Language skills and nonverbal cognitive processes associated with reading comprehension in deaf children

Why Are Causal and Temporal Connectives Difficult to Understand? A Comparison Between Italian Hearing Good and Poor Comprehenders and Deaf Poor Comprehenders

PURPOSE

Both hearing poor comprehenders (PCs) and deaf or hard-of-hearing (DHH) PCs have problems in understanding causal and temporal coherence relations signaled by connectives. The study examined whether hearing and DHH PCs' problems with connective understanding are similar and mainly related to their limited vocabulary, including knowledge of connective words, or to their poor reading comprehension abilities more generally.

METHOD

Three groups of 7- to 10-year-old readers, matched on grade level (hearing PCs, DHH PCs, and hearing good comprehenders [GCs]) performed a reading comprehension task, a vocabulary task, and causal and temporal connective understanding tasks. Hearing and DHH PCs were also matched on reading comprehension and decoding abilities.

RESULTS

The DHH PCs performed significantly worse than both the hearing GCs and PCs in temporal and causal connective understanding. Significant differences between hearing PCs and GCs were found only in causal connective understanding. DHH readers' difficulties in causal connective understanding were significantly associated with poorer vocabulary knowledge. In contrast, vocabulary knowledge did not uniquely contribute to hearing PCs' difficulties with causal connective understanding, once their reading comprehension skills were controlled for.

CONCLUSIONS

The results suggest that despite a similar reading profile, DHH PCs' difficulties with causal connective understanding are more closely related to their vocabulary delay, whereas hearing PCs' difficulties are more strongly influenced by their poor text integration processes (as indexed by their reading comprehension skills). Neither vocabulary knowledge nor reading comprehension skills contributed to the explanation of DHH readers and hearing PCs' temporal connective understanding.

Innovative protocol of an exploratory study evaluating the acceptability of a humanoid robot at home of deaf children with cochlear implants

The purpose of this paper is to introduce a research methodology for the assessment of the acceptability of a humanoid robot at home for children with cochlear implants (CI). The quality of audiology rehabilitation for cochlear implanted child administrated at the hospital with pluri-weekly sessions is a major prognostic factor in the outcome on communications abilities, but represents also a constraint for families related to the access to care that are more difficult. Further, home training with tools would balance the equitable distribution of care in the territory and promote the child's progress. The humanoid robot should allow an ecological approach to this complementary training. Before developing this approach, it is necessary to study the acceptability of the humanoid robot at home, both by cochlear implanted child and their families. Ten families were chosen to have a humanoid robot at home, to explore their acceptability of the humanoid robot Pepper. The study lasts for 1 month per participants (i.e. cochlear implemented children and parent). Participants were invited to use the robot at home as much as they want. The humanoid robot Pepper was able to communicate and proposed activities not related to rehabilitation. Once a week during the study, data were collected from participants (questionnaires and robot's logs) and the smooth running of the study was checked. Questionnaires are used to evaluate the acceptability of the robot by children and parents. User data from the robot's logs are used to quantify the time and the actual use of the robot over the period of the study. Results of the experimentation will be reported, once all 10 participants have completed their passation. The robot is anticipated to be used and accepted by children with cochlear implants and their families. Clinical trial registration: Clinical Trials ID: NCT04832373; https://clinicaltrials.gov/.

Functional connectivity alteration of the deprived auditory regions with cognitive networks in deaf and inattentive adolescents

Adolescents with early profound deafness may present with distractibility and inattentiveness. The brain mechanisms underlying these attention impairments remain unclear. We performed resting-state functional magnetic resonance imaging to investigate the functional connectivity of the superior temporal and transverse temporal gyri in 25 inattentive adolescents with bilateral prelingual profound deafness, and compared the results with those of 27 age-matched normal controls. Pearson and Spearman's rho correlation analyses were used to investigate the correlations of altered functional connectivity with the clinical parameters, including the duration of hearing loss sign language, and hearing aid usage. Compared with normal controls, prelingual profound deafness demonstrated mainly decreased resting-state functional connectivity between the deprived auditory regions and several other brain functional networks, including the attention control, language comprehension, default-mode, and sensorimotor networks. Moreover, we also found enhanced resting-state functional connectivity between the deprived auditory cortex and salience network. These results indicate a negative impact of early hearing loss on the attentional and other high cognitive networks, and the use of sign language and hearing aids normalized the participants' connectivity between the primary auditory cortex and attention networks, which is crucial for the early intervention and clinical care of deaf adolescents.

Listening comprehension in profoundly deaf children with cochlear implants: the role of auditory perception and foundational linguistic and cognitive skills

PURPOSE

The aim of the study was to investigate the listening comprehension (LC) skills in deaf and hard of hearing children (DHH) using cochlear implants (CI). Besides, personal and audiological variables that could influence the levels of competence reached were analyzed.

