Foundations for literacy: An early literacy intervention for deaf and hard-of-hearing children

Dynamic insights into research trends and trajectories in early reading: an analytical exploration via dynamic topic modeling

Introduction

Early reading has gained significant attention in the academic community. With the increasing volume of literature on this subject, it has become crucial to assess the current research landscape and identify emerging trends.

Methods

This study utilized the dynamic topic model to analyze a corpus of 1,638 articles obtained from the Web of Science Core Collection to furnish a lucid understanding of the prevailing research and forecast possible future directions.

Results

Our in-depth assessment discerned 11 cardinal topics, among which notable ones were interventions' impacts on early reading competencies; foundational elements of early reading: phonological awareness, letters, and, spelling; and early literacy proficiencies in children with autism spectrum disorder. Although most topics have received consistent research attention, there has been a marked increase in some topics' popularity, such as foundational elements of early reading and early literary proficiencies in children with autism spectrum disorder. Conversely, other topics exhibited a downturn.

Discussion

This analytical endeavor has yielded indispensable insights for scholars, decision-makers, and field practitioners, steering them toward pivotal research interrogatives, focal interest zones, and prospective research avenues. As per our extensive survey, this paper is a pioneering holistic purview of the seminal areas of early reading that highlights expected scholarly directions.

Word-Level Instruction for Deaf and Hard-of-Hearing Students: An Observation Study

Despite the fact that children's word reading and spelling skills are crucial for developing text-level comprehension and composition, little is known about what teachers do in classrooms to promote deaf and hard-of-hearing (DHH) students' learning of word reading and spelling. This observational study examined strategies teachers of DHH students used when teaching word reading and spelling to DHH students who used spoken English. One day of language arts instruction in 23 kindergartens through second-grade classrooms was observed. Teachers' word-level instruction was coded. Results indicated that teachers spent substantially more time on word-level instruction during decoding and encoding contexts than they did during text reading and writing contexts. In addition, differences were found in teachers' use of strategies depending on the instructional contexts. Teachers utilized phonological strategies considerably more frequently than any other strategy in their word-level instruction.

Association of Age of Enrollment in Early Intervention with Emergent Literacy in Children Who Are Deaf or Hard of Hearing

OBJECTIVE

Literacy skill development in deaf or hard of hearing (DHH) children is essential for success in school and beyond. Our objective was to evaluate the association between age of early intervention (EI) enrollment for DHH children and emergent literacy in preschool.

METHODS

This was a population-based study that leveraged state public health and education data on all children identified with hearing loss. The sample included children born between 2008 and 2014 enrolled in EI for hearing loss who received preschool supports (years 2011-2014) through the Ohio Department of Education. The Get it! Got it! Go!, measuring emergent literacy domains of picture naming, rhyming, and alliteration, was administered during preschool in fall and spring. Exposure was enrollment into EI before age 6 months (early) versus at/after 6 months (later). Propensity score matching and mixed model analyses were used to examine associations between EI enrollment and outcomes over time. Model least square means with 95% confidence intervals (CIs) were reported.

RESULTS

One hundred two successful matches were made for 256 preschoolers. Children enrolled in EI early had significantly higher mean scores (mean [95% CI]) over time for emerging literacy domains of picture naming (2.42 [0.47-4.37]), rhyming (1.2 [0.35-2.06]), and alliteration (0.61 [0.15-1.07]) compared with later enrolled children. Children enrolled early had significantly higher emergent literacy scores at entry, although literacy development was similar between groups.

CONCLUSION

Children enrolled in EI before age 6 months had consistently higher scores in emergent literacy components over time compared with children enrolled at/after age 6 months.

Developing a programme for training phonological awareness and assessment of its effectiveness on reading skills of elementary first graders with cochlear implant

Background

The current study aimed to develop a comprehensive phonological awareness intervention to train all levels of phonological awareness skills and to investigate its effect on the reading abilities of cochlear implanted children.

Materials and Methods

This study was the single-subject intervention. Phonological awareness intervention programme was developed and validated by experts' opinions. Six elementary first graders with cochlear implants and weak or delayed reading development, in 5-7-year-old range, were trained in phonological awareness skills. 'Auditory test of phonological awareness skills' was used to evaluate the subjects' phonological awareness skills. Nama reading test was also used to determine the level of reading performance.

Results

The results showed that all six subjects with cochlear implants had improvements of both phonological awareness skills and reading skills after participating in the phonological awareness intervention programme. This improvement was not only observed immediately after intervention but was also preserved in follow-up.

