Acquisition of tense marking in English-speaking children with cochlear implants: a longitudinal study

The Effect of Sampling Context on Preschoolers' Finite Verb Morphology Composite Scores

PURPOSE

The finite verb morphology composite (FVMC) is a valid measure for charting children's tense development and for differentiating children with and without language impairment during preschool and early elementary years. However, it is unclear whether FVMC scores vary as a function of language sample elicitation contexts. The current study evaluated the performance on FVMC in preschool-aged children across different language sampling contexts.

METHOD

Participants were 38 English-speaking children who were between the ages of 3 and 4 years and below the mastery level of tense usage in three language sampling contexts, including conversation (free-play), picture description, and narratives (story retell). FVMC from each sampling context was computed by calculating the overall accuracy of copula be, auxiliary be, third-person singular present -s, and past tense -ed combined. A linear mixed-effects model comparison was carried out to determine the effect of sampling context on FVMC scores.

RESULTS

After controlling for child age, mean length of utterance, and the number of obligatory contexts for FVMC scoring, FVMC scores were significantly higher in conversation than in picture description and narratives. In addition, FVMC scores across the three sampling contexts were significantly correlated (rs ≥ .62, p < .001).

CONCLUSIONS

Although children's performance on FVMC relative to each other was quite stable across sampling contexts, FVMC scores may vary with sampling contexts. As compared to picture description and narratives, conversation may not adequately capture the limitation in preschoolers' tense development that is important for therapeutic planning.

Delayed auditory experience results in past tense production difficulties and working memory deficits in children with cochlear implants: A comparison with children with developmental language disorder

Extent evidence has shown that morphosyntax is one of the most challenging linguistic areas for children with atypical early language experiences. Over the last couple of years, comparisons between deaf children with CIs and children with DLD have gained interest - as cases of atypical early language experiences, including, but not restricted to, delayed onset of exposure to language input and language-processing difficulties. Evidence suggests that the morphosyntactic difficulties experienced by deaf children with CIs and children with DLD are very similar in nature. However, the few studies that have directly compared both groups are inconclusive, with deaf children with CIs either performing significantly better or on par with children with DLD. These differences in findings can be attributed, in part at least, to a failure to implement essential methodological controls - even more so given that deaf children with CIs comprise a very diverse population. The goal of the present study was to directly compare the performance of deaf children with CIs to that of children with DLD on a morphosyntactic ability known to be particularly difficult for both groups. Specifically, the present study conducted a detailed examination of the past tense marking abilities of deaf children with CIs and children with DLD while controlling for factors specific to deaf children with CIs, for children's basic cognitive abilities as well as for children's age, sex assigned at birth, and SES. Past tense verbs are particularly relevant as they are used as a marker of developmental language disorder (DLD) in children learning French. Moreover, extent evidence shows that deaf children with CIs and children with DLD have important WM difficulties, but also that there is an association between auditory perception, processing abilities, and working memory (WM) abilities as well as with the acquisition of morphological features, including tense marking. Unfortunately, no study has examined the relation between the accurate production of past tense verbs and WM abilities in children with CIs and children with DLD learning French. Fifteen deaf children with CIs between 5 and 7 years of age were compared to 15 children with DLD and to 15 typically-developing monolingual controls (MON), matched on important variables, using a past tense elicitation task as well as measures of phonological and nonverbal WM abilities. The results confirm that the deaf children with CIs and the children with DLD both performed significantly lower than the MON controls on the past tense elicitation task - suggesting that difficulties with past tense verbs in French might not only be a marker of DLD but, instead, a correlate of atypical language acquisition. Of importance, the present study is the first to show that deaf children with CIs perform significantly lower than children with DLD on a past tense elicitation task - highlighting the importance of using methodological controls. As well, significant correlations were found between the performance of the deaf children with CIs and of the children with DLD on the past tense elicitation task and their phonological and nonverbal WM abilities. Taken together with previous studies conducted in the same populations, this represents another evidence suggesting that early atypical language experiences result in language and WM deficits, including morphosyntactic difficulties.

