Bennett, J. G., Gardner III, R., & Rizzi, G. L. (2014).
Deaf and hard of hearing students' through-the-air English skills:
A review of formal assessments. American Annals of the Deaf 158(5), 506-521.
DEAF AND HARD OF HEARING STUDENTS'
THROUGH'THE'AIR ENGLISH SKILLS: A REVIEW OF
FORMAL ASSESSMENTS
JESSICA G . BENNETT,
RALPH GARDNER III, AND
GLEIDES LOPES RIZZI
BENNETT IS A DOCTORAL CANDIDATE,
GARDNER AN ASSOCIATE PROFESSOR, AND
RIZZI A DOCTORAL STUDENT IN THE SPECIAL
EDUCATION PROGRAM, DEPARTMENT OF
EDUCATIONAL STUDIES, OHIO STATE
UNIVERSITY, COLUMBUS.
VOLUME 158, No. 5, 2014
TRONG CORRELATIONS exist between signed and/or spoken English
and the literacy skills of deaf and hard of hearing students. Assessments
that are both valid and reliable are key for researchers and practitioners
investigating the signed and/or spoken English skills of signing popula-
tions. The authors conducted a literature review to explore which tests
researchers are currently using, how they administer the tests, and how
reliability and validity are maintained. It was found that, overall,
researchers working with this population use the same tests of English
employed by practitioners working with hearing students (i.e., the
Peabody Picture Vocabulary Test, Expressive One-Word Picture Vocabu-
lary Test, and Clinical Evaluation of Language Fundamentals). There is
a disconnect between what is being used in research with deaf and hard
of hearing students and what is being used in practice with them. Impli-
cations for practice are discussed.
Literacy outcomes for students who are fetti & Sandak, 2000). Even children
deaf or hard of hearing have been con- with mild hearing loss struggle to de-
sistently poor (S. Qi & Mitchell, 2012; velop language (Marschark et al., 2009).
Traxler, 2000). One cause of poor liter- Having limited vocabularies compared
to their hearing peers (Connor, Heiber,
acy outcomes is delays in the develop-
Arts, & Zwolan, 2000), deaf and hard of
ment of language, whether signed or
hearing students whose first language
spoken (P Spencer & Marschark, 2010).
is American Sign Language (ASL) often
The fact is that proficient through-the-
struggle with language development.
air^ English skills are a predictor of pro-
For deaf and hard of hearing stu-
ficient print literacy skills for learners
who are deaf or hard of hearing (Geers dents, underdeveloped language skills
& Moog, 1989; Geers, Tobey, Moog, & can be an immense obstacle to acquir-
Brenner, 2008; Goldin-Meadow & May- ing English literacy skills. ASL does not
berry, 2001; Mayer, 2007,2009; Mayer & have a written form, and for such stu-
Akamatsu, 2000; Mayer & Leigh, 2010; dents who do not benefit from amplifi-
Mayer & Trezek, 2011; Mayer & Wells, cation, access to spoken English is often
1996; Moores & Sweet, 1990; Nielsen, limited. As a result, these students are
Luetke, & Stryker, 2011; Paul, 2003; Per- essentially required to learn how to
AMERICAN ANNALS OF THE DEAF
read and write in English as they learn
the language (Marschark & Harris,
1996; Mayer & Trezek, 2011; Paul,
2003; Perfetti & Sandak, 2000). Not
having a printed form of ASL, and/or
not having full face-to-face access to
the phonemes, morphemes, seman-
tics, syntax, and pragmatics of English,
inevitably delays the acquisition of
print literacy and consequently creates
a gap in academic achievement (Mars-
chark & Harris, 1996; Marschark,
Spencer, Adams, & Sapere, 2011;
McGuiness, 2004,2005; Perfetti & San-
dak, 2000). In other words, academic
achievement gaps are cyclically and
simultaneously created by delay of a
first language, delay of acquisition of
print literacy, and an overall lack of pro-
ficiency in English skills at the conver-
sational and academic levels (Luckner
& Handley, 2008; Mayer, 2009; Mayer &
Leigh, 2010).
Therefore, finding reliable tools to
measure the progress of the through-
the-air English language development
of deaf and hard of hearing students
should be a priority for teachers, clini-
cians, and researchers (Schick, 1997).
Although dozens of assessments are
available (see Easterbrooks & Baker,
2002), there is little clarity as to how
these assessments are being admin-
istered to deaf and hard of hearing
students who require access to a
visual-manual language (i.e., children
placed in Total Communication or
bilingual/bicultural programs). More-
over, most of these assessments have
been normed on typically developing
hearing children using spoken English.
If these assessments are being admin-
istered by means of some sort of
English-based sign, there may be an
important yet unknown impact on the
validity and reliability of these assess-
ments (Moores, 2006/2007).
Researchers have found that to
become fiuent readers and writers,
students who are deaf or hard of hear-
VOLUME 158, No. 5, 2014
ing need to become fiuent users of
English (Mayer 2007, 2009; Mayer &
Leigh, 2010). Teaching and providing
through-the-air opportunities for stu-
dents to become users of English
overtly may have the potential to
enable students to "think" in English
covertly as a more efficacious bridge
to learning how to read and write
English (Mayer & Wells, 1996). Conse-
quently, regardless of program type
(i.e., aural/oral. Total Communication,
bilingual/bicultural) or communica-
tion history and/or preference (e.g.,
spoken, sign-supported speech, ASL),
programming considerations should
include teaching deaf and hard of
hearing students to communicate in
English through the air (Mayer, 2007;
Mayer & Akamatsu, 2000).
Under current bilingual-bicultural
practices in deaf education, students
learn to read and write English by
attempting to make direct connections
between ASL and printed English
(Mayer & Wells, 1996; P Spencer &
Marschark, 2010). Skipping the step of
actually learning English through the
air is a method that is not based on sci-
entific evidence pertaining to bilingual
education models such as the lan-
guage acquisition research of Cum-
mings (1989; cited in Mayer & Wells,
1996); nor does this method neces-
sarily produce better deaf readers
(Luetke-Stahlman & Nielsen, 2003;
Paul, 2011; P Spencer & Marschark,
2010). Mayer and Trezek (2011) rec-
ommend that teachers sequentially
teach the form of the language in
which students are expected to read
and write, and provide them with
opportunities to generalize these skills
in natural settings. English-based sign
language is one means by which deaf
and hard of hearing students may be
able to do just that (Akamatsu &
Stewart, 1998; Convertino, Marschark,
Sapere, Sarchet, & Zupan, 2009;
Goldin-Meadow & Mayberry, 2001;
Hyde & Power, 1991; Luetke-Stahlman
& Nielsen, 2003; Mayer 2009; Mayer &
Akamatsu, 2000; Mayer & Leigh, 2010;
Paul, 2011; Perfetti & Sandak, 2000;
Power, Hyde, & Leigh, 2008; Schick &
Moeller, 1992; Wilson & Hyde, 1997).
In order to identify student language
needs and measure effectiveness of
language instruction, practitioners
need the ability to formally assess the
through-the-air English skills of stu-
dents, as we will discuss further in
the present article. Speech-language
pathologists (SLPs) typically conduct
formal measures of language and com-
munication skills of students who are
deaf or hard of hearing (Luckner &
Bowen, 2006). However, teachers also
need to understand the language
achievement levels of their students
and should be more involved in the
assessment process so that language
goals can be developed, instruction can
be designed and implemented, and
progress can be frequently monitored
(Easterbrooks & Baker, 2002; Luckner
& Bowen, 2006). Because of the signifi-
cance of through-the-air English skills
to language development and subse-
quent literacy achievement, teachers
need to fully understand the available
assessments for measuring the through-
the-air English skills of deaf and hard of
hearing students who sign, how to
administer those assessments, and how
these assessments can be used to guide
instruction (Easterbrooks & Baker,
2002; Luckner & Bowen, 2006).
The literature review we conducted
for the present article was directed
toward determining which English-lan-
guage assessment tools researchers
have most commonly used to measure
through-the-air English skills of deaf
and hard of hearing students who sign.
For the subsequent study, we posed
three specific research questions:
1. How were the assessments
adapted and administered to
AMERICAN ANNALS OF THE DEAF
REVIEW OF FORMAL ASSESSMENTS
provide access to students who
need a visual-manual mode of
communication?
2. How were reliability and validity
preserved?
3. How can the assessments be
used to guide both language and
literacy interventions in the class-
room?
In the closing sections of the article,
we make recommendations for future
research and discuss the practical
implications of using formal English-
language assessments to guide class-
room language and literacy instruction
of students who are deaf or hard of
hearing.
Overview of Assessments
for the Literature Review
In 'Assessment of Language," a chapter
in their book Language Learning in
Children Who Are Deaf and Hard of
Hearing, Easterbrooks and Baker
(2002) identified four features of Eng-
lish-language assessments: tests of
English grammar, tests of English word
meaning, tests of spoken English ver-
sus signed English, and tests of English
pragmatic skills. Easterbrooks and
Baker reviewed a total of 43 assess-
ments (see Table 1).
We used the 15 examples provided
by Easterbrooks and Baker (2002) in
"Assessment of Language" as a starting
point to determine which assessments
are currently being used to assess
through-the-air English skills of deaf
and hard of hearing students who use
sign language (i.e., ASL or English-
based sign).
In addition, two surveys (Caesar &
Khler, 2009; Luckner & Bowen,
2006) each verified that approxi-
mately half of the assessments high-
lighted by Easterbrooks and Baker
(2002) are used by SLPs in practice
(see Table 1). The two surveys also
provided additional insight into tests
VOLUME 158, No. 5, 2014
that were not highlighted by Easter-
brooks and Baker. Eor example, Luck-
ner and Bowen (2006) conducted an
online survey to better understand
current assessment practices for
students who are deaf or hard of hear-
ing. They found that these students'
language skills are most frequently
assessed by SLPs. In addition, through
the responses on the survey, Luckner
and Bowen were able to identify and
rank the eight most common meas-
ures of language being used in prac-
tice. Easterbrooks and Baker also
identified six of these language assess-
ments (see Table 1). When adjusting
the rank order to include only formal
assessments (i.e., language samples
were the second most used assess-
ment overall), Luckner and Bowen
found that the Stanford Achievement
Test series, which measures written
language, was the third most fre-
quently used formal assessment, and
that the Clinical Evaluation of Lan-
guage Eundamentals (CELE) was the
sixth most frequently used formal
assessment.
Further, Caesar and Khler (2009)
conducted a survey of language assess-
ment procedures used by school-
based SLPs who did not specifically
serve deaf and hard of hearing stu-
dents. These authors also identified a
total of 15 assessments currently being
used by SLPs. Seven of these assess-
ments were highlighted by Easter-
brooks and Baker (2002; see Table 1).
Particularly noteworthy is the finding
that the CELF-3 (Semel, Wiig, & Sec-
ord, 1995) was the most commonly
used tool among school-based SLPs
(Caesar & Khler, 2009). Considering
that the CELF appeared in both sur-
veys and is a comprehensive formal
assessment of spoken English, the
CELF was included in the literature
search for the present study along with
the 15 assessments highlighted by
Easterbrooks and Baker.
Method
Database Procedures
To determine which formal assess-
ments of language are being used to
measure the through-the-air English
skills of deaf and hard of hearing stu-
dents who sign, we conducted a liter-
ature search for each of the 15
assessments highlighted by Easter-
brooks and Baker (2002; see Table 1),
as well as a general search for the CELF.
An accompanying descriptor was used
to capture deaf and hard of hearing
students. The exact name of the
assessment was individually cross-ref-
erenced with the following terms:
deaf, deafness, hard of hearing, hear-
ing impairment, hearing loss, spoken
English, signed English, and English-
based sign. Each of the 16 test names
and descriptors was searched for in
ERIC and PsycINFO, and was also
entered in a digital library network that
searched seven databases including
Academic OneFile, Academic Search
Complete, and WoridCat (OCLC).
In addition, four journals that pub-
lish articles on sign communication
were separately searched: American
Annals of the Deaf, Communication
Disorders Quarterly, Journal of Deaf
Studies and Deaf Education, and
Journal of Speech, Language, and
Hearing Research. These journals
were chosen because the American
Annals of the Deaf and Journal of
Deaf Studies and Deaf Education are
the two leading journals in deaf educa-
tion, and Communication Disorders
Quarterly and the Journal of Speech,
Language, and Hearing Research also
frequently include studies with deaf
and hard of hearing participants. For
the American Annals of the Deaf, the
first author looked through each past
year's index by subject. The years
1991-2012 were available. The first
author read the titles of the articles
grouped under the following subjects
in the index: assessments, bilingual
AMERICAN ANNALS OF THE DEAF
Table 1
Assessments Identified by Easterbrooks and Baker (2002)

