Reading Comprehension Delays – An Expectation for Most Students with Hearing Loss

What does it mean to teach kids how to read text effectively?1 Initially, it means making certain that they can decode so proficiently that they can decode the words without much conscious attention. Texts are going to place increasing demands on students’ linguistic abilities, memories, conceptual analysis, logic, and knowledge of the world. Those demands — not question types — are the potential barriers to kids’ comprehension. The teaching of reading comprehension and learning from text should focus on how to help students surmount these cognitive, linguistic, and intellectual barriers. Students who can make sense of a text’s ideas will be able to answer any kind of questions about that text. While students who fail to scale those linguistic and conceptual barriers will struggle with the simplest of questions. All of this is especially true for students with hearing loss, who are at high risk for being a couple of years delayed in reading comprehension compared to their hearing peers.2   Click here to continue reading the Late February 2019 Update
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Advocacy Notes: Addressing Reading and Literacy in the IEP

Question from the field: My child’s IEP team shared that he is “a good reader,” but I know that he is not understanding what he reads. He struggles with vocabulary and comprehension, but because he is getting good grades and reads the words, I am having trouble getting goals and services in the IEP. How can I help him? Reading and literacy development are critical for all children. As parents and educators of children with hearing loss, our ultimate goal is for them to be literate, self-sufficient, independent members of society. While our first thought after diagnosis is communication, we ultimately strive for them to be able to be happy, independent, have friends, self-advocate, graduate from high school, and pursue any advanced education and/or career direction they desire. Ideally, hearing loss will not create any unnecessary barriers to this future success. No matter which mode of communication the child uses, achieving higher levels of literacy will be an important key to removing barriers. IEP services are based on goals; goals are based on needs; and needs are identified by assessments and concrete data. Grades do not equal access. Grades are often a reflection of the hours of intensive support from families and tutors supporting our children’s comprehension of what they are reading. Our students will very often struggle with following written and verbal directions on assignments and tests, understanding test questions that are not simple and direct, math word problems, and vocabulary in subjects such as science, social studies, electives, and physical education. It often helps to remind the IEP team that every subject in school becomes language arts instruction for the student with hearing loss. Some IEP teams may only look at one aspect of reading or select a pre-written goal from an IEP goal bank that may or may not be appropriate for the individual child with hearing loss. It is helpful for the IEP team, including the family, to consider addressing the following specific aspects of reading separately by developing individual measurable and achievable goals:

1. Decoding 2. Fluency 3. Vocabulary 4. Reading comprehension 5. Higher order thinking skills (HOTS)1

For students who have access to linguistic information through listening, the team should also consider listening comprehension needs. Often students will demonstrate comprehension of what they have heard at a higher grade level while they continue to work on improving grade level reading comprehension skills.2 It is also important to look at the accommodations page of the IEP and document anything the team agrees will support the student. Following are some examples of possible accommodations that may be added to the IEP:

1. Directions interpreted, read out loud, simplified, or clarified 2. Questions and answer choices interpreted or read out loud 3. Pre- and Post-teaching of key concepts and vocabulary 4. Development of a student generated vocabulary book 5. Opportunity to use pictures to define vocabulary words 6. Text to speech captioning or audio books

