Deaf-Accessible Parenting Classes: Insights from Deaf Parents in North Wales

Round 1

Reviewer 1 Report

The topic is excellently chosen, with its focus on the needs of deaf parents in relation to parenting training– not just basing assessment of parental needs on a child’s hearing status. The BSL community is very underserved in terms of access. Similar issues arise where e.g. middle-aged deaf people have caring responsibilities for  elderly hearing parents  - but cannot access support services as interpreters are not provided where the need is not with the patient. Thus the present study is a welcome addition to the literature, with potential to have a positive impact on practice, especially in the context of the recent passing of the BSL Act. However, some suggestions are put forward here for amending the text to enhance its impact potential.

1.       Introduction

A brief description of BSL and the deaf community should be given in the introduction, as the readership of Societies may have limited awareness of and familiarity with the British Deaf community.

 Assuming limited familiarity with deafness, it would be helpful to make some brief mention of the communication needs of oral deaf parents as well, since they are also unable to access parenting classes, and suggestions for improving access should at least consider their needs.

Some very strong claims are made - for example, in line 133, that for some, BSL is their only form of communication. This is highly unlikely to be true for more than a very small minority, since the BSL community (including the participants in this study) make extensive use of e.g. the internet, television subtitling, text messaging, etc.

2.       Parenting support

Rather than have a 2-sentence section – why not incorporate these into the end of the introduction? The same point applies for Section 6, which is only one sentence long.

3. Methods     

How were the participants recruited?

In the context of the COVID pandemic, it is important to know when the data were collected, since preferences for face-to-face delivery of courses may well have changed after several years of interacting on-line (including use of remote interpreting).

4.       Results

Since all the language information is based on self-report, it would be better  to refer to ‘report’ rather than ‘achievement’ throughout. The  reported language skills could be more carefully described. ‘Native’ is usually used in the sign language research literature to refer to those with exposure to a sign language from birth in the home environment, so ‘native /‘near-native’ would be preferable to cover both native signers and those with early but non-native exposure.

The Likert scale points are somewhat confusing in relation to reading and writing skills, since ‘good for simple conversation’ is not an appropriate description for literacy skills.

The presentation of the participants’ reported English proficiency should distinguish between accessible and inaccessible language in the environment. Do participants’ reports of ‘learning English early’ mean simply that their parents used English in communication with them? This point also arises in Section 5.1 – it is highly unlikely that output by adults in English was matched by uptake when the participants were young deaf children. Thus English should not be referred to as being learned early or as a first language.  

8. Results

A set of very strong recommendations are made here about what is required in relation to learning materials. It is stated that although reading materials provided were ‘easy-to-read’, any usefulness of written materials is rejected on the grounds that only 2/10 participants in the larger study reported ‘reading skills that were good for all knds of conversations’. In the absence of any assessment of participant reading skills or of the reading level required by existing published materials, the need for BSL-only materials is not well justified in this paper. It is important to identify specifically which types of materials pose problems. The recommendations about QR codes and watching videos with translations on smartphones need some empirical backing. It would be helpful to cite some evidence-based research to support what is proposed here as ‘ideal’.

Some of the points in section 8.3 are not to do directly with the use of interpreters, but with communication with deaf people generally (for example, watching slides on a screen or someone writing on a board while either lipreading what the presenter is saying or watching an interpreter are equally challenging). One  solution – although unlikely - might be to use deaf trainers (with interpreters) as parenting trainers for both hearing and deaf parents. Other options, such as providing adapted written material in advance, or all-deaf parenting courses (with deaf or hearing trainers) could also be considered.

Minor point

Check reference numbering. For example, Jones et al is referred to as (12) in the text but is (13) in the list of references.

Author Response

We would like to thank both reviewers for their constructive feedback. We present the reviewer comments below in regular font and our responses in italics.

The topic is excellently chosen, with its focus on the needs of deaf parents in relation to parenting training– not just basing assessment of parental needs on a child’s hearing status. The BSL community is very underserved in terms of access. Similar issues arise where e.g. middle-aged deaf people have caring responsibilities for  elderly hearing parents  - but cannot access support services as interpreters are not provided where the need is not with the patient. Thus the present study is a welcome addition to the literature, with potential to have a positive impact on practice, especially in the context of the recent passing of the BSL Act. However, some suggestions are put forward here for amending the text to enhance its impact potential.

Thanks so much for your overall positive assessment.

