The Effects of Interactive Storybook Reading With Preschoolers Who Are Deaf and Hard-of-Hearing

Abstract

Vocabulary is a consistent predictor of reading achievement for deaf and hard-of-hearing (DHH) children. DHH children tend to have a smaller vocabulary knowledge base than their hearing peers and require direct instruction in this area. There are no evidence-based vocabulary instruction strategies for this population. One reason for the lack of an evidence-base is the lack of replication studies. Interactive storybook reading (ISR), storybook reading enhanced through scripted questions and feedback, may be an effective method for teaching vocabulary to DHH children. Up till now, researchers have not conducted replication studies. This study replicates and extends a previous ISR intervention study. We implemented a multiprobe across behaviors single-case experimental design (SCED) and found a functional relation between ISR and expressive picture vocabulary knowledge for all participants. This finding provides additional evidence to support ISR as an effective vocabulary instruction strategy for young DHH children.

Keywords

deaf/hearing impaired disability populations communication/language intervention strategies

Interactive Storybook Reading (ISR) With Preschoolers Who Are Deaf and Hard-of-Hearing

Deaf and hard-of-hearing (DHH) students struggle with weak vocabulary knowledge (Harris, Terlektsi, & Kyle, 2017; Mayer, 2007). Their weak vocabulary knowledge negatively influences their reading outcomes (Harris et al., 2017; Kyle & Harris, 2010, 2011). In the late 1990s, when amplification technologies (e.g., cochlear implants and hearing aids) were less advanced, school-age DHH children had approximately one half to three fourths the expressive vocabulary of school-age hearing children (Connor, Hieber, Arts, & Zwolan, 2000; Kirk, Miyamoto, Ying, Perdew, & Zuganelis, 2000). Almost 30 years later, amplification technologies have improved (Zwolan & Sorkin, 2016). Researchers and teachers have questioned if DHH children have experienced increases in vocabulary knowledge due to their improved access to a spoken language (Svirsky, Robbins, Kirk, Pisoni, & Miyamoto, 2000). Over the last 10 years, expressive vocabulary learning in DHH children with and without amplification has improved (Harris et al., 2017). A few studies indicated that some DHH children with cochlear implants have vocabulary knowledge commensurate with their hearing peers, but overall findings have been mixed (Boons et al., 2013; Geers, Tobey, Moog, & Brenner, 2008). To shed light on inconclusive findings, Lund (2016) conducted a meta-analysis of studies comparing DHH children with cochlear implants with hearing children and found, as a whole, DHH children with cochlear implants continue to have diminished vocabulary knowledge when compared with hearing children of the same age. Similarly, Harris and colleagues (2017) found that young DHH children with and without amplification who use spoken, sign, or spoken and sign language were behind in expressive vocabulary knowledge when compared with same-age hearing peers. DHH children who use sign language were more significantly delayed in vocabulary knowledge than those who were educated using spoken language.

DHH children’s expressive vocabulary grows at a slower rate than hearing children (Harris et al., 2017). The expressive vocabulary knowledge gap between hearing and DHH children widens over time (Geers & Hayes, 2011; Harris & Terlektsi, 2011). Yet, DHH children’s expressive vocabulary knowledge is the most consistent predictor of their reading comprehension (Harris et al., 2017; Kyle & Harris, 2010, 2011), indicating that vocabulary knowledge is critical to their later reading success. Teachers of the deaf and hard-of-hearing (TODHHs) are motivated to identify effective vocabulary instructional strategies for DHH children because of the link between vocabulary and later reading.

Though vocabulary is the most heavily researched reading subskill in the field of deaf education, there continues to be a lack of evidence-based vocabulary instruction strategies for this population (see review, Luckner & Cooke, 2010). Wendel, Cawthon, Ge, and Beretvas (2015) suggested that single-case experimental design (SCED) research can aid in establishing necessary, evidence-based practices for DHH learners. Developing an evidence-based practice using SCED studies requires researchers to replicate previous studies five times, in three different geographic locations, and across a minimum of three research groups (Horner et al., 2005). Lack of study replication is one reason there is a lack of evidence-based vocabulary practices in the field of deaf education (Luckner & Cooke, 2010).

Vocabulary and Young DHH Learners

DHH learners struggle with vocabulary for several reasons. First, DHH learners receive less benefit from incidental word learning due to their hearing loss (Brackenbury, Ryan, & Messenheimer, 2006). Second, adults tend to use simpler vocabulary with DHH children. The adults may have limited signing skills, lowered expectations of DHH children, or lowered perception of what DHH children can hear (Easterbrooks & Baker, 2002). Furthermore, communication difficulties between parents or family members and DHH children negatively influence storybook interactions (Stobbart & Alant, 2008) resulting in parents’ reading less to DHH children when compared with hearing peers (Schleper, 1995). The lack of storybook interactions between some DHH children and their parents is concerning because there is a positive relationship between storybook reading and vocabulary for young hearing children (Arnold, Lonigan, Whitehurst, & Epstein, 1994; Beck & McKeown, 2007; Hargrave & Sénéchal, 2000; Justice, Meier, & Walpole, 2005). Storybook reading is one of the most validated interventions for increasing expressive vocabulary learning in DHH children (DesJardin, Ambrose, & Eisenberg, 2009; Fung, Chow, & McBride-Chang, 2005; Gillespie & Twardosz, 1997; Lederberg, Miller, Easterbrooks, & Connor, 2014; Mueller & Hurtig, 2009; Richels, Schwartz, Bobzien, & Raver, 2016; Trussell & Easterbrooks, 2014); but, not one of the studies has been replicated.

Storybook Reading and Vocabulary

After reviewing studies regarding vocabulary and DHH students, Luckner and Cooke (2010) discovered 10 studies conducted in a span of 41 years (1967–2008) that investigated a specific strategy or program’s effect on DHH students’ vocabulary knowledge. When looking further at the 10 studies, only two of the strategies or programs investigated had positive results in more than a single study. Essentially, the field of deaf education has no evidence-based vocabulary instruction practices (Odom et al., 2005). With that in mind, Luckner and Cooke (2010) described practices considered promising (one or two studies to support their use): (a) implementing computer-aided vocabulary instruction and practice, (b) explaining semantic organization and semantic concepts, (c) teaching high-frequency words and key words, and (d) practicing word-learning strategies (e.g., context clues, word structure analysis) and inferential skills. Most of the listed practices were recommended for older DHH students. Since Luckner and Cooke’s review in 2010, a handful of studies were conducted with young DHH students (ages 4–6) indicating that direct instruction (Bowers & Schwarz, 2016; Lund & Douglas, 2016) and storybook interventions may be recommended practices for this population (Fung et al., 2005; Mueller & Hurtig, 2009; Trussell & Easterbrooks, 2014).

A child’s vocabulary can increase after having one experience with a new word during storybook reading with an adult (Justice & Ezell, 2002; Robbins & Ehri, 1994). Moreover, including an explanation of the target words as well as asking and answering questions about the target words during storybook reading elicit more gains than passively listening to the story (Hargrave & Sénéchal, 2000; Penno, Wilkinson, & Moore, 2002). Of storybook reading interventions (i.e., share reading, repeated reading, dialogic reading), dialogic reading, which is interactive in nature, has shown to be the most effective at improving children’s expressive vocabulary (Swanson et al., 2011). Based on Swanson and colleagues’ (2011) findings with hearing children and previous findings with DHH children (Fung et al., 2005; Mueller & Hurtig, 2009; Trussell & Easterbrooks, 2014), we propose that ISR interactions, which includes providing instruction, questioning, and feedback to the students, could have a similar effect on DHH children’s expressive vocabularies. Also, we suggest that we will find this positive effect on their expressive vocabulary regardless of whether DHH students are educated using a total communication (TC) or listening and spoken language (LSL) philosophy.