Morphological Awareness and DHH Students' Reading-Related Abilities: A Meta-Analysis of Correlations

This article presents the first meta-analysis on correlations of morphological awareness (MA) with reading-related abilities in deaf and hard-of-hearing (DHH) students (k = 14, N = 556). The results showed high mean correlations of MA with all three reading-related abilities: rs = 0.610, 0.712, and 0.669 (all ps < 0.001), respectively, for word reading, vocabulary knowledge, and reading comprehension. A set of moderator analysis was conducted of language, DHH students' age/reading stage and degree of hearing loss, and task type. The correlation of MA with word reading was significantly stronger in alphabetic than in non-alphabetic languages, and for fluency than accuracy; for vocabulary knowledge, the correlation was significantly stronger for production MA tasks than for judgment tasks; for reading comprehension, derivational MA tasks showed a stronger correlation than those having a mixed focus on inflection and derivation. While no other moderator effects were significant, the correlations for subsets of effect sizes were largely high for a moderator. These findings reaffirmed the importance of morphology in DHH students' reading development. The present synthesis, while evidencing major development of research on the metalinguistic underpinnings of reading in DHH students, also showed that the literature on MA is still very limited.

Early grammar-building in French-speaking deaf children with cochlear implants: A follow-up corpus study

BACKGROUND

One of the most consistent findings reported in the paediatric cochlear implant (CI) literature is the heterogeneity of language performance observed more in grammatical morphology than in lexicon or pragmatics. As most of the corpus studies addressing these issues have been conducted in English, it is unclear whether their results can be generalized to other languages. In particular, little is known about languages known for their grammatical complexity, such as French.

AIMS

The aim of this corpus study was to compare the productive use of function words (FWs) and some agreement features (AGRs) in children with CIs and children with typical development (TD) matched for mean length of utterance in words (MLU_words ), a general index of grammatical complexity, and auditory experience, as measured by hearing age (HA) and chronological age (CA), respectively.

METHODS & PROCEDURES

Natural speech samples from 116 monolingual French-speaking children, including 40 children with CIs followed longitudinally and 76 TD children, were collected. FWs and AGRs were analysed using a Part of Speech Tagger (POS-T) from the Child Language Data Exchange System (CHILDES).

OUTCOMES & RESULTS

The two groups differed by 3 years for HA and CA. No effect of family socio-economic status (SES) was found in the CI group. Stepwise regression analyses showed that the two groups did not share the same predictors of MLU_words : plurals and determiners predicted MLU_words in children with CIs, at 2 and 3 years of HA, whereas feminine markers and subject-pronouns were found to best predict MLU_words in TD children at 2 and 3 years of CA. Structural equation models (SEMs), a combination of confirmatory factor analysis (CFA) and path analysis, yielded a different hierarchical structure of grammatical relations (GRs). Selective difficulties affecting verbal clitics and other pronominal forms were found specifically in the CI group (object-pronouns, reflexive, relative and past participles). Dependency grammar analysis confirmed these contrasting developmental profiles in multiword utterances, such as preposition/nouns, subject/verbs, and verb/determiner/nouns.

CONCLUSIONS & IMPLICATIONS

Atypical grammatical patterns in children with CIs reflect a specific architecture of syntactic dependencies of FWs underpinning morphological complexity and syntactic connectivity. Clinical implications are discussed for assessment and intervention planning.