Number of articles reporting on research

Features
I of English
P^sts of E
I granni
Tests of English
word meaning
Tests of spoken English
versus signed English
Tests of English
pragmatic skilis
Note. Tests used by speech-language pathologists in practice as verified by:
a Luckner & Bowen (2006)
1= Caesar & Khler (2009)
= both Caesar & Khler (2009) and Luckner & Bowen (2006).
Assessments identified by witti signing participants (present review), exciuding
Easterbrooks and Baker (2002) the Clinicai Evaiuation of Language Fundamentals
Rhode Island Test of Lan.
(E. Engen & T. Engen, 1
Grammatical Analysis of Elicifed Language
(Moog& Geers, 1979)
Teacher Assessment of Grammatical Structures
(Moog&Kozak, 1983)
Teacher Assessment of Spoken Language
(Moog & Biedenstein, 1998)
Kendalf Conversational Proficiency Levels
French. 1999)
Test of Auditory Comprehension of Language-Revised
(Carrow-Wooifoik, 1985)^
Test of Language Development
(Newcomer & Hammill. 1988)
Receptive One-Word Picture Vocabulary Test
(Gardner, 1985)<:
Expressive One-Word Picture Vocabulary Test
(Gardner, 1981)=
Peabody Picture Vocabulary Test-Revised
(L M. Dunn & D. M. Dunn, 1981)<^
Oral and Written Language Scales
(Carrow-Woolfolk, 1994)a
Boehm Test of Basic Concepts-Revised
(Boehm, 1986)"
Syntax Screening Test (Lee, 1971)
Test of Problem Solving
(Zachman, Jorgensen, Huisingh, & Barrett, 1984)'
Test of Pragmatic Language
(Phelps-Terasaki & Phelps-Gunn, 1992)

education, communication/communi- looked for the exact phrase. For Com- or abstract as qualifying search terms,
cation strategies, education, language/ munication Disorders Quarterly, the and the exact name of each assessment
literacy, research, and testing and screen- advance search feature was also used. was searched for in the text, title, or
ing. Titles that included the phrases The descriptor terms deaf, deafness, abstract as the exact phrase. The first
spoken English, signed English, or hard of hearing, hearing loss, and author found and obtained 141 articles
English-based sign were investigated in hearing impairment were cross-refer- using these database procedures.
addition to titles that indicated that lan- enced with the exact names of the
guage assessment was the topic of the assessment. During the search of the Inclusion Criteria
article. Journal of Speech, Language, and Peer-reviewed articles that were pub-
For theJournal ofDeafStudies and Hearing Research, any of the phrases lished between 1971 (the date of the
Deaf Education, the exact names of including (iea/, deafness, hard ofhear- earliest test publication) and 2013
the assessments were entered into ing, hearing im,pairment, and hear- were selected for the literature review.
an advanced search, and the author ing loss were searched for in the title Articles were selected only if the