Conclusion

The findings of this study demonstrated the importance of planning an intervention programme about phonological awareness skills for elementary first graders with cochlear implant, and the important role of such an intervention programme in improving their performance in phonological awareness tasks, and then in reading tasks consequently. The importance of improvement in these skills could considerably affect these children's linguistic and psychological abilities, which may facilitate their education at higher grades.

Meta-Analytic Findings on Reading in Children With Cochlear Implants

This meta-analysis study aims to quantify the group differences in reading skills between children with cochlear implants and their hearing peers and between children with cochlear implants and children with hearing aids (aged between 3 and 18 years old). Of the 5,642 articles screened, 47 articles met predetermined inclusion criteria (published between 2002 and 2019). The robust variance estimation based meta-analysis models were used to synthesize all the effect sizes. Children with cochlear implants scored significantly lower than their hearing peers in phonological awareness (g = -1.62, p < 0.001), vocabulary (g = -1.50, p < 0.001), decoding (g = -1.24, p < 0.001), and reading comprehension (g = -1.39, p < 0.001), but not for fluency (g = -0.67, p = 0.054). Compared to children with hearing aids, children with cochlear implants scored significantly lower in phonological awareness (g = -0.30, p = 0.028). The percentage of unilateral cochlear implant negatively impacts the group difference between children with cochlear implants and their hearing peers. Findings from this study confirm a positive shift in reading outcomes for profoundly deaf children due to cochlear implantation. Some children with cochlear implants may need additional supports in educational settings.

Teaching Vocabulary to Improve Print Knowledge in Preschool Children with Hearing Loss

Purpose

The purpose of this article was to examine evidence that (a) published measures may tap different categories of print knowledge and result in disparate findings in the literature, (b) concept vocabulary knowledge in children with hearing loss may exacerbate deficits in conceptual print knowledge, and (c) concept vocabulary can be taught via direct instruction for preschool children with hearing loss.

Method

In Study 1, an item analysis of published print knowledge measures was performed to determine the prevalence of concept vocabulary in test items. Additionally, the performance on a conceptual print knowledge measure was compared for preschool children with and without hearing loss. In Study 2, four preschool children participated in a multiple probe across behaviors treatment design to determine if concept vocabulary could be explicitly taught to children with hearing loss.

Results

Differences emerged in use of concept vocabulary on test items across the measures, which may explain disparate findings that have been reported in this area. Additionally, children with hearing loss performed lower than children with typical hearing on items that contained concept vocabulary but not on items that did not. Finally, we found initial evidence that direct instruction can improve concept vocabulary for children with hearing loss, and it might not be necessary to separately target each concept category.

Conclusion

This series of studies lays groundwork for future research confirming a connection between conceptual print knowledge and conceptual vocabulary knowledge, and offers evidence for intervention that could be used clinically to teach conceptual vocabulary.

Differences and Similarities in the Contributions of Phonological Awareness, Orthographic Knowledge and Semantic Competence to Reading Fluency in Chinese School-Age Children With and Without Hearing Loss

Compared with the large number of studies on reading of children with hearing loss (HL) in alphabetic languages, there are only a very limited number of studies on reading of Chinese-speaking children with HL. It remains unclear how phonological, orthographic, and semantic skills contribute to reading fluency of Chinese school-age children with HL. The present study explored this issue by examining the performances of children with HL on reading fluency and three linguistic skills compared with matched controls with normal hearing (NH). Specifically, twenty-eight children with HL and 28 chronological-age-matched children with NH were tested on word/sentence reading fluency (WRF/SRF), phonological awareness (PA) which was composed of onset/vowel/lexical tone awareness, orthographic knowledge (OK), and semantic competence (SC) which comprised animal word identification, pseudo-homophone detection, and word segmentation. Results showed that children with HL lagged behind their peers with NH in WRF/SRF and most of the phonological, orthographic, and semantic subskills except onset awareness and pseudo-homophone detection. Furthermore, the significant contributors to WRF differed between the two groups with PA being the significant contributor in the children with NH while OK being the significant contributor in the children with HL. However, the significant contributor to SRF did not differ between the two groups with SC being the only significant contributor. These results revealed not only between-group differences but also similarities in the relative contributions of PA, OK, and SC to reading fluency at both word and sentence levels, which has practical implications for developing better training programs to improve reading for children with HL.

What Do Spelling Errors Tell Us about Deaf Learners of French?

