Knowledge (XXG)

Prelingual deafness

Source 📝

79:, jaundice, and complications associated with the Rh factor in the blood. These nongenetic factors account for about one fourth of the congenital hearing losses in infants while genetic factors account for over half of the infants with congenital hearing loss. Most of genetic factors are caused by an autosomal recessive hearing loss or an autosomal dominant hearing loss. Autosomal recessive hearing loss is when both parents carry the recessive gene, and pass it on to their child. The autosomal dominant hearing loss is when an abnormal gene from one parent is able to cause hearing loss even though the matching gene from the other parent is normal. This can lead to genetic syndromes, such as 159:, and a higher socioeconomic status. Despite being fitted with hearing aids or provided with oral instruction and speech therapy at a young age, prelingually deaf children are unlikely to ever develop perfect speech and speech-reception skills. Some researchers conclude that deaf children taught exclusively through spoken language appear to pass through the same general stages of language acquisition as their hearing peers but without reaching the same ultimate level of proficiency. Spoken language that may develop for prelingually deaf children is severely delayed. 155:, auditory comprehension of speech sounds precedes the development of language. Without auditory input, a person with prelingual deafness is forced to acquire speech visually through lip-reading. Acquiring spoken language through lip-reading alone is challenging for the deaf child because it does not always accurately represent speech sounds. The likelihood of a deaf child successfully learning to speak is based on a variety of factors including: ability to discriminate between speech sounds, a higher than average non-verbal 207:(ASL), is a well known form of communication that is linguistic for both hearing and deaf individuals. Deaf children learning a sign language such as ASL go through a series of language milestones from birth through one year of age. These milestones are similar to those of spoken language. A deaf child is aware of their environment, enjoys human interaction, smiles, and enjoys hand play from birth to 3 months of age. From 3–6 months a deaf child also begins to babble, referred to as finger 117:
as functionally deaf. These children do not develop speech skills without help from a speech pathologist. Such children display speech comprehension difficulties, even when other modes of language (such as writing and signing) are up to their age level standard. Children who lose their hearing after they have acquired some amount of language, even if it is just for a short while, demonstrate a much higher level of linguistic achievement than those who have not had any language exposure.
171:. After a year and a half of experience, researchers found the deaf culture was able to identify words and comprehend the movements of others' lips. There is a greater opportunity to hear a sound depending on the location of electrodes compared to the tissue and the number of remaining neurons located in the auditory system. In addition, individual capacities, as well as the neural supply to the cochlea, play a role in the process of learning with cochlear implantation. 211:. These gestures of the deaf children do not have real meaning, any more than babble noises have meaning, but they are more deliberate than the random finger flutters and fist clenches of hearing babies. Between 6–12 months, deaf children use manual communication and communicate with gestures, such as pulling and pointing. Many deaf children sign their first word around 8 months and up to 10 or more signs by 12 months. 108:
with implants receive a lot of oral educational support. It is a goal for some audiologists to test and fit a deaf child with a cochlear implant by six months of age, so that they don't get behind in learning language. In fact, there are expectations that if children get fit for implants early enough, they can acquire verbal language skills to the same level as their peers with normal hearing.
241:
Deaf students who have deaf parents outperform their deaf peers who have hearing parents on every subtest of the WISC-R performance scale. This is due to the fact that deaf parents are better prepared than hearing parents to meet the early learning needs of the deaf child; thus, they acquire language
196:
for the purpose of expressing what they are feeling. This term refers to gestures that are being used by deaf individuals who were reared in isolation from other deaf signers. Homesign is viewed as a biological component of language because it originates directly from the deaf child and because it is
219:
Learning three-dimensional grammar, such as in ASL, boosts the child's visual and spatial abilities to higher than average levels. To succeed at learning to read, the deaf child must have a strong language to base it upon. Additionally, communication difficulties with the teacher can impair reading.