TC and LSL Philosophies

Due to Universal Newborn Hearing Screening initiatives, young DHH children may receive early intervention services from their local education agencies at an early age. DHH children’s educational teams, including their parents, can decide to follow several different philosophies regarding communication. Two communication philosophies commonly followed are TC and LSL (Marschark, 2007).

The TC philosophy supports DHH children’s learning spoken or signed language or both to be successful academically and socially. Under the TC philosophy, DHH children tend to use amplification technologies, such as hearing aids or cochlear implants, when beneficial. These children may or may not have sufficient access to sound to develop a spoken language. In the TC classroom, the teachers and students will use any linguistic means necessary (e.g., spoken English, American Sign Language [ASL], sign supported spoken language [ASL signs in English word order]) to communicate (Baker & Knight, 1998).

LSL philosophy supports DHH children learning a spoken language, assisted through listening and speech reading, to be successful academically and socially. Under the LSL philosophy, DHH children must use amplification technology—hearing aids, FM systems, and cochlear implants—to the fullest extent and should have enough access to sound to develop a spoken language. In the classroom, teachers and students use spoken English for instruction. Amplification technology is monitored frequently to ensure it is working properly. During instruction, teachers use FM systems, provide the students an unobstructed view of their face while speaking, and cue the students to use their listening skills throughout a lesson (Robertson, 2013).

Although teachers who adhere to TC or LSL philosophies may teach the same content, the language or modality used by the students and teachers during instruction may be different. Specifically regarding ISR, the teachers would ask the children questions, instruct the target vocabulary, and provide feedback using the language or modality of the classroom. The students would respond in their preferred language or communication modality.

ISR

ISR engages children in active vocabulary learning within a meaningful context and reflects Vygotsky’s (1978) theory of learning mediated by a more knowledgeable other. Easterbrooks and Trussell (2016) noted that ISR had a potentially positive evidence-base for increasing the picture vocabulary knowledge of young DHH students who use LSL (Fung et al., 2005) and sign and speech together (Mueller & Hurtig, 2009; Trussell & Easterbrooks, 2014). Fung and colleagues (2005) conducted a study with a 3 (ISR, typical reading, and control conditions) by 2 (pretest and posttest) factorial design involving kindergarten through second-grade DHH children (N = 28) matched on age and hearing abilities. Parents implemented ISR using scripted questions, and vocabulary picture prompts presented during instruction. At posttest, the DHH children who participated in the ISR condition performed better on expressive vocabulary measures than DHH children in the other two conditions. Mueller and Hurtig (2009) conducted a withdrawal single-case design study with four DHH children who used sign language. The DHH children and their parents used e-books. The e-books delivered interactive storybook content via a virtual (animated), fluent signer who read the book and asked questions. The fluent signer was withdrawn in the design. The researchers measured the DHH children’s growth regarding the target expressive vocabulary. A functional relation between the interaction with the interactive e-book and the DHH children’s expressive vocabulary growth was not established because the participants learned new vocabulary in all phases of the study. Finally, Trussell and Easterbrooks (2014) implemented a multiprobe across behavior SCED examining the effects of ISR instruction on the expressive vocabulary of kindergarten and first-grade DHH children who used sign language. Similar to Fung et al. (2005), the researcher implemented ISR using scripted questions and vocabulary picture prompts during instruction. A functional relation was established between the ISR instruction and students’ target expressive vocabulary learning. We propose to address some of the limitations of Trussell and Easterbrooks’ (2014) investigation in the present study replication, therefore, the study is described in more detail later.

ISR borrows features from dialogic reading (Whitehurst et al., 1988). Dialogic reading is language instruction that uses a storybook as a shared referent between the adult and child. The adult asks questions to elicit the target vocabulary from the child (Whitehurst et al., 1988) and teaches the target vocabulary when the child is unable to answer the question. There are two techniques in dialogic reading. One technique was developed to increase the vocabulary of 2- to 3-year-old children, and the second technique was developed to increase the vocabulary of 4- to 5-year-old children. The first technique, for younger children, is to ask primarily Wh- questions to label items in the book’s pictures. After the child has developed the needed vocabulary for the book, the adult asks open-ended questions about the items the child can label. Regarding the second technique for older children, the adult reads the entire book to the child during the first instructional session. Next, the adult follows the PEER cycle. PEER denotes the following steps: Prompt, Evaluate, Expand, and Re-prompt (Whitehurst et al., 1994). The first step in the PEER cycle is to prompt the child with a question about the pictures in the book or the story. The prompt is one of five question types represented by the acronym CROWD: (a) completion, (b) recall, (c) open-ended, (d) wh-, and (e) distancing questions (Whitehurst et al., 1994). Completion questions are cloze sentences (e.g., “The ____ has sharp teeth.”). Recall questions require the child to remember a detail about the pictures or story (“Who falls asleep first?”). Open-ended questions encourage the child to answer the question using their thoughts and do not have a single right answer (“Why are they tiptoeing?”). Wh- questions begin with what, where, or why and do not require the student to remember details about the story (“Who is the crocodile holding?”). Distancing questions attempt to connect the story or pictures to the child’s life (“What do you eat when you are very hungry?”; Zevenbergen & Whitehurst, 2003).

The second step is to evaluate and indicate if the answer was right or wrong. After evaluating the answer, the adult expands on the child’s answer by rephrasing and adding more information to the response. Last, the adult re-prompts the child by asking the CROWD question again. The PEER sequence repeatedly occurs throughout dialogic reading (Zevenbergen & Whitehurst, 2003).

ISR differs from dialogic reading because it combines the two different dialogic reading techniques together to address DHH children’s lowered vocabulary levels while engaging them in challenging questioning to encourage growth. During ISR, the adult and child use the book as a shared referent, engaged in the PEER cycle using the CROWD question prompts, but focus on the pictures instead of the story. The intention is to build vocabulary while still asking a variety of questions and providing feedback and expansions appropriate for children’s age levels. The CROWD questions discuss what was happening in the pictures, and not necessarily the story. These parameters replicate the original study (Trussell & Easterbrooks, 2014).

The Original Study

Trussell and Easterbrooks (2014) implemented a multiprobe across behaviors SCED with five kindergarten and first-grade DHH students. A functional relation was established between ISR, incorporating picture cards as well as scripted CROWD questions, and picture vocabulary growth. The goal of the original study was to investigate if ISR was an effective strategy to improve the picture vocabulary of DHH children who use sign supported spoken language to communicate. Trussell and Easterbrooks (2014) implemented ISR for 15 min a day, 4 days a week, for 3 weeks and measured the DHH students’ ability to label the targeted picture vocabulary cards using sign or speech. Researchers conducted the study in three phases: baseline, intervention, and maintenance. During baseline, the teacher participant showed DHH students a clip-art picture of the target vocabulary and marked whether or not they knew the target vocabulary on a data sheet. None of the student participants engaged in ISR during the baseline phase. During the intervention phase, the researcher engaged in ISR instruction with the DHH students. The researcher asked students CROWD questions to elicit the target vocabulary. When the researcher taught or students expressed the target vocabulary, the researcher showed the corresponding picture card to the DHH students. The researcher did not follow the PEER cycle. During the maintenance phase, the DHH students engaged in activities other than the ISR instruction for 10 sessions. After 10 sessions, the teacher participant showed the students the picture cards and marked whether or not students remembered the picture vocabulary label. Upon conclusion of the study, the researchers noted that ISR with picture prompts and scripted CROWD questions was an effective strategy for teaching picture vocabulary to kindergarten and first-grade DHH students who use sign supported spoken language.

