Co-regulation between young deaf and hard-of-hearing children and their caregivers: study protocol of Calming Together

BACKGROUND: Children who are deaf and hard-of-hearing (DHH) often experience more difficulties with self-regulation than their typical hearing peers. Self-regulation develops partly through internalization of regulation strategies provided by their caregivers during co-regulation. Co-regulation is a dynamic process through which caregivers and children influence and regulate each other's emotions and physiological responses. Given the essential role of co-regulation in the development of self-regulation it is important to investigate co-regulation in DHH children and their caregivers, given the limited research that has examined this subject. The present paper describes a study, Calming Together, which aims to examine co-regulation in 2- and 3-year-old DHH children and their parents, investigating how different facets of child and parent self-regulation such as temperament, executive function (EF), general self-regulation, and sleep are related and how they contribute to co-regulation.

METHODS: Calming Together will be a longitudinal study with data collected at three points in time. Participants will include 2- and 3-year-old children with permanent bilateral hearing loss, along with their parents. Measures at Time 1 will include (a) child EF assessment, (b) an observation of parent-child interaction, and (c) parental questionnaires. Parents will also receive equipment and instructions so that they can complete an assessment of sleep using actigraphy and a sleep diary. At Time 2 and Time 3, completed three and six months after the home visit, parents will complete questionnaires on self-regulation and co-regulation.

DISCUSSION: The Calming Together study will be among the first to investigate co-regulation in young DHH children and their parents in ecologically valid home settings. By assessing both parent and child factors, it will provide insights into how co-regulation unfolds in daily life and how it relates to broader aspects of self-regulation. The study will also include both mothers and fathers to investigate their potentially unique contributions toward co-regulation and the development of self-regulation in DHH children. Findings may inform early intervention strategies to support parent-child interactions and enhance self-regulation in DHH children. The study was retroactively registered in Open Science Framework (OSF) on April 15th 2025 ( https://doi.org/10.17605/OSF.IO/CHEKA ).