The Connected Life: Using Access Technology at Home, at School and in the Community

Round 1

Reviewer 1 Report

This is a very interesting article and one that pulls together very effectively the field of access technology for deaf children.

It needs to be noted that this is written for the 'developed' first world nations and can have no significant impact for professionals, families or deaf ppl in 3rd world/ developing countries as this level and range and depth of technology, resources and access is not available nor on the horizon for the near future. The author/s would need to clarify this in some way, without being patronising, but a def need for reality of context.

This is a well written article and is almost ready for publication - The following comments fall into questions, proposed considerations and corrections as well as on matters related to 1st world contexts. 

To start with, the only part of the article that was jarring and out of place was the very emotive oral/speech advocacy language in the first paragraph or two - it is very biased and could even indicate a conflict of interest. This will cause a significant audience to immediately stop reading, which is not the impact you would like. The rest of the article is of value too all families and educators and deaf children and adults alike. This def needs to be changed. So too the references to needing to "simplify" the information for the reader to understand in ll 73 and ll 181 (this comes across as a little patronising too).

Questions/ Edits:

reference is made to FEET as measurement, which is not international, so assuming once more this is for a 1st world country?

Check accuracy - NTID is in NY (it is stated as Michigan here)

ll195 replace h/aid technology with hearing technology

There is a tendency to write about your local context assuming that all the readers will know this/ be able to access this or should even access it*(your  context must be 1st world and very well resourced - so where some countries are still struggling with newborn screening and very late identification - even if you were to kindly give them access to your guidelines (see next sentece), they would be of no value in their list of core priorities - trust you understand). Reference to a published guideline for classroom characteristics for reverberation - this is country specific/ 1st world/ 

Reference is made to a "strong theoretical rationale" for RMS and yet there are only a very few references ... so rephrase (I also note in those articles there is also no context provided, and yet it is very clear that they are also very advanced technology contexts), so the rationale cannot be assumed.

Reference to the need for Educational Audiologists or ToD who know a lot about audio tech are once again very 1st world. Most countries in the global south have a dire shortage of (or none at all) audiologists.... just basically trained.... there is no such thing as an educational audio.

ll 497 an RMS

ll 346 refers to deaf children all typically having access to music and TV etc...  once again, a very out of touch, rich perspective .... when a certain audience reads this, they will feel alienated and 'lied to' from the title and abstract.. Additionally referring to public spaces having wifi and streaming etc etc.... totally inappropriate except for a few high economic countries.

Reference to less is know about speech/ lipreading and its benefits - read a bit further here

Reference to it being obvious that one reason a child wont use their RMS because they are SL users is not OK, a bias/ and if supported by research, its biased research or hand selected.... this is not always the case, so this then adds to the 'bias' from the 1st introduction.

Thank you for this paper,I enjoyed reading this

 

 

 

 

 

 

 

 

 

Author Response

Thank you for your thoughtful comments.

Comment 1: It needs to be noted that this is written for the 'developed' first world nations and can have no significant impact for professionals, families or deaf ppl in 3rd world/ developing countries as this level and range and depth of technology, resources and access is not available nor on the horizon for the near future. The author/s would need to clarify this in some way, without being patronising, but a def need for reality of context.

-yes, the reality is that this technology is not available to children and families in contexts where even basic hearing aid technology is not available. I have included this through reference to the recent WHO report. However, the intended audience for this paper is readers who have access to this technology; I believe this is clear from the abstract.

Comment 2: To start with, the only part of the article that was jarring and out of place was the very emotive oral/speech advocacy language in the first paragraph or two - it is very biased and could even indicate a conflict of interest. This will cause a significant audience to immediately stop reading, which is not the impact you would like. The rest of the article is of value too all families and educators and deaf children and adults alike. This def needs to be changed.

-I understand this perspective, although I don't agree that the information is emotive or biased, it is factual. However, I have clarified that the focus of the article is on technology which supports spoken language development for children where that is the communication goal.

Comment 3: So too the references to needing to "simplify" the information for the reader to understand in ll 73 and ll 181 (this comes across as a little patronising too).

-I'm afraid I don't agree that "for simplicity" is patronizing. The sentence from line 181 has been shortened based on another reviewer's suggestion

Questions/ Edits:

Comment 4: reference is made to FEET as measurement, which is not international, so assuming once more this is for a 1st world country?