METHODS

Thirty-four children using CI were enrolled. LC skills were assessed through the standardized Italian test "Comprensione Orale-Test e Trattamento" (CO-TT). A univariate analysis was conducted to compare LC with gender, listening mode (unilateral or bilateral), maternal level of education and family income. A bivariate analysis was performed to search possible connections between children's performances and their individual characteristics, audiological conditions, and language levels. Finally, a multivariate analysis was performed using a stepwise hierarchical linear regression model which included all variables whose p value resulted  ≤ 0.05.

RESULTS

Twenty-one children using CI (61.8%) showed adequate performances in terms of chronological age, while 13 (38.2%) showed difficulties in LC. Maternal level of education, age at diagnosis and non-verbal cognitive level accounted for 43% of the observed variance. Auditory attention skills explained an additional 15% of variance. Morphosyntactic comprehension added a further 12% of variance.

CONCLUSION

CI can really help many DHH children to reach adequate LC skills, but in some cases difficulties remain. Factors influencing LC need to be early investigated and considered when planning an appropriate rehabilitative intervention.

Relationship Between Vocabulary Knowledge and Reading Comprehension in Deaf and Hard of Hearing Students

Deaf and hard of hearing (DHH) students face great challenges in becoming proficient readers. Vocabulary knowledge is consistently considered to be an important factor affecting DHH students' reading ability. However, the mechanism that underlies the relationship between vocabulary knowledge and reading comprehension in DHH students remains unclear. Thus, the aim of this study was to determine the roles of word segmentation and reading fluency in the contribution of vocabulary knowledge to Chinese DHH students' reading comprehension. A battery of tasks were administered to 116 Chinese DHH students from Grades 4 to 6 (mean age = 14.66 years). The results showed that vocabulary knowledge contributed to reading comprehension significantly in Chinese DHH students, and word segmentation and reading fluency played mediating roles in this relationship. Besides, the chain mediation effect of word segmentation and reading fluency was also significant. Revealing these mechanisms, which underlie the relationship between vocabulary knowledge and reading comprehension, is helpful to tailor remediation for DHH students.

Linguistic but Not Cognitive Weaknesses in Deaf or Hard-of-Hearing Poor Comprehenders

This study examined the reading comprehension profiles, and the related linguistic and cognitive skills, of 146 Chinese students in Grades 3-9 who are deaf or hard of hearing (d/Dhh). Employing a rigorous regression approach, the current study identified 19 unexpected poor comprehenders, 24 expected average comprehenders, and 16 unexpected good comprehenders. Compared to the expected average and unexpected good comprehenders, the unexpected poor comprehenders performed worse in broad linguistic skills (i.e., Chinese sign language comprehension, vocabulary, and segmental and suprasegmental phonological awareness), but their weaknesses in cognitive skills (i.e., working memory and executive function) were less severe. These findings suggest that weak linguistic skills are possible indicators of reading comprehension difficulties for students who are d/Dhh.

Teaching With Picture Books on Deaf and Hard-of-Hearing Students'Creativity

Studies have shown that teaching with picture books can help improve creativity development of deaf and hard-of-hearing (DHH) students. A quasi-experimental research design was applied in this study. Deaf and hard-of-hearing students in grades 3-6 from two cities, B and T, were selected as the samples in a pilot study. The Evaluation of Potential Creativity (EPoC) test tool (Ver. A) was applied to measure creativity through student performance on individual tests of divergent and integrative thinking. Following thirty 40-min lessons over 10 weeks, the EPoC test tool (Ver. B) was used to measure student creativity in the experimental and control groups. The results showed the following: (1) the performance of DHH students was better on graphic divergence than on verbal divergence, (2) performance on the divergent dimensions of creativity was significantly higher for DHH students from the experimental group than the control group, and (3) there was no difference in integrative thinking between the two groups in the posttest. In practice, teachers could use picture books in their lesson plans to improve the creativity of DHH students that results from divergent thinking. Future research should focus on the development of creativity in DHH students through integrative thinking with a longer teaching intervention.

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.

Assessment of Cortical Auditory Function Using Electrophysiological and Neuropsychological Measurements in Children with Bone-Anchored Hearing Aids

Children suffering from conductive or mixed hearing loss may benefit from a bone-anchored hearing aid system (BAHA Attract implantable prosthesis). After audiological rehabilitation, different aspects of development are improving. The objective of this case report is to propose a comprehensive framework for monitoring cortical auditory function after implantation of a bone-anchored hearing aid system by using electrophysiological and neuropsychological measurements.

