The articles reviewed were published between 1971-2016. The trend of the research methodologies used in research on the play of children who are deaf showed that the research design used mostly in the period between 1970 and 1999 was predominantly quantitative methods. Articles published after 1980 employed qualitative research method. See Figure 3. For the methodological trend in research on the play of children who are deaf.
7.2. Targeted Population
7.3. Research Trend
The review showed an increase in the number of articles published that focus on the play of children who are deaf in more recent years (see Figure 4). The increase suggests a growing interest in research on children’s play that existed in the period between 1980 and 1999. Also, the review showed a significant decline in research on play of children who are deaf between 2000-2009. Despite the recent increase from 2010, there is still a need to examine play of children who are deaf and to focus on the current needs of children who are deaf and are ASL/English bilingual bimodal and those with cochlear implants.
7.4. Research Focus
The data analysis identified six focus area including; play behaviors, communication during play, language and play, play interactions, play and literacy and play and therapy. Figure 5 shows the number of studies and the research focus.
7.5. Language, Literacy, and Play
Play in ECE programs is a tool to support language and literacy development. The only one study that focused on the use of children play in developing literacy skills reported its effect of on students’ storybook reading skills (Pataki, Metz, & Metz, 2014) . The review noted there were limited studies that explored language, and play of children who are deaf ( Casby & McCormack, 1985;
Cornelious and Hornett (1990) noted that language and play of children who are deaf varied with the play context. In Lederberg (1991) study children with high language ability were observed to engage in triadic interactions with teachers and other peers and preferred play partners with similar language ability. A more recent play by Quittner et al. (2016) found that children who had early implantation had early access to spoken language which impacted their symbolic play and novel noun learning. There were only two studies that occurred in an ASL English bilingual play environment (Musyoka, 2015a, b) . Musyoka’s (2015a) study echoed the findings by Lederberg (1991) that the play partners influenced the use of language during play. Contrarily, Musyoka’s (2015b) findings conflicted previous findings on the social and cognitive play behaviors of a deaf child. In Musyoka’s study, the deaf child in a bilingual program demonstrated similar behaviors as those reported in research with hearing children. Earlier studies had reported low social and cognitive play behaviors.
8. Discussion, Conclusion, and Future Implications
The earliest studies that focused on the play of children who are deaf dated back to 1970s (Arnold & Tremblay, 1979; Brackett & Henniges, 1976; Darbyshire, 1977; Kretschmer, 1972) . Among hearing children, although there is evidence of research on children play as early as the 1920s and 1930s (Bott, 1928; Green, 1933; Parten, 1933 ), the 1970s were a prolific period regarding research on children’s play (Sutton-Smith, 1983) . This suggests there was a delay in investigating play of children who are deaf. The delay in research on deaf children may explain why most research on deaf children’s play employed comparative research methodologies. The choice of comparative research methodology is noted in several studies that examined play of children with special needs (Merry, 1933; Singer & Streiner, 1966; Cowan, 1972) . Therefore, previous research interest on children with special needs was not to understand the children’s play behaviors but to understand how they deviated from their peers who were considered the “norm”.
The majority of the research in this review focused on social aspects, and cognitive aspects observed in play behaviors of children who are deaf. Only one study focused on literacy development (Pataki, Metz, & Metz, 2014) . The absence of research on play and literacy among children who are deaf is unexpected finding because play in ECE has not only been associated with the whole child’s development but with the development of literacy skills. Also, the absence deviates from what was observed in earlier studies of young hearing children’s play that examined literacy skills within play context (Cook 2000; Johnson, Christie, & Wardle 2005; Gmitrova & Gmitrova, 2003; Pederson, Rook-Green, & Elder, 1981; Pellegrini, 1980; Saltz, Dixon, & Johnson, 1977; Saracho, 2001, 2004; Yawkey, 1981; Wolfgang, 1974) . In fact, as early as 1983 there was a compiled review of literature that focused on play as a vehicle for developing literacy in young children (Isenberg & Jacob, 1983) .
Although previous research showed interplay of language, cognition and social interaction such as play (Connolly, Doyle, & Reznick, 1988; McCune-Nicolich, 1995; McCune-Nicolich, 1981; Piaget, 1962) , the current review noted a lack of research on the play where language access and use were considered critical. In most of the studies examined reference was made to the type of communication system the students used as opposed to their language ability and use. Since deaf students can either access language using an auditory modality or visually modality or bimodal, there is a need for studies that address how students access language, their language ability and the nature of play observed.
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