For all children, regardless of level of hearing loss, research has shown that “early cognitive and linguistic development predict later achievement.”3  The results of Betty Hart and Todd Risley’s 1995 study3 can be extremely effective in helping the IEP team members understand the importance of on-going and intensive attention to addressing all aspects of literacy. Hart and Risley studied children from 7 months to the age of 3 in order to determine how many words they were exposed to prior to entering school. This was not a special education study. Participants were divided by socio-economic status, and what was found was a 30 million word gap between the lowest socio-economic group and the highest socioeconomic group. Specifically, the higher socio-economic group were exposed to 45 million words, the middle socio-economic group heard 26 million words, and the children in the low socio-economic group heard 13 million words. These numbers resonate with educators who are not experts in teaching children who are deaf and hard of hearing. Additionally, these researchers followed up with approximately half of the families when their children were in 3rd grade. The results indicated that “measures of accomplishment at age three were highly indicative of performance at the ages of nine and ten on various vocabulary, language development, and reading comprehension measures.”4 For the IEP teams to understand the unique needs of our children with hearing loss, as well as the potential, we must continue to educate the educators. Teams should continuously gather actual data separate and apart from the grade reports. Parents and teachers of the deaf/hard of hearing can help to support the other IEP team members regarding the importance of closing this language gap for students with hearing loss. No matter which mode of communication the family has chosen, it is imperative that teams continue to address all levels of the foundations for reading, work to close the gaps, and provide meaningful access to language. Sample Goals:
  • VocabularyBaseline: STUDENT displays some difficulty when listening in environments with background noise and/or multi-talker babble. STUDENT is able to demonstrate discrimination of close-set vocabulary and short passages in the presence of background noise with 65% accuracy. Goal: By DATE, STUDENT will be able to demonstrate discrimination of close-set vocabulary and short passages in an environment with background noise or multi-talker babble with 80% accuracy as measured by teacher charted data.
  • Reading comprehensionBaseline: STUDENT is able to answer who was in the story with 70% accuracy. She is struggling to retell basic details about the story when prompted with 45% accuracy. Goal: By DATE, STUDENT will be able to answer basic who, what, when, and where questions about a story that has been read to her with 80% accuracy in 3 out of 4 trials as measured by teacher created assessments and work samples
  • Higher order thinking skills (HOTS)Baseline: After reading grade level passages, STUDENT is able to demonstrate mastery of basic WH questions with 80% accuracy. However, when asked to respond to questions that do not involve concrete details (ie: make predictions, inferences, and identify cause and effect, (s)he is only able to respond with 44% accuracy. Goal: By DATE, after independently reading a grade level passage, STUDENT will demonstrate an understanding of HOTS (ie: prediction, inference, and cause and effect) by responding to open-ended questions with 80% accuracy as measured by work samples and teacher charted data.
  1. 1.
  2. 2.
  3. 3. NELP Report: Developing Early Literacy (2009). Summary from Reading Rockets.
  4. 4. The Early Catastrophe: The 30 Million Word Gap by Age 3″ by. University of Kansas researchers Betty Hart and Todd R. Risley (2003). Summary
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Reading Comprehension Delays – An Expectation for Most Students with Hearing Loss

What does it mean to teach kids how to read text effectively?1 Initially, it means making certain that they can decode so proficiently that they can decode the words without much conscious attention. Texts are going to place increasing demands on students’ linguistic abilities, memories, conceptual analysis, logic, and knowledge of the world. Those demands — not question types — are the potential barriers to kids’ comprehension. The teaching of reading comprehension and learning from text should focus on how to help students surmount these cognitive, linguistic, and intellectual barriers. Students who can make sense of a text’s ideas will be able to answer any kind of questions about that text. While students who fail to scale those linguistic and conceptual barriers will struggle with the simplest of questions. All of this is especially true for students with hearing loss, who are at high risk for being a couple of years delayed in reading comprehension compared to their hearing peers.2 Research consistently has shown that phonological skills, specifically phonemic awareness, are strong predictors of later reading proficiency. Improving students’ phonemic awareness skills alone is not sufficient. It is also critical to explicitly teach students how to apply the phonological skills they learn and connect letters to sound.3 Students who are deaf or hard of hearing do not need to use (only) spoken language to understand and use phonological awareness, Supplementing this understanding through visual, tactile, and kinesthetic cues is often needed.4 Essential components of reading instruction5 for students with hearing loss means explicit and systematic instruction in –
  • Phonemic awareness: Reliant on ability to perform fine auditory discrimination, including high frequency hearing
  • Phonics: Reliant on ability to clearly hear the sound/letter associations to be able to compare/contrast
  • Vocabulary development: Reliant primarily on incidental learning and exposure through having been read to by family
  • Reading fluency, including oral reading skills: Requires appropriate intonation, pronunciation, ‘instant’ phonics recognition, understanding of syntax and punctuation, knowledge of wide range of vocabulary, etc.
  • Reading comprehension strategies: Relies on understanding story grammar, being able to take the perspectives of other (Theory of Mind), broad vocabulary, understanding of multiple meaning words, figurative language, idioms, etc.
 A 20152 study that compared children with hearing loss to typically hearing students found:
  • Reading comprehension difficulties of children with hearing loss may be poorer than predicted from word-reading skills. There is a need to examine BOTH the word reading and reading comprehension for stories that are within the child’s word-reading ability.
  • Children with hearing loss may be especially poor at integrating their outside knowledge with information in the texts. They are likely to benefit from guidance when answering inference questions to help them use more efficient comprehension strategies and encourage them to incorporate different sources of information.
The teaching of reading comprehension and learning from text should focus on how to help students surmount these cognitive, linguistic, and intellectual barriers. Major attention needs to be spent on reading and making sense of texts rather than upon answering particular types of questions about texts.1 Learning strategies that happen before and during reading can help students overcome challenges that they face when gaining access to and attempting to understand text, resulting in improved comprehension.2 Comprehension instruction should be aimed at teaching students:1
  • Word meanings and the meaningful parts of words (morphology).
  • How to infer word meanings from context and structure.
  • How to untangle the complex syntax of sentences.
  • How to interpret the cohesive links across a text.
  • How to identify and interpret the organizational plan or structure of a text and how to use this organization as a memory aid.
  • How to interpret an author’s tone.
  • How to use (and not overuse) one’s knowledge to help make sense of a text.
  • How to summarize text information effectively.
  • How to monitor one’s comprehension — recognizing whether understanding is taking place and taking appropriate action if it is not.
  • How to rehearse text information so that it is remembered/learned.
  • How to interpret the graphic elements of texts (e.g., illustrations, charts, graphs, tables).
  • To develop the reading stamina required for understanding longer texts.
  • To recognize what a text says and what it does not.
  • How to compare and combine information appropriately from multiple texts.
Teaching morphology to students who are deaf or hard of hearing is often necessary.6,7 Facilitating the learning of morphologically complex words is particularly important because these words comprise 60-80% of the new words that school-age children must acquire to successfully read grade-level text.3 Similarly, problems with understanding syntax may result in difficulties with reading comprehension.3,8 These challenges become more pronounced when reading academic texts that comprise complex grammatical structures.8 Underdeveloped vocabulary becomes insufficient to support effective reading comprehension and writing, and in turn, has a negative impact on overall academic performance.3 Vocabulary is the key to content literacy for students with hearing loss.9 A variety of educational strategies are recommended to improve vocabulary and reading comprehension. 3, 10   For more information, see Maximizing Effectiveness of Reading Comprehension Instruction in Diverse Classroom.  

