, 25.7) = 4.08, p < 0.05, indicating a different developmental trajectory for the two groups. ITH significantly produced CV shapes in canonical and postcanonical sessions, whereas IHL did not significantly produce CV shapes until the postcanonical sessions. Thus, the results support the view that IHL show less focus on basic canonical syllables (the CV syllable) than ITH. For both canonical syllables in general (as reported in the previous section), and for canonical syllables of the shape CV in particular, IHL showed slower growth than ITH. Glottal stops and glides. Table 2 provides data for glottal stops and glide production by the two groups across the three sessions. Overall, the proportion of glottal stops reduced from precanonical to postcanonical sessions for both groups. There was also substantial individual variability within the IHL group, especially in the precanonical sessions. Even though glottal production showed a tendency to be higher at all three stages in IHL than in ITH, no significant main effect for group or session, or interaction effect was revealed. Glides were rarely produced by either infant group. The only statistically significant effect was the main effect for Session, F (2, 42) = 4.43, p < Post hoc contrast tests indicated that the number of glides were significantly lower in precanonical sessions (M = 0.02, SD = 0.03) when compared to canonical sessions (M = 0.03, SD = 0.05) for both infant groups. No significant difference in glide production between canonical and postcanonical sessions was noted. Table 2. Average proportion (and standard error) of syllables containing glottal stops and glides across three sessions for ITH and IHL Group and Session Glottal Stops Glides ITH Precanonical 0.07 (0.02) 0.01 (0.004) Canonical 0.04 (0.01) 0.06 (0.02) Postcanonical 0.03 (0.01) 0.04 (0.01) IHL Precanonical 0.11 (0.06) 0.03 (0.01) Canonical 0.05 (0.02) 0.04 (0.01) Postcanonical 0.06 (0.01) 0.02 (0.01) 128 Iyer & Oller

45 Discussion The present study sought to obtain data on relatively little-explored aspects of prelinguistic vocalizations through comparisons of IHL and ITH, matched on the basis of vocal development. Results addressed specific hypotheses regarding similarities and differences between IHL and ITL for volubility, CB, and other prelinguistic syllable types, syllable shapes, and glottal and glide production. Volubility In this study, a negative finding would be of most significance. Indeed, results indicated similar frequency of vocalizations in ITH and IHL. Thus, contrary to speculation by early researchers (e.g., Teervoort, 1962 ; Fry, 1966 ; Mowrer, 1960 ), volubility was not lower in IHL than ITH for syllables or utterances. The present results are in concordance with Clement (2004), Moeller et al. (2007), and van den Dikkenberg-Pot et al. (1998), who noted similar volubility in IHL and ITH. Furthermore, the present study provided data that refutes prior speculations (e.g., Lenneberg et al., 1965 ) that ITH would surpass IHL in volubility after the onset of CB. Results did not indicate reliable differences in volubility between the two groups before, at, or after the onset of CB. One of the key early claims (a speculation unsupported empirically) was that volubility in IHL tended to decrease across development. In fact, the present work indicates that the reduction in utterances per minute from the precanonical to the canonical session was more notable for ITH than for IHL. Because the rate of syllable production in ITH did not correspondingly decrease with the onset of CB, the likely explanation for a reduction in rate of utterance production with the onset of CB in ITH is that more syllables were produced per utterance in canonical sessions than in precanonical sessions. Because utterances, as defined here, roughly correspond to breath groups, it may be that when ITH start producing canonical syllables they also produce longer strings of syllables within a breath group (or utterance) than before, perhaps as a result of increasing respiratory control. The common occurrence of reduplicated and variegated babbling, i.e., strings of canonical syllables, at the onset of CB in ITH appears to support this possibility ( Oller, 1980, 2000 ; Smith, Brown-Sweeney, & Stoel-Gammon, 1989 ). Because IHL were considerably older and, therefore, physiologically more mature than ITH, even in precanonical sessions a corresponding increase in syllables per utterance would not necessarily be expected with the advent of canonical syllable production for IHL, and indeed none appeared to occur. Still, the changes in rate of syllable and utterance production were not statistically reliable for either IHL or ITH in the present study, and their interpretation is therefore speculative. The interpretation of the lack of significant volubility differences between IHL and ITH should be tempered by the limited sample size. Type II error is obviously a possibility, i.e., the error of failing to reject the null hypothe sis when, in fact, Prelinguistic Vocalizations 129

46 the alternative hypothesis is true, but it should be remembered that several studies (all with small samples) have now failed to find low volubility in IHL. Of course, the circumstances of developmental matching are inherently different from those of age matching, and those circumstances should be considered in interpretation. Notably, empirical investigations with both styles of matching have thus far failed to find a difference in volubility between IHL and ITH. An additional caveat is that IHL were fitted with appropriate amplification and enrolled in extensive intervention programs and this may have positively influenced volubility in IHL. Finally, the circumstances of recording should be kept in mind. In the present work, six IHL, who were enrolled in early intervention programs, were recorded as they interacted with a speech-language pathologist, whereas ITH were recorded as they interacted with their parents. The two youngest IHL were recorded with their parents in a manner similar to that used with ITH. In all cases, the circumstance of recording interaction was designed to maximize vocalization from the infants. Given the developmental matching procedure, we deemed it reasonable to use an elicitation procedure with each group and adapted the procedure to the age and social abilities of the child. Still, in future work it might be instructive to compare elicitation results for vocalization by parents and speech-language pathologists. It is conceivable that parents would be either better or poorer at eliciting vocalizations from either IHL or ITH, but to our knowledge this topic has never been empirically addressed. In addition, it may be useful to evaluate whether similar results for volubility are obtained under more naturalistic circumstances, e.g., in free play. In summary, the findings from the present study add to a growing body of evidence that volubility may be a fairly robust maturational phenomenon in infancy. Little (if any) variation in volubility appears to exist across groups of infants as a result of important handicapping conditions. Growth in Canonical Babbling and Other Prelinguistic Syllable Types With respect to individual syllable types, the groups showed some similarities and some differences. Both ITH and IHL showed reduced production of quasi-resonant nuclei across sessions. Once CB reached 0.15, 4 quasi-resonant nuclei were rarely produced by either group. Thus, it appears that primitive 4 The present study used the criterion of 0.15 CB ratio as an indicator of the onset of CB. This criterion differs from that reported in the first papers on CB from the Miami project because the denominator in those studies was not syllables, but utterances and, consequently, the value of the CB ratio could sometimes exceed 1 (e.g. Oller et al., 1985). With the syllables denominator, as adopted by the Miami group in later work, the CB value could range precisely from 0 to 1 (Lynch et al., 1989). For this calculation procedure, the criterion ratio for onset of CB was, therefore, lowered to 0.15 rather than the prior value of 0.2. Although the prior 0.2 criterion and utterances denominator had been used in session selection of ITH samples for the present study, all the data were recoded and reinterpreted here, so there was no need to maintain the old procedure. 130 Iyer & Oller

