Pour aider les professionnels de la santé et de l’audition à soutenir les parents d’enfants sourds, nous avons identifié des questions couramment posées par les parents et apporté des réponses fondées sur les données probantes. Ce faisant, un récit compatissant et positif sur la surdité et les enfants sourds est proposé, qui s’appuie sur des données de recherche récentes concernant la nature critique de l’exposition précoce à un langage visuel entièrement accessible, qui aux États-Unis est l’ American Sign Language (ASL). Ces données comprennent le rôle de la langue des signes dans l’acquisition du langage, le développement cognitif et l’alphabétisation. Signer à la maison permet aux parents d’offrir un environnement stimulant et sans anxiété pour le développement de la petite enfance. Il est important même si leur enfant bénéficie également de l’attention et des soins d’une communauté de signeurs. Ce ne sont pas seulement les premières années de la vie d’un enfant qui importent dans l’acquisition du langage ; ce sont les premiers mois, les premières semaines, même les premiers jours. Les enfants sourds ne peuvent pas attendre l’introduction d’un langage accessible. La famille au complet doit l’apprendre en même temps que l’enfant sourd. Même une aisance modérée de la part de la famille est profitable pour l’enfant. Apprendre la langue des signes ensemble peut être une expérience d’attachement précieuse pour la famille.

Diversification of the scientific workforce usually focuses on recruitment and retention of women and underrepresented racial and ethnic minorities but often overlooks deaf and hard-of-hearing (D/HH) persons. Usually classified as a disability group, such persons are often members of their own sociocultural linguistic minority and deserve unique support. For them, access to technical and social information is often hindered by communication- and/or language-centered barriers, but securing and using communication access services is just a start. Critical aspects of training D/HH scientists as part of a diversified workforce necessitates: (a) educating hearing persons in cross-cultural dynamics pertaining to deafness, sign language, and Deaf culture; (b) ensuring access to formal and incidental information to support development of professional soft skills; and (c) understanding that institutional infrastructure change may be necessary to ensure success. Mentorship and training programs that implement these criteria are now creating a new generation of D/HH scientists.

Cochlear implants (CIs) in small children who do not yet have a firm footing in first language acquisition are an on-going experiment with human subjects, in the sense that the risks involved have not been properly identified, much less assessed, due to the failure to focus on the biology of language and its role in first language acquisition. Too often, the developmental cognitive milestones of the deaf child and the right to language are not considered, and we risk contributing to cases of linguistic deprivation with all the ensuing consequences. We propose an immediate remedy: to teach deaf children a sign language, along with training in speech and speech-reading. For many families, such as those that live far from a Deaf community, as in a rural situation, this presents practical problems, which we address.

The National Institutes of Health has recognized deaf and hard‐of‐hearing students as an underrepresented group in science research by supporting the RIT‐RISE (Research Initiative for Scientific Enhancement) Scholars program. Students join our program at the end of their first year and engage in research during the academic year, full‐time summer research at RIT after year two, and then full‐time summer research at an affiliated campus after year three. Students and their mentors are supported for travel to the ABRCMS (Annual Biomedical Research Conference for Minority Students), as well as a discipline‐specific conference before they apply for Ph.D. schools in their fourth year. The program includes mentored research experiences and supplemental research training that prepares students to apply for and enter biomedical, biobehavioral and clinical science Ph.D. programs. Several unique courses and a co‐curricular program have been created to better prepare the scholars for research careers. We will describe our curriculum and our recruiting process, as well as steps that we have taken to address communication challenges in the research lab setting, which are distinct from challenges that are typically encountered in classrooms and teaching labs.Support or Funding InformationThis project is supported by NIH 1R25GM122672.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The influence of early language and communication experiences on lifelong health outcomes is receiving increased public health attention. Most deaf children have non-signing hearing parents, and are at risk for not experiencing fully accessible language environments, a possible factor underlying known deaf population health disparities. Childhood indirect family communication-such as spontaneous conversations and listening in the routine family environment (e.g. family meals, recreation, car rides)-is an important source of health-related contextual learning opportunities. The goal of this study was to assess the influence of parental hearing status on deaf people's recalled access to childhood indirect family communication. We analyzed data from the Rochester Deaf Health Survey-2013 (n = 211 deaf adults) for associations between sociodemographic factors including parental hearing status, and recalled access to childhood indirect family communication. Parental hearing status predicted deaf adults' recalled access to childhood indirect family communication (χ2 = 31.939, p < .001). The likelihood of deaf adults reporting "sometimes to never" for recalled comprehension of childhood family indirect communication increased by 17.6 times for those with hearing parents. No other sociodemographic or deaf-specific factors in this study predicted deaf adults' access to childhood indirect family communication. This study finds that deaf people who have hearing parents were more likely to report limited access to contextual learning opportunities during childhood. Parental hearing status and early childhood language experiences, therefore, require further investigation as possible social determinants of health to develop interventions that improve lifelong health and social outcomes of the underserved deaf population.