VOLUME 158, No. 5, 2014 AMERICAN ANNALS OF THE DEAF

REVIEW OF FORMAL ASSESSMENTS
authors used performance on at least
one of the subtests of an assessment as
a dependent variable as it related to
deaf and hard of hearing students
using either spoken or signed English,
ages birth to 21 years. Articles were
only included if participants used
some form of signed communication,
and/or the assessment was specifically
analyzed for use with deaf and hard of
hearing populations. Articles were
included if they had been published
after the date of the version of the
assessment indicated by Easterbrooks
and Baker (2002; see Table 1), and all
versions of the CELF were included. A
full reference list of all the assessments
searched for in the literature review
can be found in Table 2.
For the purposes of the review, arti-
cles were omitted if the participants did
not sign at all or if the author(s) did not
mention the use of some form of
signed communication. In addition, if
participants were not learning English
(i.e., the native language either spoken
or signed was Arabic, French, Italian,
etc.), the articles were not included.
Studies that focused on postsecondary-
age participants were not included
(e.g., Auer & Bernstein, 2008, had study
participants 18-45 years old). Theses,
dissertations, book chapters, confer-
ence presentations, and unpublished
studies were not included. Application
of the criteria resulted in compilation of
a set of 28 studies.
Interobserver Agreement
The third author of the present article
acted as the second observer and
coded all 28 studies. Coding categories
included the assessments given,
accommodation/administration, use of
language sample, and use of additional
language assessment. If disagreements
existed, both observers went back to
recode that item, and each disagree-
ment was discussed until 100% agree-
ment was reached for each item.
VOLUME 158, No. 5, 2014
Table 2
Assessments Searched For in the Literature Review
Author, year
Boehm (IS
Carrow-Woolfolk(1985)
;Carrow-Woolfolk(1994)
L. M.Dunn & D. M.Dunn (1981)
E. Engen & T. Engen (1983|
French (1999)
Gardner (1981)
Gardner (1985)
I Moog & Biedenstein (1998)
Moog&Geers (1979)1
Moog& Kozak(1983)
Phelps-Terasaki & Phelps-Gunn (1992)
Newcomer & Hammill (1988)
Semel, Wiig, & Secord (1989)
Semel, Wiig, & Secord (1995)
Semel, Wiig, & Secord (1996)
SemeL Wg. & Secord (2003) Clinical Evaluation of Language
|Semel, Wiig, & Secord (2006)
Wiig, Secord, & Semel (1992)
Eachman, Jorgensen, Huisingh,
" & Barrett (1984)
Results
The 28 articles referenced 45 uses of
eight different assessments (Figure 1).
These 28 articles appeared in 17 dif-
ferent journals (Figure 2). Twelve of
the 28 articles reported use of more
than one of the eight assessments
examined; 7 of the articles also re-
ported use of language samples; 15 of
the studies used the assessments eval-
uated in the present study in addition
to other assessments. None of the 28
articles directly addressed how to
adapt these assessments for deaf and
hard of hearing students who use Eng-
lish-based sign. Table 3 provides a sum-
mary of each of the reviewed studies.
Fach article was coded on the basis of
author, target assessments, administra-
tion of the test, use of a language sam-
Name of assessment
Boehm Test of Basic Concepts-Reviset
Test of Auditory Comprehension of
Language-Revised
Oral and Written Language Scales: Listening
Comprehension and Oral Expression
Peabody Picture Vocabulary Test-Revised
Rhode Island Test of Language Structures
Kendall Conversational Proficiency Levels
xpressive One-Word Picture Vocabulary TestJ
Receptive One-Word Picture Vocabulary Test
Northwestern Syntax Screening Test
Teacher Assessment of Spoken Language
Grammatical Analysis of Elicited Language
Teacher Assessment of Grammatical Structures
Test of Pragmatic Language
Test of Language Development-Primary
(2nd ed.)
Clinical Evaluation of Language Fundamentals-
Revised
Clinical Evaluation of Language Fundamentals-3
linical Evaluation of Language Fundamentals-3
Fundamentals-4
Clinical Evaluation of Language Fundamentals-4
Clinical Evaluation of Language Fundamentals-
Preschool
Test of Problem Solving
ple, and use of additional language
assessments (not including speech
perception, articulation, or reading/
writing). Each of the 28 studies is also
listed in the references, indicated with
an asterisk.
As Table 3 shows, 7 of the 15
assessments suggested by Easter-
brooks and Baker (2002) appeared in
the literature:
Expressive One-Word Picture
Vocabulary Test (EOWPVT; Gard-
ner, 1981)
Grammatical Analysis of Elicited
Language (GAEL; Moog & Geers,
1979)
Oral and Written Language
Scales (OWLS; Carrow-Woolfolk,
1994)
AMERICAN ANNALS OF THE DEAF
 Peabody Picture Vocabulary Test- Figure 1

Revised (PPVT-R; L. M. Dunn & Frequency of Assessments Used in Empirical Journal Articles on Research With
D. M. Dunn, 1981) Deaf and Hard of Hearing Students Who Signed, 1971-2013
Rhode Island Test of Language
Structures (E. Engen & E. Engen,
1983)
Test of Auditory Comprehension
of Language-Revised (TACL-R;
Carrow-Woolfolk, 1985)
Test of Language Development
series (TOLD; Newcomer & Ham-
mill, 1988)

Eour versions of the CELF (CELE-3,

CELF-4, CELF-P [for preschool], and
CELE-R; Semel, Wiig, & Secord, 1989, PPVT CELF EOWPVT GAEL TACL OWLS Rhode TOLD
island
1995, 1996, 2003, 2006; Wiig, Secord,
& Semel, 1992) appeared in seven Name o f Assessment

articles.
As seen in Eigure 1, the researchers
who included deaf and hard of hearing
participants in their peer-reviewed
Notes. PPVT, Peabody Picture Vocabulary Test. CELF, Clinical Evaluation of Language Fundamentals.
EOWPVT, Expressive One-Word Picture Vocabulary Test. GAEL, Grammatical Analysis of Elicited Lan-
guage. TACL, Test of Auditory Comprehension of Language. OWLS, Oral and Written Language Scales.
Rhode Island, Rhode Island Test of Language Structures. TOLD, Test of Language Development.

journal articles most frequently used

(a) the PPVT, (b) the CELE, and (c) the
EOWPVT, respectively (with the CELE
and EOWPVT appearing the same
number of times). These results are
consistent with the findings of Caesar
and Khler (2009), who found that the
CELE, the PPVT, and the EOWPVT were Figure 2

respectively, the first, second, and Number of Articles per Journal

fourth most commonly used assess- 14
ment by school-based SLPs. The
g 12-
results are also somewhat consistent
with SLPs specifically working with 1 *"
deaf and hard of hearing students; 8-
Luckner and Bowen (2006) found that o
the top two formal assessments used
by SLPs were, respectively, the PPVT
1
Z ,
'
and the EOWVPT. In Luckner and
Bowen's survey, when language sam- Aniericon Ear and Journal of Journal of lohg\' & Oilur
Annals of the Hearing Deaf Studies Speech and Neurolology
ples were discounted, the CELF was
and Deaf Hearing
ranked sixth. In the following sections, Education Disaixiers
we analyze these three assessments
Name of Journal
all of which are individually adminis-
tered. The PPVT and the EOWPVT are Note. There was one article in each of the following journals: Applied Psycholinguistics; Archives of
tests of English word meaning, while Disease in Childhood; Audiology Neurotology; Australia and New Zealand Journal of Developmental Dis-
the CELF can be used as a comprehen- abilities; Child Language Teaching and Therapy; Communication Disorders Quarterly; International
Journal of Audiology; International Journal of Disability; Development and Education; Pediatrics; Inter-
sive measure of general language abil- national Journal of Speech-Language Pathology; Journal of Speech, Language, and Hearing Research;
ity Therefore, for the purposes of the Volta Review.

VOLUME 158, No. 5, 2014 AMERICAN ANNALS OF THE DEAF

REVIEW OE FORMAL ASSESSMENTS

Table 3
Summary of the Reviewed Articles
Use of language
Author(s) Assessment(s) Mode of administration sample? Additional language assessment
Beai-Alvarez, Lederberg, EOWPVT; Simultaneous No No
& Easterbrooks, 2011 PPVT Communication
Ching, Crowe, Martin, Day, PPVT Not available No Preschool Language Scale 4
Mahler, Youn, et al., 2008
Connor, Hieber, Arts, ' Spoken English, speechreading No Picture Vocabulary subtest of
& Zwolan, 2000 permitted, no sign the Woodcock-Johnson Tests of
Cognitive Ability
Dodd, Woodhouse, & PPVT Total Communication (assumed) Yes Brown's morpheme development
Mclntosh, 1992 procedure; mean length utterance;
Reynell Development Receptive
Language Scale; Type Token Ratio;
Dore's Conversational Act
Categories
Seers, Moog, & Schick, 1984 No
Geers, Nicholas, & Seedy, 2003 TACL Simultaneous Communication Yes No
(Seers & Schick, 1988 G A t "" """" Manually coded English No No
and speech
Geers, Tobey, Moog, & EOWPVT; Preferred communication mode No Lexical Neighborhood Test;
Brenner, 2008 CELF-4; PPVT Bamford-Kyle-Bench sentence test
Gioia, 2001 'VflH HfpPVT Total Communication Yes No
Guo, L. Spencer, & PPVT Spoken and signed English Yes Expressive Communication subtest
Tomblin, 2013 (regardless of history) of Preschool Language Scale-3
Hay-McCutcheon, Kirk, CELF-3; Preferred communication mode No Reynell Development Language
Henning, Gao, & R. Oi, 2008 CELF-4 Scales
Krinsky, 1990 PPVT Presented test items with No No
fingerspelling; all students
responded in American
Sign Language
^ Lederberg & P. Spencer, 2008 Language of the school (signs No Communicative Development
only. Simultaneous Communication, Inventories; Carolina Picture
or spoken only) Vocabulary Test
Luetke-Stahlman & Nielsen, 2003 OWLS Signing Exact English No Test of Phonological Awareness
E. M. Miller, Lederberg, EOWPVT; Directions presented in sign and No Phonological Awareness Test
& Easterbrooks, 2013 PPVT spoken language; stimuli presented (2nd ed.)
in spoken language only.
Simultaneous Communication
used for vocabulary tests.
Moeller, 2000 EOWPVT; Signing Essential English No Preschool Language Assessment
PPVT Instrument
MurptiyS Dodd, 2010 Given in signed English; both children No Tests of Reception of Grammar
answered in spoken English
Nielsen & Luetke-Stahlman, EOWPVT; CELF-R; Signing Exact English Yes Assessing Semantic Skills Through
2002 CELF-3; OWLS; Everyday Themes; Language
PPVT; Rhode Processing Test
Island Test of
Language
Structures; TOLD
Orlando & Shulman, 1989 PPVT "Signing was main mode
s communication!