WHAT THIS PAPER ADDS

What is already known on this subject The productive use of FWs has been identified as a particular area of weakness in children with CIs compared with TD children. In addition, heterogenous grammatical performance has often been found after 1-3 years of CI use, regardless of demographic factors such as age at implantation, duration of deafness or SES. What this paper adds to existing knowledge Assessing the early building of FWs and AGRs in children with CIs helps to understand the syntactic complexity and hierarchical structure of their language. Since most corpus studies on grammatical morphology have been conducted in English, it is not clear whether their difficulties can be generalized to other languages. The French language has a system of FWs and inflections that determine the morphophonological properties of nominal and verbal forms. Early grammar learning in children with CIs born with profound deafness were compared with the two groups of TD children matched both for duration of auditory experience (i.e., HA of CI children, CA of TD children) and for MLU_words . We found a similar profile between groups at 2 years but not at 3 years for HA and CA. The two groups do not share the same predictors of MLU_words : namely, plurals and determiners for CI children versus feminine markers and subject pronouns for TD children. They show a different syntactic organization of GRs. Children with CIs struggle with selective difficulties affecting verbal clitics and pronominal forms (object-pronouns, reflexive, relative and past participles). Consistent with theories of morphophonological richness and syntactic connectivity, our results support the distributional learning hypothesis of language acquisition that infants and toddlers are sensitive to FWs and AGRs at an early age. Specific components of syntactic organization are disrupted in children with CIs. What are the potential or actual clinical implications of this work? This work has potential clinical implications because it unravels the limitations of morphophonological processing in children with CIs. Its results highlight a specific difficulty in learning FWs and AGRs in a verbal inflectional morphology context.

Use of ultrasound visual feedback in speech intervention for children with cochlear implants

The purpose of the present study was to evaluate the efficacy of ultrasound visual feedback in speech intervention for young children with cochlear implants. Although ultrasound technology has been used for intervention in children with speech sound disorders, there is little systematic evidence regarding relative efficacy of ultrasound visual feedback for young children with cochlear implants. Two children with cochlear implants participated in this study. The children's articulation was tested using Goldman-Fristoe Test of Articulation-2 and probes. Therapy was provided semi-weekly for 30-minute sessions over the course of nine to 10 weeks. Visual inspection showed an increasing trend in production accuracy to the criterion accuracy of 80% for target sounds. Maintenance of skills were observed at two weeks and two months post-intervention. The results of this study indicated that ultrasound visual feedback is likely an effective intervention tool for treating speech sound disorders in children with cochlear implants. Future studies including a larger sample size should be conducted to verify these findings.

El desarrollo de las habilidades narrativas en niños: una revisión sistemática de la literatura

Este artículo pretende identificar los modelos teóricos que describen el desarrollo de la narrativa oral en niños y establecer cuáles componentes del lenguaje influyen en dicho proceso. Con este propósito, llevamos a cabo una revisión sistemática de las investigaciones más recientes sobre este tema (2000-2019). Analizamos 10 estudios longitudinales que reportan resultados de medidas del lenguaje y la narrativa oral tomados durante el seguimiento de una población de niños y niñas por un periodo de al menos 12 meses. Estas medidas son la conciencia metalingüística, el lenguaje estructural y el discurso narrativo, entre otras. Nuestros resultados indican que la habilidad de contar un relato es uno de los mejores predictores del desarrollo del lenguaje en la etapa preescolar y del aprendizaje de la lectoescritura en la edad escolar. También encontramos que los modelos para explicar este proceso son escasos y que ignoran con frecuencia el componente pragmático.

Tense Marking in the Kindergarten Population: Testing the Bimodal Distribution Hypothesis

Purpose The purpose of this study was to explore whether evidence for a bimodal distribution of tense marking, previously documented in clinically referred samples, exists in a population-based sample of kindergarten children from a rural county in Tennessee. Method A measure of tense marking, the Test of Early Grammatical Impairment (TEGI) Screening Test, was individually administered to consented kindergarten students (N = 153) across three elementary schools in a single school district. The consented children constituted 73% of kindergartners in the district. Cluster analysis was used to evaluate the number and composition of latent classes that best fit the distribution of the TEGI Screening Test scores. Results Analysis of the scores revealed a distribution that deviated significantly from normality. Cluster analyses (Ward's, k-means, single linkage) revealed a two-cluster solution as the best fitting model. The very large effect-size difference in mean TEGI Screening Test score between the two clusters (d = 4.77) provides validation of an identifiable boundary delineating typical from atypical tense marking in this sample of kindergartners. The difference in tense marking across the two clusters was not attributable to child chronological age. The percentage of the sample comprising the low-performing cluster aligns with specific language impairment and developmental language disorder prevalence estimates. Conclusion Additional demonstrations of a bimodal distribution of tense marking in future studies with carefully defined samples could strengthen the clinical marker evidence and utility of this linguistic feature.