116:
Children who are prelingually deaf and cannot hear noise beneath 60 decibels—about the intensity level of a vacuum cleaner—do not develop oral language comparable to their peers. Children born with profound hearing impairment, 90 decibels and above (about the level of a food blender), are classified
258:
that were 5-6 times larger than those of hearing adults over the Left and Right occipital regions and ERPs 2-3 times larger than hearing participants over the left temporal and parietal regions (which are responsible for linguistic processing). Because both hearing and deaf adults using ASL showed
237:
Mothers who are deaf themselves model signs during face-to-face interactions with their deaf babies. They mold the hands of their babies to form shapes of signs. They exaggerate their facial expressions and provide models in the direct line of vision of their deaf babies. Caregivers of both hearing
228:
are also reduced in comparison to age-matched hearing children's span for spoken words. Deaf children vary widely in their developmental experience with sign language, which affects development of short-term memory processes. Children who begin language acquisition at older ages and/or have limited
300:
Not being exposed to accessible language at a certain time in early childhood combined with lack of access to the educational and clinical services that expose deaf children to language at the appropriate age are all factors that contribute to language acquisition of prelingually deaf individuals.
287:
Academic achievement of deaf students is predicted to a large extent by the same factors that predict the academic achievement of normally hearing students, such as social class and the presence of additional handicapping conditions. This means that deafness, by itself, does not determine academic
182:
Cochlear implants give deaf individuals the chance to understand auditory messages. Progress was analyzed after several groups of children were given vocabulary and language tests. After three years of practice, the children with the devices did as well as children that had no previous issues with
174:
Research has continuously found that early implantation leads to better performance than older implantation. Studies continue to show that children with prelingual deafness are able to interact in society comfortably when implantation occurs before the age of five. Exposure to non-auditory signals
296:
The deaf children of hearing parents may not have significant exposure to any language in early childhood. Because of their sensory loss, these children perceive little of their parents' speech. Because in most cases the parents do not sign the children are also not exposed to a conventional sign
107:
can stimulate the auditory nerve directly to restore some hearing, but the sound quality isn't that of a normal hearing ear, suggesting that deafness cannot be fully overcome by medical devices. Some say that the benefits and safety of cochlear implants continues to grow, especially when children
175:
prior to implantation may negatively affect the ability to process speech after the implantation. Speech production is a slower procedure in the beginning since creating words requires more effort. Children who had almost two years of experience with cochlear implants were able to generate
229:
language input during early childhood have underdeveloped sign language skill, which, in turn, affects their short-term memory development. However, with the linguistic element removed, deaf children's performance is equivalent to age-matched hearing children on short-term memory tasks.
283:
are at a high risk for not being exposed to accessible language at the right time in early childhood. This is because in most countries poverty translates into a lack of access to the educational and clinical services that expose deaf children to language at the appropriate age.
134:. A child who is exclusively or predominantly an oral communicator can experience social isolation from their hearing peers, particularly if no one takes the time to explicitly teach them social skills that other children acquire independently by virtue of having normal hearing. 26:
that occurs before learning speech or language. Speech and language typically begin to develop very early with infants saying their first words by age one. Therefore, prelingual deafness is considered to occur before the age of one, where a baby is either born deaf (known as
266:
is responsible for language, this implies that sign movement is linguistically salient. The movement processed on the left side (language) implies that the right visual field is stronger in deaf and hearing ASL due to the hemispheric association being
223:
Additionally, deaf children performed more poorly in short-term memory spans for written words in comparison to age-matched hearing children simply because they are not as familiar with English words. Short-term memory spans for signs and
191:
There is an innate desire to produce language in both hearing and deaf population. All babies vocalize to communicate. Deaf children who have not been exposed to sign language create their own gesture communication known as
124:
that is in large part tied to delayed language acquisition (e.g., language deprivation). It is also directly tied to their inability to pick up auditory social cues. A child who uses sign language, or identifies with the
129:
does not generally experience this isolation, particularly if they attend a school for the deaf, but may conversely experience isolation from their parents if they do not know, or make an effort to learn
254:
Deaf children often have enhanced perceptual skills to compensate for the impaired auditory input, and this continues throughout adulthood. Congenitally deaf adults who used sign language showed
43:, of the 3,742,608 babies screened, 3,896 were diagnosed with hearing loss before the age of three months or 1.7 babies per 1,000 births were diagnosed with hearing loss in the United States. 39:
There are approximately 12,000 children with hearing loss in the United States. Profound hearing loss occurs in somewhere between 4 and 11 per every 10,000 children. In 2017, according to the
51:
Prelingual hearing loss can be considered congenital, present at birth, or acquired, occurring after birth before the age of one. Congenital hearing loss can be a result of maternal factors (
91:, which are concomitant with hearing loss. Acquired hearing loss can be the result of toxicity (drugs given as treatment when in the neonatal intensive care unit) and infections such as 991:"Cochlear implantation (CI) for prelingual deafness: the relevance of studies of brain organization and the role of first language acquisition in considering outcome success" 1065: 147:
Deaf children do not acquire speech the same as hearing children because they cannot hear the language spoken around them. Spoken language is based on combining
183:
hearing. Specifically, cochlear implants allow children with prelingual deafness to acquire skills similar to children with minimal or mild hearing loss.