For deaf students, spelling acquisition is a considerable challenge, especially because the spelling code is based on an oral language to which most of them have limited access. Most studies conducted with deaf students have reported that they lag behind their hearing peers. However, few studies have used a fine-grained error classification grid. The use of such a grid makes it possible to draw a precise portrait of writers' orthographic knowledge. The purpose of this study was to describe the spelling skills of 19 deaf students (Mage = 10.9 years) and to compare their errors with those of 20 hearing students of the same age and 17 younger hearing students at the same reading level. The results indicate that deaf students are not quantitatively different from hearing students but that their errors are qualitatively different from those of hearing students.

Rethinking Emergent Literacy in Children With Hearing Loss

Long-term literacy outcomes for children with hearing loss, particularly those with severe-to-profound deafness who are fitted with cochlear implants (CIs) lag behind those of children with normal hearing (NH). The causes for these long-term deficits are not fully clear, though differences in auditory access between children who use CIs and those with NH may be a partial cause. This paper briefly reviews the emergent literacy model as proposed by Whitehurst and Lonigan (1998). We then examine the development of each of Whitehurst and Lonigan’s identified factors in children who use CIs and how the extant knowledge of language and literacy development in children who use CIs may bear on the emergent literacy model. We then propose to modify the model for children who use CIs based on their unique developmental trajectories, influenced at least in part by their unique auditory access. We conclude with future directions for further development of an evidence-based emergent literacy model for children who use CIs and how this model could be used to inform intervention.

Reading and Deafness: State of the Evidence and Implications for Research and Practice

Over the years, persistently low achievement levels have led scholars to question whether reading skill development is different for deaf readers. Research findings suggest that in order for deaf students to become proficient readers, they must master the same fundamental abilities that are well established for hearing learners, regardless of the degree of hearing loss or communication modality used (e.g., spoken or signed). The simple view of reading (SVR), which hypothesizes the critical role both language abilities and phonological skills play in development of reading comprehension, provides a model for understanding the reading process for a wide range of students and has the potential to shed light on the challenges deaf students have historically experienced in achieving age-appropriate outcomes. Therefore, the purpose of this paper is to review the components of the SVR and use this conceptual model as the basis for exploring and discussing both historical and current research evidence in reading and deafness, with a particular focus on phonological skills. Recommendations for future research and practice based on the existing body of literature will also be provided.

Evidence-Based Interventions for Learners Who Are Deaf and/or Multilingual: A Systematic Quality Review

Purpose Many educators and speech-language pathologists have difficulty providing effective interventions to the growing population of d/Deaf and hard-of-hearing (DHH) learners who use more than 1 language. The purpose of this review article was to identify evidence-based interventions for speech, language, and literacy used with DHH multilingual learners (DMLs), monolingual DHH learners, and hearing bilingual learners without hearing loss. Interventions used with these groups can inform the practice of professionals providing services to DMLs. Method This review article considered speech, language, and literacy interventions used with DHH and hearing bilingual learners from birth to 21 years of age. The following electronic databases were searched: Academic Search Complete/EBSCO (CINAHL, Education, ERIC), Linguistics & Language Behavior Abstracts, PsycINFO, and PubMed. Data describing article, participant, methodological, and intervention variables were extracted from studies. The methodological quality of studies was examined using the Council for Exceptional Children's (2014) standards for evidence-based practice in special education. Results A total of 144 studies were reviewed, describing over 9,370 learners aged 1.8-22.0 years. Two studies investigated DMLs, 76 investigated DHH learners, and 67 investigated hearing bilingual learners. A total of 146 different interventions were examined. Most studies reported positive effects. Only 17 studies met all quality indicators specified by the Council for Exceptional Children (2014): 7 examined DHH learners, and 10 examined hearing bilingual learners. There was insufficient evidence for any intervention to be considered an evidence-based intervention, although 6 could potentially contribute to evidence-based practice. Conclusions No evidence-based interventions for DMLs were identified. A small number of interventions examined in high-quality studies of DHH and hearing bilingual learners were identified, which may be appropriate for use with DMLs following further investigation. Supplemental Material https://doi.org/10.23641/asha.9108386.

Visual sequential processing and language ability in children who are deaf or hard of hearing

This study investigated the role of sequential processing in spoken language outcomes for children who are deaf or hard of hearing (DHH), ages 5;3-11;4, by comparing them to children with typical hearing (TH), ages 6;3-9;7, on sequential learning and memory tasks involving easily nameable and difficult-to-name visual stimuli. Children who are DHH performed more poorly on easily nameable sequencing tasks, which positively predicted receptive vocabulary scores. Results suggest sequential learning and memory may underlie delayed language skills of many children who are DHH. Implications for language development in children who are DHH are discussed.

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.

