**4. Conclusion**

110 Hearing Loss

before setting limits.

Fig. 9. Frequency of previous situations, maternal behaviors, and reactions of children

The quality of interactions established between mothers and children with hearing loss were positively correlated with the social skills of the children and with the context variables. The results indicated that the interactions established between mothers and children favor the acquisition and maintenance of the social skills repertoire. For the hearing loss group both mothers and children presented a poor social skills repertoire in comparison to the normative group.

**Total**

As for *Communication*, the HL group, when compared to the normative group reported talking to their children less frequently about subjects of their interests and in fewer social contexts. In these occasions the HL children presented poor social skills behavior.

Regarding *Expressiveness*, it was observed that the mothers of the normative group expressed affection and praised more frequently than those from the HL group. The children who belonged to the normative group again presented more social skills than HL group. On the other hand, mothers from the HL group used less punishing strategies for education when compared to the normative group.

For *Limits Establishment,* it was observed that mothers of children with hearing loss identified fewer approved behaviors when compared to the normative group, and children were less obedient.

When parents establish limits children of the normative group apologize and/or offer explanations (social skills) more frequently than children with HL.

Families of Children with Hearing Loss and Parental Educational Practices 113

These results are in accordance to the field literature which affirms that for this population there is a great difficulty in communicating (Boscolo & Santos, 2005). Other authors have also found out that mothers of children with hearing loss are less spontaneous than with normative children (Brito & Dessen, 1999). Additionally, mothers of children with hearing loss are less involved in their development, being more concerned in taking basic care rather than talking to them (Canho, Neme & Yamada, 2006). However, the results of the present research do not prove that low repertoire of social skills is associated to behavior problems, a finding in agreement with some other studies (Cia & Barham, 2009; Gargiulo, 2003).

For efficiently talking to children with hearing loss mothers are required to know sign language. Due to its additional cost they avoid learning it, impairing the promotion of better interactions and consequently the development of children's social skills (Lacerda, 2003; Negrelli & Marcon, 2006). Affection expressing behaviors are also less frequent in the clinical group. Children tend to see their mothers as models. When they are not affectionate

In relation to limits establishments it can be observed that mothers of children with hearing loss used fewer negative practices than the normative population. Considering the results expressed in Figure 8 it can be observed that children from both groups disobey; that is a reason for mothers to establish limits. It can also be noticed that the mothers talk to their children with hearing loss who on their turn obey and justify themselves when behaving

Overall, the results of the present research confirm the findings of previous studies, concerning educational practices (little communication and little affection expressions) with children social skills deficits (Rodrigues, Carrara, Palamin & Bolsoni-Silva, 2010; Bolsoni-

Mothers of children with hearing loss are less equalitarian and spontaneous than with other children, besides being more restricting and controlling (Brito & Dessen, 1999). Data from the present research do not allow affirming about different practices, considering siblings with or without hearing loss. The results show that the mothers of children with hearing loss seem to establish limits in a skilful manner (talking) and that their children obey and

Intervention procedures with this population should teach the importance of affection and communication, not only for the care, or to determine limits, but also in other situations of interest for the child. It is important to teach the social skills repertoires. The more skilful the mothers, the more skilful the children will be (Bolsoni-Silva, Loureiro & Marturano, 2011). Skilful behavior is not always easy to achieve considering that mothers are frequently overloaded with chores. The Brazilian literature has pointed to the cultural aspect present on interactions between parents and children, in which the interaction of mother-children are the most studied, indicating aspects in their practices as more restricting and controlling, associated to anxiety and anguish patterns (Brito & Dessen, 1999; Oliveira, Simionato, Negrelli & Marcon, 2004; Guarinello, 2004; Dias, Rocha, Pedroso & Caporali, 2005). Nevertheless, studies with fathers have not been frequently developed (Brito, 1997; Canho, Neme e Yamada, 2006), taking into consideration its important role on the children's development. An early counseling and follow-up are extremely important as a mean of

they favor this deficit in their children.

Silva, Rodrigues, Abramides, Souza & Loureiro, 2010).

express themselves similarly to the normative population.

improperly.

Parents establish limits in order to teach their children society rules, and also to deal with children carelessness behaviors towards their own belongings and those at home. The mothers of the normative group recognized mostly that they acted incorrectly concerning the children education, qualifying "incorrect behavior" as beating and shouting (negative practices).