47 vowel-like productions diminished with the onset of CB for both ITH and IHL. Similarly, the production of marginal syllables was not reliably different between the two groups. Thus, unlike the child studied by Lynch et al. (1989), IHL behave similarly to ITH in the production of these precanonical syllable types. On the other hand, although the findings are not statistically significant, fully resonant nuclei appear to diminish across sessions for ITH but not for IHL. Continued predominance of vowel-like elements even after the onset of CB in IHL has also been noted by Koopmans-van Beinum et al. (2001). The results suggest that growth in syllables containing both consonant-like and vowel-like elements does not occur in IHL as rapidly as in ITH, a pattern that may lead to a persistence of syllables containing vowel-like elements alone. Other investigations, e.g., Kent and Bauer (1985) and Nathani et al. (2006), observed that vowels in their studies were predominant in ITH until 16 to 20 months of age, while in the present study canonical syllables outnumbered vowels by 10 months of age (although only by a small amount). This apparent age difference across the studies is hard to interpret. Only the present study reported data with respect to the onset of CB, and only the present study was longitudinal. It is also possible that the ITH in the present study were more advanced in vocal development than those in the prior studies because the ITH in the present study were fully canonical by 7 months old, whereas the ITH in the Nathani et al. (2006) study had not reached a fully canonical stage until 9 months old. The present results cannot be generalized to indicate with any precision when canonical syllables become the predominant vocal types in ITH. The point that seems more reliable, based on the present study and the others cited, is simply that canonical syllable production increases with age and eventually overtakes full vowel production in ITH. The present results further suggest that this may happen faster in ITH than in IHL. To illustrate this point further, consider canonical syllable production. Whereas ITH achieved CB ratios of 0.25 and 0.41 on average in canonical and postcanonical sessions (SD = 0.11 and 0.24, respectively), IHL achieved CB ratios of 0.11 and 0.25 in the same sessions (SD = 0.15 and 0.23, respectively). Thus, it appears that IHL consolidate the production of canonical syllables more slowly than ITH. This result was statistically reliable even with the exclusion of the outlier infant in the IHL group. In the absence of audition, the onset of CB does not appear to guarantee timely continued development of canonical syllable production. This conclusion is tentative because it is possible that differences in the session selection process for the two groups could have resulted in the canonical sessions for ITH being biased toward higher CB ratios than the sessions sampled for IHL. For ITH, these sessions were specifically selected because prior codings had suggested these infants exceeded the CB ratio criterion in the samples. For IHL, the sessions had been selected to occur after the onset of the canonical stage as designated by teacher/parent report, but were not specifically selected to have criterion-level CB ratios. Although it would have been Prelinguistic Vocalizations 131

48 ideal to select sessions for IHL on criterion CB ratios as well, these ratios were not available for this group. The data can be broken down an additional way to help gain perspective on why we are inclined to take seriously the fact that IHL showed slower growth of CB from canonical to postcanonical sessions than ITH. First, recall that the data were all recoded for the present study and that only some of the samples in both groups actually met or exceeded the 0.15 CB ratio criterion designated as canonical. Six ITH and three IHL met or exceeded the CB ratio criterion in the designated canonical sample, while two ITH and five IHL failed to reach the criterion. The average postcanonical CB ratio was higher for the ITH than the IHL in both cases: 0.44 to 0.38 for those who met the canonical criterion in the designated canonical sample, and 0.33 to 0.23 for those who did not meet the criterion. Perhaps more important, a comparison of the amount of increase in CB ratio from the canonical to postcanonical session showed an average of 0.14 for the six ITH who had met the criterion at the canonical stage, but only an average increase of 0.02 for the three IHL who met the criterion. It is also notable that only four of the eight IHL achieved 0.15 CB ratios in their postcanonical sessions, while seven of the eight ITH achieved the criterion. Prior evaluation of the stability of CB in laboratory samples after the date of designated onset of CB suggests that ITH indeed do sometimes fail to meet the criterion, quite often in the first month after the designated onset (about 50% of samples), but much less often at 3 months after onset (less than 15% of samples). The results are thus consistent with the expectation that ITH show more consistent growth of CB than IHL once the canonical stage is underway. Still, research with larger sample sizes is necessary to confirm this apparent tendency. Other Aspects of Prelinguistic Vocal Development Two additional aspects explored in the present study production of varied syllable shapes and production of glottal stops and glides showed similarities and differences between the two infant groups. Syllable shapes. Both ITH and IHL predominantly produced open syllable shapes. Nathani et al. (2006) reported that closed syllable shapes emerged in English-learning ITH only at months of age. Similarly, Vihman (1993) noted that ITH who were learning English produced closed syllables in significant quantities only after acquiring a 25-word vocabulary. Given that both ITH and IHL were prelinguistic in the current investigation, the absence of a substantial proportion of closed syllables is not surprising. It may be that open syllable shapes are part of our biological heritage ( Jakobson, 1968, originally published 1941), perhaps due to the stronger acoustic cues for initial, as opposed to final, consonants (for a review, see Stevens, 2002 ). Closed syllable shapes might require considerable exposure to an ambient linguistic environment that includes final consonants before they become prominent. See von Hapsburg and Davis (2006), however, for contrasting results. 132 Iyer & Oller

49 Glottal stops and glides. Overall, the present data show a weak and not statistically reliable tendency toward more frequent production of glottal stops by the IHL and a reduction in glottal stop production across sessions for both infant groups (see Table 2 ). This finding appears surprising, given previous reports of considerable differences in glottal stop production between ITH and IHL (e.g., Kent et al., 1987 ; Oller et al., 1985 ). It may be that the small sample size, variability within infant groups, and the low proportion of glottal stops, in general, might have precluded finding reliable group differences in glottal stop production. Another reasonable possibility to consider is that glottal stops may have been rarely produced by IHL because they were considerably older than those studied in previous investigations. The reports of high usage of glottal sequences in IHL have pertained to younger infants. This point is underscored by the observation that the highest proportion of glottal stops (0.47) in the present study occurred in the precanonical session of the youngest IHL in a sample at 8 months of age. No differences in groups on glide production were noted. Again, small sample size, variability, and overall low proportions of glides might have obscured group differences in glide production. These findings are in accord with recent data from Clement (2004) that did not reveal reliable differences in glide production between the two infant groups when they were matched for age. The present data extends those findings to suggest that even when matched for vocal development, increased production of glides by IHL was not observed, at least at prelinguistic levels of vocal development. Thus, no differences were found in the proportions of vocalizations that contained true consonants between ITH and older, but matched for vocal development, IHL. Conclusion Controlling for the onset of CB between infant groups with and without hearing loss provides both confirmations of some prior reported patterns of vocal development and lack of confirmation of others. Results provided no indication of low volubility in IHL compared to ITH, a finding that adds to growing empirical evidence that casts serious doubt on the widespread belief that hearing loss is accompanied by low volubility. On the other hand, IHL, after the onset of CB, did not consolidate and stabilize their production of CB as quickly as ITH, a pattern that has previously been reported but for which empirical support has been tentative. Fully resonant nuclei instead appeared to persist in IHL even in postcanonical sessions, unlike ITH. This pattern is potentially very important because canonical syllables are the foundation for the vast majority of words in natural languages without them no one can truly command a spoken language. Production of quasi-resonant nuclei and marginal syllables were comparable between the two groups, a pattern that tends to confirm reports that Prelinguistic Vocalizations 133