Good versus Poor Readers: Before, During, and After Reading2


Before Reading

-Use test features (e.g., headings, illustrations) to get a sense of what they will read and help themselves set a purpose for reading. -Set goals and ask questions that will help them be selective in the focus of their reading. -Consider what they already know about the topic. -Observe how text is organized, which prepares them to make connections between and among concepts. -Begin reading without a purpose for reading. -Do not consider (or do not have) background knowledge about the topic. -Do not recognize how text is organized and therefore do not have a plan for how to approach reading it. -Lack motivation or interest in reading.

During Reading

-Read fluently (quickly and accurately) and use word identification strategies to decode unfamiliar words. -Use strategies (i.e., context clues, prior knowledge) to figure out the meaning of vocabulary and concepts. -Recognize and use text structures to make connections between the meanings of sentences and/or concepts. -Ask and answer questions while they are reading. -Make predictions about what will happen next and evaluate their predictions as they read further. -May make mental images of what they are reading to help them visualize what they read. -Identify the main ideas as they read to determine what is important, what is supportive, and what is less important. -Monitor their reading by recognizing comprehension problems and using fix-up strategies to repair their understanding. -Have difficulty decoding words, particularly multisyllable words, resulting in slow labored reading that detracts focus from comprehension. Laborious reading is also likely to result in frustration and a desire to just “get it done.” -Have limited vocabulary and lack strategies to figure out new words. -May not have background knowledge of the topic of the text, which impedes their ability to make connections between the text and what they already know. -Do not recognize text structures. -Move through the text, even if they do not understand what they have read. -May be easily distracted because they are not actively engaged with the text. -Are not aware when comprehension has broken down and/or lack strategies to repair comprehension problems when they do.