However, the study had several limitations. Often, storybook interventions are implemented with children who are 3 to 4 years old or younger (see review, Towson & Gallagher, 2016). For DHH children with language delays, the earlier vocabulary instruction is started, the better the outcome (Meinzen-Derr, Wiley, & Choo, 2011). Another limitation was that the researcher taught the ISR instruction. When researchers conduct intervention instruction, the instructional strategy’s ecological validity is called into question (Gast & Ledford, 2014). Will classroom TODHHs be able to implement ISR similarly with similar results? Last, the study has not been replicated and, as mentioned earlier, studies must be replicated with similar results to establish a strategy as an evidence-based practice.

In the original study, ISR was implemented differently from how it is typically carried out with students who have disabilities. For instance, picture vocabulary cards were shown to the DHH students when the vocabulary word was said or signed during the ISR instruction. ISR studies including hearing children with disabilities (Towson & Gallagher, 2016) do not mention using picture vocabulary cards during instruction. Therefore, it is possible that the student participants were trained to label the cards. This training may have influenced their expressive vocabulary growth rather than the discussion surrounding the vocabulary word, which is the intention of ISR. Also, the PEER sequence was not followed (Trussell & Easterbrooks, 2014). Perhaps, the picture prompts are a required support when the adult does not follow the PEER cycle.

Although the reviewed studies indicate that ISR has a positive influence on vocabulary growth, there does seem to be a caveat. When implementing ISR with DHH children, it seems the adult must script the questions before instruction (Fung et al., 2005; Trussell & Easterbrooks, 2014). When TODHHs questioning behavior during ISR instruction was reviewed in an earlier study, there was not much variety in their questions. Even with training, the TODHHs primarily asked wh- and yes/no questions (Trussell & Easterbrooks, 2013). Instructional practices must be implemented with fidelity to be successful (Gast & Ledford, 2014). Scripting the questions prior to instruction may be a necessary part of ISR, and those questions must be asked with fidelity.

In the present study, we employed a “making it happen” implementation science framework (Fixsen, Scott, Blase, Naoom, & Wagar, 2011) to increase the likelihood that the teachers would implement ISR with fidelity. We helped TODHHs to implement ISR in their classrooms by providing professional development prior to the instruction, monitoring their implementation throughout the study, giving feedback on their implementation fidelity, and coaching them when they were not implementing ISR with fidelity.

The purpose of the present study was to increase the evidence-base surrounding ISR as a vocabulary instructional strategy. The evidence-base will be increased through replicating and extending previous research (Trussell & Easterbrooks, 2014) with preschool-age children who are DHH and who use various communication modes and languages. The present study also addressed previous alterations in the ISR instruction, such as the elimination of picture prompts and the PEER sequence during ISR instruction. The primary research questions were as follows:

Research Question 1: What effect does ISR integrating the PEER sequence without picture prompts have on the vocabulary of DHH preschool children who use LSL or sign supported spoken language?

The secondary research question was as follows:

Research Question 2: If there is a positive effect for each group, will it maintain over time?

Method

Participants and Setting

Teacher participants implemented ISR in two different classrooms along the same timeline. The two classrooms followed different communication philosophies, LSL and TC. Both classrooms were located in the same public school building in the northwestern United States. These classrooms were established and run by the state’s outreach program for DHH students. All the student participants met the following inclusion criteria: (a) had a diagnosed hearing loss; (b) received services from the state educational services for the deaf; (c) had no severe visual, cognitive, or physical disability that would inhibit their ability to utilize the instructional materials; (d) attended preschool; (e) had a vocabulary development goal on their Individualized Education Program indicating a need for vocabulary instruction established through the educational agencies’ evaluations and plan; and (e) participated in a classroom for DHH students for 90% or more of their school day.

LSL class

The LSL classroom followed a LSL philosophy. Five DHH preschool children in the LSL preschool class participated in the study. The student participants were in their second year of preschool and used primarily spoken English. Student participants are described further in Table 1. The LSL teacher participant held a state-certification, instructed in the LSL preschool classroom using spoken English, employed strategies to ensure optimal access to spoken communication (e.g., face-to-face communication, repeating or recasting questions, and sound-field FM system) during instruction and had 2 years of teaching experience.

Table 1.

Participant Demographics.

Participant	Class	Age^a	Gender	Amplification	4 HzUnaided PTA(L/R) (dB)	Communication mode	Language in the home
Zeb	LSL	5;3	M	CI	CI/15	Speech	English
Kaitlyn	LSL	5;1	F	2 HA	60/55	Speech	English
Clara	LSL	4;11	F	2 HA	23/4	Speech	English
Leslie	LSL	4;3	F	CI	74/CI	Speech	English
Pete	LSL	3;10	M	None	5/65	Speech	English
Lucas	TC	4;8	M	2 CI	None	Speech/Sign	English
Brittany	TC	3;8	F	2 HA	40/59	Sign	ASL
Kristina	TC	4;6	F	2 CI	29/29	Speech/Sign	English
Tyson	TC	5;2	M	2 HA	58/61	Speech/Sign	English
Hailee	TC	3;9	F	2 HA	36/38	Speech/Sign	English
Abigail	TC	4;10	F	2 HA	56/58	Speech/Sign	Spanish

Note. PTA = pure tone average; L = left; R = right; LSL = listening and spoken language, TC = total communication; M = male; F = female; CI = cochlear implant; HA = hearing aid; ASL = American Sign Language.

Age expressed in years;months.

TC class

The TC classroom followed a TC philosophy. The TC teacher participant and her six students used sign supported spoken language (Bishop, 2010). The student participants were in their second year of preschool. Student participants are described further in Table 1. The TC teacher participant held a state-certification, instructed using sign and spoken language together, employed strategies to ensure optimal access to spoken and visual communication (e.g., face-to-face communication, sound-field FM system, and conceptually accurate signs), had 10 years of teaching experience, and was a certified educational sign language interpreter.

Setting for both classrooms

During probe assessment sessions, the student participants worked with the teacher participants in a one-to-one setting. The teacher participants did not use an FM system during probe assessment sessions because each child did not have a personal FM system. During instruction, the student participants were in a small group setting, often sitting in a semicircle, with the teacher across from them. The teacher participants used a sound-field FM system during all instruction sessions.

Research Design—Both Classrooms

A multiprobe across behaviors SCED (Gast & Ledford, 2014) was implemented to determine if a functional relation existed between 15 to 20 minutes of ISR instruction and picture vocabulary acquisition. Multiple baseline SCEDs are used when a taught skill or behavior cannot be unlearned (Gast & Ledford, 2014). SCEDs reflect of the nature of special education settings (Horner et al., 2005) because all participants receive instruction (Gast & Ledford, 2014).

Procedures—Both Classrooms

Recruitment

The teacher and student participants were a convenience sample of participants based on the primary author’s professional connections with the state’s deaf education outreach program. First, the primary author obtained approval, recruited the teacher participants, and obtained consent from both teacher participants. Next, the teacher participants sent letters to the parents whose children met the inclusion criteria and obtained parent permission (100% participation rate). Last, the teacher participants asked the student participants if they wanted to talk about or look at pictures in the book to obtain assent at the beginning of each session.

Independent variable

ISR was implemented for 15 to 20 minutes a day, 4 days a week for approximately 3 weeks. During ISR instruction, the teacher participants did not read the text in the books. The teachers used the books as a shared focus between themselves and the student. They asked the student participant’s scripted CROWD questions about the pictures and followed the PEER cycle. The following is an example of an exchange from the study: Teacher (prompt): “What does the gorilla’s hair feel like?” Student: “furry” Teacher (evaluation and expansion): “Yes, he feels furry. He has lots of hair.” Teacher (re-prompt): “What does the gorilla’s hair feel like?” Commonly during the first one or two sessions with each book, the student participants were unable to answer the CROWD questions because they did not know the target vocabulary. In those instances, the teacher participant answered the question herself and provided a re-prompt (Teacher [prompt]: “What are the boys doing?” Students: No response. Teacher [expansion]: “Chasing. The boys are chasing the dog.” Teacher [re-prompt]: “What are the boys doing?”). Both teachers used traditional paperback books and did not show the PowerPoint slides during the instruction.