The Comparison of the Morphological and Syntactic Awareness Skills of Deaf and Hard of Hearing Students Regarding Agreement and Tense Categories that Exist in Verbs in Reading Activities with those of Students Without Hearing Disabilities

The difficulties in learning skills that deaf and hard of hearing students encounter stem from morphology and syntactic morphology (morpho-syntax) and it is clear that there are limited studies related to these. In this study, it is aimed at examining hearing and deaf and hard of hearing students' morpho-syntactic actions which are compatible with the Turkish Sign Language and the awareness skills of these actions in the time categories. In total 122 students; 57 deaf and hard of hearing students from secondary and high school and 65 hearing students have participated this study. The data is gathered through DMASTR and SuperLab 5 software programs where data is collected by a process with a "word reading method" and "an inclusion of agreement and tense categories in actions". In the outcome of the study it is identified that students hard of hearing had an underachievement in the agreement and tense categories compared to hearing students. At the agreement category, in terms of reading duration it is seen that deaf students' verbs with disagreement compared with verbs with agreement, they read faster. In the tense category, it is clear that deaf and hard of hearing students' accuracy rate of reading words have got similarities in the categories of past and future tenses whereas they have got inadequacies in the present tense, when the data is observed in terms of the speed of reaction and reading duration, it is seen that they are more successful in the past tense. In accordance with these findings, it is indicated that hard of hearing students have shared the same reading skills with their hearing peers whereas they had plenty of difficulties related to reading skills some of them which are from the fields of morphology and syntactic morphology, in the steps of formal education.

A Technology-based Intervention to Increase Reading Comprehension of Morphosyntax Structures

The purpose of this study was to examine the effectiveness of a technology-based intervention (LanguageLinks: Syntax Assessment and Intervention®; Laureate Learning Systems, Inc., 2013) to improve reading comprehension for d/Deaf and hard of hearing (DHH) elementary students. The intervention was a self-paced, interactive program designed to scaffold learning of morphosyntax structures. Participants included 37 DHH students with moderate to profound hearing levels, 7-12 years of age, in Grades 2-6. Assessment data were collected pre- and post- an 8-week intervention using a randomized control trial methodology. Findings indicate the intervention did not appear to be effective in improving performance, and 17 out of 36 morphosyntax structures were found difficult to comprehend for participants in the treatment group. These difficult structures included aspects of pronominalization, the verbal system, and number in nouns. Results are compared to previous research, with recommendations for future areas of research related to increasing knowledge of morphosyntax for learners who are DHH.

Morphological Accuracy in the Speech of Bimodal Bilingual Children with CIs

Sign language use in the (re)habilitation of children with cochlear implants (CIs) remains a controversial issue. Concerns that signing impedes spoken language development are based on research comparing children exposed to spoken and signed language (bilinguals) to children exposed only to speech (monolinguals), although abundant research demonstrates that bilinguals and monolinguals differ in language development. We control for bilingualism effects by comparing bimodal bilingual (signing-speaking) children with CIs (BB-CI) to those with typical hearing (BB-TH). Each child had at least one Deaf parent and was exposed to ASL from birth. The BB-THs were exposed to English from birth by hearing family members, while the BB-CIs began English exposure after cochlear implantation around 22-months-of-age. Elicited speech samples were analyzed for accuracy of English grammatical morpheme production. Although there was a trend toward lower overall accuracy in the BB-CIs, this seemed driven by increased omission of the plural -s, suggesting an exaggerated role of perceptual salience in this group. Errors of commission were rare in both groups. Because both groups were bimodal bilinguals, trends toward group differences were likely caused by delayed exposure to spoken language or hearing through a CI, rather than sign language exposure.

Evaluating English Morpheme Accuracy, Diversity, and Productivity Measures in Language Samples of Developing Bilinguals

Purpose

This work explores the clinical relevance of three measures of morpheme use for preschool-age Spanish-English bilingual children with varying language skills. The 3 measures reflect accuracy, diversity (the tense marker total), and productivity (the tense and agreement productivity score [TAP score]) of the English tense and agreement system.