A hypothesis for the differences between the clinical and nonclinical groups could be related to the absence of oral expression of children with hearing loss. The mothers can communicate with their children, but, as the children do not have access to the spoken content it impairs the acquisition and maintenance of the social skills repertoire. The intervention programs which advise families on how to interact with their children must consider this aspect and propose an additional training, in order to guarantee more communication between parents and children. The results seem to suggest super protection (Gargiulo, 2003) from the mothers of children with hearing loss, considering that they establish few limits for the behavior of their children. The hypothesis of the study was partially confirmed. Children with hearing loss and their mothers reported fewer social skills. However, they did not present more behavioral problems than the normative population.

The results also showed a connection between positive parental practices and infantile social skills. It was observed the reduced use of negative practices and absence of behavior problems (Patterson, Reid & Dishion, 2001). The nonclinical group reported statistically lower incidence of negative practices. In both groups there was low occurrence of negative practices and behavior problems.

The RE-HSE-P (Bolsoni-Silva, Loureiro & Marturano, 2011) was useful to add some knowledge about interactions between mothers and children with hearing loss. In regard to social skills it has also favored the identification of behavioral patterns, specific for this population that indicated more behavioral deficits.

The results also emphasized the fact that many times mothers of children with hearing loss behaved just like the mothers in the nonclinical population. Some of the similar practices were: talking about several subjects, expressing affection, establishing limits, and facing behaviors that they did not approve. Children from the HL group also demonstrated social skills. Both parents and children need to have their social skills repertoire improved , but it becomes necessary to consider behaviors which are already present on their repertoires (Goldiamond, 1974/2002).

The externalizing and internalizing behaviors which were reported by the hearing loss group are insufficient to consider that the children have disruptive problems (APA, 2006). In addition, both groups present interactions which are classified as behavior problems. They could be avoided if the mothers learned how to reinforce (praise, thank) the good behaviors.

Studies about social educational skills show that talking to the children about several subjects, especially the ones of their interest in different situations promoted social skills and reduced the probability of behavior problems (Bolsoni-Silva, Loureiro, & Marturano, 2011). In the present research such behaviors were less frequently observed during interactions with hearing loss children, which possibly favors the children's poor repertoire of social skills.

Parents establish limits in order to teach their children society rules, and also to deal with children carelessness behaviors towards their own belongings and those at home. The mothers of the normative group recognized mostly that they acted incorrectly concerning the children education, qualifying "incorrect behavior" as beating and shouting (negative

A hypothesis for the differences between the clinical and nonclinical groups could be related to the absence of oral expression of children with hearing loss. The mothers can communicate with their children, but, as the children do not have access to the spoken content it impairs the acquisition and maintenance of the social skills repertoire. The intervention programs which advise families on how to interact with their children must consider this aspect and propose an additional training, in order to guarantee more communication between parents and children. The results seem to suggest super protection (Gargiulo, 2003) from the mothers of children with hearing loss, considering that they establish few limits for the behavior of their children. The hypothesis of the study was partially confirmed. Children with hearing loss and their mothers reported fewer social skills. However, they did not present more behavioral problems than the normative

The results also showed a connection between positive parental practices and infantile social skills. It was observed the reduced use of negative practices and absence of behavior problems (Patterson, Reid & Dishion, 2001). The nonclinical group reported statistically lower incidence of negative practices. In both groups there was low occurrence of negative

The RE-HSE-P (Bolsoni-Silva, Loureiro & Marturano, 2011) was useful to add some knowledge about interactions between mothers and children with hearing loss. In regard to social skills it has also favored the identification of behavioral patterns, specific for this

The results also emphasized the fact that many times mothers of children with hearing loss behaved just like the mothers in the nonclinical population. Some of the similar practices were: talking about several subjects, expressing affection, establishing limits, and facing behaviors that they did not approve. Children from the HL group also demonstrated social skills. Both parents and children need to have their social skills repertoire improved , but it becomes necessary to consider behaviors which are already present on their repertoires

The externalizing and internalizing behaviors which were reported by the hearing loss group are insufficient to consider that the children have disruptive problems (APA, 2006). In addition, both groups present interactions which are classified as behavior problems. They could be avoided if the mothers learned how to reinforce (praise, thank) the good behaviors. Studies about social educational skills show that talking to the children about several subjects, especially the ones of their interest in different situations promoted social skills and reduced the probability of behavior problems (Bolsoni-Silva, Loureiro, & Marturano, 2011). In the present research such behaviors were less frequently observed during interactions with hearing loss children, which possibly favors the children's poor repertoire of social

practices).

population.

practices and behavior problems.