VOLUME 158, No. 5, 2014 AMERICAN ANNALS OF THE DEAF

Table 3 (continued)
4b
Summary of the Reviewed Articles

Use of language
Author(s) Assessment(s) Mode ot administration sample? Additional language assessment
Ranee, Barker, Sarant, PPVT Speech only except sign No No
support when needed to
& Ching, 2007
maintain interest and cooperation.;
PPVT; GAEL Signing Essential English Yes Language Proficiency Interview;
Schick & Moeller, 1992
elicited narration
CELF-P; PPVT Specialists served as sign No Language Proficiency Profile
P. Spencer, 2004 language interpreters and
used the language mode
of the school.
P. Spencer, Barker, & CELF-3 Speech and signed English No
Tomblin, 2003 (Simultaneous Communication)
Tomblin, L. Spencer, Flock, Rhode Island Simultaneous Gommunication Yes Index of Productive Syntax Scoring
Tyler, & Gantz. 1999 Test of Language (signed English) System
Structures
Wake, Poulakis, Hughes, CELF-3; PPVT Speech and sign language No No
Carey-Sargeant, & interpreter
Rickards, 2004
Yim, 2011 EOWPVT; PPVT Four participants used Tot Test de Vocabulario en Imgenes
Gommunication. Peabody
Yoshinaga-ltano, Baca, & TAGL; EOWPVT Not available Expressive Language subscale of
Sedey, 2010 the Minnesota Ghild Development
Inventory
Yoshinaga-ltano TAGL;TOLD Majority: Signing Exact English. No Test of Syntactic Abilities; Ghild
Downey 1996 Some cases: Seeing Essential Language Abilities Measure
English or signed English
Notes. EOWPVT, Expressive One-Word Picture Vocabulary Test. PPVT, Peabody Picture Vocabulary Test. GAEL, Grammatical Analysis of Elicited Language.
TACL, Test of Auditory Comprehension of Language. CELF Clinical Evaluation of Language Fundamentals. OWLS, Oral and Written Language Scales. TOLD,
Test of Language Development.

present article, more attention will be
given to the CELF.
Peabody Picture
Vocabulary Test (PPVT)
In practice, the PPVT (L. M. Dunn & D.
M. Dunn, 1981) is the most widely
used test with deaf and hard of hearing
students (Luckner & Bowen, 2006;
Prezbindowski & Lederberg, 2003), and
is the second most commonly adminis-
tered to hearing students (Caesar &
Khler, 2009). This norm-referenced
test provides age-equivalent, standard
scores, and percentiles for hearing stu-
dents ages 2.5 years through adulthood
(Easterbrooks & Baker, 2002). A test of
English word meaning, the PPVT is
used to assess receptive vocabulary;
the administrator gives a spoken word
to the student and asks him or her to
point to the one of four pictures that
corresponds with that word (Easter-
brooks & Baker, 2002; Prezbindowski &
Lederberg, 2003). Among the 28 stud-
ies found in the literature review for
the present article, the PPVT was also
the most frequently used in research
(see Figure 1); 17 studies used per-
formance on the PPVT as a dependent
variable. Nine of these 17 studies paired
the PPVT with other language meas-
ures; in 6 of these 9 studies, it was
paired with the EOWPVT (see Table 3).
Although many examiners adminis-
tered the test using spoken and signed
English (Beal-Alvarez, Lederberg, &
Easterbrooks, 2011; Dodd, Woodhouse,
& Mclntosh, 1992; Geers et al., 2008;
Guo, L. Spencer, & Tomblin, 2013;
Luetke-Stahlman & Nielsen, 2003;
Moeller, 2000; Nielsen & Luetke-
Stahlman, 2002; Orlando & Shulman,
1989; Schick & Moeller, 1992; R
Spencer, 2004; Wake, Poulakis, Hughes,
Carey-Sargeant, & Rickards, 2004; Yim,
2011), there are reliability and validity
concerns about using the PPVT with
deaf and hard of hearing students
because some signs are iconic (Geers,
Nicholas, & Sedey, 2003; M. Miller,
2008; White & Tischler, 1999). Sign
iconicity occurs when a sign is visually
similar to the target word, and the sign

