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AIM Center Brief: The Provision of AIM to Students Who Are Deaf or Hard of Hearing

Joanne Karger, J.D., Ed.D.
February 10, 2014

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This brief discusses two issues associated with the provision of accessible instructional materials (AIM) to students who are deaf or hard of hearing. The first section describes the physical basis of reading challenges experienced by many students who are deaf or hard of hearing. The second section focuses on research pertaining to the use of sign language representations in conjunction with print and digital text for this population of students.

Section I: Physical Basis of Reading Challenges

Research concerning individuals who are deaf or hard of hearing has shown that many read far below grade level (Holt, 1993; Traxler, 2000; Wauters, Van Bon, & Tellings, 2006). For example, Holt (1993) found that the median reading comprehension score for 17-year-old deaf or hard of hearing students was at a 4.5 grade level. Similarly, an examination of the norming sample for the Stanford Achievement Test showed that the median comprehension scores of students who were deaf or hard of hearing fell in the "Below Basic" category, corresponding to a grade equivalent between third and fourth grade for children aged 14 or higher (Traxler, 2000). Researchers have also reported that the average student who is deaf or hard of hearing graduates from high school reading at about the fourth grade level and that approximately 20% of this population leaves school reading at or below the second grade level (Luckner, Sebald, Cooney, Young, & Muir, 2005/2006).

The physical nature of the reading difficulties experienced by individuals who are deaf or hard of hearing is reflected in the fact that these individuals tend to demonstrate weaknesses in phonological awareness and working memory, two interconnected areas that are critical to the development of reading fluency (Koo, Crain, LaSasso, & Eden, 2008; Luckner & Urbach, 2012; Luckner et al., 2005/2006). A number of studies have highlighted the phonological awareness and processing challenges of deaf individuals (Koo et al., 2008; Luckner et al., 2005/2006; Miller, 1997). Phonological awareness includes "the ability to recognize that words in spoken languages are composed of a set of meaningless discrete segments called phonemes" (Koo et al., 2008; internal citations omitted) as well as the ability to rhyme and to be aware of syllables (James, Brinton, Rajput, & Boswami, 2013). Because individuals who are deaf or hard of hearing do not have adequate auditory access to spoken language (Koo et al., 2008), they have difficulty developing an understanding of the phonological structure of language (James et al., 2013)—i.e., it is difficult for them to learn to "crack" the phonological code (Luckner et al., 2005/2006).

Working memory refers to a "set of cognitive functions that allow individuals to actively maintain and manipulate information in the service of cognition" (Hall & Bavelier, 2010, p. 459). Research has shown that individuals who are deaf or hard of hearing tend to have challenges with respect to working memory in a number of areas, including sequential recall (i.e., processing a stimulus in the same order in which it is presented), processing speed (i.e., speed to complete a cognitive task), attention (i.e., cognitive process of focusing on one particular aspect of their environment), and memory load (i.e., cognitive complexity presented by a task) (Hamilton, 2011). All of these challenges are related to processes that are involved in the comprehension and learning of language (Hamilton, 2011).

Moreover, both phonological awareness and working memory are associated with functions in the central nervous system (Buchsbaum, Pickell, Love, Hatrak, Bellugi, & Hickok, 2005; MacSweeney, Waters, Brammer, Woll, & Goswami, 2008; MacSweeney, Brammer, Waters, & Goswami, 2009). Recent research using functional magnetic resonance imaging (fMRI) to study the brain activity of deaf individuals and individuals who have dyslexia has found that these two groups, both of whom experience challenges with respect to phonological processing, show a similar pattern of enhanced levels of activation in the left dorsal inferior frontal gyrus, which is different from the pattern for hearing individuals (MacSweeney et al., 2008; MacSweeney et al., 2013). These data suggest that the phonological processing deficits of deaf and hard of hearing individuals and those of individuals with dyslexia are associated with abnormal functioning in the central nervous system. Similarly, fMRI research has shown that different areas of the brain are activated for working memory tasks performed by hearing subjects as compared to deaf individuals (Buchsbaum et al., 2005). This research suggests that the working memory difficulties of deaf or hard of hearing individuals are specific to inherent physical limitations associated with the auditory system. These limitations help account for the onerous task that deaf or hard of hearing students may encounter when they must learn to work with and comprehend written English in order to access the general education curriculum.

