A summary of the 2019 First Signs Evaluation

This evaluation identified the outcomes of Deaf Aotearoa’s First Signs service, through document analysis, a literature review, and views of families who are currently or ever part of First Signs service, Advisors on Deaf Children (AODCs), two leaders of the First Signs service, and then interviews with a sample of families.

113 families participated in an online and paper-based survey that asked what they thought of the outcomes for their child (28% response rate).

33 AODCs participated in an online survey that asked for their opinion of the outcomes for the children on their caseload (83% response rate).

This evaluation concluded that First Signs provides a valuable service that has significant social impact on its service users, for both child and the family. Overall, feedback from the survey and interviews suggest that the First Signs service has had substantial impact on the well-being, identity, and communication skills of deaf children.

Outcomes
Aligned with the evaluation of three other similar international services, most families and AODCs agree that First Signs helps to:

  • Teach families how to communicate visually, and helps with overall communication
  • Teach deaf children to communicate what they want to say
  • Teach families how to sign with their child
  • Provide greater awareness of deaf people’s experiences and abilities
  • Make families feel more confident and able to support their child
  • Make families feel more positive about their child’s future
  • Helps children start school with age-appropriate language, including spoken language
  • Helps develop strong self-esteem in children.

Families found learning to sign was also helpful for children with aided hearing and good speech, particularly at times when hearing was difficult, safety was an issue, or the English word was not known.

Slightly more Māori whānau participants, in comparison to other ethnicities, joined First Signs so their child could start school with age-appropriate communication, learning about raising a deaf child, and learning about Deaf lives. Although some caution should be used when assessing these results, it may be that tangata whenua are more sensitive to cultural approaches in working with deaf people, given their own experience of marginalisation.

First Signs outcomes are providing an avenue for children who are deaf and hard of hearing (deaf children) to learn a language and be more connected to their family. By these means, First Signs is helping to reduce language delays, poor educational outcomes, isolation of the deaf child from their family, parent distress, and development of mental ill health.

Significant numbers of deaf children can now learn language and become educated at levels similar to their hearing peers. This is not due to the First Signs service alone, but rather the combination of services focused on addressing the effects of deafness, including early identification, advanced technology support through cochlear implants and hearing aids, Advisors, as well as early access to sign language. Together, these mean that real options are now available for families.

In a Language Outcome Report provided by the Ministry of Education, nearly half (48%) of a sample of 100 deaf children at age four and a half to five, including some children who had received First Signs support, demonstrated language abilities at or above their current age level when compared with their same age peers. A further 18% did not have a significant language delay when compared with same age peers.

Together with Language Outcome Report data, developing NZSL assessments undertaken by First Signs facilitators, will provide a systematic approach to measuring the linguistic progress of deaf children in the future.

Areas for improvement
Although First Signs provide a service much loved by a large majority of families and Advisors, some areas for improvement were identified that would further improve the service’s outcomes:

  • More service, more frequency, and more in preschool and school settings, and in more remote areas.
  • More opportunities for time-poor families to meet.
  • More training for some facilitators, to support family centred approaches including:
    • flexibility in the programme’s goals, times, and curriculum to suit families’ situations
    • increases in diplomacy for some facilitators to ensure parents do not have to defend their choices.

This training and support may also help to reduce staff turnover within First Signs.

While there is clearly considerable collaboration between the various services to deaf children, there is also some indication from families, AODCs and First Signs that there are areas to improve, particularly on transitions to preschool and school.

The numbers of families choosing First Signs have increased over time. Currently, roughly 17% of deaf children receiving Advisor services are accessing First Signs service, in comparison to a study that found a third of local parents choose to incorporate sign language in their support packages. Regular evaluations or monitoring will show if the numbers continue to increase over time.

The findings of this review, based on data from families and Advisors on Deaf Children, validates the outcomes supported by First Signs. This evaluation concludes it is largely working very well and is much needed and appreciated by families and AODCs. It provides guidance for service improvement focused on family centred approaches and transition planning with AODCs.

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