Effective practices in teaching indigenous students with conductive hearing loss.

Hearing impairment due to conductive hearing loss can have a devastating effect on children's language development, and consequently educational outcomes, especially for Indigenous students, for whom there may be the additional issue of being educated in their second or third language. With appropriate interventions, however, Indigenous students with conductive hearing loss can achieve high standards of written literacy and do well at school. This article will outline some of the key findings to date from a longitudinal study (1) investigating effective teaching strategies to improve the literacy, and hence educational, outcomes of Australian Indigenous students with conductive hearing loss (CHL). Drawing on both qualitative and quantitative data, the research has identified a number of teaching strategies that are likely to assist in improving educational outcomes (especially in relation to early literacy skills) and examined the influence of the broader school environment.

One common cause of hearing impairment in children worldwide is conductive hearing loss (CHL) as a consequence of otitis media (OM) during the preschool years, especially for indigenous children (2) (Higgins, 1997; W. A. Otitis Media Group, 1993). Among Australian Indigenous children, the incidence of conductive hearing loss as a result of otitis media (middle ear disease) ranks among the highest in the world (McPherson & Knox, 1992), and up to 70 percent of children are likely to be affected (Couzos, Metcalf, & Murray, 2001). The prevalence of otitis media/conductive hearing loss in urban Australian Indigenous children is higher than in the general population and children in remote areas are at even greater risk (Couzos et al., 2001).

Otitis media/conductive hearing loss occurs earlier, lasts longer, and recurs more frequently among Australian Indigenous children than among other populations (Boswell, 1997; Kelly & Weeks, 1991). These children may have their first bout of otitis media soon after birth and continue to experience the disease throughout childhood. This is a critical time for acquisition of language, communication skills, and literacy skills.

Language Development of Children With Conductive Hearing Loss

Conductive hearing loss has a negative effect on language development. One significant contributing factor is its fluctuating condition, meaning children receive variable input rather than a consistent model of language (Walker & Wigglesworth, 2001). Further, conductive hearing loss can affect children's development of auditory discrimination and processing skills, phonological awareness, short-term auditory memory skills, and auditory sequential memory skills (Nienhuys & Burnip, 1988; NSW Health Department Working Party on Ear Disease in Aboriginal Children, 1996). Ultimately, this affects the ability of a child to perform well in tasks requiring literacy and numeracy skills. This, in turn, may cause children to become disinterested in school and attend school less regularly. Consequently, they become less adept at recognizing classroom routines and less able to use the contextualized cues that arise from familiarity with those routines to enhance comprehension. This can affect not only schoolwork but also social interaction, leading to inappropriate social behavior, and other negative behaviors such as irritability, disobedience, distractibility, and overactivity, which, in turn, can lead to social isolation (Lowell, 1993). The correlates of this affliction, therefore, include school failure, absenteeism, early school dropout, and reduced employment opportunities. For many Australian Indigenous students, the influence of language and cultural differences compounds the difficulties caused by conductive hearing loss.

Most Australian Indigenous students speak either a different first language from English, or alternatively speak a dialect of English (Aboriginal English). Some students use Standard Australian English (SAE) only when they are at school, and so are at a disadvantage compared to the majority of non-Indigenous students for whom SAE is the first language. Because the language acquisition of the family does not mirror the school language, it is likely that many Australian Indigenous students have less familiarity with the sounds and structures of SAE than most mainstream Anglo Australian students do.

Associated with language differences are marked cultural differences, which can make adjustment to the world of the classroom difficult for many Australian Indigenous students. The majority of these students come from cultural backgrounds quite different from those of their teachers (Harris & Malin, 1994; Partington, 1998) and many do not speak English at home (Christie, 1985; Malcolm, Kessaris, & Hunter, 2003). For many, particularly for children in the early years of school, the classroom is a foreign environment where they are alienated and unsuccessful (Malin, 1990). Also, participation in school can be interrupted by family commitments to such events as funerals and ceremonies. Irregular attendance as a consequence of these and other factors can compound the intermittent acquisition of language due to episodes of OM/CHL, and increase the disadvantage for students in literacy learning. Furthermore, the availability within the family of literacy learning resources (e.g., books, magazines, and language games) that are commonly available to non-Indigenous students is much more limited for Indigenous students.

Thus, otitis media is a medical problem with significant educational and social implications, but there has been little research into effective instructional techniques to combat the hearing-loss problems associated with otitis media (but see Howard, 1991; Lowell, 1993; O'Brien & Burnip, 1993). The main solution employed to date has been classroom amplification systems. Few teachers have been exposed to strategies they can employ with, or in the absence of, such systems. Implementing educational interventions to overcome the negative effects of this disease can be expected to improve Indigenous students' success at school and subsequent academic and employment opportunities. However, it is also important to take account of the wider school environment in which literacy development takes place and to consider broader contextual factors that may impact on the achievement of Australian Indigenous students in literacy development.