Dependent variable

The dependent variable was the number of correctly labeled picture cards in ASL, spoken English, or sign supported spoken lanuage together. The teacher participant showed the student participant the slide of the picture vocabulary on a laptop, said “What is that?” or “What is/are he/she/they doing?” and allowed the student participant to think for 5 seconds. If the student participant responded incorrectly or did not respond, the teacher participant moved on to the next picture. If the student participant responded correctly, the teacher participant marked the data sheet (1 = correct, 0 = incorrect) and moved on to the next picture. The student participant had one opportunity to respond for each picture slide.

Materials—Both Classrooms

Books

The primary author and teacher participants chose the following books: Goodnight Gorilla by Peggy Rathman (Book 1), Tumble Bumble by Felicia Bond (Book 2), and Clifford’s First Autumn by Norman Bidwell (Book 3). These books aligned with the teacher participants’ unit-based curriculum, contained many illustrations with few words, and had a simple plot (Zevenbergen & Whitehurst, 2003).

Technology

The primary and fourth authors developed PowerPoint presentations that contained the pictures of the target vocabulary. The slides consisted of white backgrounds with a color picture (Sarchet et al., 2014) of the target item from the books. The primary author shared the PowerPoint presentations with the teacher participants. Also, each teacher participant was given a digital video camera to record the assessment probe and intervention instruction sessions.

Procedures—Both Classrooms

Professional development

The primary author met with the teacher participants for 4 hr on two separate occasions. During the first meeting, the primary author explained how to engage in SCED research, implement ISR, and manage the technology (e.g., digital cameras, slides). Also, the teacher participants and primary author choose possible vocabulary words from the books. At the second meeting, the primary author modeled ISR for the teacher participants. Then, the teacher participants role-played implementing ISR with each other; the primary author digitally recorded the role-play sessions. The primary author and the teacher participants viewed the sessions, completed procedural fidelity (see Figure 1), and discussed how the teachers implemented ISR. Last, the teacher participants role-played implementing ISR a second time to address procedural fidelity concerns from the first role-play session. Each teacher participant conducted ISR in the role-play situation with 85% fidelity or higher (Kennedy, 2005) and was deemed ready to implement ISR in their classroom. The book used during professional development was not used in the study.

Figure 1.

A portion of the procedural fidelity data collection tool.

Vocabulary targets

The teacher participants and primary author chose 10 potential vocabulary words from the books during the professional development meetings. Before the study began, the student participants completed a pretest of 30 possible target picture vocabulary. The students were shown pictures of the potential target vocabulary via a PowerPoint presentation on a laptop and were asked to label the picture. The student participants’ responses were recorded. The final list of target picture vocabulary, listed below, was developed from the students’ responses to ensure that no student participant knew more than two of the target vocabulary words per set prior to intervention. There were five target words for each book. Each set of five words contained three nouns (one fingerspelled), one adjective, and one verb (Trussell & Easterbrooks, 2014; Book 1: gorilla, cage, zoo [fingerspelled], furry, carry; Book 2: ant [fingerspelled], alligator, blanket, sharp, hop; Book 3: store, park [fingerspelled], puppy, excited, chase). Both teacher participants and other educational service providers, speech-language pathologists, physical therapists, and para-educators agreed not to teach the target picture vocabulary at any time outside of the ISR instruction.

ISR scripts

The first and fourth author scripted the questions to target each word (five words for each book). Each word was targeted 4 to 5 times depending on the number of times the item was referred to or pictured in the book. Each book had 20 to 25 questions. See Figure 1 for examples of the questions scripted for Book 1.

Social validity data collection

Upon completion of the intervention instruction and maintenance data collection, the teacher participants completed a researcher-created social validity questionnaire. The primary author emailed the questionnaire to the participants with five Likert-type statements (e.g., This intervention would be easy to implement in my classroom. Strongly disagree—1—2—3—4—5— strongly agree) and two open-ended questions (e.g., If you were going to change this intervention in any way, how would you change it to implement in your classroom?). The teacher participants completed the survey. The survey outcomes appear in the “Results” section.

Procedural fidelity and interrater reliability (IRR) data collection

All sessions were digitally recorded to collect procedural fidelity and IRR data (see Figure 1 for example of fidelity data sheet). Prior to the beginning of the study, the primary and fourth author determined two sessions (assessment probe and instruction) each week (50% of the sessions) to collect procedural fidelity. Viewed sessions were randomly selected but equally spaced during the baseline, intervention, and maintenance phases. The primary author taught the fourth author how to code the instructional sessions from the videos of the teacher participants’ role-playing sessions. Next, the primary and fourth author collected procedural fidelity on one session from the first week, as practice, to see how similarly they coded. After comparing their ratings on one session, the primary author explained the acceptable forms of evaluation again. Then, the two coded a second session from the first week. The average reliability between the two coders was 97%, meeting the pre-established requirement of 95% to begin coding sessions independently. The two practice sessions were not included in the calculations.

After practice, the fourth author watched assessment probe sessions as well as instruction sessions while the study was ongoing. The data collected helped the primary author determine if the teacher participants were following the scripts during each session. Moreover, the primary author watched 30% of the sessions viewed by the fourth author to determine reliability. These sessions were chosen randomly but evenly spaced throughout the study. The results are detailed later in the methods section.

Baseline phase

The probe assessment sessions were conducted in a one-to-one setting and took 2 to 3 minutes depending on the student participants’ attention to the task. The teacher participant showed the student participant the slide of the picture vocabulary on a laptop, asked “What is that?” or “What is/are he/she/they doing?” allowed the student participant to think for 5 seconds, and recorded their response. The student participant was allowed one opportunity during the assessment session to label the picture slide. Upon the conclusion of the session, the teacher participant would offer general encouragement related to effort. The primary author graphed the scores. No teacher or student participants engaged in ISR during the baseline phase.

The phase-change rule from the baseline phase into intervention phase for Book 1 was a minimum of five data points with a mean of 1.0 or less, or until baseline was stable (i.e., minimum variability in the data path with no trend or slope; Kazdin, 2011; Trussell & Easterbrooks, 2014). In other words, the student participants were shown the picture vocabulary slides one time each session for five sessions to ensure they did not know the picture vocabulary labels and were not learning the labels without instruction. Once baseline was established for Book 1, intervention began. The Books 2 and 3 were not instructed. Baseline data were collected through probe assessment sessions. Baseline data for Books 2 and 3 were established through a minimum of five probes with three of those probes occurring consecutively before intervention with a mean of 1.0 or less or until baseline was stable (Kazdin, 2011).

Intervention phase

At the beginning of each ISR instruction session, the teacher participants collected data individually from the student participants following the procedures described in the baseline phase probe assessments. The teacher participants followed the ISR procedure described previously. The mastery criteria for the intervention phase were a minimum of five data points with four out of five correctly labeled target picture vocabulary (Trussell & Easterbrooks, 2014) on two out of three consecutive data points. When the student participants met these criteria, the next book was introduced. If a student participant did not meet the mastery criteria for the target vocabulary, the teacher participant would continue the instruction for a minimum of eight sessions. After eight sessions, the student participant would be moved on to the next book.

Maintenance phase

Once the mastery criteria for each book were met, the student participants did not interact with any of the instructional materials for eight sessions. The teacher participants administered a maintenance probe using the probe assessment procedures described previously.