Using Technology and Assessment to Personalize Instruction: Preventing Reading Problems

Children who fail to learn to read proficiently are at serious risk of referral to special education, grade retention, dropping out of high school, and entering the juvenile justice system. Accumulating research suggests that instruction regimes that rely on assessment to inform instruction are effective in improving the implementation of personalized instruction and, in turn, student learning. However, teachers find it difficult to interpret assessment results in a way that optimizes learning opportunities for all of the students in their classrooms. This article focuses on the use of language, decoding, and comprehension assessments to develop personalized plans of literacy instruction for students from kindergarten through third grade, and A2i technology designed to support teachers' use of assessment to guide instruction. Results of seven randomized controlled trials demonstrate that personalized literacy instruction is more effective than traditional instruction, and that sustained implementation of personalized literacy instruction first through third grade may prevent the development of serious reading problems. We found effect sizes from .2 to .4 per school year, which translates into about a 2-month advantage. These effects accumulated from first through third grade with a large effect size (d = .7) equivalent to a full grade-equivalent advantage on standardize tests of literacy. These results demonstrate the efficacy of technology-supported personalized data-driven literacy instruction to prevent serious reading difficulties. Implications for translational prevention research in education and healthcare are discussed.

Development of Phonological, Lexical, and Syntactic Abilities in Children With Cochlear Implants Across the Elementary Grades

PURPOSE

This study assessed phonological, lexical, and morphosyntactic abilities at 6th grade for a group of children previously tested at 2nd grade to address 4 questions: (a) Do children with cochlear implants (CIs) demonstrate deficits at 6th grade? (b) Are those deficits greater, the same, or lesser in magnitude than those observed at 2nd grade? (c) How do the measured skills relate to each other? and (d) How do treatment variables affect outcome measures?

PARTICIPANTS

Sixty-two 6th graders (29 with normal hearing, 33 with CIs) participated, all of whom had their language assessed at 2nd grade.

METHOD

Data are reported for 12 measures obtained at 6th grade, assessing phonological, lexical, and morphosyntactic abilities. Between-groups analyses were conducted on 6th-grade measures and the magnitude of observed effects compared with those observed at 2nd grade. Correlational analyses were performed among the measures at 6th grade. Cross-lagged analyses were performed on specific 2nd- and 6th-grade measures of phonological awareness, vocabulary, and literacy to assess factors promoting phonological and lexical development. Treatment effects of age of 1st CI, preimplant thresholds, and bimodal experience were evaluated.

RESULTS

Deficits remained fairly consistent in type and magnitude across elementary school. The largest deficits were found for phonological skills and the least for morphosyntactic skills, with lexical skills intermediate. Phonological and morphosyntactic skills were largely independent of each other; lexical skills were moderately related to phonological skills but not morphosyntactic skills. Literacy acquisition strongly promoted both phonological and lexical development. Of the treatment variables, only bimodal experience affected outcomes and did so positively.

CONCLUSIONS

Congenital hearing loss puts children at continued risk of language deficits, especially for phonologically based skills. Two interventions that appear to ameliorate that risk are providing a period of bimodal stimulation and strong literacy instruction.

Factorial Validity and Measurement Invariance of the Test of Preschool Early Literacy-Phonological Awareness Test Among Deaf and Hard-of-Hearing Children and Hearing Children

OBJECTIVES

Emerging evidence suggests that early phonological awareness in deaf and hard-of-hearing (DHH) children with functional hearing is significantly related to their reading acquisition, and the assessment of phonological awareness can play a critical role in preventing reading difficulties. Validation of the scores obtained from standardized assessments when used with DHH students is crucial to support the assessments' intended interpretations and implications of test scores. Using archival data sets, the aim of this study was twofold: (a) to establish the factorial validity of the item scores on the Test of Preschool Early Literacy-Phonological Awareness (TOPEL-PA) for DHH children with functional hearing and hearing children and (b) to test measurement invariance across these groups. Our archival data sets included assessments of DHH children, hearing children from low socioeconomic status (SES) backgrounds, and hearing children from a range of SES backgrounds. We hypothesized that a second-order unifying ability, Phonological Awareness, along with four first-order subtest factors would explain inter-item associations among the 27 items on the TOPEL-PA. We further hypothesized that patterns of associations among the item scores would be similar across groups and that the individual items would function similarly across groups.

DESIGN

Seven hundred and thirty-three children from three samples participated in the study; 171 were DHH children (Mage = 58.7 months old, SDage = 12.5 months old), 195 were low-SES hearing children (Mage = 55.5 months old, SDage = 3.5 months old), and 367 were diverse-SES hearing children (Mage = 53.4 months old, SDage = 8.9 months old). All DHH children were able to identify the referent of monosyllabic spoken words on the Early Speech Perception Test.