(Goldiamond, 1974/2002).

skills.

population that indicated more behavioral deficits.

These results are in accordance to the field literature which affirms that for this population there is a great difficulty in communicating (Boscolo & Santos, 2005). Other authors have also found out that mothers of children with hearing loss are less spontaneous than with normative children (Brito & Dessen, 1999). Additionally, mothers of children with hearing loss are less involved in their development, being more concerned in taking basic care rather than talking to them (Canho, Neme & Yamada, 2006). However, the results of the present research do not prove that low repertoire of social skills is associated to behavior problems, a finding in agreement with some other studies (Cia & Barham, 2009; Gargiulo, 2003).

For efficiently talking to children with hearing loss mothers are required to know sign language. Due to its additional cost they avoid learning it, impairing the promotion of better interactions and consequently the development of children's social skills (Lacerda, 2003; Negrelli & Marcon, 2006). Affection expressing behaviors are also less frequent in the clinical group. Children tend to see their mothers as models. When they are not affectionate they favor this deficit in their children.

In relation to limits establishments it can be observed that mothers of children with hearing loss used fewer negative practices than the normative population. Considering the results expressed in Figure 8 it can be observed that children from both groups disobey; that is a reason for mothers to establish limits. It can also be noticed that the mothers talk to their children with hearing loss who on their turn obey and justify themselves when behaving improperly.

Overall, the results of the present research confirm the findings of previous studies, concerning educational practices (little communication and little affection expressions) with children social skills deficits (Rodrigues, Carrara, Palamin & Bolsoni-Silva, 2010; Bolsoni-Silva, Rodrigues, Abramides, Souza & Loureiro, 2010).

Mothers of children with hearing loss are less equalitarian and spontaneous than with other children, besides being more restricting and controlling (Brito & Dessen, 1999). Data from the present research do not allow affirming about different practices, considering siblings with or without hearing loss. The results show that the mothers of children with hearing loss seem to establish limits in a skilful manner (talking) and that their children obey and express themselves similarly to the normative population.

Intervention procedures with this population should teach the importance of affection and communication, not only for the care, or to determine limits, but also in other situations of interest for the child. It is important to teach the social skills repertoires. The more skilful the mothers, the more skilful the children will be (Bolsoni-Silva, Loureiro & Marturano, 2011).

Skilful behavior is not always easy to achieve considering that mothers are frequently overloaded with chores. The Brazilian literature has pointed to the cultural aspect present on interactions between parents and children, in which the interaction of mother-children are the most studied, indicating aspects in their practices as more restricting and controlling, associated to anxiety and anguish patterns (Brito & Dessen, 1999; Oliveira, Simionato, Negrelli & Marcon, 2004; Guarinello, 2004; Dias, Rocha, Pedroso & Caporali, 2005). Nevertheless, studies with fathers have not been frequently developed (Brito, 1997; Canho, Neme e Yamada, 2006), taking into consideration its important role on the children's development. An early counseling and follow-up are extremely important as a mean of

Families of Children with Hearing Loss and Parental Educational Practices 115

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Calderon, R. (2000). Parental involvement in deaf children's education programs as a

Canho, P. G. M., Neme, C. M. B., & Yamada, M. O. (2006). A vivência do pai no processo de

Cia, F. & Barham, E. J. (2009). Repertório de habilidades sociais, problemas de

Del Prette, Z. A. P. & Del Prette, A. (2006). *Psicologia das habilidades sociais na infância*, Editora

Del Prette, Z. A. P. & Del Prette, A. (1999). *Psicologia das Habilidades Sociais: Terapia e educação*,

Dias, T. R. S.; Rocha, J. C. M.; Pedroso, C. C. A. & Caporali, S. A. (2005). Educação bilíngüe

Gargiulo, R. M. (2003). *Special Education in contemporary society: an introduction to* 

Gatto, C. I. & Tochetto, T.M. (2007). Deficiência auditiva infantil: implicações e soluções. *Revista CEFAC*; Vol. 9, No. 1, (December 2006), 110-15, ISSN: 1516-1846.