Method

Measures were generated from language samples collected at the beginning and end of the participants' preschool year. Participants included 74 typically developing Spanish-English bilinguals and 19 peers with low language skills. The morpheme measures were evaluated with regard to their relationships with other language sample measures, their ability to reflect group differences, and their potential for capturing morphological development at group and individual levels.

Results

Across both groups, the tense marker total and TAP scores were associated with other language measures and demonstrated both group differences and growth over time. The accuracy measure met few of these benchmarks.

Conclusion

The tense marker total and TAP score, which were designed to capture emerging morphological abilities, contribute valuable information to a comprehensive language assessment of young bilinguals developing English. Case examples are provided to illustrate the clinical significance of including these measures in assessment.

What Clinicians Need to Know About Early Literacy Development in Children With Hearing Loss

Purpose Children with hearing loss may not reach the same level of reading proficiency as their peers with typical development. Audiologists and speech-language pathologists (SLPs) have important roles to play in preventing this problem early in children's development. In this tutorial, we aim to communicate how the habilitation practices of audiologists and intervention services of SLPs can support early literacy skill development in children with hearing loss. Method We describe key findings from peer-reviewed research articles to provide a review of early literacy skill development, to explain the relationship between early literacy skills and conventional reading skills, and to highlight findings from early literacy skill intervention studies that included children with hearing loss who use spoken language. We conclude with a hypothetical case study to illustrate how audiologists and SLPs can support early literacy acquisition in children with hearing loss. Conclusion Findings from studies of young children with hearing loss suggest that a promising approach to improving reading outcomes is to provide explicit early literacy instruction and intervention.

A multilinguistic analysis of spelling among children with cochlear implants

This study examines the spelling of nine elementary school children with cochlear implants (CIs) who use spoken language, and compares their performance with children who have typical hearing and children who are hard of hearing (HH). Compared to children with typical hearing, children with CIs did not produce a significantly different percentage of misspelled words (p = 0.431, d = 0.38), but their spelling errors comprised significantly lower percentages of homophone substitutions (p = 0.019, r = 0.61) and legal vowel errors (p = 0.011, r = 0.61). Children with CIs and children who are HH did not produce a significantly different percentage of misspelled words (p = 0.521, d = 0.31) or a significantly different distribution of categorical spelling errors. Results suggest that children with CIs utilize similar linguistic strategies as their peers who are HH but different strategies than peers with typical hearing when attempting to spell unfamiliar words.

Let's Be Explicit About the Psycholinguistic Bases of Developmental Measures: A Response to Leonard, Haebig, Deevy, and Brown (2017)

PURPOSE

The purpose of this letter is to clarify the psycholinguistic underpinnings of the tense marker total and tense agreement productivity score and to extend the discussion of when composite diversity and productivity measures are best used.

CONCLUSION

We encourage the use of composite diversity and productivity measures when assessing grammar early in development, but we discourage the use of composite accuracy measures until children demonstrate emergence of diverse tense/agreement morphemes across a sufficient number of low-frequency sentence frames.

Grammatical Abilities in Young Cochlear Implant Recipients and Children With Normal Hearing Matched by Vocabulary Size

PURPOSE

This study sought to expand understanding of the impact of cochlear implantation on grammatical acquisition by comparing young children who have vocabularies of comparable size. Two research questions were investigated: (a) Do young cochlear implant (CI) recipients have grammatical skills comparable to those of children with normal hearing (NH) matched by spoken vocabulary size? (b) Do these groups show associations between vocabulary size and grammatical measures?

METHOD

The participants included 13 CI recipients at 24 months postactivation (chronological ages = 33-60 months; M = 44.62) and 13 children with NH between 27 and 30 months old (M = 20.69). The 2 groups were matched by their vocabulary size. Four grammatical outcomes were analyzed from the MacArthur Communicative Development Inventory (Fenson, Marchman, Thal, Dale, & Reznick, 2007) and 20-min language samples: (a) grammatical complexity, (b) mean length of utterances, (c) tense marker total, and (d) productivity scores.

RESULTS

The 2 groups showed comparable grammatical skills across the 4 measures. Consistently significant associations between vocabulary size and grammatical outcomes were found in the CI group, with fewer associations in the NH group.

