Language Ability after Early Detection of Hearing Impairment
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《新英格兰医药杂志》
To the Editor: I was surprised that the article by Kennedy et al. (May 18 issue)1 about language acquisition in deaf children did not mention signing or sign language. Deaf children cannot hear. This creates natural limits on the effectiveness of speech as a medium for the acquisition of language. Hearing parents can and do learn to sign. Deaf children gain real language competence through signing. The introduction of sign language into the infant's environment as the result of hearing screening should be the test of the efficacy of screening and progress in language acquisition.
John Grima, Ph.D.
McKay–Dee Hospital Center
Ogden, UT 84403
j.grima@comcast.net
References
Kennedy CR, McCann DC, Campbell MJ, et al. Language ability after early detection of permanent childhood hearing impairment. N Engl J Med 2006;354:2131-2141.
The authors reply: We agree with Grima that effective intervention must occur after screening for its benefit to be demonstrable. Our study design did not specify the intervention chosen, but only 26 of 120 participants in our study had profound hearing losses, and only 16 participants used sign language as their principal mode of expressive communication, including 11 for whom it was also the principal mode of receptive communication. These findings suggest that the families and professionals involved in managing the hearing losses did not consider signing to be the appropriate intervention in the 94 participants with moderate or severe losses. We did test signing ability using British Sign Language,1,2 but we did not report these findings because of the small number of observations (nine) and the doubtful validity of combining the assessments of oral language scores and signed language scores. Oral language skills were the most appropriate outcome to report, not only because they were the only relevant mode of communication in 87 percent of our participants but also because the acquisition of these skills allows for effective communication with most people.
Colin Kennedy, M.D.
University of Southampton
Southampton SO16 6YD, United Kingdom
crk1@soton.ac.uk
Peter Watkin, M.Sc.
Whipps Cross University Hospital National Health Service Trust
London E17 3LA, United Kingdom
Sarah Worsfold, B.Soc.Sci.
University of Southampton
Southampton SO16 6YD, United Kingdom
References
Herman R, Holmes S, Woll B. Assessing British sign language development: receptive skills test. Gloucestershire, England: City Forest Bookshop, 1999.
Herman R, Grove N, Holmes S, Morgan G, Sutherland H, Woll B. Assessing British sign language development: production test (narrative skills). London: City University, 2004.
John Grima, Ph.D.
McKay–Dee Hospital Center
Ogden, UT 84403
j.grima@comcast.net
References
Kennedy CR, McCann DC, Campbell MJ, et al. Language ability after early detection of permanent childhood hearing impairment. N Engl J Med 2006;354:2131-2141.
The authors reply: We agree with Grima that effective intervention must occur after screening for its benefit to be demonstrable. Our study design did not specify the intervention chosen, but only 26 of 120 participants in our study had profound hearing losses, and only 16 participants used sign language as their principal mode of expressive communication, including 11 for whom it was also the principal mode of receptive communication. These findings suggest that the families and professionals involved in managing the hearing losses did not consider signing to be the appropriate intervention in the 94 participants with moderate or severe losses. We did test signing ability using British Sign Language,1,2 but we did not report these findings because of the small number of observations (nine) and the doubtful validity of combining the assessments of oral language scores and signed language scores. Oral language skills were the most appropriate outcome to report, not only because they were the only relevant mode of communication in 87 percent of our participants but also because the acquisition of these skills allows for effective communication with most people.
Colin Kennedy, M.D.
University of Southampton
Southampton SO16 6YD, United Kingdom
crk1@soton.ac.uk
Peter Watkin, M.Sc.
Whipps Cross University Hospital National Health Service Trust
London E17 3LA, United Kingdom
Sarah Worsfold, B.Soc.Sci.
University of Southampton
Southampton SO16 6YD, United Kingdom
References
Herman R, Holmes S, Woll B. Assessing British sign language development: receptive skills test. Gloucestershire, England: City Forest Bookshop, 1999.
Herman R, Grove N, Holmes S, Morgan G, Sutherland H, Woll B. Assessing British sign language development: production test (narrative skills). London: City University, 2004.