40: 31:) or loses hearing before the age of one. This hearing loss may occur for a variety of reasons and impacts cognitive, social, and language development. 259:
larger ERPs occipital regions, the heightened response to visual stimuli is also due to knowing and using sign language and not only due to deafness.
242:'on schedule'. Additionally, deaf children of deaf parents pass through language development stages earlier because the visual pathways are fully 297:
language. Until recently, education of deaf emphasized speech training and the deaf children also were not exposed to sign language in school.
664: 238:
children and deaf children reinforce the child's early attempts at communication, thus encouraging further and more elaborate communication.
330: 103:
Hearing aids and cochlear implants may make the child able to hear sounds in their hearing range, but do not restore normal hearing.
873: 825: 785: 151:
to form words which are then organized by grammatical rules in order to convey a message. This message is language. In normal
120:
In children, this type of hearing loss can lead to social isolation for several reasons. First, the child experiences delayed
335: 1125:"Cerebral organization for language in deaf and hearing subjects: biological constraints and effects of experience" 346: 470: 179:
and sound out most vowels. They develop skills to understand more information as well as put together letters.
121: 744: 497: 310: 262:
Both hearing and deaf adults using ASL also show larger ERPs over the left than right hemisphere. Since the
255: 204: 1235: 353: 1195: 1136: 1094: 280: 152: 88: 60: 521: 28: 1123:
Neville HJ, Bavelier D, Corina D, Rauschecker J, Karni A, Lalwani A, et al. (February 1998).
1211: 1102: 971: 920: 791: 340: 325: 626: 1203: 1164: 1022: 912: 869: 821: 781: 726: 660: 606: 588: 570: 168: 1154: 1144: 1066:"Deaf couples' babies found to babble with hands Study compares practice to learning sounds" 1012: 1002: 963: 902: 814: 773: 716: 578: 562: 104: 263: 76: 56: 1199: 1140: 1098: 1017: 990: 583: 550: 425: 399: 225: 84: 907: 890: 1229: 1159: 1124: 268: 200: 131: 80: 975: 924: 795: 449: 375: 315: 126: 23: 967: 288:
success or failure but rather interacts with many other factors in complex ways.
1129:
Proceedings of the National Academy of Sciences of the United States of America
949:"The Effectiveness of Cochlear Implants for Children With Prelingual Deafness" 243: 176: 92: 1207: 1007: 574: 721: 704: 148: 1045:
Andrews J, Logan R, Phelan J (2008). "Milestones of Language Development".
1026: 948: 916: 730: 683: 592: 1168: 1149: 777: 320: 208: 193: 72: 68: 64: 1215: 1183: 1106: 471:"Summary of Infants Not Passing Hearing Screening Diagnosed by 3 Months" 52: 167:
Speech perception can be corrected prior to language acquisition with
71:), infections, toxicity (pharmaceutical drugs, alcohol, other drugs), 566: 864:
Mayberry R (2002). "chapter 4". In Segalowitz, Rapin (eds.).
705:"Factors Affecting Psychosocial Adjustment of Deaf Students" 551:"Autosomal recessive nonsyndromic deafness genes: a review" 156: 1085:
Meier R (1991). "Language Acquisition by Deaf Children".
1047:
Advance for Speech-Language Pathologists and Audiologists
426:"Research and Tracking of Hearing Loss in Children | CDC" 246:
at an earlier age than the comparable auditory pathways.