Procedural Fidelity and IRR—Both Classrooms

During procedural fidelity for the assessment sessions, the following teacher participant behaviors were measured: (a) request for assent, (b) delivering the appropriate prompt for the picture item, (c) giving no feedback for each item, and (d) providing praise based on effort at the end of the session. In addition, the fourth author documented the student participant’s response behavior in 50% of the sessions. For the LSL teacher participant’s assessment probe sessions, she adhered to the assessment protocol 96% of the time on average (range 83% to 100%). The fourth author and the LSL teacher participant agreed on the accuracy of the students’ responses 96% of the time on average (range = 80%–100%). For the TC teacher participant’s assessment probe sessions, she adhered to the assessment protocol 94% of the time on average (range = 80%–100%). The fourth author and the TC teacher participant agreed on the accuracy of the students’ responses 93% of the time on average (range = 70%–100%).

During procedural fidelity and reliability for the ISR instruction sessions, the following teacher participant behaviors were measured: (a) request for assent, (b) delivering CROWD question prompt as scripted (20–25 questions per book), (c) evaluating the students’ responses (defined as saying/signing similar words or phrases—“Yes!” “Right!” “Good,” “Let’s try/look again.” “No” or a head shake or head nod paired with an appropriate facial expression), (d) expanding the student response (defined as rephrasing and adding one piece of information to the student participant’s response), and (e) re-prompting the student participants using the scripted CROWD question (see Figure 1). When the student participants did not respond, we coded the response as NR (no response) and did not include evaluation as part of that PEER cycle opportunity.

For the intervention sessions, The LSL teacher participant asked the scripted questions 87% of the time on average (range = 68%–100%). Her lower averages were due to accidentally skipping a page or overlooking questions during instruction. In addition, she completed the PEER sequence 76% of the time on average (range = 50%–89%). Of the PEER sequence, the LSL teacher participant most frequently omitted the re-prompting step, which lowered her PEER sequence implementation average. The TC teacher participant asked the scripted questions 88% of the time on average (range = 63%–100%). Her lower averages were due to interruptions (classroom staff issues, unplanned visitors) during instruction. Furthermore, she completed the PEER sequence 83% of the time on average (range = 75%–92%). Similar to the LSL teacher participant, the TC teacher participant most often omitted the re-prompting portion for the PEER sequence, which lowered her average.

To determine IRR, the first author reviewed 30% of the probe assessment and intervention videos viewed by the fourth author. IRR was calculated using point-by-point agreement (i.e., Agreements/Agreements + Disagreements × 100; Kazdin, 2011). For the LSL teacher participant, average IRR was 94% for probe assessment sessions, 98% for student responses, and 96% for intervention sessions. Similarly, The TC teacher participant’s average IRR was 99% for probe assessment sessions, 97% for students’ responses, and 96% for intervention sessions.

Results

See Figures 2 to 5 and Table 2. Sessions 11 and 12 are missing for all the student participants due to a school holiday. Session 22 is missing for all the student participants in the TC classroom due to a field trip. All other missing data points indicate student participant absences. We analyzed the data at the individual level for the following features: stability, level, trend, immediacy of effect, consistency, and percentage of non-overlapping data (Kratochwill et al., 2013).

Figure 2.

Zeb’s, Kaitlyn’s, and Clara’s graphs—LSL class.

Figure 3.

Leslie’s and Pete’s graphs—LSL class.

Figure 4.

Lucas’s, Brittany’s, and Kristina’s graphs—TC class.

Figure 5.

Tyson’s, Hailee’s, and Abigail’s graphs—TC class.

Table 2.

Participant Data Path Means.

Student’s name	Change in level						Immediacy of effect						PNOD
	Book 1		Book 2		Book 3		Book 1		Book 2		Book 3		Book 1	Book 2	Book 3
	BL	INT	BL	INT	BL	INT	BL	INT	BL	INT	BL	INT	%	%	%
Zeb	1.00	4.40	1.29	4.80	1.43	4.20	0.33	4.00	1.33	4.67	2.00	3.67	100	100	80
Kaitlyn	1.00	4.25	0.40	4.20	1.40	3.40	1.00	4.00	0.67	3.67	1.67	3.00	100	100	60
Clara	1.00	4.40	1.57	4.40	2.00	4.20	1.00	4.00	1.33	4.00	3.00	3.67	100	100	60
Leslie	1.00	4.00	0.33	2.75	2.00	3.20	1.00	3.67	0.67	2.33	2.00	2.33	80	80	60
Pete	0.00	3.60	1.14	4.40	0.57	2.75	0.00	3.33	1.33	4.00	1.33	2.33	100	100	60
Lucas	0.00	3.40	0.00	4.00	0.00	3.60	0.00	3.00	0.00	4.00	0.00	2.67	100	100	80
Brittany	0.00	3.25	0.00	3.40	1.33	3.60	0.00	3.33	0.00	3.00	1.67	4.67	100	100	60
Kristina	0.00	4.20	0.67	4.80	1.33	4.20	0.00	3.67	1.00	4.67	1.67	3.67	100	100	80
Tyson	0.00	4.40	0.00	3.00	1.20	3.80	0.00	4.00	0.00	2.67	1.33	3.00	100	100	100
Hailee	0.00	3.50	1.33	4.20	0.00	3.40	0.00	3.33	2.00	4.33	0.00	2.33	100	100	100
Abigail	0.00	2.25	0.17	2.00	0.17	2.60	0.00	1.67	0.33	0.67	0.00	1.67	80	60	60

Note. Change in level = mean of the data points in the data path for phase indicated (BL or INT; Kazdin, 2011); Immediacy of effect = mean of the last three data points in BL or the first three data points in INT; PNOD = percentage of non-overlapping data; BL = baseline; INT = intervention.

LSL Class

As seen in Figures 2 and 3, the student participants in the LSL class demonstrated a stable baseline for Books 1, 2, and 3 with a low mean accuracy. Zeb was the exception with a variable baseline data path displaying a descending trend. Introducing ISR instruction to the student participants lead to an increase in the student participants’ ability to correctly label the target picture vocabulary. Their data paths displayed a change in level and immediacy of effect (see Table 2 for means) from baseline to intervention phases for all books. During the intervention phase, the student participants’ data paths presented an increasing trend. An increasing trend indicated that ISR instruction continued to gradually increase their ability to correctly label the target picture vocabulary over several sessions. During baseline and intervention phases, the student participants’ paths were consistent within and across phases with the exception of Pete. Pete’s data path during the intervention phase for Book 3 was not consistent with his previous intervention phase data paths for Books 1 and 2. The student participants who used LSL remembered the picture vocabulary words learned. All the student participants, except Leslie, had 100% non-overlapping data for Books 1 and 2. Leslie had 80% for Books 1 and 2. For Book 3, the student participants had 60% to 80% non-overlapping data (see Table 2).

TC Class

See Figures 4 and 5 and Table 2 for the TC class student participants’ data. Prior to intervention, the student participants in the TC class obtained stable baseline data paths with low mean accuracy for Books 1, 2, and 3. Initiating ISR instruction resulted in an increase in the student participants’ ability to accurately label the target vocabulary pictures. Their data paths demonstrated a change in level and immediacy of effect (see Table 2 for means) from baseline to intervention phases for all books. During the intervention phases, the student participants’ data paths presented an increasing trend. An increasing trend indicates that the ISR instruction gradually increased their accuracy over several sessions. They maintained the picture vocabulary words learned during instruction. During baseline and intervention phases for Books 1 and 2, the student participants’ paths were consistent within and across phases. For Book 3, baseline data paths were consistent within and across phases; however, Lucas, Brittany, and Hailee’s intervention data paths were not consistent within phases. All of the student participants, except Abigail, had 100% non-overlapping data for Books 1 and 2. Abigail had 80% for Books 1 and 2. For Book 3, the student participants had 60% to 100% non-overlapping data (see Table 2).