We present the case of a seven-year-old boy with a congenital hearing loss due to a plurimalformative syndrome, including outer and middle ear malformation. After the diagnosis of hearing loss and the audiological rehabilitation with a BAHA Attract implantable prosthesis, the cortical auditory evoked potentials were recorded. We performed a neuropsychological evaluation using the Wechsler Intelligence Scale for Children – Fourth Edition, which was applied according to a standard procedure.

The P1 latency was delayed according to the age (an objective biomarker for quantifying cortical auditory function). The neuropsychological evaluation revealed that the child's working memory and verbal reasoning abilities were in the borderline range comparing with his nonverbal reasoning abilities and processing abilities, which were in the average and below-average range, respectively.

Cortical auditory evoked potentials, along with neuropsychological evaluation, could be an essential tool for monitoring cortical auditory function in children with hearing loss after a bone-anchored hearing aid implantation.

Auditory Reasoning Skills of Cochlear Implant Users

OBJECTIVES

This study compared the auditory reasoning skills of school-going children with early and late cochlear implantation and assessed the relationship between auditory reasoning skills, language development, vocabulary knowledge, and communication skills.

MATERIALS AND METHODS

In this case series study, 90 pre-lingually deaf children aged 7-10 years were assessed. Children were divided into two groups: early-implanted group with children who received cochlear implants before 3 years of age (mean, 23.45; 12-35 months) and late-implanted group with children implanted after 3 years of age (mean, 50.54; 36-84 months). Tests were performed in the auditory-visual condition. Correlational analyses were used to assess the relationships between daily communication skills, language development performances, vocabulary knowledge, and auditory reasoning skills of both the groups.

RESULTS

Auditory reasoning skills were better in the early-implanted group than in the late-implanted group (Mann-Whitney U test=518, p<0.05). Language performances of the early-implanted group were significantly better than those of the late-implanted group (receptive language performances: Mann-Whitney U=522, p<0.05; expressive language performances: Mann-Whitney U=552, p<0.05). Stepwise regression analysis showed that expressive language performances, vocabulary knowledge, and chronological age could predict 82% of the variance.

CONCLUSION

Reasoning skills of children with cochlear implants should be supported during the language-learning process.

Screening Tests Reveal High Risk Among Adjudicated Adolescents of Auditory Processing and Language Disorders

PURPOSE

The study investigated the prevalence of risk factors for auditory processing and language disorders among adolescents residing at a local juvenile detention center.

METHOD

A total of 782 adjudicated adolescents with normal hearing were screened with the Randomized Dichotic Digits Test (Strouse & Wilson, 1999) and the Dichotic Words Test (Moncrieff, 2015). A subset of 420 of those adolescents was also screened with the Clinical Evaluation of Language Fundamentals (CELF; Semel, Wiig, & Secord, 2003).

RESULTS

More than 70% of the adolescents produced weakness on at least 1 dichotic listening test. One third of those produced weakness across both dichotic listening tests, consistent with a binaural integration deficit pattern. Nearly 48% of the subgroup of adolescents produced CELF scores that fell below the criterion for age. Dichotic listening and language scores were more associated in participants with poor performance in both ears during dichotic tests, who also produced the lowest scores on the CELF. There was no main effect of race, but 17- and 18-year-old Black adolescents produced lower CELF scores than White adolescents of the same age.

CONCLUSIONS

School-age children referred for disciplinary action may have undiagnosed deficits in auditory processing and/or language. Efforts to screen, diagnose, and remediate these deficits could lead to improvements in communication, learning, and language skills in this population.

Effect of age at cochlear implantation and at exposure to Cued Speech on literacy skills in deaf children

The aim of this study was to investigate how age at cochlear implantation (CI) and age at exposure to Cued Speech (CS, Manual system that resolves the ambiguity inherent lipreading) could impact literacy skills in deaf children. Ninety deaf children fitted with CI (early vs late) and exposed to CS (early vs late) from primary schools (from Grade 2 to Grade 5) took part in this study. Five literacy skills were assessed: phonological skills through phoneme deletion, reading (decoding and sentence comprehension), word spelling and vocabulary. The results showed that both age at CI and age at first exposure to CS had some influence on literacy skills but there was no interaction between these factors. This implies that the positive effects of age at CI, especially on all literacy skills in the younger children, were not strengthened by age at exposure to CS.

Verbal Working Memory in Children With Cochlear Implants

PURPOSE

Verbal working memory in children with cochlear implants and children with normal hearing was examined.

PARTICIPANTS

Ninety-three fourth graders (47 with normal hearing, 46 with cochlear implants) participated, all of whom were in a longitudinal study and had working memory assessed 2 years earlier.

METHOD

A dual-component model of working memory was adopted, and a serial recall task measured storage and processing. Potential predictor variables were phonological awareness, vocabulary knowledge, nonverbal IQ, and several treatment variables. Potential dependent functions were literacy, expressive language, and speech-in-noise recognition.