Section II: Use of Sign Language Representations in Conjunction with Text

Printed Text

A small body of research has examined the use of sign language pictures to assist in the reading of printed text for individuals who are deaf or hard of hearing. For example, Robbins (1983) found that the reading comprehension scores of a sample of 81 elementary and secondary deaf students improved when the students used printed text together with sign language pictures placed above the words. Similarly, a study involving a sample of prelingually deaf students aged 6–8 revealed higher scores for word identification and immediate retention among those who used print plus pictures of sign as compared to those who used print alone (Stoefen-Fisher & Lee, 1989). A third study found that the use of signed English pictures together with printed text significantly enhanced the reading comprehension performance of deaf students, in particular those who were considered poor readers (Wilson & Hyde, 1997).

Digital Text

Research has also begun to explore the use of sign language representations in conjunction with digital text. In fact, the use of technology has been identified as a successful practice that can support the teaching of literacy to students who are deaf or hard of hearing (Easterbrooks & Stephenson, 2013). Dowaliby and Lang (1999) compared the following five conditions as part of a computer-based science lesson for 144 deaf college students with varying reading levels: (a) text only, (b) text and content movies, (c) text and sign movies, (d) text and adjunct questions, and (e) all of the conditions together. The study found that students with lower reading levels participating in the lesson with text and adjunct questions and the lesson with all conditions performed comparably to students with higher reading levels participating in the lesson with text only. Lang and Steely (2003) later summarized three research studies with results that supported the conclusion that there can be a beneficial learning effect for deaf students associated with the use of text and American Sign Language (ASL) explanations, combined with graphic organizers and other supports such as adjunct questions.

In another study, Gentry, Chinn, and Moulton (2004/2005) compared the reading comprehension scores of 28 students, ages 9–18, using four different formats: print only, print plus pictures, print plus sign language, and print plus pictures plus signs. The researchers found that the reading comprehension levels of students using any of the formats other than print were higher than those of students using print alone, with the highest levels among students using the print plus pictures format.

Research on the implementation of a multimedia literacy program, entitled Cornerstones, is also informative. This program included the use of instructional practices as well as text accompanied by videotaped stories in ASL or in Signing Exact English (SEE)/cued speech. In a study of 32 deaf and hard of hearing students using the Cornerstones program, Loeterman, Paul, and Donahue (2002) found that students' in-depth knowledge of words increased. Wang and Paul (2011) similarly found statistical differences between the Cornerstones approach and a typical literacy instructional approach in two of three experiments.

Recently, Vesel (2011) reported that the content knowledge of students who are deaf or hard of hearing improved when they used a digital science program that included a signing avatar. Finally, Nikolaraizi, Vekiri, and Easterbrooks (2013) examined the ways in which deaf students used a multimedia software package consisting of narrative texts along with Greek Sign Language (GSL) videos, pictures, and concept maps. The package contained GSL videos corresponding to the entire text as well as to each sentence. The researchers found that the students used the various visual resources; however, they did not do so in a strategic manner to support their reading comprehension. For example, the students preferred to watch the entire GSL video after reading the full text rather than use the sentence GSL videos to support their understanding of particular words or sentences.

While the above studies differ somewhat from one another, collectively they suggest that the use of sign representations can be a valuable resource to support students who are deaf or hard of hearing in reading and understanding digital text. This finding is particularly relevant for students who are comfortable and familiar with using sign language. Moreover, the provision of supplemental instruction in conjunction with technology appears to be most effective.

The physical nature of deafness helps account for the observed gap in reading proficiency between deaf and hearing students. Given that much of the general education curriculum is transmitted through print as a phonemically coded language, some students who are deaf or hard of hearing could benefit from the provision of accessible digital texts that include sign language representations.


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IDEAs that Work logoThis report was written with support from the National Center on Accessible Instructional Materials (NCAIM), a cooperative agreement between CAST and the U.S. Department of Education, Office of Special Education Programs (OSEP), Cooperative Agreement No. H327T090001. The opinions expressed herein do not necessarily reflect the policy or position of the U.S. Department of Education, Office of Special Education Programs, and no official endorsement by the Department should be inferred.


Last Updated: 02/24/2014

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