Social Validity—Both Classrooms

The teacher participants completed a social validity survey. They strongly agreed or agreed that the instruction was easy to implement, cost-effective, beneficial to their students, appropriate to their classrooms, and sustainable. When asked if they felt that the instruction was beneficial to all their students, the teacher participants replied that the instruction was effective for students who have the ability to attend, understand classroom routines, and have been in the school environment previously. When asked what they would change about the instruction, the teacher participant who implemented the TC philosophy felt that the materials needed to be revisited for teachers who are using sign language. She lost the eye contact with the students when she looked down to remind herself of the questions. Eye contact is critical when using a visual communication system.

Discussion

The purpose of this study was to replicate and extend previous findings regarding ISR and its effects on the picture vocabulary knowledge of preschool DHH students who are educated using the LSL or TC philosophy. Our primary research questions pertained to the effect ISR, implemented using the PEER cycle and without picture prompts, has on the vocabulary of preschool DHH children who are educated using the LSL or TC philosophy. We answered the question by implementing a multiprobe across behaviors SCED. Multiple probe across behaviors SCED studies demonstrate experimental control when the following requirements are met: (a) a minimum of three tiers (i.e., sets of behaviors) that are similar yet functionally independent are identified, (b) condition change criteria (i.e., stability of behavior) are selected, (c) the dependent variable is measured repeatedly and simultaneously, (d) changes in the dependent variable (i.e., behavior change) coincide with the introduction of the independent variable, and (e) consistent behavior change occurs every time the independent variable is introduced for a minimum of three different and temporally related time points (Gast & Ledford, 2014).

A functional relation was established between ISR and correctly labeling targeted picture vocabulary. For Zeb, behavior change was documented by the change in level and immediacy of effect from baseline to intervention condition, which was replicated across three books. Furthermore, Zeb increased the accuracy of his picture labeling responses during the intervention condition for Books 1, 2, and 3. This was replicated across Kaitlyn, Leslie, Pete, Lucas, Brittany, Kristina, Tyson, and Hailee. For Clara and Abigail, the lack of immediacy of effect for one set of behaviors (Clara-Book 3, Abigail-Book 2) weakens the functional relation and warrants further discussion (Kratochwill et al., 2013). These findings support previous research (Fung et al., 2005; Mueller & Hurtig, 2009; Trussell & Easterbrooks, 2014) indicating that DHH students’ picture vocabulary can be improved through ISR. Furthermore, these findings extend previous results (Trussell & Easterbrooks, 2014) to include implementation by classroom TODHHs following the PEER cycle with a younger DHH population.

Similar to the findings for hearing children with (see review by Towson & Gallagher, 2016) and without disabilities (see review by Hargrave & Sénéchal, 2000), engaging in the PEER cycle during ISR instruction is an effective means of teaching vocabulary to DHH students. Perhaps, the ample opportunities for feedback embedded in the PEER cycle provide the support a child needs to learn the new words without picture support during instruction. For each book, there were 20 to 25 scripted questions or opportunities to respond, but, using the PEER cycle increased that number to 40 to 50 opportunities to respond. Completing the PEER cycle may ensure that there are multiple opportunities for interaction and thereby influencing DHH children’s expressive vocabulary learning.

When looking at the teacher participants’ procedural fidelity averages, they adhered to the ISR instruction plan. As mentioned before, they most often forgot to re-prompt the students during the PEER sequence. Both teachers had implemented storybook reading, using the CROWD question prompt, in their classrooms before the study began. They scripted the CROWD questions prior to instruction and asked those questions during instruction. However, they were not implementing the PEER sequence or collecting data on how their storybook instruction was influencing their students’ vocabulary growth directly. Having previous experience with at least a portion of ISR may have had a positive effect on their ability to implement the PEER sequence using the CROWD prompts with fidelity. Also, the fourth author was monitoring the TODHHs’ procedural fidelity throughout the study and sharing that information with the primary author. If the TODHHs fell below 80% fidelity for more than one session, the primary author would provide the teacher coaching and feedback. Initial and ongoing professional development may be critical to implementing ISR instruction with fidelity (Guskey & Yoon, 2009). Teachers and administrators who choose to implement ISR should keep this in mind.

In addition, we found that students who are educated using LSL or TC philosophies gain expressive picture vocabulary knowledge through ISR. With a few exceptions noted in the “Results” section, the student participants in both classroom had consistent data paths within and across phases. This consistency leads us to propose that a TODHH could predict a student participant’s performance before and after introducing ISR instruction. Furthermore, the student participants in both classroom had between 60% and 100% non-overlapping data. When the percentages of non-overlapping data are relatively high, we can surmise that the instruction was fairly effective in both the TC and LSL classrooms. Discovering interventions or instructional strategies that TODHHs can implement in classrooms following various educational philosophies is critical to developing evidence-based practices that support the learning of diverse groups of DHH children.

During baseline for some student participants, there is variability. The teacher participants did not praise the students’ ability to label the picture during the baseline probe assessment sessions. Perhaps, the student participants were not sure of their answer and assumed that no praise meant that they were labeling the picture wrong. This may be why some student participants labeled the picture in some sessions and did not in other sessions. At the same time, the student participants’ graphs suggest that they did learn picture vocabulary during the ISR intervention. Even if the student participants had some knowledge before intervention, they still learned new vocabulary. There is a small possibility the student participants learned the vocabulary words through other means; however, their data do not support this hypothesis. Finally, the data indicate that Abigail, Clara, and Leslie may not have benefited as much from ISR instruction as the other student participants. According to parent report, Abigail was surrounded by three languages at home and school. Her parents spoke Spanish in the home and her teachers and classmates used English and ASL. Leslie and Clara knew more vocabulary prior to instruction than the other student participants in their class. Potentially, additional modifications (e.g., instructional support in the students’ native language or target word sets for each child) need to be made to ISR instruction to adequately meet the needs of students who are trilingual and those who have a larger vocabulary base at the beginning of instruction.

The importance of the present study to the field of special education is twofold. First, there is an ongoing need to address the persistent vocabulary struggles of DHH students (Luckner & Cooke, 2010). When TODHHs want to improve DHH children’s vocabulary, they should consider ISR instruction. Second, replicating previous works is a path to developing evidence-based practices. Researchers should collaborate to replicate previous studies developing evidence-based practices for all students who access special education. Similarly, replications support TODHHs and special education teachers in the classroom. With more evidence-based practices available to choose from, educators can comply with current laws, such as Every Student Succeeds Act (2015).

Limitations and Future Research

This study had several limitations that lead us to suggestions for future researchers. First, the current study included a relatively small sample—the sample size was appropriate for the single-case research design used. However, the extent to which the results of this study can be generalized to student populations or settings other than those represented herein is unknown. Future researchers should consider replicating this work with additional DHH populations, perhaps, to include those educated in environments that align with a bilingual (English and ASL) education philosophy.

Second, we did not address comprehension of the new vocabulary words. Including comprehension instruction as well as assessing comprehension could inform researchers or teachers about how well the students understand what the words mean. Also, the present study did not include a generalization measure. A generalization measure (e.g., a black-and-white line drawing or different picture of the target item) may demonstrate the student’s ability to use the vocabulary word in a different context. An additional issue related to design is the lack of counterbalancing of the books or instructional material to control for order effects. Potentially, the order the books were implemented in may have influenced the student participants’ vocabulary learning. Future researchers may consider adding a comprehension and generalization component to the ISR intervention as well as counterbalancing the order of the books to control for internal threats to validity.

Third, the student and teacher participants engaged in ISR 4 to 5 times repeatedly with each book per the procedures from the original study. Due to this, we limited our ability to determine if the ISR procedures including the PEER sequence, the repeated exposure to the words and books, or some combination of the two are responsible for the student participants learning the vocabulary words. To tease this out more clearly, future researchers may decide to conduct ISR using different books every session to investigate if the ISR procedure itself without repetition with the materials has a similar effect on student participants’ vocabulary labeling knowledge.