After Reading

-Reflect on content that was read. -Summarize important points from the reading. -Draw inferences. -May go to other sources to clarify concepts they did not understand. -Believe success is a result of effort. -Do not use strategies to reflect on reading. -Cannot summarize important points. -Do not seek out information to help them understand what they read. -Think success is a result of luck or some other external variable rather than strategic effort.
  1. 1. Shanahan, T. (2017). If you really want higher test scores: Rethink reading comprehension instruction. Website link to blog.
  2. 2. Kyle, F.E., & Cain, K. (2015). A comparison of deaf and hearing children’s reading comprehension profiles. Topics in Language Disorders, 35(2), 144-156. Link to PDF
  3. 3. Berkeley, S. & Barber, A.T. (2014). Maximizing Effectiveness of Reading Comprehension Instruction in Diverse Classroom. Paul H. Brookes Publishing, Baltimore, MD. Link to book source
  4. 4. Narr, R.A.F. (2006). Teaching phonological awareness with deaf and hard-of-hearing students. Teaching Exceptional Children, Mar/Apr, 53-58. Link to PDF
  5. 5. Antunez, B. (2002). English language learners and the five essential components of reading instruction. Website link to blog.
  6. 6. Koppenhaver, D.A. & Wollak, B.A. (2014). Morphemic decoding instruction for students who are deaf or hard of hearing. American Reading Forum Yearbook, 34, 1-14.
  7. 7. Bow, C.P., Blamey, P.J., Paatsch, L.E., & Sarant, J.Z. (2004). The effects of phonological and morphological training on speech perception scores and grammatical judgments in deaf and hard-of-hearing children. Journal of Deaf Studies and Deaf Education, 9,(3), 305-314. Link to abstract
  8. 8. Cannon, J.E. & Kirby, S. (2013). Grammar structures and d3eaf and hard of hearing students: A review of past performance and a report of new findings. American Annals of the Deaf, 158(3), 292-310. Link to abstract
  9. 9. Dunaway, A. (2017). Content literacy in students with hearing loss: Vocabulary is key. Link to blog
  10. 10. New Mexico School for the Deaf. Educational Strategies that Work with Deaf and Hard of Hearing Students. Link to PDF of PowerPoint presentation
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Hearing Loss and Sarcasm: The Problem is Conceptual NOT Perceptual

Individuals with hearing loss often have difficulty detecting and/or interpreting sarcasm. These difficulties can be as severe as they are for persons with autism spectrum disorder and challenges often continue into adulthood 1,2. Even children with good language and social skill development are at risk for comprehension of sarcasm, or verbal irony.   Continue Reading the Early February 2019 Update  
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Advocacy Notes: Eligibility for Fully Mainstreamed, High Functioning Students with Hearing Loss