1. Introduction

A brief description of BSL and the deaf community should be given in the introduction, as the readership of Societies may have limited awareness of and familiarity with the British Deaf community.

Thank you for pointing this out. We have added additional information about BSL and the Deaf community to the “The Deaf community in North Wales” section and we hope that this provides a sufficient amount of background for the readership of Societies.

Assuming limited familiarity with deafness, it would be helpful to make some brief mention of the communication needs of oral deaf parents as well, since they are also unable to access parenting classes, and suggestions for improving access should at least consider their needs.

Thanks so much for pointing this out. We now clarify the distinction between Deafness and deafness (upper-case vs. lower-case d) in the introduction and point out that deaf parents are also unable to fully access parenting classes. However, as the reviewer suggests, deaf parents are likely to have different needs from Deaf parents, and we cannot consider the needs of oral deaf parents because none of our participants were oral deaf parents. We have therefore added information that the needs of deaf parents are beyond the scope of this study.

Some very strong claims are made - for example, in line 133, that for some, BSL is their only form of communication. This is highly unlikely to be true for more than a very small minority, since the BSL community (including the participants in this study) make extensive use of e.g. the internet, television subtitling, text messaging, etc.

Thanks so much for pointing this out. We deleted this particular sentence as part of our revisions.

2. Parenting support

Rather than have a 2-sentence section – why not incorporate these into the end of the introduction? The same point applies for Section 6, which is only one sentence long.

Thank you, we have followed your recommendation and changed the sections as requested. To avoid sub-sub-sub-headings, we have additionally changed the structuring of the results section of Study 1. We have also renumbered the sections and sub-sections, so that the numbering better reflects the two different studies. 

3. Methods     

How were the participants recruited?

In the context of the COVID pandemic, it is important to know when the data were collected, since preferences for face-to-face delivery of courses may well have changed after several years of interacting on-line (including use of remote interpreting).

Thank you for this comment. We have added the information that the data were collected in 2019. We have also added the following sentences to the general discussion: “While the data were collected in 2019, and thus before the Covid-19 pandemic, we believe that the main findings of our studies still hold. Participants’ preferences with respect to online vs. face-to-face classes may have changed due to the pandemic, but regardless of the format of the classes themselves, materials still need to be translated into BSL, a BSL-English interpreter needs to be present for all sessions, and relevant adjustments need to be made to accommodate Deaf parents.”

4. Results

Since all the language information is based on self-report, it would be better  to refer to ‘report’ rather than ‘achievement’ throughout. The  reported language skills could be more carefully described. ‘Native’ is usually used in the sign language research literature to refer to those with exposure to a sign language from birth in the home environment, so ‘native /‘near-native’ would be preferable to cover both native signers and those with early but non-native exposure.

Thanks so much for this comment. We have changed “achieved better language skills” to “reported better language skills” in section 2.2.1. This was the only mention of “achieve” or “achievement” in connection with language skills in the text, and we have there made no further changes. Our rating scale does, in fact, cover both “native” and “near-native” (see Figure 1), except that we called the latter “almost native” and that “native” was a separate category from “almost native”. We believe that this does cover both native signers and those with early but non-native exposure, and we have therefore not made any additional changes.

The Likert scale points are somewhat confusing in relation to reading and writing skills, since ‘good for simple conversation’ is not an appropriate description for literacy skills.

Thank you for pointing this out. We do not refer to literacy skills in the Likert scale or anywhere else in our paper, but to reading and writing. And we do think that ‘good for simple conversation’ is appropriate with respect to reading and writing, as people do communicate with each other through reading and writing, for example, through letters, text messaging, WhatsApp etc. We have therefore not made any changes to the paper.

The presentation of the participants’ reported English proficiency should distinguish between accessible and inaccessible language in the environment. Do participants’ reports of ‘learning English early’ mean simply that their parents used English in communication with them?

Thank you for pointing this out. We have added a sentence to clarify that “overall participants reported learning English early, but the learning environments that they report suggest that English was mostly inaccessible to them in these situations”.

This point also arises in Section 5.1 – it is highly unlikely that output by adults in English was matched by uptake when the participants were young deaf children. Thus English should not be referred to as being learned early or as a first language. 