The variability found in several of the student participants’ baseline may be explained by the lack of praise or reinforcement. Gast and Ledford (2014) recommended that researchers integrate praise as a constant in their assessment phases when they are not specifically investigating the effects of praise or reinforcement. Future researchers should consider planning praise as part of the assessment phases. Implementing planned praise during assessment sessions may result in more stable baselines for those student participants who are unsure of their answers. In addition, the phase-change decisions were based on a mean score to replicate the conditions of the original study. Phase-change decisions should be based on a data pattern such as stability. Stability is required to predict the data pattern for future phases (Kazdin, 2011). Future researchers should consider using specific data patterns as criteria for phase changes to ensure a pattern is established for predicting later phases when examining ISR.

Also, we relied on the school and teacher participants’ assessments (i.e., requiring student participants to have vocabulary goal on their Individualized Education Program to be eligible for the study) to determine if the student participants required vocabulary instruction. The student participants’ current vocabulary knowledge may have influenced their performance during baseline and intervention. Future researchers should measure expressive vocabulary levels as part of their inclusion criteria to better explain variability in the student participants’ performance through the study. Last, the social validity data collection was most likely biased. The limited number of teacher participants made it impossible to complete the survey anonymously. The teacher participants were experienced with ISR and had a previous connection with the researchers. Future researchers should seek to gather social validity data without introducing bias.

Conclusion

Study replication is critical to developing evidence-base practices in education. When referring to SCED research, a minimum of five high-quality replications in three different geographical locations by three different research teams is required to establish an evidence-based practice (Horner et al., 2005). The purpose of this study was to replicate a previous ISR intervention study with young DHH students. Our findings indicate that ISR implemented by a teacher using the PEER cycle is effective for improving the picture vocabulary of preschool-age DHH students who use speech only, sign only, and sign supported spoken language. Future researchers should consider replicating this study to address the current studies’ limitations and increase the evidence-base surrounding ISR with young DHH learners.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

References

Arnold

Lonigan

Whitehurst

Epstein

(1994). Accelerating language development through picture book reading: Replication and extension to a videotape training format. Journal of Educational Psychology, 86, 235–243. doi:10.1037//0022-0663.86.2.235

Baker

Knight

(1998). Total communication: Current policy and practice. In Gregory

Knight

McCracken

Powers

Watson

(Eds.), Issues in deaf education (pp. 77–87). London, England: David Fulton Publishers.

Beck

I. L.

McKeown

M. G.

(2007). Increasing young low-income children’s vocabulary repertoires through rich and focused instruction. The Elementary School Journal, 107, 251–271. doi:10.1086/511706

Bishop

(2010). Happen can’t hear: An analysis of code-blends in hearing, native signers of American sign language. Sign Language Studies, 11, 205–240. doi:10.1353/sls.2010.0007

Boons

De Raeve

Langereis

Peeraer

Wouters

van Wieringen

(2013). Expressive vocabulary, morphology, syntax and narrative skills in profoundly deaf children after early cochlear implantation. Research in Developmental Disabilities, 34, 2008–2022. doi:10.1016/j.ridd.2013.03.003

Bowers

L. M.

Schwarz

(2016). Assessing response to basic concept instruction: Preliminary evidence with children who are deaf. Communication Disorders Quarterly, 34, 221–231. doi:10.1177/1525740112469662

Brackenbury

Ryan

Messenheimer

(2006). Incidental word learning in a hearing child of deaf adults. Journal of Deaf Studies and Deaf Education, 11, 76–93. doi:10.1093/deafed/enj018

Connor

C. M.

Hieber

Arts

H. A.

Zwolan

T. A.

(2000). Speech, vocabulary, and the education of children using cochlear implants. Journal of Speech Language and Hearing Research, 43, 1185–1204. doi:10.1044/jslhr.4305.1185

DesJardin

J. L.

Ambrose

S. E.

Eisenberg

L. S.

(2009). Literacy skills in children with cochlear implants: The importance of early oral language and joint storybook reading. Journal of Deaf Studies and Deaf Education, 14, 22–43. doi:10.1093/deafed/enn011

10.

Easterbrooks

S. R.

Baker

S. K.

(2002). Language learning in children who are deaf and hard of hearing: Multiple pathways. Boston, MA: Allyn & Bacon.

11.

Easterbrooks

S. R.

Trussell

J. W.

(2016). Encouraging emergent reading in deaf and hard of hearing children. In Marschark

Spencer

P. E.

(Eds.), The Oxford handbook of deaf studies in language (pp. 377–392). New York, NY: Oxford University Press.

12.

Every Student Succeeds Act. (2015). 20 U.S.C. 6301 et seq. Retrieved from https://www.whitehouse.gov/the-press-office/2015/12/10/white-house-report-every-student-succeeds-act

13.

Fixsen

Scott

Blase

Naoom

Wagar

(2011). When evidence is not enough: The challenge of implementing fall prevention strategies. Journal of Safety Research, 42, 419–422. doi:10.1016/j.jsr.2011.10.002

14.

Fung

P.-C.

Chow

B. W.-Y.

McBride-Chang

(2005). The impact of a dialogic reading program on deaf and hard-of-hearing kindergarten and early primary school-aged students in Hong Kong. Journal of Deaf Studies and Deaf Education, 10, 82–95. doi:10.1093/deafed/eni005

15.

Gast

D. L.

Ledford

J. R.

(2014). Single case research methodology: Applications in special education and behavioral sciences (2nd ed.). New York, NY: Routledge.

16.

Geers

A. E.

Hayes

H. H.

(2011). Reading, writing, and phonological processing skills of adolescents with 10 or more years of cochlear implant experience. Ear and Hearing, 32, 495–595. doi:10.1097/AUD.0b013e3181fa41fa

17.

Geers

A. E.

Tobey

Moog

Brenner

(2008). Long-term outcomes of cochlear implantation in the preschool years: From elementary grades to high school. International Journal of Audiology, 47(Suppl. 2), S21–S30. doi:10.1080/14992020802339167

18.

Gillespie

Twardosz

(1997). A group storybook-reading intervention with children at a residential school for the deaf. American Annals of the Deaf, 142, 320–332. doi:10.1353/aad.2012.0224

19.

Guskey

T. R.

Yoon

K. S.

(2009). What works in professional development? Phi Delta Kappan, 19, 495–500.

20.

Hargrave

A. C.

Sénéchal

(2000). A book reading intervention with preschool children who have limited vocabularies: The benefits of regular reading and dialogic reading. Early Childhood Research Quarterly, 15, 75–90. doi:10.1016/S0885-2006(99)00038-1

21.

Harris

Terlektsi

(2011). Reading and spelling abilities of deaf adolescents with cochlear implants and hearing aids. Journal of Deaf Studies and Deaf Education, 16, 24–34. doi:10.1093/deafed/enq031

22.

Harris

Terlektsi

Kyle

F. E.

(2017). Concurrent and longitudinal predictors of reading for deaf and hard of hearing children in primary school. Journal of Deaf Studies and Deaf Education, 22, 233–242. doi:10.1093/deafed/enw101

23.

Horner

R. H.

Carr

E. G.

Halle

Mcgee

Odom

Wolery

(2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71, 165–179. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/001440290507100203

24.

Justice

Ezell

(2002). Use of storybook reading to increase print awareness in at-risk children. American Journal of Speech-Language Pathology, 11, 17–29. doi:10.1044/1058-0360(2002/003)

25.

Justice

Meier

Walpole

(2005). Learning new words from storybooks: An efficacy study with at-risk kindergartners. Language, Speech, and Hearing Services in Schools, 36, 17–32. doi:10.1044/0161-1461(2005/003)

26.