50 the most frequently occurring precanonical sounds in infants tend to be similar in ITH and IHL, and that the pattern holds when the groups are matched for development. Glide and glottal production did not vary between the two groups. The lack of difference between IHL and ITH on glottal sequences may have been influenced by the advanced age of the IHL in this study, and it will be important in the future to further evaluate the possibility that excessive production of glottal sequences in IHL is restricted to younger ages. Taken together, these results suggest that early interventionists working with infants with hearing loss might want to focus their intervention goals to a greater extent on enhancing the quality of prelinguistic vocalizations, especially canonical syllables. Of course, volubility and other aspects of prelinguistic vocalization should continue to be closely monitored in IHL and, if any deficits are noted, they should be addressed. However, findings from this study indicate that canonical syllables are especially vulnerable to hearing loss, and early interventionists should continue to promote the production of these syllables well beyond the initial emergence in order to ensure the consolidation of canonical syllable production. Although the present study provides the first general comparison of early vocal development in IHL and ITH with developmental matching, it would be even more useful if future studies could match infants by both age and level of vocal development this would require a three- or four-group study. Recent initiatives on early detection of hearing loss via universal newborn hearing screening should greatly assist in this process because new longitudinal data on IHL in the first year of life should be easier to acquire now than in the past. Acknowledgement This work has been supported by grants from the National Institutes of Deafness and Other Communication Disorders, National Institutes of Health (R01DC to D. K. Oller, PI, and Eugene Buder, Co-PI, with a subcontract to the University of Georgia, Suneeti Nathani, PI, and by prior grants R01DC00484 and R01DC01932 to D. K. Oller, PI). Portions of this work were presented at the 1999 and the 2006 American Speech-Language-Hearing Association conventions in San Francisco, CA, and Miami, FL, respectively, and at the 2000 Symposium for Research in Child Language Disorders in Madison, WI. The authors acknowledge the invaluable assistance of Jennifer Brill, Kelly James, and Erin Reinstein in data analysis, and Alan Cobo-Lewis and Daniel Yanosky in statistical analysis. References Camp, B. W., Burgess, D., Morgan, L. J., & Zerbe, G. (1987). A longitudinal study of infant vocalization in the first year. Journal of Pediatric Psychology, 12, Iyer & Oller

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55 The Volta Review, Volume 108(2), Measuring Metacognition: A Prospect for Objective Assessment Yasser A. Al-Hilawani, Ed.D. ; Fatimah A. Dashti, Ph.D. ; and Ahmad A. Abdullah, Ph.D. This study compares the performances of students with typical hearing, students who are deaf and hard of hearing, students with typical hearing who were low-achieving, and students with typical hearing who were institutionally raised by testing with a newly constructed tool of metacognition that also measured reaction time. Results revealed no significant differences between students with typical hearing and students who are deaf and hard of hearing in scores on the instrument and in reaction time. The performance of these two groups of students was significantly better in obtaining correct scores and in having less reaction time compared to performances of students who were institutionally raised and low-achieving. The performance of institutionalized students did not differ significantly from that of low-achieving students in obtaining correct scores, but the institutionalized students reaction time was significantly longer. When time was used as a factor in determining students correct responses, the performance of institutionally raised and low-achieving students was disadvantaged when compared with that of students with typical hearing and students who are deaf and hard of hearing. Introduction For the purpose of this research, metacognition refers to strategic employment of one s cognitive processes and resources to construct knowledge, and employ thinking and problem-solving skills to reach understanding and Yasser A. Al-Hilawani, Ed.D., is an Associate Professor of Special Education in the Department of Educational Psychology at Kuwait University. Fatimah A. Dashti, Ph.D., is an Assistant Professor of Instructional Technology in the Department of Curriculum and Instruction at Kuwait University. Ahmad A. Abdullah, Ph.D., is an Associate Professor of Special Education in the Department of Educational Psychology at Kuwait University. Correspondence concerning this article should be addressed to Dr. Al-Hilawani, Department of Educational Psychology, College of Education, Kuwait University, P. O. Box Kaifan, Code No , Kuwait, or by at [email protected]. Measuring Metacognition 139

56 insight into one s environment ( Brown, 1978 ; Flavell, 1976, 1978, 1979, 1999 ). This definition of metacognition (Brown, 1978 ; Flavell, 1976, 1978, 1979, 1999 ) encompasses features of intelligent ability; entails employing one s higherorder thinking processes, such as recognition, discrimination, judgment, and cognitive restructuring of events for effective functioning in life; and covers the process of performing interactive mental juggling to maintain one s connection to the task on hand for decision making and task fulfillment ( Al-Hilawani, 2000, 2001, 2003 ; Al-Hilawani, Easterbrooks, & Marchant, 2002 ). Studies of metacognition and individuals with hearing loss have been conducted by generating responses to specific problematic situations ( Jonas & Martin, 1985 ; Martin & Jonas, 1986 ) or by presenting real-life pictures to assess abilities related to accurate syntheses, analyses, perceptions, judgments, predictions, and explanations of what students usually experience in real-life situations ( Al-Hilawani, 2000, 2001 ). The latter test included situations covering human aspects associated with desires, intentions, interactions, emotions, communications, and object identifications. It used pictures to measure metacognition based on the notion that students with hearing loss are strong in simultaneous visual processing, meaning that they rely on visual-spatial perception to process information (Al-Hilawani, 2000, 2001, 2003, 2006 ; Al-Hilawani et al., 2002 ). The importance of this study comes from the attempt to objectively measure mental thought and belief practice through the process of metacognition. For the purpose of this study, we designed and built a new assessment tool suitable for elementary and upper-level students to measure metacognition in three specific domains: the naïve psychology, the naïve physics, and the naïve biology. These three domains focus on knowing about people, plants and animals, and physical objects as they exist in the natural environment. They constitute most of the external world in which individuals interact and form the areas in which critical thinking skills are most likely utilized ( Wellman & Gelman, 1992 ). The importance of this study also comes from the attempt to examine the relationship between metacognition, as viewed in this research study, and reaction time. We believe it is important to measure reaction time when measuring metacognition because individuals in real-life situations sometimes only have one chance to pass a quick and accurate judgment, and then act accordingly ( Al-Hilawani, 2000 ). Reaction time could affect students social interactions because students who are slow in responding to demands, requests, and/ or social cues may face negative consequences. Traditionally, reaction time was studied with reference to students intelligence quotient (IQ). Research shows that there is a correlation between reaction time and IQ; individuals with high ability processed information faster than those with low ability (e.g., Bates & Stough, 1998 ; Jensen, 1998 ). Crawford, Deary, Allan, and Gustafsson (1998) demonstrated that stimulus inspection time was strongly associated with the perceptual-organizational factor of the Wechsler Adult Intelligence Scale Revised (WAIS-R; Wechsler, 1981 ) but only modestly related to general 140 Al-Hilawani, Dashti, & Abdullah

57 intelligence. Unlike the research that used laboratory tasks to examine the relationship between reaction time and IQ, we used pictures that depicted reallife knowledge and situations representing the naïve psychology, the naïve physics, and the naïve biology domains to examine the relationship between reaction time and metacognition. The study compared the performances of students with typical hearing, students who are deaf and hard of hearing, students with typical hearing who were low-achieving, and students with typical hearing who were institutionally raised by testing with a newly constructed tool of metacognition that also measured reaction time. We selected these four groups of students due to differences in their hearing status and in their daily academic and life experiences. We expected that students performance on this measure would be affected by their hearing status, by their cognitive system, by the state of their psychological health, and/or by the quality of their daily life experiences. The group selection exemplified these four elements to help give this approach to metacognition the discriminating effect needed for future modification, refinement, and use. One assumption in this study is that time is a variable that affects daily learning and interaction. Another assumption is that building a computerized measuring tool using pictures is one way to capitalize on a learner s visual-spatial perception and processing, allowing a modality assessment when dealing with students who have a low verbal repertoire ( Al-Hilawani, 2000, 2003 ). We hypothesized that a significant difference would exist between the performances of students with typical hearing and students with hearing loss, and that these two groups would obtain significantly higher scores on the metacognitive measure than the students who were low-achieving and institutionally raised. We also hypothesized that significant differences would exist between students with typical hearing and students with hearing loss in their reaction time to the presented tasks. Finally, we wanted to see if the reaction time of students who were low-achieving or institutionally raised would be the slowest when compared with that of students with typical hearing and students who are deaf and hard of hearing. Method Participants A total of 156 students participated in this study and the participants were divided into four groups. The first group consisted of 48 students with typical hearing (mean age = years; standard deviation [SD] = 0.54 years; age range = 9.00 to years). There were 24 boys (mean age = years; SD = 0.47 years; age range = 9.47 to years) and 24 girls (mean age = 9.86 years; SD = 0.53 years; age range = 9.00 to 10.71). Students in this group had no obvious disabilities nor were they enrolled in special education services. They all attended mainstream schools. Measuring Metacognition 141