555:
Frontiers in Bioscience: A Journal and Virtual Library
522:"Audiology Information Series: Childhood Hearing Loss" 868:(2nd ed.). Elsevier Science. pp. 71–107. 813: 816:Language development in exceptional circumstances 627:"Hearing Loss at Birth (Congenital Hearing Loss)" 607:"Hearing Loss at Birth (Congenital Hearing Loss)" 678: 676: 989:Campbell R, MacSweeney M, Woll B (2014-10-17). 942: 940: 938: 936: 934: 859: 857: 1040: 1038: 1036: 855: 853: 851: 849: 847: 845: 843: 841: 839: 837: 650: 648: 646: 400:"Speech and Language Developmental Milestones" 807: 805: 8: 749:American Speech-Language-Hearing Association 631:American Speech-Language-Hearing Association 549:Duman, Duygu; Tekin, Mustafa (2012-06-01). 197:a global occurrence, transcending culture. 1118: 1116: 709:Journal of Deaf Studies and Deaf Education 475:Centers for Disease Control and Prevention 430:Centers for Disease Control and Prevention 380:Centers for Disease Control and Prevention 1158: 1148: 1016: 1006: 906: 720: 582: 745:"Effects of Hearing Loss on Development" 1184:"Language Acquisition by Deaf Children" 366: 891:"Implications of prelingual deafness" 770:A Concise Introduction to Linguistics 492: 490: 7: 331:Language exposure for deaf children 16:Deafness before language is learned 812:Bishop D, Mogford K, eds. (1994). 14: 684:"Noise Sources and Their Effects" 659:(7th ed.). Boston: Pearson. 995:Frontiers in Human Neuroscience 947:McKinley AM, Warren SF (2000). 820:(1st ed.). Hove: Erlbaum. 1064:Angier, Natalie (1991-03-22). 655:Gleason JB, Ratner NB (2009). 1: 956:Journal of Early Intervention 908:10.1016/s0140-6736(00)05294-6 768:Rowe, Bruce M. (2015-07-22). 376:"Types of Hearing Loss | CDC" 215:Reading and short-term memory 968:10.1177/10538151000230040501 75:, trauma, low birth weight, 866:Handbook of Neuropsychology 657:The development of language 498:"Deafness and hearing loss" 336:List of notable deaf people 279:Deaf children from a lower 250:Neuropsychological function 112:Social and cognitive impact 1252: 1182:Meier, Richard P. (1991). 450:"Deafness and HearingLoss" 347:The Butterflies of Zagorsk 889:Margolis AC (July 2001). 187:Sign language acquisition 1008:10.3389/fnhum.2014.00834 233:Children of deaf parents 311:Congenital hearing loss 703:Polat F (2003-07-01). 205:American Sign Language 1150:10.1073/pnas.95.3.922 778:10.4324/9781315664491 722:10.1093/deafed/eng018 354:The Language Instinct 275:Sociocultural factors 281:socioeconomic status 153:language acquisition 138:Language acquisition 89:Waardenburg syndrome 61:herpes simplex virus 1200:1991AmSci..79...60M 1141:1998PNAS...95..922N 1099:1991AmSci..79...60M 29:congenital deafness 20:Prelingual deafness 1188:American Scientist 1087:American Scientist 469:CDC (2019-12-04). 424:CDC (2017-10-23). 374:CDC (2019-03-21). 341:Models of deafness 326:Hearing impairment 292:Early intervention 143:Speech acquisition 122:social development 666:978-0-205-59303-3 169:cochlear implants 163:Cochlear implants 105:Cochlear implants 1243: 1220: 1219: 1179: 1173: 1172: 1162: 1152: 1120: 1111: 1110: 1082: 1076: 1075: 1073: 1072: 1061: 1055: 1054: 1042: 1031: 1030: 1020: 1010: 986: 980: 979: 953: 944: 929: 928: 910: 886: 880: 879: 861: 832: 831: 819: 809: 800: 799: 765: 759: 758: 756: 755: 741: 735: 734: 724: 700: 694: 693: 691: 690: 680: 671: 670: 652: 641: 640: 638: 637: 623: 617: 616: 614: 613: 603: 597: 596: 586: 561:(7): 2213–2236. 