ABSTRACT Deaf and hard of hearing (DHH) children often have limited or delayed access to language during early childhood, which has harmful consequences for language acquisition and many aspects of child development. While there have been great strides in technology and available interventions to support language acquisition, there is still tremendous variability in language skills and development outcomes of DHH children. This is in part because families have to navigate a complex landscape of early interventions while deciding how best to support their DHH child. The first aim of this project is to document how families plan and manage language learning for their children using a series of interviews and surveys. A major challenge in understanding how best to support DHH children is that without centralized ways to find families, most research studies recruit participants through organizations like cochlear implant clinics and school programs, and focus on just a subset of DHH children (e.g., just those learning ASL, or just those using cochlear implants). This raises issues of sampling bias – children affiliated with a certain program may be quite different from children not affiliated with that program. The second aim of this study is to use a new database of all identified DHH children between 0 and 3 years old in California to recruit a large sample that includes children across the full spectrum of interventions and language backgrounds. We will document patterns in family language planning, participation in early intervention, and early language skills in whatever language(s) children are learning. This will provide crucial information about how often children receive various interventions, how often they achieve age-appropriate language skills, and whether there are any disparities in access to early intervention support and language outcomes. The third aim is to validate a new multi-lingual language assessment designed for DHH children. The findings from this study hold the potential to inform evidence-based interventions, enhance early childhood language planning, and pave the way for improved outcomes and opportunities for DHH children by fostering their language development and overall well-being.

PROJECT NARRATIVE This research project aims to document family language planning and participation in early interventions, and identify health and demographic disparities in access to interventions or vocabulary skills in deaf and hard of hearing children. This study will make use of a new database of all identified deaf and hard of hearing children in California, and – for the first time ever in the United States – recruit a large prospective sample of children who are representative of the full spectrum of language use and communication preferences. The results of this study will provide critical information about how families navigate the landscape of early interventions, and how these interventions relate to language outcomes.