Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review

Elizabeth M. Fitzpatrick · Candyce Hamel · Adrienne Stevens · Misty Pratt · David Moher · Suzanne P. Doucet +2 more

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Hearing Impairment and Communication Language Development and Disorders Hearing Loss and Rehabilitation

Abstract

CONTEXT: Permanent hearing loss affects 1 to 3 per 1000 children and interferes with typical communication development. Early detection through newborn hearing screening and hearing technology provide most children with the option of spoken language acquisition. However, no consensus exists on optimal interventions for spoken language development. OBJECTIVE: To conduct a systematic review of the effectiveness of early sign and oral language intervention compared with oral language intervention only for children with permanent hearing loss. DATA SOURCES: An a priori protocol was developed. Electronic databases (eg, Medline, Embase, CINAHL) from 1995 to June 2013 and gray literature sources were searched. Studies in English and French were included. STUDY SELECTION: Two reviewers screened potentially relevant articles. DATA EXTRACTION: Outcomes of interest were measures of auditory, vocabulary, language, and speech production skills. All data collection and risk of bias assessments were completed and then verified by a second person. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the strength of evidence. RESULTS: Eleven cohort studies met inclusion criteria, of which 8 included only children with severe to profound hearing loss with cochlear implants. Language development was the most frequently reported outcome. Other reported outcomes included speech and speech perception. LIMITATIONS: Several measures and metrics were reported across studies, and descriptions of interventions were sometimes unclear. CONCLUSIONS: Very limited, and hence insufficient, high-quality evidence exists to determine whether sign language in combination with oral language is more effective than oral language therapy alone. More research is needed to supplement the evidence base.

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2009Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement 2009Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.2011GRADE guidelines: 3. Rating the quality of evidence 2010Peabody Picture Vocabulary Test 2004A Process for Systematically Reviewing the Literature: Providing the Research Evidence for Public Health Nursing Interventions 2007Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs 2007Peabody Picture Vocabulary Test 2000Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs

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2018Support for parents of deaf children: Common questions and informed, evidence-based answers 2019Language and Reading Progress of Young Deaf and Hard-of-Hearing Children 2018Executive Function in Deaf Children: Auditory Access and Language Access 2023Learning a Sign Language Does Not Hinder Acquisition of a Spoken Language 2024Assessment for Reading Instruction

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