“…Particularly in cases where there is little to no sign language used in a hearing-status mismatched parent-child dyad, as is often the case with children who are candidates for cochlear implantation, the establishment of joint attention can serve as an important scaffold for children to learn about communicative intent, as is the case for children in hearing-status matched dyads. Thus far, researchers have focused on hearing-mismatched parent-child dyads to identify strategies used by parents to engage children's attention (Gale & Schick, 2009;Lieberman et al, 2014), characterize parents' adaptive social behaviors (Nowakowski et al, 2009), and compare overall amounts of joint attention across dyad types (i.e., hearing parent-deaf child, hearing parent-hearing child, and deaf parent-deaf child) (Nowakowski et al, 2009;Spencer, 2004;Spencer et al, 1992). Although these studies generally include small sample sizes and children with highly heterogeneous hearing issues, their findings show that while hearing parents are sensitive to deaf children's communicative efforts, the overall rate of maternally initiated joint attention is lower in hearing status-mismatched dyads.…”