VOLUME 158, No. 5, 2014 AMERICAN ANNALS OF THE DEAF

REVIEW OF FORMAL ASSESSMENTS
itself provides context clues from
which an observer could infer the
meaning of the word without having
ever been exposed to the sign (Kon-
stantareas, Oxman, & Webster, 1978).
In other words, even hearing partici-
pants who do not know sign language
could correctly infer the correct pic-
ture based on the sign given by the
examiner. For example, the sign for the
word drum is the action of beating on
a drum with drumsticks, and the sign
for the word tying is the action of tying
a ribbon or lace (M. Miller, 2008).
Because sign iconicity potentially can
inflate scores on an assessment of
overall vocabulary ability (White & Tis-
chler, 1999), it can render an assess-
ment invalid, though, in a study of
preschool children (Moeller, 2000),
mode of communication was not
found to have a significant impact on
PPVT scores. Examiners have tried to
control for sign iconicity by finger-
speliing test items (see, e.g., Krinsky,
1990). But fingerspeliing might also be
problematic, making test items more
difficult than they would be for hearing
children. In addition, M. Miller (2008)
suggests measuring the sign iconicity
of test items by giving the test to non-
signing participants using sign lan-
guage. Appropriate adjustments to test
items can then be made accordingly.
Conversely, although some signs
may be iconic, others do not have a
one-to-one match between signs and
spoken words, which can also make
the test more difficult for children rely-
ing on signs. Not having a one-to-one
match between signs and spoken
words potentially can also invalidate
the PPVT for deaf and hard of hearing
students who sign. For example, for
the Fnglish root word run there are
11 different signs that are dependent
on context (e.g., "The man is running"
versus "His nose is running"). To con-
trol for this, Beal-Alvarez et al. (2011)
preemptively agreed on acceptable
VOLUME 158, No. 5, 2014
signs. Both sign iconicity and muldple
signs for one English word should be
considered when the PPVT is adminis-
tered and its results are assessed.
The Expressive One-Word
Picture Vocabulary Test
(EOWPVT)
According to practitioner surveys, the
second most widely used test with deaf
and hard of hearing students (Luckner
& Bowen, 2006), and the fourth most
widely used test with hearing students
(Caesar & Khler, 2009), is the EOW-
PVT (Gardner, 1981). This norm-refer-
enced test provides age-equivalent
scores and percentiles for hearing stu-
dents ages 2.0-12.5 years (Easter-
brooks & Baker, 2002). A test of
English word meaning, the EOWPVT
is used to assess expressive vocabu-
lary; the administrator asks students to
name the objects, actions, and con-
cepts they see when shown a series of
pictures (Easterbrooks & Baker, 2002;
Prezbindowski & Lederberg, 2003).
Seven empirical studies reported
performance on the EOWPVT as a
dependent variable. All seven studies
also used the EOWPVT in conjunction
with additional language measures
(see Table 2). The EOWPVT is most
commonly paired with the PPVT. Of
the six studies that paired the EOW-
PVT with the PPVT,fiveused additional
tests we do not examine in the present
article (Geers et al, 2008; E. M. Miller,
Lederberg, & Easterbrooks, 2013;
Moeller, 2000; Nielsen & Luetke-
Stahlman, 2002; Tim, 2011); one study
paired the EOWPVT with the TACL
(Yoshinaga-Itano, Baca, & Sedey, 2010).
As is evident from the summary of
these findings, the PPVT and EOWPVT
are only measures of English word
meaning, and additional, more com-
prehensive tests need to be used if a
complete picture is to be obtained of
overall though-the-air "processes and
components of reading" in English,
including phonemes, morphemes,
semantics, syntax, and pragmatics
(Paul, 2003). The importance of stu-
dents having an understanding of all
of the aforementioned facets of Eng-
lish cannot be underestimated, consid-
ering that literacy skills build upon
these "spoken language" skills (Perfetti
&Sandak, 2000).
Clinical Evaluation of
Language Fundamentals
(CELF)
It was found by Caesar and Kohler
(2009) that the third edition of the
CELF (CELF-3; Semel et al., 1995,1996)
was SLPs' most frequently used tool
for assessing language. Luckner and
Bowen (2006) found that it was the
sixth most frequently used formal
assessment among SLPs working
specifically with deaf and hard of hear-
ing students, although the exact ver-
sion was not specified.
The most recent version of the
CELF, the CELF-4 (Semel et al., 2003),
is a comprehensive assessment tool
composed of 18 subtests that measure
total language, expressive and recep-
tive language, language content, lan-
guage structure, and language memory
(Paslawski, 2005; Semel et al., 2003).
The CELF-4 is a norm-referenced test
designed to measure general language
ability and to diagnose and determine
the severity of a language disorder in
hearing students ages 5-21 years. Stan-
dard scores are available for each sub-
test; age-equivalent scores are available
for all but two subtests. To provide a
complement to the formal data pro-
duced through administration of the
CELF, the assessment includes a prag-
matic profile (i.e., authentic assess-
ment; Easterbrooks & Baker, 2002)
that can be completed by teachers and
parents (Semel et al., 2003). The prag-
matic profile complements the litera-
ture regarding language assessment
for deaf and hard of hearing students.
AMERICAN ANNALS OF THE DEAE
which advocates use of authentic
assessmentsincluding language
samplesfor a full understanding of
the language development of a partic-
ular student (Easterbrooks & Baker,
2002; Schick, 1997).
As part of the validity studies for the
CELF-4, a sample of 60 students with
mild to moderate hearing loss took the
test, using amplification devices dur-
ing its administration. No form of sign
language was used to present the test
stimuli or instructions during the
validity studies (Semel et al., 2003).
Researchers had questioned the relia-
bility and validity of the PPVT and
FOWPVT with deaf and hard of hearing
students using a visual-manual form of
communication (Moores 2006/2007),
and they had similar concerns when
administering the CELF. P Spencer
(2004) addressed this issue when
administering the CELF-P:
For children in signing programs,
Fnglish-hound morphemes and gram-
matical words were signed using the
conventions of each child's school.
Because several children were slightly
older than the oldest norm group for
the CELF, standard scores could not
always be legitimately computed.
Therefore, a "percent-of-age" score
was calculated. This was obtained by
calculating an age-equivalent score
for each child based on instrument
norms, dividing this score by the
child's chronological age, and multi-
plying by 100. (p. 399)
Seven empirical studies reported
use of results from administration of
the CELF as a dependent variable (see
Table 2). Semel et al. (2003) recom-
mend supplementing results of the
CELF-4 with those of other formal and
informal measures in order to obtain
an overall evaluation of a student's lan-
guage ability. Indeed, results of the
review for the present article indicate
VOLUME 158, No. 5, 2014
that in 5 of the 7 studies that used the
CELF, researchers also used additional
measures. In fact, in 5 of the 12 studies
in which researchers used more than
one of the target assessments, the
CELF was used.
As seen in Table 3, use of four differ-
ent versions of the CELF was reported
in the literature we reviewed: the
CELF-3, the CELF-4 (Semel et al., 2003,
2006), the revised edition (CELF-R;
Semel et al., 1989), and the preschool
edition (CELF-P; Wiig et al, 1992). Five
studies used the CELF-3, two used the
CELF-4, one used the CELF-R, and one
used the CELF-E Because they were
conducting longitudinal studies, Hay-
McCutcheon, Kirk, Henning, Gao, and
R. Qi (2008) used both the CELF-3 and
CELF-4, and Nielsen and Luetke-
Stahlman (2002) used both the CELF-
3 and the CELF-R.
As also shown in Table 3, four stud-
ies that used the CELF also used
assessments investigated in the pres-
ent article in addition to the CELF. The
tests used in tandem with the CELF
included the EOWPVT, the PPVT, the
OWLS, the Rhode Island Test of Lan-
guage Structure, and the TOLD. Five of
the studies used additional language
assessments not analyzed in our liter-
ature review (see Table 3). Addition-
ally, Nielsen and Luetke-Stahlman
(2002) used language samples in addi-
tion to the CELE. P Spencer, Barker,
and Tomblin (2003) used the CELF as
the sole measure of language.
In two studies, CELF assessments
were administered in the participants'
preferred communication mode (see
Table 3). In one of the studies, tests
were administered through inter-
preters, although it is unclear what
mode the interpreters used. In two of
the studies, the CELF was adminis-
tered in Simultaneous Communication
(SimCom) by means of signed English.
We assume that in the case study by
Nielsen and Luetke-Stahlman (2002),
the CELF was administered by means
of Signing Exact English (SEE). It is also
important to note that three of the
studies used normative scores (Hay-
McCutcheon et al., 2008; Nielsen &
Luetke-Stahlman, 2002; P Spencer et
al., 2003), three used standard scores
(Geers et al., 2008; Murphy & Dodd,
2010; Wake et al., 2004); as previously
mentioned, "percent of age" was used
in the study by P Spencer (2004).
To summarize, when the CELF is
being administered to deaf and hard of
hearing students, it seems that Eng-
lish-based sign can be used to assess
through-the-air English skills without
compromising the integrity of the test
results. Additional assessments such as
vocabulary tests and/or language sam-
ples may be needed to complement
data obtained with the CELF. In the fol-
lowing sections, the three research
questions we posed at the beginning
of the present review are directly
addressed.
Research Question 1:
How^ Avere the Assessments
Adapted and Administered
to Provide Access to Students
Who Need a Visual-Manual
Mode of Communication?
One of the primary objectives of our
review was to determine how through-
the-air English skills are assessed with
deaf and hard of hearing students who
sign. All tests examined in the review
except the GAEL and the Rhode
Island Test of Language Structures
are normed on hearing children. In
this review, the GAEL, which is only
normed on deaf and hard of hearing
children who use spoken English, was
used three times and the Rhode Island
Test was used once (see Table 3). Espe-
cially for the tests that were normed on
hearing students, it is important to
understand how they are most fre-
quently being administered in order to
better determine how the reliability
AMERICAN ANNALS OF THE DEAF
REVIEW OF FORMAL ASSESSMENTS

and validity of the scores were pre- Figure 3

served, and to be able to accurately Frequency of Reference to Different Modes of Communication Used to Administer
interpret the results so that language Assessments

interventions can be implemented and

monitored in the classroom.
Our literature review showed that
researchers administered the tests in
a number of communication modes:
SimCom, Total Communication, man-
ually coded English, SEE, and Seeing
Essential English, generally using the
preferred mode and/or the language
of the school, using spoken English
with no sign, using an interpreter, and
fingerspelling (see Figure 3). Unfortu-
nately, for four of the studies it was
unclear how the tests were adminis-
tered to the signing participants. In
fact, in the two cases in which inter-
preters were used, it is also unclear
what specific mode or modes of com-
munication were used. Further, the
preferred communication method
could have also included any of the
specific modes listed. It can be inferred
that in the study by Nielsen and Luetke-
Stahlman (2002), the tests were admin-
istered in SEE, given that the sole
participant in the case study used that
method of communication, as did her
parents, teachers, and classmates.
Even within the categories listed
here, variations of test administration
were common depending on the stud-
ies' settings, participants, and goals.
Eor example, although some studies
used students' preferred communica-
tion mode, others used spoken and
signed English for all children with
cochlear implants regardless of stu-
dents' communication history (e.g.,
Guo et al, 2013). In the study by Con-
nor, Hieber, Arts, and Zwolan (2000),
spoken English was used and speech-
reading was permitted, but no sign lan-
guage was used regardless of a child's
preferred method of communication.
In Krinsky (1990), because many test
items on the PPVT did not have single-
sign equivalents, the test was adminis-
Mode of Communication
Notes. Preferred communication = preferred mode of communication. SEE = Signing Exact Engiish.
SEE2 = Seeing Essential English. SC = Simultaneous Communication. TC = Total Communication.
tered infingerspellingto control for
between-student variability The stu-
dents were permitted to respond in
their preferred mode; all responded
in ASL
Also important to note is that some
studies used a combination of pro-
cedures for test administration. Eor
example, in E. M. Miller et al. (2013),
"the directions were presented in sign
and spoken language for children who
used sign language, with the stimuli
presented in spoken language only
Simultaneous Communication was
used for the vocabulary tests with
these children" (p. 211). In Ranee,
Barker, Sarant, and Ching (2007), test
administrators only used sign support
when it was needed to maintain inter-
est and cooperation; otherwise, the
test was given orally It is unclear how
this may have affected the results
between subjects. Despite these few
exceptions, it can be concluded that
tests should be administered in the
preferred English-based communica-
tion mode of the student and/or the
communication mode consistently
used by the school.
Research Question 2 :
How Were Reliability and
Validity Preserved?
As discussed above, the effect the var-
ious communication modalities have
on the reliability and validity of formal
assessments is a legitimate concern
(see, e.g., Moores 2006/2007). How-
ever, keeping in mind that the overall
goal is to enable students to have
native-like through-the-air English flu-
ency to ease the process of mastering
print literacy, it seems that the validity
of a measure is less of a concern than
reliability For example, Prezbindowski
and Lederberg (2003) addressed the
issue of using specific communication
modalities in the assessments of Eng-
lish though-the-air: "If the goal is to
assess how well a child would function
within a classroom using a specific
communication modality, then assess-
ment of the child's vocabulary in that
modality or language is sufficient" (p
384). With further respect to validity, it
seems perfectly acceptable to assess
students in their preferred English-
based communication mode as long as
examiners understand that deaf and