RESULTS

Children with cochlear implants showed deficits in storage and processing, similar in size to those at second grade. Predictors of verbal working memory differed across groups: Phonological awareness explained the most variance in children with normal hearing; vocabulary explained the most variance in children with cochlear implants. Treatment variables explained little of the variance. Where potentially dependent functions were concerned, verbal working memory accounted for little variance once the variance explained by other predictors was removed.

CONCLUSIONS

The verbal working memory deficits of children with cochlear implants arise due to signal degradation, which limits their abilities to acquire phonological awareness. That hinders their abilities to store items using a phonological code.

Response to de Wit et al., 2016, "Characteristics of Auditory Processing Disorders: A Systematic Review"

PURPOSE

This letter to the editor is in response to a review by de Wit et al. (2016), "Characteristics of Auditory Processing Disorders: A Systematic Review," published in April 2016 by Journal of Speech, Language, and Hearing Research.

CONCLUSION

The author argues that the conclusions in the de Wit et al. (2016) review are unfortunate in light of advances made in the clinical diagnosis and treatment of bottom-up auditory processing disorders in children.

Comprehension of texts by deaf elementary school students: The role of grammatical understanding

BACKGROUND

The aim of this study was to analyze how the reading process of deaf Spanish elementary school students is affected both by those components that explain reading comprehension according to the Simple View of Reading model: decoding and linguistic comprehension (both lexical and grammatical) and by other variables that are external to the reading process: the type of assistive technology used, the age at which it is implanted or fitted, the participant's socioeconomic status and school stage.

DESIGN

Forty-seven students aged between 6 and 13 years participated in the study; all presented with profound or severe prelingual bilateral deafness, and all used digital hearing aids or cochlear implants. Students' text comprehension skills, decoding skills and oral comprehension skills (both lexical and grammatical) were evaluated.

RESULTS

Logistic regression analysis indicated that neither the type of assistive technology, age at time of fitting or activation, socioeconomic status, nor school stage could predict the presence or absence of difficulties in text comprehension. Furthermore, logistic regression analysis indicated that neither decoding skills, nor lexical age could predict competency in text comprehension; however, grammatical age could explain 41% of the variance. Probing deeper into the effect of grammatical understanding, logistic regression analysis indicated that a participant's understanding of reversible passive object-verb-subject sentences and reversible predicative subject-verb-object sentences accounted for 38% of the variance in text comprehension.

CONCLUSIONS

Based on these results, we suggest that it might be beneficial to devise and evaluate interventions that focus specifically on grammatical comprehension.

Theory of Mind and Reading Comprehension in Deaf and Hard-of-Hearing Signing Children

Theory of Mind (ToM) is related to reading comprehension in hearing children. In the present study, we investigated progression in ToM in Swedish deaf and hard-of-hearing (DHH) signing children who were learning to read, as well as the association of ToM with reading comprehension. Thirteen children at Swedish state primary schools for DHH children performed a Swedish Sign Language (SSL) version of the Wellman and Liu (2004) ToM scale, along with tests of reading comprehension, SSL comprehension, and working memory. Results indicated that ToM progression did not differ from that reported in previous studies, although ToM development was delayed despite age-appropriate sign language skills. Correlation analysis revealed that ToM was associated with reading comprehension and working memory, but not sign language comprehension. We propose that some factor not investigated in the present study, possibly represented by inference making constrained by working memory capacity, supports both ToM and reading comprehension and may thus explain the results observed in the present study.

Evidence of an association between sign language phonological awareness and word reading in deaf and hard-of-hearing children

BACKGROUND AND AIMS

Children with good phonological awareness (PA) are often good word readers. Here, we asked whether Swedish deaf and hard-of-hearing (DHH) children who are more aware of the phonology of Swedish Sign Language, a language with no orthography, are better at reading words in Swedish.

METHODS AND PROCEDURES

We developed the Cross-modal Phonological Awareness Test (C-PhAT) that can be used to assess PA in both Swedish Sign Language (C-PhAT-SSL) and Swedish (C-PhAT-Swed), and investigated how C-PhAT performance was related to word reading as well as linguistic and cognitive skills. We validated C-PhAT-Swed and administered C-PhAT-Swed and C-PhAT-SSL to DHH children who attended Swedish deaf schools with a bilingual curriculum and were at an early stage of reading.

OUTCOMES AND RESULTS

C-PhAT-SSL correlated significantly with word reading for DHH children. They performed poorly on C-PhAT-Swed and their scores did not correlate significantly either with C-PhAT-SSL or word reading, although they did correlate significantly with cognitive measures.

CONCLUSIONS AND IMPLICATIONS

These results provide preliminary evidence that DHH children with good sign language PA are better at reading words and show that measures of spoken language PA in DHH children may be confounded by individual differences in cognitive skills.