546: 540: 539: 537: 535: 526: 518: 512: 511: 509: 508: 494: 485: 484: 482: 481: 466: 460: 459: 457: 456: 446: 440: 439: 437: 436: 421: 415: 414: 412: 411: 396: 390: 389: 387: 386: 371: 1251: 1250: 1246: 1245: 1244: 1242: 1241: 1240: 1226: 1225: 1224: 1223: 1181: 1180: 1176: 1122: 1121: 1114: 1084: 1083: 1079: 1070: 1068: 1063: 1062: 1058: 1044: 1043: 1034: 988: 987: 983: 951: 946: 945: 932: 888: 887: 883: 876: 863: 862: 835: 828: 811: 810: 803: 788: 767: 766: 762: 753: 751: 743: 742: 738: 702: 701: 697: 688: 686: 682: 681: 674: 667: 654: 653: 644: 635: 633: 625: 624: 620: 611: 609: 605: 604: 600: 548: 547: 543: 533: 531: 524: 520: 519: 515: 506: 504: 496: 495: 488: 479: 477: 468: 467: 463: 454: 452: 448: 447: 443: 434: 432: 423: 422: 418: 409: 407: 398: 397: 393: 384: 382: 373: 372: 368: 363: 307: 294: 277: 264:left hemisphere 252: 235: 217: 189: 165: 145: 140: 114: 101: 57:cytomegalovirus 49: 37: 17: 12: 11: 5: 1249: 1247: 1239: 1238: 1228: 1227: 1222: 1221: 1174: 1135:(3): 922–929. 1112: 1077: 1056: 1032: 981: 962:(4): 252–263. 930: 881: 874: 833: 826: 801: 786: 760: 736: 715:(3): 325–339. 695: 672: 665: 642: 618: 598: 541: 513: 486: 461: 441: 416: 391: 365: 364: 362: 359: 358: 357: 350: 343: 338: 333: 328: 323: 318: 313: 306: 303: 293: 290: 276: 273: 251: 248: 234: 231: 226:fingerspelling 216: 213: 188: 185: 164: 161: 144: 141: 139: 136: 113: 110: 100: 97: 85:Usher syndrome 48: 45: 36: 33: 15: 13: 10: 9: 6: 4: 3: 2: 1248: 1237: 1234: 1233: 1231: 1217: 1213: 1209: 1205: 1201: 1197: 1193: 1189: 1185: 1178: 1175: 1170: 1166: 1161: 1156: 1151: 1146: 1142: 1138: 1134: 1130: 1126: 1119: 1117: 1113: 1108: 1104: 1100: 1096: 1092: 1088: 1081: 1078: 1067: 1060: 1057: 1052: 1048: 1041: 1039: 1037: 1033: 1028: 1024: 1019: 1014: 1009: 1004: 1000: 996: 992: 985: 982: 977: 973: 969: 965: 961: 957: 950: 943: 941: 939: 937: 935: 931: 926: 922: 918: 914: 909: 904: 900: 896: 892: 885: 882: 877: 875:9780444503602 871: 867: 860: 858: 856: 854: 852: 850: 848: 846: 844: 842: 840: 838: 834: 829: 827:0-86377-308-7 823: 818: 817: 808: 806: 802: 797: 793: 789: 787:9781315664491 783: 779: 775: 771: 764: 761: 750: 746: 740: 737: 732: 728: 723: 718: 714: 710: 706: 699: 696: 685: 679: 677: 673: 668: 662: 658: 651: 649: 647: 643: 632: 628: 622: 619: 608: 602: 599: 594: 590: 585: 580: 576: 572: 568: 564: 560: 556: 552: 545: 542: 530: 523: 517: 514: 503: 499: 493: 491: 487: 476: 472: 465: 462: 451: 445: 442: 431: 427: 420: 417: 405: 401: 395: 392: 381: 377: 370: 367: 360: 356: 355: 351: 349: 348: 344: 342: 339: 337: 334: 332: 329: 327: 324: 322: 319: 317: 314: 312: 309: 308: 304: 302: 298: 291: 289: 285: 282: 274: 272: 270: 269:contralateral 265: 260: 257: 249: 247: 245: 239: 232: 230: 227: 221: 214: 212: 210: 206: 202: 201:Sign language 198: 195: 186: 184: 180: 178: 172: 170: 162: 160: 158: 154: 150: 149:speech sounds 142: 137: 135: 133: 132:sign language 128: 123: 118: 111: 109: 106: 98: 96: 94: 90: 86: 82: 81:Down syndrome 78: 74: 70: 66: 62: 58: 54: 46: 44: 42: 34: 32: 30: 25: 21: 1236:Deaf culture 1194:(1): 60–70. 