Question from the field: “I have several students with hearing loss who are high functioning, fully mainstreamed, and get good grades. My administrators feel like the students can be dismissed from the IEP process, but I know there are still areas of need for me to work on. How can I support these students?”   As we know, in Special Education, grades do not reflect equal educational access1. It is fairer to say that grades reflect a student’s background knowledge, and degree of student effort to try to figure out the information they regularly miss due to lapses in auditory access and incidental learning. Students with hearing loss are typically working much harder than their hearing peers in class due to many factors such as fragmented speech perception, ambient noise and distance from the speaker, which can affect access to what is being said by teachers, peers, and other speakers. No matter how successful the student with hearing loss is as measured by grades, the sheer volume of the amount of information coming at them all day causes auditory fatigue, anxiety, and at times even social isolation2. In addition to communication access factors that can get in the way, students  with hearing loss who have good grades often continue to have discrepancies in vocabulary, both foundational and academic, immature social communication skills, degraded auditory skills in the presence of noise, difficulties with pragmatic language, a lack of understanding of their own hearing loss and their accommodations, and a need for additional self-advocacy skills to be addressed and supported. Below is a small sampling of students with whom I have worked who are very high functioning, and still have deficits that support the need for an IEP: 5th grade student: This boy uses both a hearing aid and a cochlear implant. He has been in the mainstream since early elementary school. His IEP team did see the need for goals and services, but the “aha moment” came during a Listening and Spoken Language session when it was discovered that, due to lack of incidental hearing, he had never learned all of the vocabulary that goes along with bedding and linens. With this clear example of how much incidental learning he was missing his team added CART to his IEP. High school sophomore: This student has always been placed in the mainstream setting and is extremely bright. While she had been a candidate for a CI for many years, it wasn’t until her sophismore year that she decided to get the implant. With her hearing aids she could not hear the questions or comments from her peers or whole-class discussion. She told me that during unstructured times in class and on campus when her friends would talk to her she would just nod her head and hope it was the right answer. She was in honors classes, on a sports team, and earning good grades, but she was not accessing linguistic information in school. High School senior: This girl wears bilateral hearing aids and has always been placed in the mainstream setting. She has always gotten good grades as well as being an accomplished athlete. Her testing showed that she did not have any academic needs, but the DHH providers were able to share data with the administration showing that she still had deficits in communication, auditory skills, and self-advocacy that needed to be addressed in IEP goals prior to graduation. There are endless examples of high functioning students with hearing loss from every educational level who, despite their “good” academic grades and their ability to have conversations one-on-one in quiet, continue to struggle in the educational setting. Grades do not equal access to education. To be considered eligible for specialized instruction in public school, the student (1) must have a qualifying condition (i.e., hearing loss), and (2) must need specialized instruction in order to get the benefit of his/her education. Another term for this is that the student must exhibit an adverse educational effect from the disability area, which is subject to local definition and interpretation. Nowhere in IDEA is it written that only students with academic deficits (aka ‘bad grades’) can be eligible for special education services. Access to education and proposed goals are not limited to reading, writing, and math. Often the tests used in an evaluation do not have sufficient scope or depth to identify the more subtle or underlying gaps in skills. Assessment in the areas of listening, auditory skill development, attention, pragmatic language, communication, and social and behavioral skills should be included in addition to an in-depth language assessment3. For children who are deaf or hard of hearing, the definition of adverse effect should also be determined by a student’s progress as well as their performance at the time of evaluation. If a child has not met the expectation for one year of growth in one year’s time, he should receive special education and related services. Ultimately, the school district is accountable for students it finds ineligible for special education. If those students do not make adequate annual progress – one year’s growth in one year’s time – the parents can take legal action to prove the school’s liability4. Teachers of the deaf/hard of hearing can obtain data in the following areas of need in preparation for an IEP in order to identify baselines and new goals:  
  1. 1. Listening to a degraded signal (noise, distance, audio recordings, videos)
    1. 1. Following class discussion
    2. 2. Following and participating in a conversation with a partner or small group with other small groups also conversing
    3. 3. Understanding verbal directions without visual support in the presence of noise (i.e., playground, PE, assemblies)
    4. 4. Auditory comprehension when listening to a recording or computer voice
  2. 2. Social Communication
    1. 1. Independently initiating conversations with peers during unstructured times
    2. 2. Joining an existing conversation and maintaining topic not of their choosing
    3. 3. Explaining their hearing loss and/or accommodations to familiar/unfamiliar adults and/or peers
    4. 4. Communication repair when they are not understood
    5. 5. Asking for clarification when they do not understand their communication partner
  3. 3. Self-Advocacy
    1. 1. Care and maintenance of hearing assistance technology (i.e., hearing devices)
    2. 2. Consistent use of hearing assistance technology
    3. 3. Using appropriate language to report when hearing technology is not working, needs to be turned on, or needs to be muted
    4. 4. Understanding and asking for accommodations as appropriate for grade level (this can grow over time)
    5. 5. Independently asking for clarification of directions/assignments/discussions in an age appropriate manner
  Students with all levels of hearing loss can suffer from what is referred to as Swiss cheese hearing. They do hear, so they don’t always know what they did not hear. When the general education teacher or the student self-reports that they “heard everything” the teacher of the deaf/hard of hearing can support the team in ways to determine what may have been missed. They can advocate for self-advocacy goals, and other IEP goals as appropriate. A very helpful resource for on-going training of general education teachers and non-DHH providers and IEP team members is “I know he can hear me.” The surprising impact of hearing loss on comprehension5 and The Cascading Impact of Hearing Loss6.     References
  1. Howey, Patrica (2016). Good Grades: Does My Child Still Need Special Instruction?
  2. Tiredness in Deaf Children
  3. Johnson, C., DesGeroges, J., Seaver, L. (2013). Educational Advocacy for Students who are Deaf or Hard of Hearing: The Hands & Voices Guidebook. Chapter 3: A Question of Eligibility.
  4. Forest Grove School District v. T.A.
  5. Anderson, K. L. (2014). Supporting Success for Children with Hearing Loss
  6. Anderson, K. L. (2017). The Cascading Impact of Hearing Loss:
    Author: Melinda Gillinger, M. A. Special Education Consultant
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Hearing Loss and Sarcasm: The Problem is Conceptual NOT Perceptual