The strategies that formed the focus of the present project can be grouped into several main areas:

* Classroom management (e.g., modifying the classroom environment to minimize noise; organizing class seating arrangements to maximize listening so that, for example, children with CHL are seated close to the speaker and can see the speaker clearly, to enable them to use nonverbal cues to assist comprehension; using routines to enable children with CHL to predict what will happen next)

* Increasing student awareness of hearing problems, and of the factors in the classroom environment that adversely affect hearing, and helping them to become more responsible for the quality of their own learning environment

* Developing the language skills that underlie written literacy (phonological awareness; explicitly linking sounds to written language; text level skills; and semantic or "world" knowledge)

* Using a variety of teaching methods (e.g., one-to-one; small group; whole group).

In addition, information was collected about the broader school context. These data included interviews with school administrators, specialist literacy teachers, school health personnel, and similar people.

Description of the Project

The project from which the data in this article come had as one of its aims the identification of teaching strategies and school environments that would enhance the outcomes in written literacy of Australian Indigenous students in Preschool to Year 3 (ages 5-8 years). The project was conducted in Western Australia, a state whose area covers approximately one million square miles. Sixteen schools, and 80 teachers and teaching assistants, were involved in the research. Over 500 Indigenous students were in participating classes over the duration of the project.

In an interactive and iterative process, the researchers gathered information on student ear health and educational achievement pre- and post-intervention; provided professional development for teachers on desirable strategies (obtained from the literature and prior planning with speech pathologists and curriculum writers; e.g., Department of Education, 2002); and followed the course of change in each classroom through recording lessons, interviewing teachers, and analyzing documents regularly over the two years of the project.

To identify effective teachers, the project investigated the proportion of participating students with conductive hearing loss in their classes who had consistently shown improved achievement in literacy skills, or were consistently achieving age-relevant targets for literacy performance (e.g., mastery of skills as assessed by Literacy Net, Education Department of Western Australia, 2000). Data maps (see below) from these teachers then were analyzed to identify common characteristics that contributed to student achievement. The strategies ranged across a broad spectrum of classroom practice, and the most effective teachers used a wide range of strategies to achieve the best outcomes.

Teacher Preparation. All of the teachers received professional development at the start of their involvement in the study and throughout its duration. Professional development was assumed to be a complex process (Fullan, 2001) involving, among other things, teacher commitment, pressure to implement the strategies, the development of relationships with the change agents, and a perception that the change was highly desirable (Garet, Porter, Desimone, Birman, & Yoon, 2001; Richardson & Placier, 2001; Showers, Joyce, & Bennett, 1987). The initial professional development (PD) encompassed an overview of otitis media and conductive hearing loss and its consequences, the physical classroom environment, and the teaching methods. Following the initial PD session, teachers were visited regularly throughout the project to monitor implementation of the strategies and provide feedback on their efficacy. In addition, the expectations for the teachers' practice were made clear so that in subsequent visits they felt pressure to implement the practices (Fullan, 1995).

Data Gathering. A significant feature of data gathering was the use of a data mapping strategy. Researchers routinely sat in on classes, identifying the employment of specific strategies as they occurred. The observations were subsequently mapped and the teaching strategies observed were discussed with teachers individually. The resulting data maps provided an overview of teaching emphases of individual teachers and of the whole group.

The most effective teachers utilized the data maps to engage in their own analysis of their work, and to ensure they were employing methods that were effective, according to the literature, for teaching students with conductive hearing loss. Although this was a case of research reflexivity, it was an integral part of the study, as the researchers were expected to feed their findings back into schools as the study progressed. Analysis of the data maps identified a range of characteristics and factors that contribute to effective literacy teaching for Australian Indigenous students with conductive hearing loss. It is outside the scope of the present article to discuss all these characteristics and factors--these will be the subject of forthcoming publications. The focus here will be on an overview of the characteristics of the learning environment that contribute to effective teaching of Australian Indigenous students with CHL.

Characteristics of Effective Literacy Learning Environments

The study identified two major characteristics of effective literacy learning environments.

Language Development. An important characteristic of the effective teachers was their focus on language development, especially on the development of the oral language skills that underlie written literacy. These skills include explicit teaching of phonological awareness skills (e.g., rhyme and rhythm; syllable segmentation; and production and reception of the sounds of SAE in all word positions, which is particularly important when some SAE sounds do not form part of the sound repertoire of Australian Indigenous languages or of Aboriginal English). The language skills these teachers emphasized need to be learned by all children in the early years of literacy development, but the effective teachers of Australian Indigenous students with CHL continued to use these strategies beyond Pre-primary/Year 1, recognizing that some of the language experiences and skills needed for success in written literacy have not been part of the preschool experiences of many Australian Indigenous children and that, therefore, they will need more time to establish a firm foundation of these skills.