VOLUME 158, No. 5, 2014 AMERICAN ANNALS OF THE DEAF

hard of hearing students who have bet-
ter oral/spoken skills will be evaluated
more accurately than those who do
not use oral English primarily (Gold-
stein & Bebko, 2003).
Before reporting her study. Schick
(1997) gave an overview of the assess-
ment of language competence. She
provided a few salient points with
regards to using language measures
that have been normed on hearing
students:
The main difficulty with depending on
tests designed for hearing students to
assess English-language skills in deaf
students is that the tests assume a cer-
tain relationship between overall lan-
guage skills and individual measures
such as vocabulaiy skills and metalin-
guistic knowledge. These relation-
ships may not he the same in deaf and
hearing students. . . . In addition,
issues related directly to deafness and
sign language sometimes make test
items less effective when used with
deaf students, (p. 236)
Schick also stated that test results for
deaf and hard of hearing students are
likely to be below average when com-
pared to those of hearing peers. This is
predictable considering that literacy
skills of students who are deaf or hard
of hearing are also below average
when compared to those of hearing
peers, and considering the relation-
ship between through-the-air sign
skills and literacy skills. Regardless,
Schick argued that the benefit of
employing formal measures of lan-
guage is that they can be more reliably
used to compare information gained
across students than language samples
alone. However, language samples are
an important component in the over-
all assessment process. As did Schick,
Easterbrooks and Baker (2002) recom-
mended that educators obtain and
analyze student language samples to
VOLUME 158, No. 5, 2014
further determine if the formal meas-
ures they used were reliable and valid.
In the studies examined in the pres-
ent review, it is clear that researchers
tried to maintain the reliability of the
various assessments used in several
ways. Beal-Alvarez et al. (2011) col-
lected and established acceptable sign
choices for the PPVT and EOWPVT at
the beginning of a larger ongoing
4-year research project. Geers and
Schick (1988) reported that partici-
pants' scores refiected their best pro-
duction whether signed, spoken, or
both. Still other researchers adminis-
tered the test in some form of English-
based sign and used the normative
data and/or standard scores as
presented in the manual (Hay-
McCutcheon et al., 2008; Murphy &
Dodd, 2010; Nielsen & Luetke-
Stahlman, 2002; Wake et al., 2004;
Yoshinaga-Itano et al., 2010). Connor
et al. (2000) used age-equivalent
scores for the PPVT. Lederberg and
Spencer (2008) used the raw score of
the number of objects labeled cor-
rectly when they gave the GAEL, so
that they could confirm scores with
other test measures (i.e., the Commu-
nication Development Inventory and
the Carolina Picture Vocabulary Test).
Examiners should indicate how the
test was administered and how it was
scored to provide context to the test-
ing environment, so that others can
accurately interpret the results and
compare deaf and hard of hearing stu-
dents' results to those of typically
developing hearing peers. Consistently
administering the test is especially
important to being able to compare
deaf and hard of hearing students
within a program and to compare
annual test results of individual stu-
dentsultimately, this is what makes
assessments reliable.
In summary, if the ultimate goal is to
assessand teachEnglish, then
regardless of modality, tests should be
as reliable and valid for deaf and hard
of hearing students who sign as they
are for hearing students. In order for
this type of reliability and validity to
exist across all schools, additional
research is needed with deaf and hard
of hearing students to determine
appropriate protocols for those with
varying levels of communication skills.
Research Question 3:
How Can the Assessments Be
Used to Guide Both Language
and Literacy Interventions in
the Classroom?
By better understanding deaf and hard
of hearing students' overall language
needs in comparison to those of hear-
ing peers, researchers and practition-
ers can use formal assessments to
guide both language and literacy inter-
ventions in the classroom. First, based
on the results of the present review, it
is clear that language measures that
have been standardized on normally
hearing children can also be used to
assess through-the-air English skills of
deaf and hard of hearing children who
sign. Specifically, formal language
measures allow examiners to compare
these students' ability with that of
hearing peers. This is valuable, espe-
cially considering that 87% of deaf and
hard of hearing students spend at least
part of their day in an inclusive or
mainstream setting (U.S. Department
of Education, 2009). In these cases it is
necessary for deaf and hard of hearing
students to be compared to typical
hearing peers, especially because the
standards (e.g., the Common Core
Standards; National Governors Associa-
tion Center for Best Practices, 2010) for
both subgroups are the same. In addi-
tion, deaf and hard of hearing students
are likely being informally compared to
their hearing peers in the classroom
(Nielsen & Luetke-Stahlman, 2002).
Second, in some of the studies,
these formal measures were used to
AMERICAN ANNALS OF THE DEAF
REVIEW OF FORMAL ASSESSMENTS
compare deaf and hard of hearing stu-
dents who were served within the
same program to monitor individual
student growth from year to year (e.g.,
Hay-McCutcheon et al., 2008; Nielsen
& Luetke-Stahlman, 2002). Finally, with
a comprehensive measure such as the
CELF, various language structures can
be targeted for intervention. Knowing
precisely which essential English skill
areas (i.e., phonology, morphology,
semantics, syntax, and pragmatics) are
strong and which are weak is an essen-
tial step in closing the language and lit-
eracy gaps between students who are
deaf or hard of hearing and hearing
students (Mayer & Trezek, 2011).
Discussion
The purpose of the present study was
to review the literature on current lan-
guage assessment tools being used to
measure the through-the-air English
skills of deaf and hard of hearing stu-
dents who sign. The PPVT, the EOW-
PVT, and CELF are the three most
commonly used measures among deaf
education researchers. The CELF is the
most commonly used overall language
assessment used in practice with hear-
ing students and in research with deaf
and hard of hearing students, yet is the
sixth most commonly used overall lan-
guage assessment in practice with deaf
and hard of hearing students.
We found that, overall, researchers
assessed deaf and hard of hearing stu-
dents with tests normed on hearing
students with, employing a variety of
English-based sign methods. It appears
that using English-based sign does not
interfere with the reliability or validity
of assessment results, although modi-
fications may be needed for certain
test items or subtests. Measuring and
monitoring the through-the-air English
skills of deaf and hard of hearing stu-
dents is an essential component of
improving their language skills and,
therefore, their literacy skills. Only 9
VOLUME 158, No. 5, 2014
of the 28 articles found in our review
were published in journals that target
the field of deaf education. Efforts to
more widely disseminate information
on which assessments are useful and
how to administer them to signing
deaf and hard of hearing students is a
critical next step in bridging research
to practice.
Limitations
The review for the present study
focused on how to assess the through-
the-air English skills of deaf and hard of
hearing students who sign; therefore,
it was not comprehensive to the entire
range and entire population of such
students. For example, Martin and
Bench (1997) investigated adaptations
that were necessary to administer the
CELF to children who had severe and
profound hearing loss but did not use
a form of signed communication, in
regard to the use of conjunctions (e.g.,
before and after). Relevant informa-
tion on the findings of Martin and
Bench might pertain to students who
sign, and should be further investi-
gated. Moreover, the present study
only looked at formal assessments.
Researchers and practitioners also
need to consider how informal class-
room assessments or curriculum-
based measures might be used to
ensure mastery of language skills that
ultimately lead to higher achievement
on standardized measures (Luckner &
Bowen, 2006). For example, a language
sample could be obtained in the natu-
ralistic environment in order to assess
functional communication (Prezbin-
dowski & Lederberg, 2003) and gener-
alization of explicitly taught skills.
Finally, there was subjectivity in the
processes of determining which stud-
ies to include and how the studies
were summarized in Table 3. It is pos-
sible that different scholars might
obtain different results and interpreta-
tions; however, interrater reliability
scores indicate the strength of the
present literature review.
Future Research
Future research that includes the for-
mal assessment of the through-the-air
English skills of deaf and hard of hear-
ing students who sign should qualify
the extent to which the assessments