RESULTS

Test of confirmatory item factor analyses of the hypothesized second-order factor structure revealed that a second-order unifying ability along with four first-order subtest factors well explained associations among the item scores for all groups. This aligned with the scoring structure of the TOPEL-PA, providing strong evidence for factorial validity of the item scores for DHH children as well as for hearing children groups. The measurement invariance test results provided evidence that the vast majority of TOPEL-PA items functioned similarly for hearing children and DHH children with speech perception abilities, suggesting that the utility of the assessment scores obtained from DHH children is consistent with the scores obtained from hearing children.

CONCLUSION

Results of our study suggest that researchers and practitioners can use the TOPEL-PA to assess DHH children with functional hearing. It also suggests that the two skills measured on the TOPEL-PA (blending and elision) are qualitatively similar for DHH and hearing children, but the latent mean score obtained from the DHH children significantly differed from those of the hearing groups, suggesting a quantitative difference.

Feasibility of a Recasting and Auditory Bombardment Treatment With Young Cochlear Implant Users

PURPOSE

There is little to guide clinicians in terms of evidence-based interventions for children with cochlear implants who demonstrate morpheme errors. This feasibility study tested the utility of a treatment targeting grammatical morpheme errors.

METHOD

Three children (ages 4-5 years) received Enhanced Conversational Recast treatment, a version of conversational recast treatment that focuses on a single morpheme error at a time, emphasizes attention to clinician input, and uses high linguistic variability with clinician input. A period of recasting was followed by 24 auditory presentations of the target morpheme in short sentences. After an initial baseline period, children were treated in individual sessions over 21-26 days.

RESULTS

All children showed improved use of targeted grammatical morpheme use, both in elicited contexts and in terms of spontaneous use. Spontaneous use was best for the 2 children who were implanted earliest and whose audiograms showed the best hearing postimplant. Performance by a 3rd child diagnosed with auditory neuropathy spectrum disorder was more variable but still showed positive change.

CONCLUSIONS

The results indicate that the treatment can be effective for children with cochlear implants. The pattern of results across children also suggests potential variables that may moderate treatment effects.

Developing Sound Skills for Reading: Teaching Phonological Awareness to Preschoolers With Hearing Loss

This study evaluated the effectiveness of intervention for developing deaf and hard-of-hearing (DHH) preschoolers' phonological awareness (PA) skills. Thirty children (mean age 57 months) with aided, bilateral hearing loss (and who primarily communicated using spoken English) were recruited in the year prior to commencing formal schooling. The study used an experimental design with participants assigned to one of two intervention conditions-vocabulary instruction, or explicit PA instruction. Both intervention programs were based around items drawn from a common word set and presented over six short weekly sessions by a researcher using a computer tablet. Overall, participants showed greater knowledge of word items used in interventions and improved performance on rhyme-based PA skills following intervention. However, the PA group showed significantly greater improvement than the vocabulary group for both overall PA performance and for consonant-vowel-consonant blending. DHH children's order of PA skill development was also examined, with comparison to that shown for children without hearing loss. The results provide early encouraging evidence about the potential benefit of explicit PA instruction for this population.

Evaluating the Structure of Early English Literacy Skills in Deaf and Hard-of-Hearing Children

Better understanding the mechanisms underlying developing literacy has promoted the development of more effective reading interventions for typically developing children. Such knowledge may facilitate effective instruction of deaf and hard-of-hearing (DHH) children. Hence, the current study examined the multivariate associations among phonological awareness, alphabetic knowledge, word reading, and vocabulary skills in DHH children who have auditory access to speech. One hundred and sixty-seven DHH children (M age = 60.43 months) were assessed with a battery of early literacy measures. Forty-six percent used at least 1 cochlear implant; 54% were fitted with hearing aids. About a fourth of the sample was acquiring both spoken English and sign. Scores on standardized tests of phonological awareness and vocabulary averaged at least 1 standard deviation (SD) below the mean of the hearing norming sample. Confirmatory factor analyses showed that DHH children's early literacy skills were best characterized by a complex 3-factor model in which phonological awareness, alphabetic knowledge, and vocabulary formed 3 separate, but highly correlated constructs, with letter-sound knowledge and word reading skills relating to both phonological awareness and alphabetic knowledge. This supports the hypothesis that early reading of DHH children with functional hearing is qualitatively similar to that of hearing children.