58 The second group consisted of 42 students who were low-achieving (mean age = years; SD = 1.24 years; age range = 8.89 to years). There were 24 boys (mean age = years; SD = 1.25 years; age range = 8.89 to years) and 18 girls (mean age = years; SD = 1.27 years; age range = 9.08 to years). Students in this group were failing their classes and at risk of dropping out of school. They were officially labeled slow learners by the Kuwait Ministry of Education because they had IQ scores ranging from 70 to 85 and were experiencing academic and learning difficulties. They were not able to compete in mainstream classrooms and some of them had been retained in previous grades. These students were being educated in self-contained special education classrooms located within the mainstream school buildings. They studied a modified version of the mainstream curriculum. Because of the procedures applied and the measures used to conduct the assessment and diagnostic process, this group of students probably included those with learning, emotional, and mild mental disabilities in addition to borderline low-functioning students. It is not required that the evaluation process differentiate academic difficulties caused by disabilities or low-functioning ability from those caused by environmental factors (e.g., inappropriate instruction, lack of opportunity to learn, and cultural and economic disadvantages). The range of the Wechsler Intelligence Scale for Children-Revised (WISC-R; Wechsler, 1974 ) scores for the 24 boys was 58 to 85 with a mean of and a standard deviation of The range of the WISC-R IQ scores for the 18 girls was 59 to 85 with a mean of and a standard deviation of The third group of students consisted of 42 students who are deaf and hard of hearing (mean age = years; SD = 1.01 years; age range = to years). There were 24 boys (mean age = years; SD = 0.91 years; age range = to years) and 18 girls (mean age = years; SD = 1.14 years; age range = to years). Three students had a mild-to-moderate hearing loss (range from db); 7 students were hard of hearing (range from db); 4 students had a severe-to-profound hearing loss (range from db); and 27 students had a profound hearing loss (range from db). The level of hearing loss was not available for one participant. Thirtysix students were born with hearing loss, one student was diagnosed at age 1 year, and two students were diagnosed at age 2 years. There was no information available to determine the age of onset for the other three students. All students in this group had no other disabling conditions and were educated in a special school for the deaf where they studied a simplified version of the mainstream school curriculum. They received training in signing and speaking simultaneously. Some participants were using hearing aids at the time this study was conducted. The fourth group consisted of 24 students who were institutionally raised (mean age = years; SD = 1.23 years; age range = 9.05 to years). There were 12 boys (mean age = years; SD = 0.83 years; age range = 9.05 to 142 Al-Hilawani, Dashti, & Abdullah

59 11.51 years) and 12 girls (mean age = years; SD = 1.20 years; age range = 9.05 to years). These students attended mainstream schools and lived in a government-run facility called the Welfare Home, which is overseen by the Kuwait Ministry of Social Affairs and Labor. The Welfare Home facility was established in 1961 to serve and house abandoned infants and children as well as those who came from broken families due to illness, divorce, death, disabilities, and imprisonment of parents. According to information published by the Welfare Home, children residents usually suffer from psychological deprivations and from symptoms associated with fear and anxiety. Instrumentation We consulted the work of Wellman and Gelman (1992) to obtain information on the three knowledge domains of naïve psychology, naïve physics, and naïve biology, as well as reviewed the work of Al-Hilawani (2000, 2003 ) to find how metacognition is approached in real-life situations to construct an objective measure of metacognition. Examples of naïve psychology include identification and understanding of people as psychological beings whose actions are triggered or could be explained by psychological states. These actions (internalmental or external-mechanical) are interpreted in the light of intentional acts; unexpected events (which are likely expressed by internal-mental states); and internal-mental states, such as desire, sadness, pain, fear, anger, disgust, surprise, and happiness. Examples of naïve physics include cause-effect relationships and understanding the identification, classification, and transformation of physical objects. Examples of naïve biology include identifying and understanding the processes of organic growth, reproduction, inheritance, classification, eating and sleeping, and illness and death, among others. These three general domains shape the acquisition of specific insights and awareness and are considered the basis for further conceptual understanding, development, and knowledge acquisitions ( Wellman & Gelman, 1992 ). We consider knowledge of these domains related to the common knowledge that everyone should have based on age, experience, and culture. Pictures were used to represent the contents of these domains because using pictures allows one to control the influence of language levels that may exist among students ( Al-Hilawani, 2000, 2001, 2003 ) and because pictures are suitable for representing and collecting various types of information, such as naming drawings based on their shape and size and describing the intent of the person who created them ( Bloom & Markson, 1998 ). We constructed an instrument to measure metacognition by visualizing and specifying the real-life scenarios that reflect the above-mentioned examples to cover each of the three domains. We then conducted a search of the Internet and the MasterClips ( IMSI, ) image collection (which contained more than 303,000 photos and images grouped into main categories and subcategories such as plants, animals, people, objects, cartoons, transportation, military, Measuring Metacognition 143

60 and home) to find images that represented each specified scenario in the three domains. We selected a target picture as well as four additional picture options. One of the four options was the correct choice because it matched with or directly related to the target picture. The target picture and the four optional pictures constituted one item in the metacognition measuring instrument. For the purpose of this study, we constructed a total of 28 test questions using cartoon drawings. We formed 12 test items for the biology domain, 7 test items for the physics domain, and 9 test items for the psychology domain one item for each of the seven internal mental states (fear, surprise, pain, anger, desire, disgust, and sadness) and two test items for the two intentional acts. For example, to represent the first intentional act in the psychology domain, we selected a picture showing a robber holding a sack of money in his hand and four options of pictures, one of which showed the consequence of such an act (i.e., being behind bars). For the second intentional act, we selected a drawing of a scared man holding a bedcover up close to his eyes and four options of pictures, one of which showed a masked man pointing a gun. The measuring instrument did not include the traditional false-belief task used to test theory of mind due to lack of appropriate and suitable pictures. Once the first draft of the measuring instrument was complete, we asked four faculty members in the Kuwait University College of Education to review the tool. We informed the reviewers that the purpose of the instrument was to measure students knowledge of real-life problems and situations as well as their reasoning and problem-solving skills. We asked each reviewer to comment on the clarity as well as relationship between each target picture and the four choices, and to indicate whether the target picture matched with or related appropriately to the correct option. This piloting process yielded 71% agreement. The reviewers commented that 8 out of 28 target pictures had more than one correct option and that some options were unclear and confusing. We addressed the reviewers comments by searching for and replacing the images in question. After replacing these pictures, we asked the four reviewers to comment again on the modified instrument to determine if their comments and suggestions were followed and implemented satisfactorily. This second round of the pilot testing yielded 100% agreement that there was only one correct answer among the four options that correctly reflected the relationship with the target picture, and that the other three options functioned appropriately as distracters. The paper version of the metacognition measuring instrument was transformed into an electronic version to accurately measure students reaction time by allowing each test item to remain on the computer screen for a specific and equal amount of time. A portion of this reaction time is called inspection time, which refers to the period that is required by a participant to accurately process the presented information. Inspection time is a factor that underlies performance on tests of intelligence (e.g., Deary & Stough, 1996 ). Both reaction time and inspection time are inseparable and intertwined for purposes of this study. 144 Al-Hilawani, Dashti, & Abdullah