1191: 1187: 1177: 1132: 1128: 1093:(1): 60–70. 1090: 1086: 1080: 1069:. Retrieved 1059: 1050: 1046: 998: 994: 984: 959: 955: 901:(9275): 76. 898: 894: 884: 865: 815: 769: 763: 752:. Retrieved 748: 739: 712: 708: 698: 687:. Retrieved 656: 634:. Retrieved 630: 621: 610:. Retrieved 601: 567:10.2741/4046 558: 554: 544: 532:. Retrieved 528: 516: 505:. Retrieved 501: 478:. Retrieved 474: 464: 453:. Retrieved 444: 433:. Retrieved 429: 419: 408:. Retrieved 406:. 2015-08-18 403: 394: 383:. Retrieved 379: 369: 352: 345: 316:Deaf history 299: 295: 286: 278: 261: 253: 240: 236: 222: 218: 199: 190: 181: 173: 166: 146: 127:Deaf culture 119: 115: 102: 50: 38: 19: 18: 1053:(2): 16–20. 502:www.who.int 77:prematurity 1071:2024-02-10 754:2020-03-18 689:2012-04-11 636:2020-03-18 612:2012-04-11 507:2020-03-18 480:2020-03-06 455:2012-04-11 435:2020-03-18 410:2020-03-18 385:2020-03-18 361:References 244:myelinated 203:, such as 177:diphthongs 93:meningitis 35:Statistics 22:refers to 1208:0003-0996 575:1093-9946 99:Treatment 1230:Category 1216:29774278 1107:29774278 1027:25368567 976:59361619 925:30550367 917:11458947 796:60995200 731:15448056 593:22652773 534:18 March 321:Deafness 305:See also 209:babbling 194:homesign 73:asphyxia 69:diabetes 65:syphilis 24:deafness 1196:Bibcode 1169:9448260 1137:Bibcode 1095:Bibcode 1018:4201085 1001:: 834. 584:3683827 53:rubella 1214:  1206:  1167:  1157:  1105:  1025:  1015:  974:  923:  915:  895:Lancet 872:  824:  794:  784:  729:  663:  591:  581:  573:  47:Causes 1212:JSTOR 1160:33817 1103:JSTOR 972:S2CID 952:(PDF) 921:S2CID 792:S2CID 525:(PDF) 404:NIDCD 59:, or 1204:ISSN 1165:PMID 1023:PMID 913:PMID 870:ISBN 822:ISBN 782:ISBN 727:PMID 661:ISBN 589:PMID 571:ISSN 536:2020 529:ASHA 256:ERPs 1155:PMC 1145:doi 1013:PMC 1003:doi 964:doi 903:doi 899:358 774:doi 717:doi 579:PMC 563:doi 87:or 41:CDC 1232:: 1210:. 1202:. 1192:79 1190:. 1186:. 1163:. 1153:. 1143:. 1133:95 1131:. 1127:. 1115:^ 1101:. 1091:79 1089:. 1051:18 1049:. 1035:^ 1021:. 1011:. 997:. 993:. 970:. 960:23 958:. 954:. 933:^ 919:. 911:. 897:. 893:. 836:^ 804:^ 790:. 780:. 772:. 747:. 725:. 711:. 707:. 675:^ 645:^ 629:. 587:. 577:. 569:. 559:17 557:. 553:. 527:. 500:. 489:^ 473:. 428:. 402:. 378:. 271:. 157:IQ 95:. 83:, 67:, 63:, 55:, 1218:. 1198:: 1171:. 1147:: 1139:: 1109:. 1097:: 1074:. 1029:. 1005:: 999:8 978:. 966:: 927:. 905:: 878:. 830:. 798:. 776:: 757:. 733:. 719:: 713:8 692:. 669:. 639:. 615:. 595:. 565:: 538:. 510:. 483:. 458:. 438:. 413:. 388:.

Index

deafness
congenital deafness
CDC
rubella
cytomegalovirus
herpes simplex virus
syphilis
diabetes
asphyxia
prematurity
Down syndrome
Usher syndrome
Waardenburg syndrome
meningitis
Cochlear implants
social development
Deaf culture
sign language
speech sounds
language acquisition
IQ
cochlear implants
diphthongs
homesign
Sign language
American Sign Language
babbling
fingerspelling
myelinated
ERPs

Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.