The strengths and weaknesses in verbal short-term memory and visual working memory in children with hearing impairment and additional language learning difficulties

Language profile of children with cochlear implants: comparative study about the effect of age of cochlear implantation and the duration of rehabilitation

PURPOSE

The analysis of different language domains and exploration of variables that affect the outcomes of cochlear implantation would help to document the efficacy of cochlear implantation and intervention programs. The aim of this work was to examine the language profile of children with Cochlear Implants (CI) and to assess the effect of age at the time of cochlear implantation and the impact of duration of rehabilitation on the development of linguistic abilities for cochlear implanted children.

METHODS

The study was conducted on 46 Arabic speaking children using unilateral CI who are receiving regular post-cochlear auditory and language rehabilitation in the phoniatrics unit, Kasr Alaini hospital. A Proficient Preschooler Language Evaluation (APPEL TOOL) was applied for the assessment of different language domains.

RESULTS

Children who received post implant rehabilitation for ≥ 2 years showed significant improvement in all subtests' scores of APPEL tool than children who received same rehabilitation for ≤ 1 year. There was no significant difference of language scores between children who have received CI before age of 3 years and those who have been implanted after age of 3 years.

CONCLUSION

This study showed that the language profile of CI children was beneficially affected by the longer duration of therapy post implantation.

Arabic phoneme-grapheme correspondence by non-native, deaf children with cochlear implants and normal hearing children

OBJECTIVE

This study aimed to compare the error patterns of Arabic phoneme-grapheme correspondence by a group of Malay children with cochlear implants (CIs) and normal hearing (NH) and the effects of the visual graphical features of Arabic graphemes (no-dot, single-dot, and multiple-dots) on the phoneme-grapheme correspondence.

METHODS

Participants were matched for hearing age (Mean, M = 7 ± 1.03 years) and duration of exposure to Arabic sounds (M = 2.7 ± 1.2 years). All 28 Arabic phonemes were presented through a loudspeaker and participants pointed to the graphemes associated with the presented phonemes.

RESULTS

A total of 336 and 616 tokens were collected for six children with CI and 11 NH children for each task, i.e., phonemes repetition and phoneme-grapheme correspondence. Both groups found it easier to repeat phonemes than the phoneme-grapheme correspondence. The children with CIs showed more confusion ([ظ, ز, ذ, ض, خ, ب, ه, س, ع, & ث] >10% correct scores) in phoneme-grapheme correspondence than the NH children ([ظ:14%] and [ث: 27%]). There was a significant interaction (p = 0.001) among the three visual graphical features and hearing status (CI and NH).

CONCLUSION

Our results infer that non-native Malay children with CIs and NH use different strategies to process the Arabic graphemes' visual features for phoneme-grapheme correspondence.

The relationships between language, working memory and rapid naming in children with mild to moderate hearing loss

OBJECTIVE

Hearing loss is associated with reduced quality and quantity of auditory input, and difficulty in cognitive and language skills. This study aimed to investigate the relationship between language, working memory, and rapid naming skills in children with mild to moderate sensorineural hearing loss (MMHL).

METHODS

Twenty children with MMHL with the same auditory experience and demographical conditions using bilateral hearing aids were included. Verbal memory subscale of the Working Memory Scale (WMS), consisting of verbal short-term memory (V-STM) and verbal working memory (V-WM) subtests, was administered to all participants. They also completed rapid automatized naming tasks and standardized language measures.

RESULTS

The language score showed a moderate and significant correlation with verbal memory (VM) score (p = 0.03, r = 0.48) and a moderate and negative correlation with rapid automatized naming (RAN) duration (p = 0.06, r = -0.61). The VM score showed a moderate and significant negative correlation with RAN duration (p = 0.01, r = -0.67). The language level has a strong and significant positive correlation with V-STM (p = 0.007, r = 0.60), V-WM (p = 0.009, r = 0.58), and VM level (p = 0.003, r = 0.65). VM subtests levels have a strong and significant positive correlation with each other (p = 0.017, r = 0.53). RAN level has a strong and significant negative correlation with VM (p = 0.001, r = -0.70), V-WM (p = 0.001, r = -0.76), V-STM (p = 0.001, r = -0.69), and language level (p = 0.001, r = -0.77).

CONCLUSION

The results suggest that the language, verbal working memory, and rapid naming skills of children with MMHL are closely related. It is recommended that the relationship between verbal short-term memory, verbal working memory, rapid naming skills, and language skills should be considered in therapeutic and educational settings. To the best of our knowledge, this is the first study to examine the relationships between verbal-short-term -working memory, duration of rapid automatized naming, and language skills in children with MMHL.

Variation in Auditory Experience Affects Language and Executive Function Skills in Children Who Are Hard of Hearing

OBJECTIVE

Children who are hard of hearing (CHH) experience delays in spoken language and executive function, but the mechanisms for these deficits remain unresolved. Differences in auditory experience and language skills have been examined as contributing factors to deficits in executive function, primarily with children who are deaf and children with cochlear implants. The theoretical model of cumulative auditory experience quantifies auditory dosage as how much speech is audible and how often children wear their hearing aids. CHH with higher auditory dosage have better language outcomes than peers with less auditory dosage. However, the effects of auditory experience on executive function have not been studied in CHH. The goal of this study was to examine the influences of auditory experience and language skills on the development of executive function in CHH.