61 The sequence of the 28 test items were counterbalanced and presented in random order to each participating student. Each test item was timed to appear on the computer screen for 1 minute. If the student did not select one of the four options as an answer to the presented picture within 1 minute, the next test item would appear immediately on the computer screen. The maximum time allowed to complete this test was 30 minutes: 28 minutes for the actual test and 2 minutes for the two trial exercises. We assigned one point for each test question answered correctly. Thus, the maximum possible score that a student could receive was 28 out of 28. After administrating the computerized measuring instrument to the student participants, we obtained the correlation of each item with the total score to remove any weak test item from the final analysis. Results showed that 27 out of 28 test items correlated significantly with the total score. The correlation ranged from 0.23 to The one test item that did not correlate significantly (r = 0.13, p = 0.10) with the total score was from the biology domain; selecting the right answer for this question depended on participants knowledge of carnivores and herbivores and the interrelationship between them. We decided to use all 28 test items to analyze the data of this study, which yielded a reliability coefficient (alpha) of 0.78, because removal of this test item from calculation of the reliability level did not enhance the alpha level dramatically (i.e., alpha = 0.79). Obtaining the coefficient alpha of 0.78 for this test s administration is acceptable for research purposes ( Nunnally, 1967 ; Salvia & Ysseldyke, 1981 ). Procedures A student in the Kuwait University College of Education administered the test to all participants. The lead author trained the data collector in two separate sessions, each of which lasted for approximately 1 hour. The two training sessions covered the nature of the test, the operation and function of the computer program (which began with two trial test items followed by the actual test items), the instructions to participating students, the seating arrangement of students and the data collector during the test administration, and two comprehensive training exercises. During the two trial exercises, the lead author and the data collector took turns administering the test and entering responses into a desktop computer. During the actual test administration, the data collector began by asking each participant to sit in front of the computer screen. The data collector then walked the student through the two trial test items. The first trial test item presented on the computer screen was a picture of an apple and four options two kittens, three bananas, an open book, and a robot. Students were required to point to the option that was related to or matched the target picture. The second trial test item showed a target picture of a red circle and the options were three red triangles and a red circle. Students were required to point to Measuring Metacognition 145

62 the shape that was related to or matched the target picture. When students selected the best option out of the four available pictures in each of the two trial test items, the data collector clicked on that option with the mouse. When students finished taking the two trial exercises, they proceeded to take the actual test. We asked the data collector to enter students answers into the computer to control for unnecessary time variations, inconsistent data entry, and/or unintended answers that would be more likely to happen if students entered their answers into the computer themselves. When a student finished taking the test, the computer program automatically stored the test results of that student. We asked the data collector to give these instructions to each participant when administering the two practice test items: The test session begins with the data collector s introducing herself to each student: Hi. My name is. (The data collector says her name.) What is yours? (Student says his/her name.) Then the data collector continues: I would like to show you a game on this computer. (The data collector points to the computer.) I want you to try this game and then I want you to tell me if you like it. I want you to play this game fast, but I also want you to be accurate when choosing your answers. The data collector starts the first practice test item by saying: What is this picture? (The data collector points to the target picture.) When the student answers the question, the data collector then says: I want you to find a picture (the data collector points with the index finger in a sweeping manner from left to right to the four pictures underneath the target picture) that goes with this picture. (The data collector points to the target picture.) When the student points to one of the four pictures, the data collector uses the mouse to enter the student s answer into the computer. When the participant finishes the second practice test item, the data collector asks, Do you understand this game? If the answer is no, the data collector restarts the two practice test items on the computer and repeats all the previous steps. If the answer is yes, the data collector asks, Do you want to go through the two practice test items again? If the answer is yes, the data collector restarts the practice exercises. If the answer is no, the data collector says, Now I will start the game. I want you to point to one of the four pictures that goes with the picture in the middle of the computer screen. Do this game fast but be accurate in your responses. Do not ask questions when the game starts because I am not allowed to talk. Shall I start the game? If the participant decides not to play the game, the data collector thanks the student and then sends him/her back to class. If the participant wants to play the game, the data collector starts the game. For students who are deaf and hard of hearing, the data collector delivered the same instructions using simultaneous spoken and signed Arabic language. Because we were measuring reaction time, the data collector did not repeat instructions, nor was she pointing to options during the actual test administration. We also asked the data collector to gather further information on each participating student including gender, date of birth, school performance 146 Al-Hilawani, Dashti, & Abdullah

63 (i.e., grades in math, science, and language), IQ score (when available), and hearing loss in decibels for students who are deaf and hard of hearing. Results We obtained information not only on whether students responses were correct and how much time they took to choose an answer, but also on whether the correct response to each item on the test was influenced by the mean reaction time to that item. Therefore, we calculated the mean reaction time to each of the 28 items. We then used the 28 mean reaction times to decide whether a student should receive a score for each of the 28 test items when the selected option was correct. If a student s response to a test item was correct and fell at or below the calculated mean reaction time, the student would get one point for that item. If the student s response was correct but took more time than the assigned mean reaction time for that item, the student would receive 0 points. Table 1 presents means and standard deviations of the following variables: raw scores on the response to items on the test of metacognition, students reaction time to items on the test, and scores based on the mean reaction time to respond to each item on the test. The table shows that students with typical hearing and students who are deaf and hard of hearing obtained the highest correct raw scores. Moreover, the means of correct scores for all four groups of students decreased when we scored the test using the mean reaction time that students took to answer each of the 28 items. It appears that setting a time limit negatively affected the performance of all participants. We began the analyses by conducting the Pearson product-moment correlations, which showed no significant relationship between scores on test of metacognition and reaction time (r = 0.04, p = 0.59) for the participants. There was, however, a significant negative correlation between the age variable and student groups (r = 0.42, p < 0.01). We used one-way analysis of variance (Univariate Analysis of Variance, or ANOVA) to find if there were significant differences in age among the four groups of students. ANOVA showed significant differences among the four groups, F (3, 152) = 16.95, p < The Scheffe post hoc measure revealed that the students with hearing loss, students who were low-achieving, and students institutionally raised were significantly older than the group with typical hearing. No significant age difference was found between the group with hearing loss, the group who were low-achieving, and the group institutionally raised. Based on this result, we performed Multivariate Analysis of Covariance (MANCOVA) with students age as a covariate to examine the performance of the four groups of students along with the sex variable (i.e., two independent variables) on two dependent variables: scores on test of metacognition and students reaction time measured in seconds. The MANCOVA analysis showed that the age covariate was not significant (Hotelling s F (2, 146) = 0.444, p = 0.643). The MANCOVA identified significant differences based on Measuring Metacognition 147

