Purpose: Cultural competence is crucial for the successful provision of speech, language, and hearing services. The purpose of this study was to assess and describe gains in cultural awareness, cultural competence, and self-efficacy after service-learning study abroad experiences and to examine whether gains in these areas are related to higher clinical skills ratings in speech-language pathology and audiology students. Method: Sixteen speech-language pathology and audiology students participated in two international study abroad experiences (Nicaragua and Malawi). Students completed a survey on cultural awareness, competence, and self-efficacy beliefs and journal entries before, during, and after their trips. In addition, the supervisors assessed the clinical skills of the students by the end of the trip. The researchers applied a mixed-methods approach to analyze data from the survey, clinical ratings, and journals. Results: Students showed significant increases in cultural awareness, competence, and self-efficacy. Gains in self-efficacy and cultural awareness were highly correlated with students' clinical ratings in cultural competence as judged by their supervisors. Two main themes were identified from the journal entries: continuing community involvement and growth in cultural self-efficacy. Conclusion: Service-learning study abroad experiences help students develop cultural awareness and competence skills and increase their self-efficacy beliefs. Using a mixed-methods approach can help identify strengths and weaknesses in the training of speech-language pathology and audiology students with regard to cultural competence. Supplemental Material: https://doi.org/10.23641/asha.12642647

Purpose: The purpose of this study was to examine whether oral bilingualism could be an advantage for children with hearing loss when learning new words.Method: Twenty monolingual and 13 bilingual children with hearing loss were compared with each other and with 20 monolingual and 20 bilingual children with normal hearing on receptive vocabulary and on three word-learning tasks containing nonsense words in familiar (English and Spanish) and unfamiliar (Arabic) languages. We measured word learning on the day of the training and retention the next day using an auditory recognition task. Analyses of covariance were used to compare performance on the word learning tasks by language group (monolingual vs. bilingual) and hearing status (normal hearing vs. hearing loss), controlling for age and maternal education.Results: No significant differences were observed between monolingual and bilingual children with and without hearing loss in any of the word-learning task. Children with hearing loss performed more poorly than their hearing peers in Spanish word retention and Arabic word learning and retention.Conclusions: Children with hearing loss who grew up being exposed to Spanish did not show higher or lower word-learning abilities than monolingual children with hearing loss exposed to English only. Therefore, oral bilingualism was neither an advantage nor a disadvantage for word learning. Hearing loss negatively affected performance in monolingual and bilingual children when learning words in languages other than English (the dominant language). Monolingual and bilingual children with hearing loss are equally at risk for word-learning difficulties and vocabulary size matters for word learning.

Purpose: The goal of this study was to identify predictors of expressive vocabulary in young Spanish-speaking children who are deaf or hard of hearing living in the United States. Method: This cross-sectional study considered 53 children with bilateral hearing loss between 8 and 34 months of age ( M = 24, SD = 6.9). Demographic variables, variables related to the hearing loss, and intervention variables were included in a hierarchical regression analysis to predict expressive vocabulary quotients from the MacArthur Inventario del Desarrollo de Habilidades Comunicativas (Communicative Development Inventories; Jackson-Maldonado et al., 2003 ). Results: Chronological age, degree of hearing loss, functional hearing ability ratings, age of enrollment in early intervention, and the interaction between chronological age and age of intervention accounted for 61.5% of the vocabulary variance. Children who received intervention by 6 months of age achieved significantly higher vocabulary outcomes than children who started intervention later. Conclusion: The children's mean vocabulary outcomes were below average when compared with hearing peers. This was especially true for older children, children with moderately-severe-to-profound hearing loss, and children who began intervention after 6 months of age. This delay in vocabulary outcomes has the potential to interfere with future reading and academic outcomes.

Purpose: Graduate programs often use practicum experience with clients from nonmajority cultures to improve students' cultural responsiveness. Yet, it is not clear whether simply working with a client from a nonmajority culture actually confers this benefit or whether students are thinking about how to include culturally responsive behaviors when they are considering how to address a clinical case. Method: Twenty first-year speech-language pathology graduate students (10 Spanish–English bilinguals, 10 monolingual English speakers) were split into three groups: monolingual experimental ( n = 4), bilingual experimental ( n = 4), and control ( n = 12). The experimental groups completed a structured practicum with bilingual Hispanic/Latino clients. They received a 1-hr training in cultural responsiveness and then implemented a systematic language intervention in English or Spanish. Changes to cultural responsiveness were measured via think-aloud cases, and changes to confidence were measured with published, self-report scales. Reflective journal entries revealed what aspects of the clinical practicum students found most salient. Results: Experience working with bilingual clients did not have a substantial effect on students' confidence in their cultural competence. No substantial change was found in cultural responsiveness on the think-aloud for any group. Cultural responsiveness did not appear to be top-of-mind for the students. Conclusions: Simply working with clients from nonmajority cultures does not create a scenario where cultural responsiveness is likely to improve. Additional targeted, purposeful training in cultural responsiveness is necessary.

Theory of Mind (ToM) is a construct that includes a range of connected abilities linked to the understanding of others’ mental states. During the last three decades, ToM development has been studied extensively in deaf and hard of hearing (DHH) individuals and performances compared to the typically hearing (TH) population. Given the advances in the early diagnosis of deafness, interventions, and hearing devices over this period, variations in task performance among DHH participants might have been reduced. The current systematic review aims to synthesize all studies of ToM in DHH individuals and answer the following question: Do DHH individuals (Population), compared to a control sample of TH and/or among themselves (Comparator), in an assessment of ToM (Intervention), have differentiated results (Outcome)? After a search of the literature, 97 papers were included. We found that, in general, TH participants outperformed their DHH peers in ToM measures; however, there was a wide range of results. Explanations for this variability included the quality of early interactions and early exposure to both signed and spoken language. The review also indicates that the understanding of false belief was the most studied component within ToM, while other components, such as understanding intention and irony, require further research. Implications of these findings for clinical practice are discussed.

Purpose: Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanish-speaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency. Method: Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency. Results: We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not. Conclusions: Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English. Supplemental Material: https://doi.org/10.23641/asha.21644846