CONCLUSIONS

The 2 groups showed similar grammatical abilities. The young CI recipients appeared to be following a typical pattern of linguistic development.

Development of Grammatical Accuracy in English-Speaking Children With Cochlear Implants: A Longitudinal Study

PURPOSE

We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span.

METHOD

Ten children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years with typical hearing were included as well. All children participated in a story-retell task. We computed percent grammatical communication units (PGCU) in the task.

RESULTS

Children with CIs showed significant improvement in PGCU over the 3-year span. However, they produced lower PGCU than children with typical hearing who had matched hearing age at 4 and 5 years postimplantation. At the individual level, some children with CIs were able to produce PGCU comparable to children with typical hearing as early as 3 years after implantation. Better speech-perception skills at earlier time points were associated with higher PGCU at later time points. Moreover, children with and without CIs showed similar rankings in the types of grammatical errors.

CONCLUSION

Despite having auditory-perceptual and information-processing constraints, children who received CIs before age 30 months were able to produce grammatical sentences, albeit with a delayed pattern.

Narrative skills in deaf children who use spoken English: Dissociations between macro and microstructural devices

Previous research has highlighted that deaf children acquiring spoken English have difficulties in narrative development relative to their hearing peers both in terms of macro-structure and with micro-structural devices. The majority of previous research focused on narrative tasks designed for hearing children that depend on good receptive language skills. The current study compared narratives of 6 to 11-year-old deaf children who use spoken English (N=59) with matched for age and non-verbal intelligence hearing peers. To examine the role of general language abilities, single word vocabulary was also assessed. Narratives were elicited by the retelling of a story presented non-verbally in video format. Results showed that deaf and hearing children had equivalent macro-structure skills, but the deaf group showed poorer performance on micro-structural components. Furthermore, the deaf group gave less detailed responses to inferencing probe questions indicating poorer understanding of the story's underlying message. For deaf children, micro-level devices most strongly correlated with the vocabulary measure. These findings suggest that deaf children, despite spoken language delays, are able to convey the main elements of content and structure in narrative but have greater difficulty in using grammatical devices more dependent on finer linguistic and pragmatic skills.

Word initial fricative production in children with cochlear implants and their normally hearing peers matched on lexicon size

Fricative production is affected in children with cochlear implants (CI) as compared to age-matched normally hearing (NH) children. However, the phonological development of children with CI is rarely compared to that of NH peers matched on lexicon size. We compare the early word initial fricative development of 10 children with CI and 30 NH children matched on lexicon size and on chronological age. Children with CI are expected to differ from their NH peers when they are matched on chronological age. But, are lexical development and phonological development commensurate in children with CI as they have been shown to be in NH children? Results show that fricative production in children with CI deviates from that of age-matched NH peers. The differences between both groups disappear when they were matched on lexicon size. Thus, phonological development in children with CI is similar to that of their NH peers with comparable lexicon sizes.

Syntagmatic and paradigmatic development of cochlear implanted children in comparison with normally hearing peers up to age 7

OBJECTIVE

Grammatical development is shown to be delayed in CI children. However, the literature has focussed mainly on one aspect of grammatical development, either morphology or syntax, and on standard tests instead of spontaneous speech. The aim of the present study was to compare grammatical development in the spontaneous speech of Dutch-speaking children with cochlear implants and normally hearing peers. Both syntagmatic and paradigmatic development will be assessed and compared with each other.

METHOD

Nine children with cochlear implants were followed yearly between ages 2 and 7. There was a cross-sectional control group of 10 normally hearing peers at each age. Syntactic development is measured by means of Mean Length of Utterance (MLU), morphological development by means of Mean Size of Paradigm (MSP). This last measure is relatively new in child language research.

RESULTS

MLU and MSP of children with cochlear implants lag behind that of their normally hearing peers up to age 4 and up to age 6 respectively. By age 5, CI children catch up on MSP and by age 7 they caught up on MLU.

CONCLUSION

Children with cochlear implants catch up with their normally hearing peers for both measures of syntax and morphology. However, it is shown that inflection is earlier age-appropriate than sentence length in CI children. Possible explanations for this difference in developmental pace are discussed.