64 Table 1. Total metacognition test scores, reaction time, and test scores based on reaction time Age Score on measure Reaction time in seconds Scores based on mean of reaction time Student groups n M SD M SD M SD M SD Total hearing sample Girls Boys Total low-achieving sample Girls Boys Total deaf and hard of hearing sample Girls Boys Total institutionally raised sample Girls Boys Al-Hilawani, Dashti, & Abdullah

65 students groups (Hotelling s F (6, 290) = 8.266, p < 0.001), but showed no significant differences based on the sex variable (Hotelling s F (2, 146) = 0.804, p = 0.449), or the interaction of the sex variable with students groups (Hotelling s F (6, 290) = 1.127, p = 0.346). Next, we examined the differences among student groups based on the test scores of metacognition and reaction time. Follow-up analysis revealed no significant difference on the test of metacognition between students with typical hearing and students who are deaf and hard of hearing. Moreover, these two groups performed significantly higher on the test than the low-achieving and the institutionally raised groups, who did not show significant differences in their performance on the metacognition test. With reference to reaction time, follow-up analysis showed no significant differences among students with typical hearing, students with hearing loss, and students who were low-achieving. Analysis revealed that these three groups took significantly less time to respond to test items than the group of students institutionally raised. We performed ANCOVA to compare the performance of the four groups of students along with the sex variable (i.e., two independent variables) on the test scores that we obtained based on reaction time (i.e., one dependent variable). We used age as a covariance because there was a significant age variation among students. The ANCOVA analysis showed that the age covariate was not significant, F (1, 147) = 0.141, p = ANCOVA identified significant difference in performance based on students groups, F (3, 147) = , p < 0.001, but showed no significant difference in performance based on the sex variable, F (1, 147) = 2.339, p = 0.128, or the interaction of the sex variable with students groups, F (3, 147) = 0.772, p = Follow-up analysis showed that students with typical hearing and students who are deaf and hard of hearing did not differ significantly in their performance. Moreover, these two groups performed significantly higher than the students who were low-achieving and raised institutionally, who did not differ significantly from each other in their performance. Discussion This study compares the metacognitive performance of school-age students who have typical hearing, who are deaf and hard of hearing, who were low-achieving, and who were institutionally raised. The study used a computerized tool that also measured reaction time. We viewed the process of measuring metacognition on a continuum from low to high levels of development, and we saw that the performance of children on this continuum was determined by the characteristics of their cognitive systems, psychological states, and the quality of their daily life experiences. We considered reaction time, or the time needed to process and then respond correctly to the presented stimuli, a manifestation of hearing status, cognitive systems, psychological states, Measuring Metacognition 149

66 and the quality and quantity of daily life experiences. With this information in mind, results of this study revealed no significant difference between the performances of students with typical hearing and students with hearing loss on the test scores of metacognition, on reaction time to test items, and on the test scores obtained based on the mean reaction time. It seems that students with typical hearing and students with hearing loss are more alike than different with reference to performance on the test of metacognition, a finding supported by previous research (e.g., Al-Hilawani, 2000, 2003 ) using different measures of metacognition, and with reference to the duration of time they needed to respond correctly to the presented test items. This result indicates that young people who are deaf and hard of hearing have the ability to manage and manipulate the physical, animate, and mental worlds and to reason adequately about them in a timely manner, just as students with typical hearing. It appears the visual processing format that we used in this study allows students with hearing loss to express what they know in a problem-solving manner. This conclusion is in harmony with the successful performance of many individuals who are deaf and hard of hearing in real-life situations, an indication that they are similar to peers with typical hearing in the ability to monitor, control, and reason about their mental activities and the mental states of others (e.g., Marschark, Green, Hindmarsh, & Walker, 2000 ). Results of our current study showed that students with typical hearing and students who are deaf and hard of hearing performed significantly higher than students who were low-achieving and students institutionally raised. In turn, the low-achieving and institutionally raised students did not show significant differences on the test of metacognition and on test scores based on reaction time. A review of the literature revealed no studies had examined the influence of living in an institutional environment on the children s reaction time. The studies we found examined the influence of some emotional states and feelings on reaction times of college students. Twenge, Catanese, and Baumeister (2003) reported that undergraduates facing rejection by their peers generally reacted slower to a reaction-time game when compared with students accepted by their peers, who more accurately completed the game. The study mentioned that social rejection affected executive function by slowing down responses to unfamiliar tasks, but not automatic responses to familiar ones. In a recent study of undergraduates, Shackman et al. (2006) reported that visuospatial working memory was negatively affected and participants reacted more slowly to stimuli when task-irrelevant anxiety was induced. That is, spatial working memory was disrupted due to threat, fear, stress, and/or worry. However, the verbal working memory in the left hemisphere was not affected by such anxiety. These studies may provide clues to explain the accuracy of performance and the reaction time of students raised institutionally as presented in the test of metacognition. It appears that their performance was depressed in terms of analyzing and discriminating real-life drawings in a problem-solving manner. 150 Al-Hilawani, Dashti, & Abdullah

67 As previously explained, the students in this study who were low-achieving were officially identified as slow learners. However, students in this group were not evaluated comprehensively and, therefore, might be a mix of borderline students and those with severe learning disabilities, mild mental disabilities, and severe emotional disabilities. These students are all enrolled in the so-called program for slow learners due to lack of appropriate special education alternatives in schools. The low performance of this group on the test of metacognition and the long reaction time needed to respond correctly to test items could be explained by low mental abilities, low school performance, and unstable psychological states. Future research may include test items to represent more scenarios in the naïve biology, naïve physics, and naïve psychology domains and the interaction among them, covering the aspects and knowledge related to people, plants and animals, and physical objects as they occur in a natural environment. This could improve the reliability coefficient level of this instrument. Future research in this area may also focus on examining metacognition as measured in this study and its relationship with performances on social adjustment and adaptive behavior scales, individualized and group IQ tests and subtests, and standardized achievement tests. We suggest that groups used in future research include students who are developing typically; students who are deaf and hard of hearing; students who are gifted; and students with learning, emotional, and mental disabilities. The outcome of this research would answer questions on how the current view of metacognition is related to students achievement, ability, and maturity levels. Implications Metacognition is viewed as a way of thinking in terms of common and distinctive features analyses practiced in domain-specific knowledge ( Al-Hilawani, 2003, 2006 ). This view of metacognition is familiar to students because it starts developing very early in life when students see themselves in action rather than others. This view is also in harmony with children s nature and with what they do when they are not asleep. Children begin choosing and selecting objects early in life by comparing, contrasting, evaluating, and judging them based on their desires or wants. Results of this study reveal that using this orientation toward examining metacognition in a picture format differentiated among groups of students and showed that students with hearing loss are comparable in their performance to students with typical hearing. Metacognition can be harnessed to be at one s disposal and demand to help an individual maintain deliberate and conscious control over the way information is processed. This could be done by designing a curriculum or a training program that emphasizes the following major elements: studying common and distinctive features analyses to specify object identity, Measuring Metacognition 151