were adapted or modified so that repli-
cation is possible in both research and
practice. Specifically, the field would
benefit from a more thorough under-
standing of how sign iconicity and
fingerspelling affect the reliability and
validity of testing stimuli. Similarly, pro-
cedures used and interpretations
made on the basis of student respond-
ing should also be evaluated. (That is,
how does varied student responding
in sign and/or voice affect reliability
and validity, and, therefore, the inter-
pretation of the results?)
Future studies that focus on admin-
istering and scoring of the CELF with
students who sign are warranted. Addi-
tionally, although it did not appear to
be routinely done in the studies exam-
ined in the present review, interrater
agreement and treatment integrity
should also be reported on the admin-
istration of assessments just as it is on
participant responses for intervention.
Finally, as suggested by Luckner and
Bowen (2006), future research should
also focus on how to use the data gath-
ered from a formal language assess-
ment to design interventions that will
optimize student growth in the class-
room.
Implications for Practice
If the goal is to teach deaf and hard of
hearing students through-the-air Eng-
lish skills in order to facilitate literacy,
and if these students acquire those lan-
guage skills in a process that is qualita-
tively similar to that for hearing peers
(see the qualitative similarity hypothe-
sis; Paul & Lee, 2010), perhaps practi-
AMERICAN ANNALS OF THE DEAF
tioners should consider the assess-
ment most commonly used by SLPs
who measure these skills in hearing
students (Caesar & Kohler, 2009). The
CELFespecially in comparison to
other measureshas been gaining
popularity in the deaf and hard of hear-
ing research literature in the last 10
years. It shows promise of being able
to provide a comprehensive language
assessment of the English skills (i.e.,
grammar, word meaning, and prag-
matic skills) of deaf and hard of hear-
ing students who sign. Importantly, it
includes a pragmatic profile as one of
its subtests, and the layout of the data
makes it easy to interpret (Semel et al.,
2003) and share results with the vari-
ous professionals responsible for the
language growth and development of
any given student, which is necessary in
an applied setting (Luckner & Bowen,
2006).
It is imperative that both researchers
and practitioners document adminis-
tration procedures and any adapta-
tions made during test administration
to preserve test validity Although the
conclusion may be that tests of
English-language skills that have been
normed on hearing children maintain
their validity when administered in
English-based sign, researchers and
practitioners need to be diligent about
administering the tests consistently,
both within repeated measures with
individual participants and across par-
ticipants over time, to maintain the
reliability of the measures. It is essen-
tial that detailed notesand preferably
video footagebe taken to score inter-
rater reliability on both the implemen-
tation of the assessments and the
responses of the students, in order to
preserve the validity and reliability of
the assessments.
Both Easterbrooks and Baker (2002)
and Luckner and Bowen (2006) em-
phasized the importance of the role
that teachersthe professionals who
VoLUME 158, No. 5, 2014
have the most contact with students
have in understanding how to use
assessment data to drive instruction
and monitor language progress. Such
data can be used to assess how effec-
tive a program is in teaching through-
the-air English skills to their students.
Based on the results of the present
literature review, we encourage clini-
cians, teachers, and administrators
who work with students who are deaf
or hard of hearing to consider the
benefits of using a small battery of
tests including the CELF, the PPVT,
the EOWPVT, and informal language
assessments.
Note
1. For the purposes of the present
article, the term through-the-air refers
to signed and/or spoken English, as
employed by students who use Ameri-
can Sign Language, Simultaneous Com-
munication, Total Communication (i.e.,
speech and English-based sign used at
the same time), or speech only.
References
References marked with an asterisk (*)
indicate studies included in the litera-
ture review.
Akamatsu, C. T, & Stewart, D. A. (1998). Con-
structing Simultaneous Communication:
The contributions of natural sign language.
Journal of Deaf Studies and Deaf Educa-
tion, 3(4), 302-319.
Auer, E. T, & Bernstein, L. E. (2008). Estimating
when and how words are acquired: A natural
experiment on the development of the men-
tal lexicon./owm/ of Speech, Language,
and Hearing Research, 51, 750-758.
*Beal-Alvare2, J. S., Lederberg, A. R., & Easter-
brooks, S. R. (2011). Grapheme-phoneme
acquisition of deaf preschoolers./OM>-wa/ of
Deaf Studies and Deaf Education, 17(1),
39-60. doi:10.1093/deafed/enr030
Caesar, L. G., & Kohler, E D. (2009). Tools clini-
cians use: A survey of language assessment
procedures used by school-based speech-
language pathologists. Communication Dis-
orders Quarterly, 30(4), 226-236.
*Ching, T. Y C, Crowe, K., Martin, V, Day, J.,
Mahler, N., Youn, S., et al. (2008). Language
development and everyday functioning of
children with hearing loss assessed at 3 years
o age. International Journal of Speech-Lan-
guage Pathology', 12(2), 124-131.
*Connor, C. M., Hieber, S., Arts, H. A., & Zwolan,
T A. (2000). Speech, vocabulary, and the
education of children using cochlear
implants: Oral or Total Communication?
Journal of Speech, Language, and Hearing
Research, 43, 1185-1204.
Convertino, C. M., Marschark, M., Sapere, R,
Sarchet, T, & Zupan, M. (2009). Predicting
academic success among deaf college stu-
dents. Journal of Deaf Studies and Deaf
Education, 14(5), 324-343.
*Dodd, B., Woodhouse, L, & Mclntosh, B.
(1992). The linguistic abilities of young chil-
dren with hearing impairment: Eirst report of
a longitudinal study. Australia and New
Zealand Journal of Developmental Disabil-
ities, 18(1), 17-34.
Easterbrooks, S. R., & Baker, S. (2002). Lan-
guage learning in children who are deaf
and hard of hearing: Multiple pathways.
Boston, MA: Allyn & Bacon.
Geers, A. E., & Moog, J. (1989). Eactors predic-
tive of the development of literacy in pro-
foundly hearing-impaired adolescents. Volta
Review, 91, 69-86.
*Geers, A. E., Moog, J., & Schick, B. (1984).
Acquisition of spoken and signed English by
profoundly deaf children./owm/ of Speech
and Hearing Disorders, 49(4), 378-388.
Geers, A. E., Nicholas, J. G., & Sedey, A. L. (2003).
Language skills of children with early cochlear
imphntaiion. Ear and Hearing 24, 46S-58S.
doi: 10.1097/01.AUD.0000051689.57380.1B
*Geers, A. E., & Schick, B. (1988). Acquisition of
spoken and signed English by hearing-
impaired children of hearing-impaired or
hearing parents. Journal of Speech and
Hearing Disorders, 53(2), 136-143.
*Geers, A. E., Tobey, E., Moog, J., & Brenner, C
(2008). Long-term outcomes of cochlear
implantation in the preschool years: Erom
elementary grades to high school. Interna-
tional Journal of Audiology, 47(2), 21-30.
doi: 10.1080/14992020802339167
*Gioia, B. (2001). The emergent language and lit-
eracy experiences of three deaf preschoolers.
International Journal of Disability, Develop-
ment, and Education, 48(4), 411-428. doi:
10.1080/10349120120094293
Goldin-Meadow, S., &Mayberry, R., (2001). How
do profoundly deaf children learn to read?
Learning Disabilities Research and Practice,
16, 222-229.
Goldstein, G., & Bebko,J. M. (2003). The profile
of multiple language proficiencies: A meas-
ure for evaluating language samples of deaf
chdrea. Journal of Deaf Studies and Deaf
Education, 8(4), 452-463. doi: 10.1093/
deafed/engO27
*Guo, L Y, Spencer, L J., & Tomblin,J. B. (2013).
Acquisition of tense marking in English-
speaking children with cochlear implants:
A longitudinal study. Journal of Deaf Stud-
AMERICAN ANNALS OE THE DEAE
REVIEW OF FORMAL ASSESSMENTS
ies and Deaf Education, 18(2), 187-205.
doi: 10.1093/deafed/ens069
*Hay-McCutcheon, M. J., Kirk, K. I., Henning, S.
C, Gao, S., & Qi, R. (2008). Using early lan-
guage outcomes to predict later language
ability in children with cochlear implants.
Audiotogy Neurototogy, 13, 370-378. doi:
10.1159/000148200
Hyde, M. B., & Power, D. J. (1991). Teachers' use
of Simultaneous Communication: Effects on
the signed and spoken components. Ameri-
can Annats of the Deaf 136(5), 381-387.
Konstantareas, M., Oxman, J., & Webster, C.
(1978). Iconicity: Effects on the acquisition of
sign language by autistic and other severely
dysfunctional children. In E Siple (Ed.),
Understanding language through sign lan-
guage research (pp. 213-237). New York, NY:
Academic Press.
*Krinsky, S. G. (1990). The feeling of knowing in
deaf adolescents. American Annats of the
Deaf 135(5), 389-395.
*Lederberg, A. R., & Spencer, E E. (2008). Word-
learning abilities in deaf and hard-of-hearing
preschoolers: Effect of lexicon size and lan-
guage modality. Joumat of Deaf Studies and
Deaf Education, 14(1), 44-62. doi:10.1093/
deafed/ennO21
Luckner, J., & Bowen, S. (2006). Asse.s.sment
practices of professionals serving students
who are deaf or hard of hearing: An initial
investigation. American Annals of the Deaf
