Hard of Hearing Adults’ Interpersonal Interactions and Relationships in Daily Life
Round 1
Reviewer 1 Report
I read the article titled ‘Hard of hearing adults’ s interpersonal interactions and relationships in daily life’ with great interest. The objectives and aims for the study were very clearly articulated. The study aimed to explore deaf adults’ experiences of social interactions and social relationships in higher education, the workplace and leisure time. This is an under investigated area and once of the very few studies exploring this area from the perspective of deaf students themselves.
The use of the term hard of hearing is not justified, In the field of deaf education the term ‘deaf’ is preferred by people who have a hearing loss and generally this is the preferred term used by national and international associations. The term ‘deaf ‘ is used to refer to all types and degrees of hearing gloss , either unilateral or bilateral, temporary or permanent losses. Unless HH is the preferred term of the participants of the study I strongly encourage the use of the term deaf.
Specific comments as following:
- 1- line 12-13. The abstract does not include specific information on the setting form where the students were recruited. This info is missing from the abstract.
p.3 line 117 . consistency of the terms used. Here you use the term ‘hearing loss’.
Line 121. The term participants is preferred
Line 122. Where did you recruit the participants form? Description of the educational setting etc.
Line 123. It is stated that the research took part in 2011-2012. This is 9 years ago and loads have changed in the field of deaf education since then. For instance there is enhancement in the technology of hearing aids with Bluetooth compatibility etc… How this and other developments in the field might influence the experiences of deaf adults nowadays in 2021?
Line 127-128. Explanation and clarification si needed. What does ‘on regular base’ means?
Line 133: an integrated school is a very old term. Do you mean mainstream schools or schools where there is a hearing resource base or both?
Line 136. Special language? This is a weird term to use. Please define.
Line 182. What sort of thematic analysis was used? Deductive or theoretically driver or both. Need to be specific and explain why this was used.
Line230. It is implied that an inter-rater reliability was conducted. However this is not explicit. What was the agreement score?
Line 593: the fact that the data might be quite dated as is collected almost 10 years ago is cakcnoledg3ed as limitation. However, it still does not make up for the fact that some of the findings might not be true nowadays. IT would be preferable that the either follow up data is collected or the discussion uses up to date literature to discuss the findings.
Author Response
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Reviewers comments |
Revision |
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Specific comments as following:
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1- line 12-13. The abstract does not include specific information on the setting form where the students were recruited. This info is missing from the abstract.
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In this section, we have tried to make this section clearer for the reader. |
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p.3 line 117 . consistency of the terms used. Here you use the term ‘hearing loss’. |
This section has been rewritten and clarified. |
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Line 121. The term participants is preferred |
This section has been rewritten. |
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Line 122. Where did you recruit the participants form? Description of the educational setting etc |
The text has been revised, and more detailed information has been provided.
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Line 123. It is stated that the research took part in 2011-2012. This is 9 years ago and loads have changed in the field of deaf education since then. For instance there is enhancement in the technology of hearing aids with Bluetooth compatibility etc… How this and other developments in the field might influence the experiences of deaf adults nowadays in 2021?
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We are grateful for your comments and have taken them into consideration. Life are better in many ways with the new technology, but still there are barriers to have conversations and discussions with many people in one room. We have also highlighted the important aspects of why the result is still important 2021 and how our study extends the knowledge base about young adult with HH and their longing to belong. |
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Line 127-128. Explanation and clarification si needed. What does ‘on regular base’ means?
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This section has been rewritten and clarified. |
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Line 133: an mainstream schoolsis a very old term. Do you mean mainstream schools or schools where there is a hearing resource base or both?
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Yes, the section is rephrased. |
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Line 136. Special language? This is a weird term to use. Please define.
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This section has been rewritten. |
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Line 182. What sort of thematic analysis was used? Deductive or theoretically driver or both. Need to be specific and explain why this was used.
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The sections have been rewritten to provide more information, clarity, and focus to the readers. |
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Line230. It is implied that an inter-rater reliability was conducted. However this is nto explicit. What was the agreement score?
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This section has been rewritten and clarified. |
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Line 593: the fact that the data might be quite dated as is collected almost 10 years ago is cakcnoledg3ed as limitation. However, it still does not make up for the fact that some of the findings might not be true nowadays. IT would be preferable that the either follow up data is collected or the discussion uses up to date literature to discuss the findings.
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We agree with this comment, and we have provided more newer research with the same conclusion. This study is part of a thesis about living conditions and life experiences of young men and women who are hard of hearing and that’s why it had taken some time to finish it. The informants are part of a larger project and was first interviewed 1994 and then 1996 The informants in that study expressed interest in participating in further studies after having been involved in Brunnberg’s (2003) earlier study. This section has been rewritten. we discuss that an understanding how people with a hearing loss could perceive their life, still in 2021, an important knowledge. My dream is to do a follow up study with all of these participants in the future.