PURPOSE There have been recent advances to the adoption of pre-exposure prophylaxis (PrEP) as an effective human immunodeficiency virus (HIV) preventive treatment among men who have sex with men, but PrEP services and resources are often not accessible to those who are deaf and use American Sign Language (ASL). This article investigates PrEP knowledge among deaf gay, bisexual, and queer (GBQ) men and the contribution of social support to their perceptions regarding the effectiveness of PrEP at preventing HIV. METHODS An online health survey in ASL and English included questions about sexual orientation, HIV testing, PrEP knowledge and perceived effectiveness at preventing HIV, coming out to healthcare providers, and social support. We gathered data from 121 deaf GBQ men recruited from diverse cities in the United States, with 87% self-identifying as gay. Logistic regression analyses were used to examine the relationships between self-reported level of social support and perceived effectiveness of PrEP at preventing HIV after controlling for sociodemographic and health-related variables. RESULTS There was a significant relationship between meeting new lesbian, gay, bisexual, transgender, and queer (LGBTQ) friends online and PrEP knowledge (χ2 = 14.93; p < 0.001). After controlling for sociodemographic and health-related variables, those who discussed LGBT-related issues online and/or on a social networking site regularly were threefold more likely to perceive PrEP as being effective at preventing HIV than those who did not engage in online discussions (odds ratio = 3.12; 95% confidence interval: 1.12-8.75). CONCLUSION For deaf GBQ men, PrEP knowledge might be attained through meeting and making new LGBTQ friends online. Active engagement in online discussions about LGBT-related issues might enhance perceptions regarding the effectiveness of PrEP to prevent HIV.

To assist medical and hearing-science professionals in supporting parents of deaf children, we have identified common questions that parents may have and provide evidence-based answers. In doing so, a compassionate and positive narrative about deafness and deaf children is offered, one that relies on recent research evidence regarding the critical nature of early exposure to a fully accessible visual language, which in the United States is American Sign Language (ASL). This evidence includes the role of sign language in language acquisition, cognitive development, and literacy. In order for parents to provide a nurturing and anxiety-free environment for early childhood development, signing at home is important even if their child also has the additional nurturing and care of a signing community. It is not just the early years of a child's life that matter for language acquisition; it's the early months, the early weeks, even the early days. Deaf children cannot wait for accessible language input. The whole family must learn simultaneously as the deaf child learns. Even moderate fluency on the part of the family benefits the child enormously. And learning the sign language together can be one of the strongest bonding experiences that the family and deaf child have.

This study investigates the relationship between critical health literacy (CHL) and discussion of health information among college deaf students who use American Sign Language. CHL is crucial in making appropriate health-related decisions for oneself and aiding others in making good health-choices. Research on general youth population shows that frequent health-related discussions with both friends and family is associated with higher health literacy. However, for our sample of deaf college-aged students who might have had less access to communication at home, we hypothesize that health-related discussions with same-age peers may be more important for critical health literacy. We asked two questions to assess the frequency of health-related discussions with friends and families: "How often do you discuss health-related information with your friends" and "How often do you discuss your family medical history with your family?". Participants rated their experience on a scale from 1-5 (1=never, 5=always). To assess CHL, 38 deaf and 38 hearing participants were shown a short scenario that showed a woman confiding in her friend after finding a lump in her breast. Participants were then asked what the friend should say. Responses were scored by a team of 3 raters using a CHL rubric. As predicted, results showed a strong relationship between discussion of health-related information with friends and CHL in both deaf and hearing samples. Discussion with family was linked to CHL only for hearing participants, but not deaf participants in our study. These findings underscore the importance of socializing with health-literate, accessible peers to improve the health literacy and health outcomes of all deaf people.

People with relatively limited English language proficiency find the Internet's cancer and health information difficult to access and understand. The presence of unfamiliar words and complex grammar make this particularly difficult for Deaf people. Unfortunately, current technology does not support low-cost, accurate translations of online materials into American Sign Language. However, current technology is relatively more advanced in allowing text simplification, while retaining content. This research team developed a two-step approach for simplifying cancer and other health text. They then tested the approach, using a crossover design with a sample of 36 deaf and 38 hearing college students. Results indicated that hearing college students did well on both the original and simplified text versions. Deaf college students' comprehension, in contrast, significantly benefitted from the simplified text. This two-step translation process offers a strategy that may improve the accessibility of Internet information for Deaf, as well as other low-literacy individuals.

BIOMEDICAL WORKFORCE diversity enhances research quality and creativity and broadens the research agenda ([ 1 ][1]). However, deaf and hard-of-hearing (D/HH) individuals remain strikingly underrepresented among biomedical researchers ([ 2 ][2]). Since 2002, expert panels have listed barriers and

There is no evidence that learning a natural human language is cognitively harmful to children. To the contrary, multilingualism has been argued to be beneficial to all. Nevertheless, many professionals advise the parents of deaf children that their children should not learn a sign language during their early years, despite strong evidence across many research disciplines that sign languages are natural human languages. Their recommendations are based on a combination of misperceptions about (1) the difficulty of learning a sign language, (2) the effects of bilingualism, and particularly bimodalism, (3) the bona fide status of languages that lack a written form, (4) the effects of a sign language on acquiring literacy, (5) the ability of technologies to address the needs of deaf children and (6) the effects that use of a sign language will have on family cohesion. We expose these misperceptions as based in prejudice and urge institutions involved in educating professionals concerned with the healthcare, raising and educating of deaf children to include appropriate information about first language acquisition and the importance of a sign language for deaf children. We further urge such professionals to advise the parents of deaf children properly, which means to strongly advise the introduction of a sign language as soon as hearing loss is detected.

