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JCPSLP
Volume 16, Number 1 2014
Journal of Clinical Practice in Speech-Language Pathology
contains information that encompasses the full range of
options (Sackett et al., 1996). Every child and every family is
different, and no single method of communication is
appropriate for every child and family (Early Support, 2006).
Parents making choices should be encouraged to consider
which communication options are best for their child and
their family (Marschark & Spencer, 2003).
Conclusion
Three-year-old Australian children with hearing loss and
their families use a diverse range of languages and many of
these children use sign as part or all of their communication
system. More parents than children were multilingual, and
children were more likely to be multilingual at home rather
than in their early intervention setting. Parents in these
studies reported that the following factors were influential in
their decision-making about how their children with hearing
loss would communicate: advice from professionals,
children’s access to speech through audition, children’s
intervention experiences, children’s future opportunities,
practicalities of communication, and creating a sense of
belonging for their children.
Acknowledgements
This research would not have been possible without the
assistance of the children, families, teachers, speech
pathologists, audiologists, researchers, and organisations
that participated in and supported the LOCHI study.
Co-investigators in the research described in this paper
were Professor Sharynne McLeod (Charles Sturt University),
Dr Teresa Ching (National Acoustic Laboratories), Associate
Professor David McKinnon (Charles Sturt University) and Dr
Loraine Fordham (Charles Sturt University). While
conducting this research Kathryn Crowe was supported by
a scholarship from the Department of Industry, Innovation,
Science Research and Tertiary Education, and an
Excellence in Research in Early Years Education
Collaborative Research network scholarship from Charles
Sturt University. Sharynne McLeod was supported by the
Australian Research Council Future Fellowship
(FT0990588). The LOCHI study was conducted at the
National Acoustic Laboratories and supported by the
HEARing CRC, established and supported under the
Cooperative Research Centres Program – an initiative of the
Australian Government. The LOCHI study was partly
funded by the National Institutes of Health (R01DC008080),
awarded to Dr Teresa Ching.
References
Australian Bureau of Statistics. (2012a).
2011 Census
QuickStats
. Retrieved from http://www.censusdata.abs.
gov.au/census_services/getproduct/census/2011/
quickstat/0
Crowe, K., Fordham, L. A., McLeod, S., & Ching, T.
Y. C. (2013). “Part of our world”: Influences on caregiver
decisions about communication choices for children with
hearing loss.
Deafness and Education International
. doi:
10.1179/1557069X13Y.0000000026
Crowe, K., McKinnon, D. H., McLeod, S., & Ching,
T. Y. C. (2013). Multilingual children with hearing loss:
Factors contributing to language use at home and in early
education.
Child Language Teaching and Therapy
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103–121. doi: 10.1177/0265659012467640
Crowe, K., & McLeod, S. (2012). A systematic review
of cross-linguistic and multilingual speech and language
outcomes for children with hearing loss.
International
of the deaf told us not to sign”. However, other parents
commented on the balanced advice they had received;
for example “the teacher of the deaf provided unbiased
information, not saying we should or should not use sign”
(Crowe, Fordham et al., 2013).
Influences on parents’ decisions
about multilingualism and using
spoken English
Parents who had made decisions about whether or not to
raise their children with hearing loss in a monolingual or a
multilingual environment gave insight into what had been
important in their decision-making process. These parents
emphasised the importance in their decision-making of
early access to hearing aids and early intervention,
children’s future academic and literacy success, children’s
abilities to form friendships, participation in mainstream
Australian culture, communication with other family
members, and the availability of intervention and education
in English (Crowe, Fordham et al. 2013; Crowe, McLeod,
McKinnon, et al., 2012). Few professionals were reported to
advise against using English and there was a balance of
recommendations for and against multilingualism (Crowe,
Fordham et al., 2013; Crowe, McLeod, McKinnon, et al.,
2012).
Clinical implications
The findings of this research can help professionals and
organisations to develop information and services that cater
for the languages and communication modes used by
Australian children with hearing loss and their families,
allowing families greater access to and engagement with
intervention and education services. Knowing about some
of the different characteristics, experiences, and
perspectives that parents bring to the task of making
decisions about their children’s communication can assist
professionals better understand this process as they
support families and their children.
Future research needs
Although much has been learned from this research, there
is still more to learn about the way children with hearing
loss communicate. Clinicians and educators need to know
how the speech and language of children with hearing loss
develops when children are speakers of a wide range of
languages. Research describing speech and language
development for children with hearing loss is available for
only a small number of the languages which were reported
to be used by children and families in these studies (Crowe
& McLeod, 2012). The impact of communication mode on
spoken language outcomes also needs to be considered
carefully. Many research studies have reported that children
who use sign to communicate have poorer spoken
language outcomes. However, the findings of this research
suggest that children’s use of sign to communicate may, in
some cases, be a response to difficulties in their early
speech and language acquisition. This means that in some
cases the use of sign to communicate may be the result of
difficulty acquiring spoken language, rather than the cause
of difficulty acquiring spoken language. Parents should be
encouraged by educators and clinicians to make informed
choices about communication for their children with hearing
loss, not just to make a choice. Making an informed choice
means making a decision based on information that is
comprehensive, without bias, and evidence-based, and