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Reviewer 2 Report
Review of Disabilities Manuscript 1106818 : Hard of hearing adults’ interpersonal interactions and relationships in daily life
Social relationships and interactions across environments such as work, home, leisure are a critical component to being an active member of society. Those with hearing loss may experience barriers to such components; therefore, investigation and examination of individuals’ experiences is crucial to understanding and improving daily routines and interactions to be inclusive to all people, including those with hearing loss. Given the importance of this topic, this manuscript is appreciated. However, there are a few concerns that need to be addressed prior to publishing this manuscript at Disabilities such as the introduction, methods, results and discussion.
Introduction:
- Title needs to be revised to be adults’ not adults’s
- Line 44 states: People with hard of hearing (HH) often feel socially excluded because of the difficulty of communicating with hearing people. – Hard of hearing is a label or a way of addressing this population, I would suggest revising this to state “those who are hard of hearing”, “individuals who are hard of hearing”, or something similar. Or was “hard of hearing” another term for hearing loss?
- Assistive Technology is mentioned on line 60, does this include hearing technology such as hearing aids and/or cochlear implants? If so, this should be clearly offered as examples.
- Line 77-83 is repetitive; I would suggest eliminating one of these sentences to avoid redundancy.
- Given that AT and ICT are mentioned in the research questions more information and/or concrete examples of each (see above comment) are needed to effectively answer the proposed question.
- Section 1.1: Social relationships and communication should come before the proposed research questions. It is not clear why it is presented after the research questions or if it is something that is indicated as a variable of interest in the study.
Materials and Methods
- It appears that the participants had severe-to-profound hearing loss and they were identified as Hard of Hearing. Were they self-identified as hard of hearing? If the authors reviewed the audiogram and then identified the participants as hard of hearing, citations would be helpful to support this. Typically, on the audiogram, if an individual has a severe to profound hearing loss, clinically they would be considered deaf. More information is needed as to how the authors identified these informants/participants as hard of hearing.
- How were demographics of the participants/informants collected?
- The sentence in line 122-123 needs to be revised as “hearing loss” is stated twice. “Semi-structured interviews were held with 16 individuals (10 males, 6 females) aged 24 to 31 years with severe-to-profound hearing loss hearing loss in the years 2011 and 2012.”
- Line 127 states: “All informants used hearing aids on a regular basis and could easily have a conversation face-to-face with one person”. I would assume this means the informants or participants used a listening and spoken language communication modality. If so, this needs to be explicitly stated.
- More information is needed about the participant’s communication modality as communication is extensively discussed within this manuscript. This information should also be included in Table 1: Background of the informants.
- Line 135 states: “But it was more common that they had an own special language, mixed with communication body language and some sign language.” The participant’s communication modality is not clear. Is it listening and spoken language, is it listening and spoken language and manual communication? What does “own special language” mean exactly? This sentence needs to be revised as well.
- The sentence in line 139 is not clear and needs to be revised: “All the questions about school experiences the informants reporting on past experiences expect from this two current students.”
Results
- The sentence in line 280 is not clear and needs to be revised: “In order not to repeatedly must ask what someone has said, which makes them feel embarrassed, the HH individuals choose to exclude themselves from communicative situations.”
- Is there a reason that lines 355-358 are italicized and presented like a quote? If this is standard for the journal, then please ignore this comment. However, the way it is presented can be misconstrued for a quote from an informant/participant.
- The statement in line 366: “Regarding friendship and socializing, most of the friends and partners that people with hearing loss have over the years are also HH.” The authors should clarify this statement that this was specifically reported by the participants in the study. Otherwise, this statement reads as a generalized statement regarding all people with hearing loss.
- AT and ICT are discussed extensively in section 3.2.2, more concrete examples of AT and ICT are needed to strengthen the understanding and implications of the study as well as responses from the participants. (see comment from the Introduction).
- The results are organized by theme rather than the research questions that were presented on Page 2. I would suggest organizing this by research question so that it is clearly delineated and organized.
Discussion
- The sentence in line 550 needs to be revised: “Another of the themes in this study explores how the informants experience the social interactions and social relationships at work.”
- Limitations were offered in this manuscript and are appropriate to the study. There are a couple of other ones to consider and are worth mentioning in the manuscript. The number of participants is small which is often expected with this population; however, are the participants representative of the population? Depending on the communication modalities of all of the participants, would the results be similar or different?
This concludes my review. Thanks.
Author Response
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Reviewers comments |
Revision |
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Introduction: |
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Title needs to be revised to be adults’ not adults’
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The title has been reworded. |
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Line 44 states: People with hard of hearing (HH) often feel socially excluded because of the difficulty of communicating with hearing people. – Hard of hearing is a label or a way of addressing this population, I would suggest revising this to state “those who are hard of hearing”, “individuals who are hard of hearing”, or something similar. Or was “hard of hearing” another term for hearing loss? |
This section has been rewritten and clarified. |
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Assistive Technology is mentioned on line 60, does this include hearing technology such as hearing aids and/or cochlear implants? If so, this should be clearly offered as examples. |
Assistive Technology has been worked on to make it more focused and succinct.