-reference has been removed, although I don't think use of imperial vs metric measurements is related to socioeconomic conditions of a particular country

Comment 5: Check accuracy - NTID is in NY (it is stated as Michigan here)

-corrected, thank you

Comment 6: ll195 replace h/aid technology with hearing technology

-corrected

Comment 7: There is a tendency to write about your local context assuming that all the readers will know this/ be able to access this or should even access it*(your  context must be 1st world and very well resourced - so where some countries are still struggling with newborn screening and very late identification - even if you were to kindly give them access to your guidelines (see next sentece), they would be of no value in their list of core priorities - trust you understand). Reference to a published guideline for classroom characteristics for reverberation - this is country specific/ 1st world/ 

-as noted above, this is 1st world technology, where we have the luxury of having newborn hearing screening and widely available hearing technologies with the opportunity to improve even further on access

Comment 8: Reference is made to a "strong theoretical rationale" for RMS and yet there are only a very few references ... so rephrase (I also note in those articles there is also no context provided, and yet it is very clear that they are also very advanced technology contexts), so the rationale cannot be assumed.

-RMS has been used with children since the early 1960s and I have provided 10 references on this topic; however, I have removed the word "strong".

Comment 9: Reference to the need for Educational Audiologists or ToD who know a lot about audio tech are once again very 1st world. Most countries in the global south have a dire shortage of (or none at all) audiologists.... just basically trained.... there is no such thing as an educational audio.

-as noted previously, it has been acknowledged that this technology is generally not available outside of 1st world contexts. This is also true of these kinds of support services; however, it does not negate the fact that support services are lacking even in 1st world countries

Comment 10: ll 497 an RMS

-corrected

Comment 11: ll 346 refers to deaf children all typically having access to music and TV etc...  once again, a very out of touch, rich perspective .... when a certain audience reads this, they will feel alienated and 'lied to' from the title and abstract.. Additionally referring to public spaces having wifi and streaming etc etc.... totally inappropriate except for a few high economic countries.

-I am unclear as to who "a certain audience" is who will feel "lied to". The title of the article clearly references technology; the intended audience for this paper is readers for whom this information is applicable. While acknowledging the economic realities, these days, I believe that wifi and streaming are not restricted to "a few high economic countries".

Comment 12: Reference to less is know about speech/ lipreading and its benefits - read a bit further here

-expanded

Comment 13: Reference to it being obvious that one reason a child wont use their RMS because they are SL users is not OK, a bias/ and if supported by research, its biased research or hand selected.... this is not always the case, so this then adds to the 'bias' from the 1st introduction

-this was in fact the finding from this study, which I simply reported (not as "obvious" however). I have edited this to reference different findings from the study

Reviewer 2 Report

- They need to replace the terminology hearnig loss to deaf and hard of hearing. 

- In abstract, "This article will discuss how access ..." should replease will to was discussed .. .

- References were not written based on APA style due to some info were missing. 

Author Response

Thank you for your thoughtful comments. Terminology has been revised to use the term "deaf children" as an inclusive term, with an explanatory footnote on page 1. The suggested edit to the abstract has been made. APA style references were not required by this journal, however, all references have been reviewed for accuracy.

Reviewer 3 Report

This article introduces access technologies for hard-of-hearing children and how they can assist at home, in the educational environment and social situations.  The discussion on the factors adversely affecting children with hearing loss is evident and establishes a solid base for the later introduction of the importance of using assistive technologies.  The latter part provides a wide range of possible use of access technologies.

This article updates some new remote access technologies and suggests some future trends.  Do you have any suggestions or recommendations for clinical management for professionals or parents?  For example, how to improve the parents’ literacy in accessing technologies?  Which one is appropriate and beneficial for children with hearing difficulties?

Comments for author File: Comments.pdf

Author Response

Thank you for your thoughtful comments. Minor edits (removal of footnote, etc.) have been incorporated.

Overall comment: Do you have any suggestions or recommendations for clinical management for professionals or parents?  For example, how to improve the parents’ literacy in accessing technologies?  Which one is appropriate and beneficial for children with hearing difficulties?

-this is a very good suggestion, but I think it would be difficult to do given the wide variation in service models for both hearing health care and education - I suspect it would be too jurisdiction-specific to be useful but I am willing to consider

Comment 1: Suggested moving definition from a footnote to the body of the article

-this has been done

Comment 2: Suggest moving this paragraph "If a listener is able to identify that the acoustical environment is poor, they might be able to implement
strategies for amelioration."