Thank you for pointing this out. We have not removed mentions to being learned ‘early’ or ‘chronologically first’ because that is what our participants reported. Instead, we have added the following sentence to section 5.1 (now section 2.3.1) to clarify that the self-reported early learning may not actually correspond to early uptake of the language: “A likely reason for these low English skills despite self-reported early learning is that participants grew up in environments in which the language that surrounded them early in their lives was most likely not accessible to them. In other words, participants had early exposure to English, but very little uptake as they did not hear the English that was spoken to them.”

8. Results

A set of very strong recommendations are made here about what is required in relation to learning materials. It is stated that although reading materials provided were ‘easy-to-read’, any usefulness of written materials is rejected on the grounds that only 2/10 participants in the larger study reported ‘reading skills that were good for all knds of conversations’. In the absence of any assessment of participant reading skills or of the reading level required by existing published materials, the need for BSL-only materials is not well justified in this paper. It is important to identify specifically which types of materials pose problems. The recommendations about QR codes and watching videos with translations on smartphones need some empirical backing. It would be helpful to cite some evidence-based research to support what is proposed here as ‘ideal’.

Thank you for pointing this out. We have added additional information as to why BSL materials are necessary. Specifically, we have added information from previous studies about the average reading level of Deaf adults as well as information from previous studies about the typical reading levels required to read parenting books. While the average Deaf adult has a 4^th grade reading level, the majority of parenting books require high-school reading levels. We have also made it clearer that this recommendation is in line with our interview study and not just based on the reported reading levels, but also on all participants in the interview study agreeing that all information must be available in BSL if a Deaf parent participates. We hope that this provides the necessary background information for this particular recommendation. We have also added information from studies that have used QR codes and sign language videos to improve accessibility for members of the Deaf community. So as not to imply that this is the best way to increase accessibility, we have additionally replaced the “ideally” in the text with “for example”. We hope that this has resolved the issues.

Some of the points in section 8.3 are not to do directly with the use of interpreters, but with communication with deaf people generally (for example, watching slides on a screen or someone writing on a board while either lipreading what the presenter is saying or watching an interpreter are equally challenging). One  solution – although unlikely - might be to use deaf trainers (with interpreters) as parenting trainers for both hearing and deaf parents. Other options, such as providing adapted written material in advance, or all-deaf parenting courses (with deaf or hearing trainers) could also be considered.

It is not entirely clear to us which section this comment refers to. Section 8.3 (now section 3.2.3) is on time and space, and section 8.2 (now section 3.2.2) is on communication. Thus, we don’t have a section directly on the use of interpreters. That said, we appreciate the proposals for additional, alternative solutions. We have, however, opted to not present these additional solutions for the following reasons: Our recommendations are based on the interview study and, in the case of Study 2, particularly on the case study of a Deaf parent participating in a parenting class, and one of our aims was to present possible solutions that come directly from a member (or members) of the Deaf community. We have now clarified this at the beginning of the discussion section, like this: “The observations and recommendations below come directly from a parent and member of the Deaf community in Wales who has first-hand experience of taking part in a parenting class alongside hearing parents and through an interpreter. The recommendations are thus Deaf-community-informed and represent an attempt to give voice to and hear directly and in detail from a member of the Deaf community.” Since this member of the Deaf community did not recommend deaf trainers or providing adapted written material in advance (and neither did the 10 participants in the interview study), we have not added these suggestions. We have also not added all-deaf parenting courses as an option because this was dispreferred by the participants we interviewed, which we mention in section 2.2.7 (previously section 4.4.4).

Minor point

Check reference numbering. For example, Jones et al is referred to as (12) in the text but is (13) in the list of references.

Thanks so much for pointing this out. We have gone through the list of references and checked that all numbers in the text match the numbers in the reference list.

Reviewer 2 Report

This is an excellent study and resulting paper.  The topic is important and relevant, with compelling results that can reasonably be generalized to similar domains.  Overall, it is well-organized and easy to follow, but there appear to be typos on lines 473, 479, and 554.

Author Response

We would like to thank both reviewers for their constructive feedback. Reviewer comments in the following are in regular font and our responses are in italics.

This is an excellent study and resulting paper.  The topic is important and relevant, with compelling results that can reasonably be generalized to similar domains.  Overall, it is well-organized and easy to follow, but there appear to be typos on lines 473, 479, and 554.

Thank you so much for your positive feedback. We have corrected the typo in line 479, but we weren’t sure what the issue was with lines 473 and 554. We have therefore added punctuation to both sentences that make the structure of the sentences clearer and we hope that this has resolved the issues.