757(4), 410-417.
Luckner, J., & Handley C. M. (2008). A summary
of the reading comprehension research
undertaken with students who are deaf or
hard of hearing. American Annals of the
Deaf 153(1), 6-36.
''Luetke-Stahlman, B., & Nielsen, D. C. (2003).
The contribution of phonological awareness
and receptive and expressive English to the
reading ability of deaf students with varying
degrees of exposure to accurate English.
Journal of Deaf Studies and Deaf Educa-
tion, 8(4), 464-484. doi: 10.1093/deafed/
engO28
Marschark, M., & Harris, M. (1996). Success and
failure in learning to read: The special (?)
case of deaf children. In C. Cornolodi & J.
Oakhill (Eds.), Reading comprehension dif-
ficulties: Processes and intervention (pp.
279-300). Hillsdale, NJ: Erlbaum.
Marschark, M., Sapere, E, Convertino, C. M.,
Mayer, C, Wauters, L, & Sarchet, T (2009).
Are deaf students' reading challenges really
about reading? American Annats of the Deaf
154(4), 357-370.
Marschark, M., Spencer, E, Adams, J., & Sapere,
E (2011). Evidence-based practice in educat-
ing deaf and hard-of-hearing children: Teach-
ing to their cognitive strengths and needs.
European Journal of Special Needs Educa-
tion, 26(1), 3-ld.
Martin, L., & Bench, J. (1997). Some observa-
tions on the use of conjunctions when using
VOLUME 158, No. 5, 2014
the CELF-R with hearing-impaired children.
Child Language Teaching and Therapy,
13(1), 73-88. doi: 10.1177/02656590970
Mayer, C. (2007). What really matters in the early
literacy development of deaf children./owr-
nat of Deaf Studies and Deaf Education,
72(4), 411-431.
Mayer, C. (2009). Issues in second-language lit-
eracy education with learners who are deaf
International Journal of Bilingual Educa-
tion and Bilinguatism, 12(3), 325-334.
Mayer, C, & Akamatsu, C. T (2000). Deaf chil-
dren creating written texts: Contributions of
American Sign Language and signed forms of
English. American Annals of the Deaf
145(5), 394-403.
Mayer, C, & Leigh, G. (2010). The changing con-
text for sign bilingual education programs:
Issues in language and the development
of literacy. International Journal of Bilin-
gual Education and Bilingualism, 13(2),
175-186.
Mayer, C, & Trezek, B. J. (2011). New (?) answers
to old questions: Literacy development in
deaf and hard of hearing learners. In D.
Moores (Ed.), Partners in education: Issues
and trendsfrom the 21st International Con-
gress on the Education of the Deaf (pp.
62-74). Washington, DC: Gallaudet Univer-
sity Press.
Mayer, C, & Wells, G. (1996). Can the linguistic
interdependence theory support a bilingual-
bicultural model of literacy education for
Deaf students?yor/ of Deaf Studies and
Deaf Education, 7(2), 93-107.
McGuinness, D. (2004). Early reading instruc-
tion: What science really tells us about how
to teach reading. Cambridge, MA: MIT Press
McGuinness, D. (2005). Language development
and learning to read: The scientific study of
how language development affects reading
skill. Cambridge, MA: MIT Press.
Miller, E. M., Lederberg, A. R., & Easterbrooks,
S. R. (2013). Phonological awareness: Explicit
instruction for young deaf and hard-of-hear-
ing children./owrK/ of Deaf Studies and
Deaf Education, 75(2), 206-227 doi: 10.1093/
deafed/ensO67
Miller, M. (2008). Sign iconicity and receptive
vocabulary testing. American Annals of the
Deaf 152(5), 441-449.
*Moeller, M. P (2000). Early intei-vention and
language development in children who are
deaf and hard of hearing. Pediatrics, 106(3),
1-9. doi: 10.1542/peds.l06.3.e43
Moores, D. (2006/2007). Educational practices
and assessment. American Annals of the
Deaf 151(5), 461^63.
Moores, D., c& Sweet, C. (1990). Relationships of
English grammar and communicative fluency
to reading in deaf adolescents. Exceptional-
ity, 1(2), 97-106.
*Murphy, J., & Dodd, B. (2010). A diagnostic
challenge: Language difficulties and hearing
impairment in a secondary school student
from a non-English-speaking background.
Child Language Teaching and Therapy,
26(3), 207-220. doi: 10.1177/026565900
9349977
National Governors Association Center for Best
Practices. (2010). Common Core state stan-
dards for English/language arts. Washing-
ton, DC: Council of Chief State School
Officers.
Nielsen, D. C, Luetke, B., & Stryker, D. S. (2011).
The importance of morphemic awareness to
reading achievement and the potential of
signing morphemes to supporting reading
development./oMrwa/ of Deaf Studies and
Deaf Education, 16(3), 275-288.
Nielsen, D. C, & Luetke-Stahlman, B. (2002).
The benefit of assessment-based language
and reading instruction: Perspectives from a
case study Journal of Deaf Studies and
Deaf Education, 7(2), 149-186.
Orlando, A., & Shulman, B. (1989). Severe-
to-profound hearing-impaired children's
comprehension of figurative language.
Communication Disorders Quarterly,
12(2), 157-165. doi: 10.1177/1525740189
01200205
Easlawski, T (2005). The clinical evaluation of
language fundamentals, 4th edition (CELE-
4): A review. Canadian Journal of School
Psychology, 20, 129-134.
Paul, E (2003). Processes and components of
reading. In M. Marschark & E Spencer (Eds.),
Oxford handbook of deaf studies, language,
and education (Vol. 1, pp. 97-109). New
York, NY: Oxford University Press.
Paul, P (2011). The perils and benefits of assess-
ment. American Annals of the Deaf 156(4),
339-341.
Paul, P, & Lee, C. (2010). The qualitative similar-
ity hypothesis. American Annals of the Deaf,
154(5), 456-462.
Perfetti, C. A., & Sandak, R. (2000). Reading opti-
mally builds on spoken language: Implica-
tions for deaf readers. Journal of Deaf
Studies and Deaf Education, 5(1), 32-50.
Power, D., Hyde, M., & Leigh, G. (2008). Learn-
ing English from Signed English: An impos-
sible task? American Annals of the Deaf
153(1), 37-47.
Prezbindowski, A. K., & Lederberg, A. R. (2003).
Vocabulary assessment of deaf and hard-of-
hearing children: From infancy through the
preschool years. Journal of Deaf Studies
and Deaf Education, 8(4), 383-400.
Qi, S., & Mitchell, R. E. (2012). Large-scale aca-
demic achievement testing of deaf and hard-
of-hearing students: Past, present, and future.
Journal of Deaf Studies and Deaf Educa-
tion, 17(1), 1-18.
*Rance, G., Barker, E. J., Sarant, J. Z., & Ching, T
Y C. (2007). Receptive language and speech
production in children with auditory neu-
ropathy/dyssynchrony-type hearing loss.
Ear and Hearing, 28, 694-702.
Schick, B. (1997). The effects of discourse genre
AMERICAN ANNALS OF THE DEAF
 on English-language complexity in school-
age deaf students. Journal of Deaf Studies
and Deaf Education, 2(4), 234-251,
*Schick, B., & Moeller, M. R (1992). What is learn-
able in manually coded English sign systems?
Applied Psycholinguistics, 7J(3), 313-340.
*Spencer, R (2004). Individual differences in lan-
guage performance after cochlear implanta-
tion at 1 to 3 years of age: Child, family, and
linguistic hctoK. foumal of Deaf Studies
and Deaf Education, 9{A), 395-412.
doi: 10.1093/deafed/enh033
Spencer, R, Barker, B., & Tomblin, J, B. (2003).
Exploring the language and literacy out-
comes of pdiatrie cochlear implant users.
Ear and Hearing, 24, lid-141. doi; 10.1097/
01 .AUD.0000069231.72244.94
Spencer, P, & Marschark, M. (2010). Evidence-
based practices in educating deaf and hard
of hearing students. New York, NY: Oxford
University Rress.
Tomblin, J. B., Spencer, I.., Flock, S., Tyler, R., &
Gantz, B. (1999). A comparison of language
VOLUME 158, No. 5, 2014
achievement in children with cochlear
implants and children using hearing aids.
foumal of Speech, Language, and Hearing
Research, 42, 497-511.
Traxler, C. (2000). The Stanford Achievement
Test, ninth edition: National norming and
performance standards for deaf and hard-of-
hearing students./oz^r/ of Deaf Studies
and Deaf Education. 5(1), 33-48.
U.S. Department of Education, Office of Special
Education and Rehabilitative Services, Office
of Special Education Rrograms. (2009).
Tluenty-eighth annual report to Congress on
the implementation of the Individuals With
Disabilities Education Act, 2006 (Vol. 1).
Washington, DC: Author.
*Wake, M., Poulakis, Z., Hughes, E. K., Carey-
Sargeant, C, & Rickards, R W (2004). Hear-
ing impairment: A population study of age of
diagnosis, severity, and language outcomes
at 7-8 years. Archives of Disease in Child-
hood, 90, 238-244. doi: 10.1136/adc.2003
.039354
White, A., & Tischler, S. (1999). Receptive sign
vocabulary tests: Tests of single-word vocab-
ulary or iconicity? American Annals of the
Deaf 144(4), 33^^338.
Wilson, T, & Hyde, M. (1997). The use of Signed
English pictures to facilitate reading compre-
hension by deaf students. American Annals
of the Deaf 142(4), 333-341.
*Yim, D. (2011). Spanish- and English-language
performance in bilingual children with
cochlear implants. Otology and Neurotology.
33, 20-25.
*Yoshinaga-Itano, C, Baca, R., & Sedey A. (2010).
Describing the trajectory of language devel-
opment in the presence of severe-to-pro-
found hearing loss: A closer look at children
with cochlear implants versus hearing aids.
Otology and Neurotology, 31, 1268-1274.
*Yoshinaga-Itano, C, & Downey, D. M. (1996).
The psychoeducational characteristics of
school-aged students in Colorado with edu-
cationally significant hearing losses. Volta
Review, 98, 65-96.
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