68 similarities, and differences (e.g., shapes, pictures, and directions); grouping, categorizing, sorting, and classifying objects by use, color, shape, size, length, and/or weight; performing problem-solving activities in terms of object use, size, shape, and color, then without regard to size, shape, and color, and finally based on combinations of use, size, shape, and color; practicing pattern identification; specifying directionality (i.e., knowing left, right, up, and down, and the direction of an object when subjected to a force); classifying animate and inanimate objects; differentiating among productions, reproductions, and transformations of elements (e.g., growth and changes); examining relationships between action-reaction, cause-effect, part-whole, and vice versa; differentiating among equivalent, equal, and unequal parts and the proportion of their differences; mastering more-less relationships; acquiring identifications and representations skills; ordering and sequencing objects; building and identifying relationships among objects; practicing estimation and stating the value of objects, time, and seasons; using pantomime and hands-on experience; examining and comparing interrelationships and intrarelationships, feelings, and human relations with objects; and training in perceptions of nonverbal cues, perspective taking, reflecting and thinking back, argumentations, and predictions via hypotheses formation and verbal explanations of events. All these elements could be used to design programs from the concrete and simple basic levels using materials drawn from a child s daily life experiences to more abstract and complex levels found in school content materials. Providing training on these elements advances social competencies, enhances awareness of the surrounding environment, and improves attentiveness to emotional and mental states of selves and others. For example, enhancing social perspective-taking ability, an important social competency, is necessary for better understanding of daily life concepts such as oneself, authorities, friendships, communications, problem solving, and relating to others. When we help students assimilate these suggested program or curriculum elements and contents to a degree that they are brought easily and quickly to self-consciousness and self-awareness, they are better able to integrate intelligent features and incorporate new knowledge into their conceptual systems. These elements and contents are useful to build habits of the mind, a step toward active learning and teaching to make individuals reflect on their practices and adjust and revise their activities. These elements also enable students to explain knowledge, experiences, and behaviors as well as to invoke other individuals to act in response to students actions and mental representations of their environment. That, in turn, impacts social competency skills. Research has shown that such teaching and training leads to improved performance in understanding mental states, emotional experiences, and explicit behaviors (e.g., Dyck & Denver, 2003 ; Knoll & Charman, 2000 ; Slaughter & Gopnik, 1996 ). 152 Al-Hilawani, Dashti, & Abdullah

69 References Al-Hilawani, Y. (2000). A new approach to evaluating metacognition in hearing average-achieving, hearing underachieving, and deaf/hard-of-hearing elementary school students. British Journal of Special Education, 27 (1), Al-Hilawani, Y. (2001). Examining metacognition in hearing and deaf/hardof-hearing students: A comparative study. American Annals of the Deaf, 146, Al-Hilawani, Y. (2003). Measuring students metacognition in real-life situations. American Annals of the Deaf, 148, Al-Hilawani, Y. (2006). Visual analyses and discriminations: One approach to measuring students metacognition. American Annals of the Deaf, 151, Al-Hilawani, Y., Easterbrooks, S.R., and Marchant, G.J. (2002). Metacognitive ability from a theory-of-mind perspective: A cross-cultural study of students with and without hearing loss. American Annals of the Deaf, 147, Bates, T., and Stough, C. (1998). Improved reaction time method, information processing speed, and intelligence. Intelligence, 26 (1), Bloom, P., and Markson, L. (1998). Intentionality and analogy in children s naming of pictorial representations. Psychological Science, 9 (3), Brown, A.L. (1978). Knowing when, where, and how to remember: A problem of metacognition. In R. Glaser, (Ed.), Advances in instructional psychology, vol. 7 (pp ). Hillsdale, NJ: Lawrence Erlbaum Associates. Crawford, J.R., Deary, I., Allan, K.M., and Gustafsson, J. (1998).Evaluating competing models of the relationship between inspection time and psychometric intelligence. Intelligence, 26 (1), Deary, I.J., and Stough, C. (1996). Intelligence and inspection time: Achievements, prospects and problems. American Psychologist, 51, Dyck, M.J., and Denver, E. (2003). Can the emotion recognition ability of deaf children be enhanced? A pilot study. Journal of Deaf Studies and Deaf Education, 8, Flavell, J.H. (1976). Metacognitive aspects of problem-solving. In L.B. Resnick, (Ed.), The nature of intelligence (pp ). Hillsdale, NJ: Lawrence Erlbaum Associates. Flavell, J.H. (1978). Metacognitive development. In J.M. Scadura & C.J. Brainerd, (Eds.), Structural process theories of complex human behavior (pp ). Ayphen and Rijn, The Netherlands: Sijtoff & Noordhoff. Flavell, J.H. (1979). Metacognition and cognitive monitoring: A new area of psychological inquiry. American Psychologist, 34, Flavell, J.H. (1999). Cognitive development: Children s knowledge about the mind. Annual Review of Psychology, 50, IMSI. ( ). MasterClips Unlimited. San Rafael, CA, USA. Jensen, A.R. (1998). The suppressed relationship between IQ and the reaction time slope parameter of the Hick function. Intelligence, 26 (1), Measuring Metacognition 153

70 Jonas, B., and Martin, D.S. (1985). Cognitive improvement of hearing-impaired high school students through instruction in instrumental enrichment. In D.S. Martin, (Ed.), Cognition, education, and deafness: Directions for research and instruction (pp ). Washington, DC: Gallaudet University Press. Knoll, M., and Charman, T. (2000). Teaching false belief and visual perspective taking skills in young children: Can a theory of mind be trained? Child Study Journal, 30, Marschark, M., Green, V., Hindmarsh, G., and Walker, S. (2000). Understanding theory of mind in children who are deaf. Journal of Child Psychology and Psychiatry, 41, Martin, D.S., and Jonas, B. (1986). Cognitive modifiability in the deaf adolescent. Unpublished manuscript, Gallaudet University, Washington, DC (ERIC Document Reproduction Service No. ED ). Nunnally, J.C. (1967). Psychometric theory. New York: McGraw-Hill. Salvia, J., and Ysseldyke, J.E. (1981). Assessment in special and remedial education (2nd ed.). Boston: Houghton Mifflin. Shackman, A.J., Sarinopoulos, I., Maxwell, J.S., Pizzagalli, D.A., Lavric, A., and Davidson, R.J. (2006). Anxiety selectively disrupts visuospatial working memory. Emotion, 6, Slaughter, V., and Gopnik, A. (1996). Conceptual coherence in the child s theory of mind: Training children to understand belief. Child Development, 67, Twenge, J.M., Catanese, K.R., and Baumeister, R.F. (2003). Social exclusion and the deconstructed state: Time perception, meaninglessness, lethargy, lack of emotion, and self-awareness. Journal of Personality and Social Psychology, 85, Wechsler, D. (1974). Wechsler Intelligence Scale for Children-Revised. New York: Psychological Corporation. Wechsler, D. (1981). Wechsler Adult Intelligence Scale Revised. NewYork: Psychological Corporation. Wellman, H.M., and Gelman, S.A. (1992). Cognitive development: Foundational theories of core domains. Annual Review of Psychology, 43, Al-Hilawani, Dashti, & Abdullah