Kazdin

A. E.

(2011). Single-case research designs: Methods for clinical and applied settings (2nd ed.). New York, NY: Oxford University Press.

27.

Kennedy

(2005). Single-case designs for educational research. Boston, MA: Allyn & Bacon.

28.

Kirk

K. I.

Miyamoto

R. T.

Ying

Perdew

A. E.

Zuganelis

(2000). Cochlear implantation in young children: Effects of age at implantation and communication mode. Volta Review, 102(4), 127–144. Retrieved from https://eric.ed.gov/?id=EJ660965

29.

Kratochwill

T. R.

Hitchcock

J. H.

Horner

R. H.

Levin

J. R.

Odom

S. L.

Rindskopf

D. M.

Shadish

W. R.

(2013). Single-case intervention research design standards. Remedial and Special Education, 34, 26–38. doi:10.1177/0741932512452794

30.

Kyle

F. E.

Harris

(2010). Predictors of reading development in deaf children: A three-year longitudinal study. Journal of Experimental Child Psychology, 107, 229–243. doi:10.1016/j.jecp.2010.04.011

31.

Kyle

F. E.

Harris

(2011). Longitudinal patterns of emerging literacy in beginning deaf and hearing readers. Journal of Deaf Studies and Deaf Education, 16, 289–304. doi:10.1093/deafed/enq069

32.

Lederberg

A. R.

Miller

E. M.

Easterbrooks

S. R.

Connor

C. M. D.

(2014). Foundations for literacy: An early literacy intervention for deaf and hard-of-hearing children. Journal of Deaf Studies and Deaf Education, 19, 438–455. doi:10.1093/deafed/enu022

33.

Luckner

Cooke

(2010). A summary of the vocabulary research with students who are deaf or hard of hearing. American Annals of the Deaf, 155, 38–67. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20503907

34.

Lund

(2016). Vocabulary knowledge of children with cochlear implants: A meta-analysis. Journal of Deaf Studies and Deaf Education, 21, 107–121. doi:10.1093/deafed/env060

35.

Lund

Douglas

W. M.

(2016). Teaching vocabulary to preschool children with hearing loss. Exceptional Children, 83, 26–41. doi:10.1177/0014402916651848

36.

Marschark

(2007). Raising and educating a deaf child (2nd ed.). New York, NY: Oxford University Press.

37.

Mayer

(2007). What really matters in the early literacy development of deaf children. Journal of Deaf Studies and Deaf Education, 12, 411–431. doi:10.1093/deafed/enm020

38.

Meinzen-Derr

Wiley

Choo

D. I.

(2011). Impact of early intervention on expressive and receptive language development among young children with permanent hearing loss. American Annals of the Deaf, 155, 580–591.

39.

Mueller

Hurtig

(2009). Technology-enhanced shared reading with deaf and hard-of-hearing children: The role of a fluent signing narrator. Journal of Deaf Studies and Deaf Education, 15, 72–101. doi:10.1093/deafed/enp023

40.

Odom

S. L.

Brantlinger

Gersten

Horner

R. H.

Thompson

Harris

K. R.

(2005). Research in special education: Scientific methods and evidence-based practices. Exceptional Children, 71, 137–148. doi:10.1177/001440290507100201

41.

Penno

J. F.

Wilkinson

I. A. G.

Moore

D. W.

(2002). Vocabulary acquisition from teacher explanation and repeated listening to stories: Do they overcome the Matthew effect? Journal of Educational Psychology, 94, 23–33. doi:10.1037//0022-0663.94.1.23

42.

Richels

C. G.

Schwartz

K. S.

Bobzien

J. L.

Raver

S. A.

(2016). Structured instruction with modified storybooks to teach morphosyntax and vocabulary to preschoolers who are deaf/hard of hearing. Journal of Deaf Studies and Deaf Education, 21, 352–361. doi:10.1093/deafed/enw049

43.

Robbins

Ehri

L. C.

(1994). Reading storybooks to kindergartners helps them learn new vocabulary words. Journal of Educational Psychology, 86, 54–64. doi:10.1037/0022-0663.86.1.54

44.

Robertson

(2013). Children with cochlear implants and autism—Challenges and outcomes: The experience of the National Cochlear Implant Programme, Ireland. Cochlear Implants International, 14(Suppl. 3), S11–S14.

45.

Sarchet

Marschark

Borgna

Convertino

C. M.

Sapere

Dirmyer

(2014). Vocabulary knowledge of deaf and hearing postsecondary students. Journal of Postsecondary Education and Disability, 27, 161–178.

46.

Schleper

D. R.

(1995). Read it again and again . . . and again. Perspectives in Education and Deafness, 14(2), 16–19. Retrieved from https://eric.ed.gov/?id=EJ542745

47.

Stobbart

Alant

(2008). Home-based literacy experiences of severely to profoundly deaf preschoolers and their hearing parents. Journal of Developmental and Physical Disabilities, 20, 139–153. doi:10.1007/s10882-007-9085-1

48.

Svirsky

M. A.

Robbins

A. M.

Kirk

K. I.

Pisoni

D. B.

Miyamoto

R. T.

(2000). Language development in profoundly deaf children with cochlear implants. Psychological Science, 11, 153–158. doi:10.1111/1467-9280.00231

49.

Swanson

Vaughn

Wanzek

Petscher

Heckert

Cavanaugh

. . . Kraft

(2011). A synthesis of read-aloud interventions on early reading outcomes among preschool through third graders at risk for reading difficulties. Journal of Learning Disabilities, 44, 258–275. doi:10.1177/0022219410378444

50.

Towson

Gallagher

P. A.

(2016). Dialogic reading for young children with disabilities: A review of literature with suggestions for future research. Baskent University Journal of Education, 3(1), 58–71. Retrieved from http://buje.baskent.edu.tr/index.php/buje/article/download/126/73

51.

Trussell

J. W.

Easterbrooks

S. R.

(2013). Questions DHH teachers use in storybook reading during business-as-usual. Poster presented at the Association of College Educators-Deaf Hard of Hearing, Santé Fe, New Mexico.

52.

Trussell

J. W.

Easterbrooks

S. R.

(2014). The effect of enhanced storybook interaction on signing deaf children’s vocabulary. Journal of Deaf Studies and Deaf Education, 19, 319–332. http://doi.org/10.1093/deafed/ent055

53.

Vygotsky

L. S.

(1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University.

54.

Wendel

Cawthon

S. W.

J. J.

Beretvas

S. N.

(2015). Alignment of single-case design (SCD) research with individuals who are deaf or hard of hearing with the What Works Clearinghouse standards for SCD research. Journal of Deaf Studies and Deaf Education, 20, 103–114. doi:10.1093/deafed/enu049

55.

Whitehurst

Epstein

Angell

Payne

Crone

Fischel

(1994). Outcomes of an emergent literacy intervention in Head Start. Journal of Educational Psychology, 86, 542–555. doi:10.1037//0022-0663.86.4.542

56.

Whitehurst

Falco

Lonigan

Fischel

Debaryshe

Caulfield

(1988). Accelerating language development through picture book reading. Developmental Psychology, 24, 552–559. doi:10.1037//0012-1649.24.4.552

57.

Zevenbergen

Whitehurst

(2003). Dialogic reading: A shared picture book reading intervention for preschoolers. In On reading books to children: Parents and teachers (pp. 177–200). Mahwah, NJ: Lawrence Erlbaum.

58.

Zwolan

Sorkin

(2016). Cochlear implants 2016: Advances in candidacy, technology, and outcomes, factors that drive the expansion of pediatric cochlear implant candidacy. Perspectives of the ASHA Special Interest Groups, 1(9), 21–28. doi:10.1044/persp1.sig9.21