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improving the interaction between father and child (Marchesi, 1996; Bisol, Simioni, and Sperb, 2008; Smith, 2008).

In conclusion, studies comprising children with hearing loss and their families have shown the necessity of preventive actions and early identification of the child's condition. This permits parents orientation, the involvement into alternative forms of communication with their children insuring their development, and reducing the possibility of behavior problems. However, it is mandatory for the parents to develop educational practices such as: expression of feelings, establishment of limits, in addition to praising and reinforcing their children's appropriate behaviors.

Studies concerning the interaction between the dyads father-child and mother-child specially with hearing loss are necessary and urgent. It's important to give special attention to children since preschool up to school age creating a fertile and promising situation for optimal parents-children interactions and thus promoting the development of the child with hearing loss.

### **5. References**


improving the interaction between father and child (Marchesi, 1996; Bisol, Simioni, and

In conclusion, studies comprising children with hearing loss and their families have shown the necessity of preventive actions and early identification of the child's condition. This permits parents orientation, the involvement into alternative forms of communication with their children insuring their development, and reducing the possibility of behavior problems. However, it is mandatory for the parents to develop educational practices such as: expression of feelings, establishment of limits, in addition to praising and reinforcing

Studies concerning the interaction between the dyads father-child and mother-child specially with hearing loss are necessary and urgent. It's important to give special attention to children since preschool up to school age creating a fertile and promising situation for optimal parents-children interactions and thus promoting the development of the child with

American Psychiatric Association (2000). *Diagnostic and statistics manual of mental disorders*

Bisol, C. A.; Simioni, J. & Sperb, T. (2008). Contribuições da Psicologia brasileira para o

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programa de intervenção de habilidades sociais educativas parentais. *Psicologia Ciência e Profissão*; Vol. 28, No. 1, (February 2007), pp. (18–33), ISSN: 1414-9893. Bolsoni-Silva, A. T. & Marturano, E. M. (2008). Habilidades sociais educativas parentais e

problemas de comportamento: comparando pais e mães de pré-escolares. *Aletheia* 

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Sperb, 2008; Smith, 2008).

hearing loss.

**5. References** 

their children's appropriate behaviors.

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**1. Introduction** 

(Ryugo, Limb & Redd, 2000).

instead of directly shaping children's developmental skills.

**6** 

**Early Intervention with Children** 

Early intervention is defined as "a set of services for children six years of age or younger who are at risk of or who currently have developmental delays or social emotional problems" (Guralnick, 2005, as cited in Mahoney & Wiggers, 2007). The underlying premise for early intervention is that children's developmental or social-emotional problems can be either prevented or remediated through specialized services and activities designed to maximize their developmental learning (Bailey, et. al., 1998; Baguley, et al., 2000; Bluebanning , et. al., 2004). Early intervention is grounded in the conviction that the first five years of life are a span during which there is unique opportunity to prevent or reverse children's developmental problems. The rapid brain growth that occurs at this time of children's lives is believed to be associated with critical periods during which children are uniquely prepared to benefit from developmental stimulation that is matched to their individualized needs and abilities (Mahoney & Wiggers, 2007; Ryugo, Limb & Redd, 2000). In other words there are clearly defined times when the physiological readiness of the organism must coincide with the occurrence of specific externally derived experiences

Many early intervention programs, particularly programs for children up to age three, provide comprehensive services to families, including social support, service coordination as well as information about child's development (Brown & Arehart, 2000; Brown & Nott, 2005; Mahoney & Wiggers, 2007). Generally it is believed that services that reduce the burdens and stressors families experience can make it easier for parents to focus on the needs and care of their children (Bailey, et. al., 1998; Childress, 2004; Dunst, 2002; Kratochwill, et. al., 2007; Odom & Wolery, 2003). It is also argued that parents must play an active role in their children's development. The argument rests on research results which indicate effectiveness of early intervention services is related to the effect they have on the way parents care for or interact with their children (Bailey, et. al., 1998; Clark, 2007; Kaiser & Hancock, 2003; Mahoney, 2009; Rice & Lenihan, 2005). Therefore it is suggested that professionals who work in early intervention services should collaborate with parents

**Who Have a Hearing Loss:** 

**Parent Participation** 

Zerrin Turan *Anadolu University* 

*Turkey* 

**Role of the Professional and** 