Deaf and hard-of-hearing (D/HH) adults have lower health literacy compared to hearing adults, but it is unclear whether this disparity also occurs in adolescence. We used the Health Literacy Skills Instrument-Short Form (HLSI-SF), Short Form of the Test of Functional Health Literacy in Adults (S-TOFHLA), Comprehensive Heart Disease Knowledge Questionnaire (CHDKQ), and newly constructed interactive and critical health literacy survey items to quantify D/HH and hearing adolescents' health literacy. We adapted and translated survey materials into sign language and spoken English to reduce testing bias due to variable English language skills. Participants were 187 D/HH and 94 hearing college-bound high school students. When we adjusted for age, gender, race/ethnicity, school grade, and socioeconomic status, D/HH adolescents demonstrated weaker general and functional health literacy and cardiovascular health knowledge than hearing adolescents on the HLSI, S-TOFHLA, and CHDKQ (all ps <.0001). Standard health literacy or knowledge scores were associated with several interactive and critical health literacy skills (all ps <.05). D/HH adolescents who reported greater hearing-culture identity, having hearing aids, experiencing better hearing with assistive devices, having good quality of communication with parents, and attending hearing schools at least half of the time had higher functional health literacy (all ps <.025). Those who reported English as their best language and attending hearing schools at least half of the time had higher cardiovascular health knowledge scores (all ps <.03). Results suggest that interventions to improve D/HH adolescents' health literacy should target their health-related conversations with their families; access to printed health information; and access to health information from other people, especially health care providers and educators.

Deaf children who are not provided with a sign language early in their development are at risk of linguistic deprivation; they may never be fluent in any language, and they may have deficits in cognitive activities that rely on a firm foundation in a first language. These children are socially and emotionally isolated. Deafness makes a child vulnerable to abuse, and linguistic deprivation compounds the abuse because the child is less able to report it. Parents rely on professionals as guides in making responsible choices in raising and educating their deaf children. But lack of expertise on language acquisition and overreliance on access to speech often result in professionals not recommending that the child be taught a sign language or, worse, that the child be denied sign language. We recommend action that those in the social welfare services can implement immediately to help protect the health of deaf children.

The principle of respect for autonomy in modern medical ethics leads doctors to avoid persuasion and aim for neutrality when discussing language choices regarding deaf infants. However, at times persuasion to overcome biases is necessary and ethically mandatory. Many parents and health professionals have faith in the ability of cochlear implants (CIs) to allow deaf children to “hear” and achieve normal language and speech development. While it is good to encourage parents’ hope for their children’s future, to avoid bias, medical professionals must acknowledge the reality that CIs do not replace normal hearing. As of 2006, 80% of deaf infants in Northern Europe were receiving CIs, and as of December 2010, roughly 40% worldwide. Parents need to know that CI may not guarantee their child’s language acquisition. While a CI is usually given only to a child who will not benefit from a hearing aid, it is important to recognize that CIs are not “super hearing aids”; even hospitals that perform CI surgery make statements such as: “For most patients, a cochlear implant will not work as well as a hearing aid” 5 and studies support that statement. That’s because a hearing aid (HA) simply amplifies sound, whereas with CIs sound is transformed into electrical impulses delivered directly to the cochlear nerve. The CI-child must undergo long-term extensive training to interpret those electrical impulses. Unpredictable individual variation in outcomes is pervasive even with great effort and dedication from caregivers and the deaf child; some deaf children receive little to no auditory benefit from CIs in acquiring language. The neuronal plasticity of the brain with respect to language acquisition is maximal before the age of 3 years; if a child is not fluent in a language by the age of 5 years, that child may never achieve full fluency in any language. At the same time during this critical period, the increase in synaptic density occurs earlier and more rapidly in the occipital cortex than in the auditory; so the deaf infant’s brain is primed for visual input. Sign languages provide this visual input; access to signing can ensure language acquisition for deaf children and avoid cognitive deficits associated with linguistic deprivation. The deaf child who signs well does better academically than the deaf child who doesn’t, regardless of all other factors, and most attribute this to the fact that the signing deaf child is not at a linguistic disadvantage. Given evidence such as this, a recent panel of specialists concluded that all children born deaf should be taught a sign language immediately. We are a team of specialists in education studies, linguistics, pediatric medicine, and developmental psychology; our work focuses on deaf individuals. In order to help the practicing pediatrician, we offer here responses to common family questions. Our responses respect families’ autonomy while bearing in mind the difficulty that many parents have coming to terms with children who are different. The evidence-based information related to deaf children’s language and speech development here should help enable parents to better be involved in making the relevant decisions. Our intention is for the advice below to go directly to parents or indirectly via those involved in the educating of deaf children.

Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents' informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media.