71 Information for Contributors to The Volta Review The Volta Review is a professionally refereed journal inviting manuscripts devoted to the education, rehabilitation and communicative development of people who are deaf or hard of hearing. Its readership includes teachers of students who have hearing loss; professionals in the fields of education, speech, audiology, language, otology, medicine, technology and psychology; parents of children with hearing loss; and adults who have a hearing loss. Established in 1899, The Volta Review is the scholarly research journal of the Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell), an international, not-for-profit organization based in Washington, D.C., particularly interested in the communication abilities of people with hearing loss. The Volta Review currently seeks research manuscripts of empirically based studies focusing on practical or conceptual issues with the result of advancing knowledge relevant to the communication needs and abilities of people with hearing loss. Group and single-subject designs are acceptable. Manuscript Style and Submission Requirements In general, manuscripts should conform to the conventions specified in the Publication Manual of the American Psychological Association (APA) 5th Edition (2002) with the exceptions and considerations given below. Submission. A cover letter, one hard copy of the manuscript and accompanying figures as well as electronic files should be submitted to: Managing Editor, The Volta Review, 3417 Volta Place, NW, Washington, DC or electronically to [email protected]. Preparation. Please double-space all materials. Manuscripts should be printed (inkjet or laser) on 8½ 11 paper leaving 1 margins on all sides. Number pages consecutively with the title page as page 1. The title page should include all authors names and affiliations, regular mail and addresses, telephone and fax numbers for the corresponding author, and a running head. No author-identifying information should appear anywhere other than the title page of the manuscript. Include an abstract of words as page 2. Assemble the rest of the manuscript in the following order, starting each part on a new page: First and subsequent pages of the text, acknowledgements (include citations of grant or contract support here), references, tables, figure captions and figures. Refer to Merriam-Webster s Collegiate Dictionary, 10th Edition for preferred spellings. Length. The following page limitations apply. Research papers are subject to a page limitation of 35 pages including tables and figures. Manuscripts exceeding the page limitations are occasionally accepted for publication on a spaceavailable basis. 155

72 References. All reference citations should be closely checked in the text against the reference list to determine that dates and spellings are correct. References must follow APA style and format. Tables. Include each table on a separate page. Number tables consecutively using Arabic numerals. Each table should be referred to in the text by its number. Indicate where the tables should appear in consecutive numerical order in the text, but do not insert tables into the text. Figures. Each figure must be referred to in the main text in consecutive numerical order using Arabic numbers. Non-graphic information should not appear as figure artwork, but in the figure legend. Hand lettering is unacceptable and standard abbreviations should be used (e.g., db not db or Db). Lettering or symbols appearing on the figure artwork should be as large as possible so they will still be legible when reduced. Figure legends (captions) must be double spaced and included on a separate sheet of paper at the end of the manuscript. Figure legends should not appear on the artwork. If a table or figure has been published previously, it is the author s responsibility to obtain written permission to adapt or reprint the figure or table from the copyright holder, even if it is the author s own previously published material. This applies to any figure, table or illustration and to direct quotes of 200 or more words from a periodical. Authors will be required to submit proof of permission to the Managing Editor. Please alert the Managing Editor to potential copyright permission issues when the manuscript is submitted. High-resolution figures files are necessary for final production of manuscripts accepted for publication. Files can be submitted via as.tiff,.jpg or.eps files with a resolution of 300 dpi at size. Authors must provide a laser copy of all art that is submitted electronically. The Volta Review does not accept art that is in color or downloaded from the Internet. Photocopy reproductions are not acceptable as final printer s copy; however, photocopies should be submitted for the reviewers use. Photographs. Photographs of special equipment or materials are often desirable; however, photos of standard classroom or clinical apparatus are not instructive and should not be included with the manuscript. Footnotes. As a general policy, using footnotes within the text is discouraged; however, in certain circumstances (such as for limited clarification of terminology) footnotes can be unavoidable. In such cases, use asterisks (*) as footnotes. Terminology. To describe individuals hearing status, please use the phrase deaf or hard of hearing or with hearing loss instead of hearing impaired. In addition, please use people first language (i.e., students who are deaf or hard of hearing or students with hearing loss instead of hearing-impaired students ). If authors choose not to follow this style, provide a rationale for 156

73 using the chosen terminology. The rationale may be provided in the form of an author s note or may be integrated into the text of the manuscript. The journal reserves the right to change terminology for readability purposes with the consent of the author. Review. All manuscripts are subject to blind review by two or more professional peers. The review process takes three to four months to complete. Reviewers comments are shared with author(s). Editing. The Editor, Associate Editors and Managing Editor of the journal will edit manuscripts to verify content and to enhance readability, as well as to ensure consistency of style and correctness of grammar, spelling and punctuation. Authors will be given an opportunity to review their edited manuscripts before they are set in type. Also, if the publication schedule permits, authors will be sent page proofs of their typeset articles for final review. Authors should mark only typesetter s errors and/or answer any questions directed to them by the Managing Editor. Copy changes cannot be made at this time. Use of Word Processing. Authors must submit electronic files of their manuscript text and accompanying figure and table files to the Managing Editor once the article is approved for publication. Please use Microsoft Word only and supply a hard copy of the text, figures, tables, etc. Authors may also submit manuscripts via to the Managing Editor at [email protected]. Transfer of Copyright. The revised copyright law, which went into effect in January 1978, provides that from the time a manuscript is written, statutory copyright is vested with the author(s). This copyright can be transferred only by written agreement. Without copyright ownership, the Alexander Graham Bell Association for the Deaf and Hard of Hearing cannot issue or disseminate reprints, authorize copying by individuals and libraries or authorize indexing and abstracting services to use material from the journal. Therefore, all authors whose articles have been accepted for publication in The Volta Review are requested to transfer copyright of their articles to the association before the articles are published. Reprints. At the time of publication of the journal, each contributing author is sent three complimentary copies of the issue. Additional reprints of published articles are available at cost to the author. These must be ordered through The Volta Review, 3417 Volta Place, NW, Washington, DC Authors are not permitted to sell reprints themselves once copyright has been transferred. Author s Responsibility An author guarantees, when signing a contract with a publisher, that the work is original, that the author owns it, that no part of it has been previously published, and that no other agreement to publish it or part of it is outstanding. 157

74 If a chapter or other significant part by the same author has been published elsewhere, written permission to reprint it must be secured from the copyright holder of the original publication and sent to the publisher. It is the author s responsibility to request any permission required for the use of material owned by others. When the author has received all permissions, the author should send them, or copies of them, to the publisher. The author must provide accurate information regarding the source of any such material in their work. Permission for the use of such entities as poems, musical works, or illustrations, even when no fee is charged, is normally granted only for the first edition of a book. New editions, paperback reprints, serialization in a periodical, and so forth, will require renewed permissions from the original copyright holder. The author is responsible for any fees charged by grantors of permission to reproduce, unless other arrangements are made, in writing, with the publisher. Fees paid for reproducing material, especially illustrations procured from a picture agency, normally cover one-time use only. Whether or not the author needs permission to use any material not their own, an author should give the exact source of such material: in a footnote or internal reference in the text, in a source note to a table, in a credit line with an illustration. Where permission has been granted, the author should follow any special wording stipulated. Material Requiring Permission Copyrighted Material. The author of an original book must have written permission to use any copyrighted material that is complete in itself: short story, essay, chapter from a book, etc. The author should also seek permission to use more than one line of a short poem still in copyright or any words or music of a popular song. No permission is required for quoting from works in the public domain. Fair Use. The Fair Use Clause generally allows copying without permission from, or payment to, the copyright owner where the use is reasonable and not harmful to the rights of the copyright owner. Without prescribing precise rules to cover all situations, the clause refers to purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, and sets out four factors to be considered in determining whether or not a particular use is fair: 1. The purpose and character of the use, including whether or not such use is of commercial nature or is for nonprofit, educational purposes; 2. The amount and substantiality of the portion used in relation to the copyrighted work as a whole; 3. The nature of the copyrighted work; 158

75 4. The effect of the use upon the value or potential market of the copyrighted work. The Alexander Graham Bell Association for the Deaf and Hard of Hearing encourages the author to obtain written permission for any quotation of 150 or more copyrighted words. The author may not copy any part of a copyrighted work unless he or she uses quotation marks, indicates the source of the quotation, and if 150 or more words in length, obtains written permission from the copyright holder. 159

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