JCPSLP Vol 16 Issue 1 2014

their past (Crowe, McLeod, McKinnon, & Ching, 2012). The frequency with which sign was used by young children with hearing loss, mostly concurrent with spoken language, indicates the need for resources to support children and parents in developing sign skills. In addition, there is a need for clinicians and educators working these families to have knowledge of sign and of developing sign skills with children and their families. The languages most frequently used by the children were English, followed by Arabic, Cantonese, Vietnamese, and Spanish; however, in total the children used 29 different spoken languages to communicate (see Table 2; Crowe, McLeod, & Ching, 2012). A small percentage of children used more than one spoken language at home, and even fewer used more than one spoken language in early intervention (see Table 1; Crowe, McLeod, & Ching, 2012). Some parents reported that they had tried to raise their children with hearing loss to be multilingual, but that their children used only one spoken language (Crowe, McLeod, & Ching, 2012). The rates at which these languages were used were similar to those reported to be used by young Australian children without hearing loss in the Longitudinal Study of Australian Children (McLeod, 2011; Verdon, McLeod, & Winsler, in press). Approximately 17% of children used a spoken language other than English at home, but this language was rarely used in early intervention (see Table 1; Crowe, McLeod, & Ching, 2012). At 3-years of age, the following characteristics were important in differentiating children who used speech at home from those who used both sign and speech at home: the communication mode their mother used at home, whether children had any disabilities in addition to hearing loss, and their mothers’ level of education (Crowe, McKinnon et al., 2013). The communication mode used in early intervention for these children was best differentiated by: children’s communication mode at home, and whether their father used a language other than English at home (Crowe, McKinnon et al., 2013). For 3-year-old children the following characteristics were important in differentiating children from multilingual homes who used English at home and who used another language at home (with or without also using English): mothers’ use of English at home, children’s communication mode at home, and whether children used English at home (Crowe, McKinnon et al., 2013). While further investigation of these relationships is warranted, these relationships do indicate that how parents choose to communicate with their children is a complex issue that may draw on many aspects of the families’ experiences and characteristics. The communication of the parents of young children with hearing loss The majority of parents of children participating in this study used spoken English to communicate at home when their children were 3-years-old (Table 3), while very few of the parents used sign to communicate (Crowe, McLeod, & Ching, 2012). The languages most frequently used were English, Arabic, Cantonese, Vietnamese, and Italian; however, parents used 45 different spoken languages at home (see Table 2; Crowe, McLeod, & Ching, 2012). The rates at which these different languages were used were similar to the languages reported in the Australian census (Australian Bureau of Statistics, 2012). Approximately 20% of parents used more than one spoken language at home, compared to only 13% of children (Tables 1 and 2; Crowe, McLeod, & Ching, 2012; Crowe, McLeod, McKinnon, et al.,

Hearing Impairment (LOCHI) study (www.outcomes.nal.gov. au). The LOCHI study is an ongoing large-scale population study of over 400 children in New South Wales, Queensland, and Victoria, who were fitted with a hearing aid or cochlear implant before they were 3-years-old. Information collected as part of the LOCHI study is very broad; however, the current paper draws on information collected from three sources: 1. Parents and teachers/clinicians completed questionnaires when the participating children were 3-years-old. This provided information about how children communicated at home and in early intervention, and what languages their parents used at home. This questionnaire also collected information about other important child and parent characteristics, such as country of birth, socioeconomic status, parental education level, parental hearing status, and children’s disabilities in addition to hearing loss. Information was obtained that described 406 children and 792 of their parents. 2. Information from the children’s audiologists described how old the children were when they were diagnosed with a hearing loss, when they were first fitted with hearing aids, and the severity of their hearing loss. For children with cochlear implants, the age when their first implant was switched on was also obtained. 3. Questionnaires investigating parent decision-making about communication mode and language use for their children with hearing loss were obtained from 177 parents. The communication of young Australian children with hearing loss The majority of the 406 children participating in the LOCHI study used spoken English to communicate when they were 3-years-old (Table 1), with very few children using only sign to communicate, and approximately 25% of the children using speech and some form of sign (or symbols) to communicate (Crowe, McLeod, & Ching, 2012). The most common types of signed communication used were Australian Sign Language (Auslan), followed by Makaton and Signed English, and then alternative communication (e.g., pictures and symbols; Crowe, McLeod, & Ching, 2012). For children aged between 3 and 9 years, 33% either currently used sign, or had used sign at some time in Table 1. Children’s communication style at 3 years of age (based on data from Crowe, McLeod, & Ching, 2012) Communication style At home At intervention Communication Speech only 75% 77% mode Sign only 1% <1% Sign and speech 24% 23% Spoken Spoken English 94% 99% language use Other spoken language 17% 3% Spoken English only 82% 97% Other spoken language only 4% 1% Spoken Monolingual 86% 97% language Multilingual 13% 2% multilingualism Note. Based on data from 406 children participating in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Percentages do not all add to 100% as some children did not use any spoken language, some children used more than one language, and there were small amounts of missing data.

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JCPSLP Volume 16, Number 1 2014

Journal of Clinical Practice in Speech-Language Pathology