DESIGN

We collected measures of aided speech audibility, hearing aid use, executive function, and receptive vocabulary in 177 CHH and 86 children with typical hearing who were 5- to 10 years old and matched for socioeconomic status and nonverbal intelligence. Auditory dosage was calculated by combining each child's average hours of hearing aid use with their audibility for speech to create a variable that quantifies individual differences in auditory access.

RESULTS

CHH had lower receptive vocabulary and deficits in executive function related to working memory and selective attention compared to peers with typical hearing. CHH with greater auditory dosage had higher receptive vocabulary than CHH with lower auditory dosage. Better receptive vocabulary was associated with better scores on executive function measures related to working memory and attention. Auditory dosage was also directly associated with measures of verbal working memory.

CONCLUSIONS

CHH have deficits in language and some, but not all, areas of executive function related to working memory and attention. Auditory dosage was associated with language abilities and verbal working memory. Language was associated with individual differences in executive function skills related to attention and working memory. These results provide support for systems theories regarding the development of executive function in CHH. Interventions that improve auditory access and language may be effective for improving executive function related to working memory and attention in CHH.

Cognitive functioning in Deaf children using Cochlear implants

Background

Cognitive abilities like language, memory, reasoning, visualization, and perceptual functioning shape human action and are considered critical to the successful interaction with the environment. Alternatively, hearing loss can disrupt a child’s ability to communicate, and negatively impact cognitive development. Cochlear implants (CI) restore auditory input thereby supporting communication and may enhance cognitive performance. This study compares general cognitive development after cochlear implantation (2017–2019) in two groups of Jordanian children implanted earlier (age:4–6 years, N = 22) and later (7–9 years, N = 16) to the development of randomly selected normal hearing peers (N = 48).

Design

Visualization, reasoning, memory, and attention were assessed using the Leiter-R scale at baseline (before implantation), 8 months and 16 months post implantation for children with hearing loss. Same times of testing (baseline, 8 months and 16 months) were used for normal hearing peers.

Results

Over the 16-month period, the cognitive improvement of 4–6-year-old deaf children was greater than that of their normal hearing peers on the scales of visualization (5.62 vs. 4.40), reasoning (2.53 vs. 2.38) and memory (17.19 vs. 11.67). while the improvement of 7–9-year-old was less major than that of their normal hearing peers on all scales.

Conclusions

These results suggest that CI not only enhances communication skills but may improve cognitive functioning in deaf children. However, the extent of this improvement was dependent on age at intervention; current results demonstrated that the children received CI at young ages had better cognitive improvements.

Time-Gated Word Recognition in Children: Effects of Auditory Access, Age, and Semantic Context

Purpose We employed a time-gated word recognition task to investigate how children who are hard of hearing (CHH) and children with normal hearing (CNH) combine cognitive-linguistic abilities and acoustic-phonetic cues to recognize words in sentence-final position. Method The current study included 40 CHH and 30 CNH in 1st or 3rd grade. Participants completed vocabulary and working memory tests and a time-gated word recognition task consisting of 14 high- and 14 low-predictability sentences. A time-to-event model was used to evaluate the effect of the independent variables (age, hearing status, predictability) on word recognition. Mediation models were used to examine the associations between the independent variables (vocabulary size and working memory), aided audibility, and word recognition. Results Gated words were identified significantly earlier for high-predictability than low-predictability sentences. First-grade CHH and CNH showed no significant difference in performance. Third-grade CHH needed more information than CNH to identify final words. Aided audibility was associated with word recognition. This association was fully mediated by vocabulary size but not working memory. Conclusions Both CHH and CNH benefited from the addition of semantic context. Interventions that focus on consistent aided audibility and vocabulary may enhance children's ability to fill in gaps in incoming messages.

Working memory, short-term memory and reading proficiency in school-age children with cochlear implants

OBJECTIVE

The objective of the study was to examine short-term memory and working memory through both visual and auditory tasks in school-age children with cochlear implants. The relationship between the performance on these cognitive skills and reading as well as language outcomes were examined in these children.

METHODS

Ten children between the ages of 7 and 11 years with early-onset bilateral severe-profound hearing loss participated in the study. Auditory and visual short-term memory, auditory and visual working memory subtests and verbal knowledge measures were assessed using the Woodcock Johnson III Tests of Cognitive Abilities, the Wechsler Intelligence Scale for Children-IV Integrated and the Kaufman Assessment Battery for Children II. Reading outcomes were assessed using the Woodcock Reading Mastery Test III.

RESULTS

Performance on visual short-term memory and visual working memory measures in children with cochlear implants was within the average range when compared to the normative mean. However, auditory short-term memory and auditory working memory measures were below average when compared to the normative mean. Performance was also below average on all verbal knowledge measures. Regarding reading outcomes, children with cochlear implants scored below average for listening and passage comprehension tasks and these measures were positively correlated to visual short-term memory, visual working memory and auditory short-term memory. Performance on auditory working memory subtests was not related to reading or language outcomes.

CONCLUSIONS

The children with cochlear implants in this study demonstrated better performance in visual (spatial) working memory and short-term memory skills than in auditory working memory and auditory short-term memory skills. Significant positive relationships were found between visual working memory and reading outcomes. The results of the study provide support for the idea that WM capacity is modality specific in children with hearing loss. Based on these findings, reading instruction that capitalizes on the strengths in visual short-term memory and working memory is suggested for young children with early-onset hearing loss.