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Line 77-83 is repetitive; I would suggest eliminating one of these sentences to avoid redundancy |
This has been revised |
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Given that AT and ICT are mentioned in the research questions more information and/or concrete examples of each (see above comment) are needed to effectively answer the proposed question. |
This section has been rewritten and clarified. |
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Section 1.1: Social relationships and communication should come before the proposed research questions. It is not clear why it is presented after the research questions or if it is something that is indicated as a variable of interest in the study. |
This section has been moved to the end of the Introduction before the purpose of the study. |
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Materials and Methods |
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It appears that the participants had severe-to-profound hearing loss and they were identified as Hard of Hearing. Were they self-identified as hard of hearing? If the authors reviewed the audiogram and then identified the participants as hard of hearing, citations would be helpful to support this. Typically, on the audiogram, if an individual has a severe to profound hearing loss, clinically they would be considered deaf. More information is needed as to how the authors identified these participants /participants as hard of hearing. |
This comment is correct, but we only have their self-ratings to go on. In the manuscript, it has been clarified that their hearing is based on participants’ self-conceptions of their hearing now days. We do not have a test to verify this, as has been discussed in the study limitations. |
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How were demographics of the participants/participants collected?
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We revised the ‘Method’ section and added more detailed information and descriptions. |
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The sentence in line 122-123 needs to be revised as “hearing loss” is stated twice. “Semi-structured interviews were held with 16 individuals (10 males, 6 females) aged 24 to 31 years with severe-to-profound hearing loss hearing loss in the years 2011 and 2012.” |
This has been revised |
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Line 127 states: “All participants used hearing aids on a regular basis and could easily have a conversation face-to-face with one person”. I would assume this means the participants or participants used a listening and spoken language communication modality. If so, this needs to be explicitly stated. |
This section has been rewritten and clarified. |
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More information is needed about the participant’s communication modality as communication is extensively discussed within this manuscript. This information should also be included in Table 1: Background of the participants . |
I´m sorry to say that I have no individual data of this information |
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Line 135 states: “But it was more common that they had an own special language, mixed with communication body language and some sign language.” The participant’s communication modality is not clear. Is it listening and spoken language, is it listening and spoken language and manual communication? What does “own special language” mean exactly? This sentence needs to be revised as well. |
The text has been revised, and more detailed information has been provided. |
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The sentence in line 139 is not clear and needs to be revised: “All the questions about school experiences the participants reporting on past experiences expect from these two current students.”
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This section has been revised, rewritten, and clarified. |
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Results |
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The sentence in line 280 is not clear and needs to be revised: “In order not to repeatedly must ask what someone has said, which makes them feel embarrassed, the HH individuals choose to exclude themselves from communicative situations.” |
This has been revised. |
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Is there a reason that lines 355-358 are italicized and presented like a quote? If this is standard for the journal, then please ignore this comment. However, the way it is presented can be misconstrued for a quote from an informant/participant. |
Have rewritten this. |
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The statement in line 366: “Regarding friendship and socializing, most of the friends and partners that people with hearing loss have over the years are also HH.” The authors should clarify this statement that this was specifically reported by the participants in the study. Otherwise, this statement reads as a generalized statement regarding all people with hearing loss. |
Have clarified this. |
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AT and ICT are discussed extensively in section 3.2.2, more concrete examples of AT and ICT are needed to strengthen the understanding and implications of the study as well as responses from the participants. (see comment from the Introduction). |
This section has been rewritten and clarified. |
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The results are organized by theme rather than the research questions that were presented on Page 2. I would suggest organizing this by research question so that it is clearly delineated and organized. |
Have tried to write this section much clearer so the research question is more integrate in the themes. |
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Discussion |
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The sentence in line 550 needs to be revised: “Another of the themes in this study explores how the participants experience the social interactions and social relationships at work.” |
This has been revised. |
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Limitations were offered in this manuscript and are appropriate to the study. There are a couple of other ones to consider and are worth mentioning in the manuscript. The number of participants is small which is often expected with this population; however, are the participants representative of the population? Depending on the communication modalities of all of the participants, would the results be similar or different? |
The informants are part of a larger project and was first interviewed 1994 and then 1996 The informants in that study expressed interest in participating in further studies after having been involved in Brunnbergs (2003) earlier study. This study only had participants with severe-to-profound hearing loss, and I agree with you that it would be interesting to see if the communication modalities have an impact of the results. Some studies show that the opportunities to have friends depend of the level of hearing loss, but in others no such correlations are found. This section has been rewritten and clarified.
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Round 2
Reviewer 1 Report
I have now read the revised manuscript again and looked at the amendments that the authors did to address my comments.
I am writing to confirm that the manuscript has been significantly improved and now warrants publication in Disabilities.
Reviewer 2 Report
After reviewing the manuscript, I believe that the authors addressed my comments and it warrants publication. There is just one comment or concern that I have – which I would like the authors to address before publication. Line 99 states: “Hearing loss is a growing, global public-health problem.” – depending on the lens that you are examining this population, many would argue hearing loss is not a “problem”, especially those from the Deaf community or Deaf culture. Specifically the only issue is that this population can’t hear but they are more than capable of living full, independent lives. I don’t think this statement is needed in the manuscript or it needs to be reworded.