-this has been incorporated  

Comment 3: Suggest defining and describing speechreading

-edit made

Comment 4: Clarify the title of Figure 1

-edit made

Comment 5: FM, DM, etc. are slightly different technologies

-true. I think describing these differences gets too much into the weeds for this article, my goal was to include some terms that readers might already be familiar with to connect to their own prior knowledge

Comment 6: Reference needed for "There are likely several factors for this, such as cost (including concerns regarding loss or damage) and lack of awareness of the technology by families"

-references added

Comment 7: Provide examples for "Use of a RMS during games or competitions may need to be explained"

-examples provided

Comment 8 and 9: References for experiential learning and RMS

-there is no reference for this, this is based on the author's experience

Comment 10: References for "Although positive outcomes were often reported anecdotally [84-89], systems were expensive and complicated to use

`-this has been clarified; the references cited discussed expense and complicated use

Comment 11: References needed for "However, sometimes the effects of RMS can be more subtle, for example, faster response times to questions posed by the classroom teacher, less fatigue at the end of the day, or a greater willingness to participate in discussions

-references have been added

 

Reviewer 4 Report

Thank you for the opportunity to review this paper which provides a nice review of access technologies. Attached are specific comments but my main feedback is:

- Try to orient the reader more on what they will be reading by providing an aim for the review and state the main sections of the paper at the end of the introduction.

- There are several statements that would benefit from references.

- Please be consistent through in your use of hearing loss, deaf, or deaf and hard of hearing.

Please see attachment for specific comments.

Comments for author File: Comments.pdf

Author Response

Thank you for your thoughtful comments. Suggested minor edits (removal of "and", heading formatting, etc.) have all been incorporated

Overall comment: Please be consistent through in your use of hearing loss, deaf, or deaf and hard of hearing

-this has been addressed by using the term "deaf children" throughout, as noted in a footnote on page 1

Comment 1: It might be helpful here to state what the aim of this review paper is and what you are going to review, i.e., factors adversely affecting communication, the types of access technologies, benefits and challenges of these technologies, and the future of these 

-this has been added 

Comment 2: In the following sections you might like to provide citations to the following paper: Sven L. Mattys , Matthew H. Davis , Ann R. Bradlow & Sophie K. Scott (2012). Speech recognition in adverse conditions: A review, Language and Cognitive Processes, 27:7-8, 953-978, DOI: 10.1080/01690965.2012.705006

-this is an excellent article but keeping in mind that many readers will not have subject specific expertise, I would prefer to keep simple categories that are widely used in the field. Also, I prefer to present speaker variables as that, variables, rather than describe them as "speech degradation"

Comment 3: Do you need a reference for this? "Because microphones on hearing technologies are not as sensitive as human ears..."

-I have reworded this section for better clarity and added a reference 

Comment 4: Reverberation is seen

-corrected to Reverberation is heard

Comment 5: "The task is complex although the message is quite simple" What is the impact of this on children with hearing loss? Is there research showing that they have poorer auditory memory or sequencing skills?

-references added

Comment 6: Reference needed for " Adding visual cues via speechreading fills in some of the missing pieces in the message, providing more clarity and reducing listening and cognitive effort."

-references added

Comment 7:  Listener factors. See Mattys et al. (2012) paper previously mentioned to add to the discussion on listener factors (what they call receiver limitations).

-as noted before, this section of the paper is intended to be a general overview to provide context for the heart of the paper, which is access technologies. I think the level of detail in this paper may be confusing to readers if described

Comment 8: Reference needed for "Younger children have more difficulty processing auditory information than do older children and adults."

-references added

Comment 9: Reference needed for "However, natural language development is predicated on both direct interaction with a communication partner and language that is heard incidentally."

-clarified and references have been added

Comment 10:  Reference needed for: "Some researchers have hypothesized that the development of syntactic and pragmatic language skills may rely more heavily on a clear signal"

-clarified and reference added

Comment 11: Clarify "Best practice for accommodations would include access to captions for synchronous classes and asynchronous materials as well as a notetaker, ideally in a time and cost effective way." 

-clarified

Comment 12: Reference needed for  However, sometimes the effects of RMS can be more subtle, for example, faster response times to questions posed by the classroom teacher, less fatigue at the end of the day, or a greater willingness to participate in discussions.

-references added

Comment 13: Define Auracast

-clarified