Effects of Morphographic Instruction on the Morphographic Analysis Skills of Deaf and Hard-of-Hearing Students

Deaf and hard-of-hearing (DHH) students have delayed morphographic knowledge that negatively affects their morphographic analysis and decoding abilities. Morphographic analysis instruction may improve DHH students' morphographic knowledge delay. The purpose of this study was to determine the effects of morphographic instruction on the morphographic analysis skills of reading-delayed, late-elementary DHH students. The research question was: What effect does morphographic instruction have on the morphographic analysis skills of DHH students who are reading below grade level? The study included 3 student participants and 1 teacher participant from a local school district. The researchers used a multiprobe multiple baseline across participants design. The intervention was implemented for 20 min a day, 5 days a week for 2-3 weeks. Visual analysis of the data revealed the requisite number of demonstrations of effect and replications. The intervention improved DHH students' ability to dissect words and determine affix meanings, which may in turn positively affect their decoding abilities. Implications of this study and future research are discussed.

Language structures used by kindergartners with cochlear implants: relationship to phonological awareness, lexical knowledge and hearing loss

OBJECTIVES

Listeners use their knowledge of how language is structured to aid speech recognition in everyday communication. When it comes to children with congenital hearing loss severe enough to warrant cochlear implants (CIs), the question arises of whether these children can acquire the language knowledge needed to aid speech recognition, in spite of only having spectrally degraded signals available to them. That question was addressed in the present study. Specifically, there were three goals: (1) to compare the language structures used by children with CIs to those of children with normal hearing (NH); (2) to assess the amount of variance in the language measures explained by phonological awareness and lexical knowledge; and (3) to assess the amount of variance in the language measures explained by factors related to the hearing loss itself and subsequent treatment.

DESIGN

Language samples were obtained and transcribed for 40 children who had just completed kindergarten: 19 with NH and 21 with CIs. Five measures were derived from Systematic Analysis of Language Transcripts: (1) mean length of utterance in morphemes, (2) number of conjunctions, excluding and, (3) number of personal pronouns, (4) number of bound morphemes, and (5) number of different words. Measures were also collected on phonological awareness and lexical knowledge. Statistics examined group differences, as well as the amount of variance in the language measures explained by phonological awareness, lexical knowledge, and factors related to hearing loss and its treatment for children with CIs.

RESULTS

Mean scores of children with CIs were roughly one standard deviation below those of children with NH on all language measures, including lexical knowledge, matching outcomes of other studies. Mean scores of children with CIs were closer to two standard deviations below those of children with NH on two out of three measures of phonological awareness (specifically those related to phonemic structure). Lexical knowledge explained significant amounts of variance on three language measures, but only one measure of phonological awareness (sensitivity to word-final phonemic structure) explained any significant amount of unique variance beyond that, and on only one language measure (number of bound morphemes). Age at first implant, but no other factors related to hearing loss or its treatment, explained significant amounts of variance on the language measures, as well.

CONCLUSIONS

In spite of early intervention and advances in implant technology, children with CIs are still delayed in learning language, but grammatical knowledge is less affected than phonological awareness. Because there was little contribution to language development measured for phonological awareness independent of lexical knowledge, it was concluded that children with CIs could benefit from intervention focused specifically on helping them learn language structures, in spite of the likely phonological deficits they experience as a consequence of having degraded inputs.

Spoken english language development among native signing children with cochlear implants

Bilingualism is common throughout the world, and bilingual children regularly develop into fluently bilingual adults. In contrast, children with cochlear implants (CIs) are frequently encouraged to focus on a spoken language to the exclusion of sign language. Here, we investigate the spoken English language skills of 5 children with CIs who also have deaf signing parents, and so receive exposure to a full natural sign language (American Sign Language, ASL) from birth, in addition to spoken English after implantation. We compare their language skills with hearing ASL/English bilingual children of deaf parents. Our results show comparable English scores for the CI and hearing groups on a variety of standardized language measures, exceeding previously reported scores for children with CIs with the same age of implantation and years of CI use. We conclude that natural sign language input does no harm and may mitigate negative effects of early auditory deprivation for spoken language development.