Individuals with hearing loss often have difficulty detecting and/or interpreting sarcasm. These difficulties can be as severe as they are for persons with autism spectrum disorder and challenges often continue into adulthood 1,2. Even children with good language and social skill development are at risk for comprehension of sarcasm, or verbal irony. Even when children with hearing loss have mastered language and social skills milestones during the preschool years, there is no guarantee that they will develop an age-appropriate understanding of verbal irony later in life. The ability to understand the different types of sarcasm gains importance when we recognize how useful verbal irony is in our social lives. When all academic and work settings are considered, about 8% of conversational turns among adolescents and adults ironic 3,4. Being able to successfully use irony is associated with social competence, popularity, and peer leadership skills5,6. Irony is used to express a wide range of pragmatic functions, including:
  • Ironic criticisms (intended to rebuke; e.g., ‘You look fantastic’ said to someone who looks disheveled)
  • Why is verbal irony so difficult for children with hearing loss?Ironic compliments (intended to praise; e.g., ‘You look horrible’ said to someone who looks stunning)
  • Hyperbole (saying more than is intended; e.g., ‘Yeah, he’s the most talented person on the planet’ to communicate that someone’s talent is modest)
  • Understatement (saying less than is intended; e.g., ‘You can tell he’s upset’ said about someone displaying rage to communicate that the discontent is obvious)
  • Rhetorical questions (e.g., ‘How many times do I have to tell you to stop?’)
  • Offerings (e.g., ‘Have another slice of cake’ to someone who has already eaten most of it)
  • Over-polite requests (e.g., ‘Would you mind very much if I asked you to consider cleaning your room sometime this year?’ to a slovenly housemate)
There are a few reasons why verbal irony understanding is challenging for persons who are deaf or hard of hearing. The one we usually hear about involves difficulty picking up the auditory cues that signal irony: “He can’t understand the tone in a voice. He never has been able to understand sarcasm. He doesn’t hear that change in the tone of voice, and he doesn’t know what it means.” ~Father of a 21-year-old with hearing loss7 When considering the importance of auditory cues, there are two crucial points to consider:
  1. Speakers sometimes use an ‘ironic tone of voice’ (slow speaking rate, heavy stress, lower pitch) as a cue to irony. Visual cues can also signal irony (e.g., facial expression, body language).
  2. Irony can be delivered in a completely deadpan style (no vocal or facial/body cues)
So, auditory cues are neither necessary nor sufficient to produce or detect irony. If the problem is not necessarily perceptual, it is likely conceptual and this is the preferred explanation among contemporary researchers studying hearing loss and its relationship to ‘Theory of Mind’ So how do Theory of Mind concepts undergird our understanding of verbal irony? Although the precise age of mastery depends on the kind of irony and the nature of the cues available, verbal irony comprehension is a late-emerging social competency in hearing children (around 10 years of age). This is, in part, because it relies on advanced Theory of Mind concepts. These include the ability to think about thinking (a.k.a. metacognition) which is a sophisticated intellectual achievement. Said another way, to understand verbal irony, I need to understand what you understand, and I need to make inferences about what you intend for me to think or know.” We see this clearly in what is called the ‘intentionality’ aspect of irony comprehension8. Intentionality refers to the fact that ironic statements are intentionally insincere, and the listener needs to understand that the speaker expects the listener to know that the insincerity is intended. Verbal irony is a late-emerging, advanced social competency because children need years of experience to accrue the social knowledge needed to make accurate judgments about the meaning and intent of ironic statements. To interpret irony correctly, children also need to understand the utterance in context. All irony is context-dependent in that the meaning depends on the circumstances of which both the speaker and listener need be aware. This includes the ability to recognize and understand social norms and expectations. When it is raining at the beach and someone says, ‘What a nice day’, we understand that what they really want to communicate is ‘What horrible weather.’ They are also communicating disappointment and frustration with the situation. We know this because we are (implicitly) aware that our social norm or expectation is that people prefer to go to the beach when it is warm and sunny out. Verbal irony can be ‘about’ a lot of different things. It requires a big general fund of knowledge, and degree of social and cultural learning matter. There is a lot of ‘stuff’ that we just know and that we expect everyone else to know too. This is the shared social and cultural knowledge that hearing children acquire over time through incidental learning and language socialization. Thus, the conceptual problem with irony is rooted in the ‘Conversation Deficit’9, a general paucity of social learning opportunities, and an inability to ‘catch the moment’6: “You can’t carry on a normal conversation. It’s giving that instant comment; you can’t catch the moment. By the time you’ve got his attention, the situation might have passed. He doesn’t say he misses anything, but he wouldn’t know if he’s missing anything.” ~Mother of 21-year-old with hearing loss A deficit in verbal irony is indicative of broader issues Verbal irony seems to be especially difficult for a wide range of populations (e.g., developmental disorders, learning disability, psychiatric conditions, sensory loss). Yet, in all of these cases, the underlying problem appears to be conceptual, which often causes problems in other areas for which those concepts are relevant. Here is an example from hearing loss7: “She doesn’t know the meaning of a joke; if you say something, it’s serious. She can’t see the double meaning. She’ll laugh at Laurel and Hardy, it’s visual; but as far as language goes, she doesn’t understand, you can’t play around with it.” ~Mother of a 19-year-old with hearing loss And it isn’t only jokes. Difficulties with irony comprehension are usually accompanied by challenges in:
  • More general humor detection and appreciation
  • Distinguishing irony from other forms of non-literal language (e.g., lies, proverbs, metaphor, idioms)
  • Understanding emotional display rules (e.g., smiling when you receive a disappointing gift; showing amusement when you feel embarrassed)
  • Understanding ‘self-conscious’ emotions (e.g., embarrassment, pride, guilt; these also require sophisticated metacognition)
  • Social common knowledge (again, understanding what members of a society ‘just know’ and expect everyone else to know too: e.g., there are cat people and dog people; kids would rather eat ice cream than clean their rooms. Everyone just knows this ‘stuff’!)
Professionals working with families with children with hearing loss often believe that if we teach the language, the social skills will follow. Yet, it is becoming increasing clear that this is not always the case and, in fact, good language often accompanies poor social competence.   The good news – WE CAN HELP CHILDREN IMPROVE! When thinking about how to support social competence and pragmatic language then, it is sometimes most profitable to address Theory of Mind (the concepts behind the social skills). And here is the good news: research indicates that although persons with hearing loss often evidence severe challenges in Theory of Mind, they can also benefit greatly from appropriate Theory of Mind interventions in a short period of time10, 11. And there’s more good news. Recently, new assessment tools, educational resources, and treatment materials have become available to achieve these goals. The Theory of Mind Inventory – 212 is an assessment and treatment planning system specifically designed to support theory of mind in persons with social learning challenges. More specifically, offers:
  • Sensitive, reliable, valid, and nationally-normed assessment of a broad range of Theory of Mind Competency areas (READ MORE)
  • Electronically generated reports (EXAMPLE) which provide a list of likely developmentally appropriate treatment target for each client
  • Access to the Theory of Mind Atlas: an educational resource that explains a broad range of Theory of Mind area (what it is, when it develops, and how it is disrupted in different clinical populations including HEARING LOSS). To register for free access to the Atlas, GO HERE.
  • Downloadable Treatment Materials (see the Materials Room!) to address wide range of Theory of Mind targets
  1. 1. Peterson, C., Wellman, H.M., & Slaughter, V. (2012). The mind behind the message: advancing theory of mind scales for typically developing children and those with deafness, autism, or Asperger syndrome. Child Development, 83, 469–485
  2. 2. O’Reilly, K., Peterson, C., & Wellman, H. (2014). Sarcasm and advanced theory of mind understanding in children and adults with prelingual deafness. Developmental Psychology, 50(7), 1862-1877.
  3. 3. Gibbs, R. (2000). Irony in talk among friends. Metaphor & Symbol, 15, 5-27.
  4. 4. Hancock, J. (2004). Verbal irony use in computer-mediated and face-to-face conversations. Journal of Language and Social Psychology, 23, 447-463.
  5. 5. Peterson, C., O’Reilly, K., & Wellman, H. (2016). Deaf and hearing children’s development of theory of mind, peer popularity, and leadership during middle childhood. Journal of Experimental Child Psychology, 149, 146-158.
  6. 6. Peterson, C., Slaughter, V., Moore, C., & Wellman, H. (2016). Peer social skills and theory of mind in children with autism, deafness, or typical development. Developmental Psychology, 52(1), 46-57.
  7. 7. Gregory, S., Bishop, J., & Sheldon, L. (1995). Deaf young people and their families. Cambridge: Cambridge University Press.
  8. 8. Banasik, N. (2013). Non-literal speech comprehension in preschool children: An example from a study on verbal irony. Psychology of Language and Communication, 17(3), 309-323).
  9. 9. Peterson, C., & Seigal, M. (1995). Deafness, conversation, and theory of mind. Journal of Child Psychology & Psychiatry, 36(3), 459-474.
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Supporting Success wishes to thank Dr. Tiffany Hutchins for sharing her expertise in this article.   Click Here to download this Article
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