As would be expected, there was also a focus on such text level skills as development of vocabulary, familiarity with parts of speech, sentence structure and different text genres, and the ability to produce and comprehend extended language. Effective teachers also explicitly linked sounds to the written language to confirm the link between spoken and written language. What marked these teachers as different from less effective teachers was their continued explicit emphasis on phonological skills concurrently with the development of text level skills. Less effective teachers either assumed their students already had adequate phonological awareness skills by about their second year of formal schooling, and did very little formal work on developing those skills, or else felt driven by the curriculum to move to develop students' knowledge of different genres, regardless of whether the children would be able to handle those linguistic demands.

Effective teachers also demonstrated their awareness of the need for Indigenous students to acquire "world knowledge." Developing "world knowledge" encompasses a variety of aspects of language use, including knowledge of the way language works, the different ways of using language in different contexts, and the life experiences that enable children to make sense of what they are reading and hearing about, as well as building on children's existing experiences. Teachers provided information to students that enabled them to use SAE in various social contexts in ways that were appropriate for the setting. In addition, they informed students of the meanings of diverse concepts that may have been unfamiliar in their first language and culture (e.g., the different family relationships in Anglo-Australian society that required the use of different relational terms, particularly the more restricted use of such terms as "uncle" and "aunty" in SAE).

Normally, emphasis on the above elements of instruction would diminish as the child proceeded from Year 1 to Year 2 and beyond. However, because of the linguistic, cultural, and social differences that exist, Indigenous students are more likely to need attention to these elements well into the middle years of primary schooling. It was this ongoing emphasis that distinguished the effective teachers in the study.

Placing Teaching in Context. The effective teachers were able to demonstrate responsiveness to students' first language and home background by a diversity of practices that related the acquisition of literacy learning to the specific cultural and linguistic needs of the students. Explicitly teaching the differences between home ways and school ways (e.g., ways of showing that one is listening); explicitly teaching the difference between the child's first language and Standard Australian English; and using appropriate nonverbal cues so the students were able to respond effectively were attributes of effective teachers in this study.

Observations of classroom practice also indicated that the effective teachers used a range of strategies that were compatible with what are regarded to be Indigenous interaction styles (Christie, 1985; Frigo et al., 2004; Harris, 1987). These styles included:

* The use of indirect questions, the use of information-seeking questions (seeking information the teacher genuinely did not have) rather than display questions (that is, questions to which the teacher already knew the answer, but asked for such purposes as testing the students' knowledge, or revealing whether the students were paying attention, or to control students)

* The use of group work and peer tutoring 

* Allowing for longer wait times

* Positive rather than negative reinforcement (Galloway, 2002, 2003a, 2003b).

Through the use of these styles, the teachers were contributing to creating a classroom environment that respected different ways of interacting, and helping to scaffold the children as they learned how to operate within a mainstream educational environment that was culturally different from that with which they were familiar from home.

Conclusion

The early years of schooling are a particularly important time for literacy development, so if children get a good foundation at that time, they are much more likely to be successful in later years of education. If they do not have a good foundation of reading skills by the time they reach about Year 3-4, they will fall behind their peers, because by then learning comes to depend upon reading. Solid foundations in written literacy are especially important for Indigenous students not only for the reasons above, but also so they can be successful in their own culture, as well as in the mainstream.

It was heartening to find that the teachers who adopted the strategies identified in the professional development sessions during the study were those who were the most effective as teachers of Indigenous students with CHL. However, the researchers cannot claim full responsibility for the outcomes. Success was most evident in schools that demonstrated support for their teachers and promoted a collegial atmosphere and a well-structured plan of intervention in language development. Most effective teachers tended to work in the most effective schools, where they were encouraged to explore innovative approaches to instruction and were supported by skilled teachers and additional resources to engage students more effectively. Even so, attention to the specific skills related to literacy acquisition for Indigenous students identified in this study can enhance their learning considerably.

(1) The study Teaching Indigenous students with conductive hearing loss in remote and urban schools in Western Australia was funded by an Australian Research Council (Strategic Partnerships with Industry--Research and Training) (ARC SPIRT) Grant and the following industry partners: the Department of Education, Western Australia, Catholic Education Commission, Western Australia, and Aboriginal Independent Community Schools, Western Australia.

(2) For clarity in this paper, the term "indigenous" will be used when referring to indigenous people generally, not those of a specific geographic area; when talking about specifically about Australian Indigenous and TorresStrait Islander people, the term "Australian Indigenous people" or Indigenous will be used.

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Gary Partington is Associate Professor and Director, Centre for Indigenous Australian Knowledges, and Ann Galloway is a Post Doctoral Fellow, Kurongkurl Katitjin: School of Indigenous Australian Studies, Edith Cowan University, Mount Lawley, Western Australia.